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Billings J, Zhan Yuen Wong N, Nicholls H, Burton P, Zosmer M, Albert I, Grey N, El-Leithy S, Murphy D, Tehrani N, Wheatley J, Bloomfield MAP, Greene T. Post-incident psychosocial interventions after a traumatic incident in the workplace: a systematic review of current research evidence and clinical guidance. Eur J Psychotraumatol 2023; 14:2281751. [PMID: 38032045 PMCID: PMC10990448 DOI: 10.1080/20008066.2023.2281751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
Background: After a traumatic incident in the workplace organisations want to provide support for their employees to prevent PTSD. However, what is safe and effective to offer has not yet been established, despite many organisations offering some form of intervention after a traumatic event.Objective: To systematically review the evidence for post-incident psychosocial interventions offered within one month of a workplace trauma, and to compare the content, effectiveness and acceptability of these interventions. Given the lack of a yet clearly established evidence-base in this field, we sought to examine both published empirical research as well as guidelines published by expert groups working with staff in high-risk roles.Methods: We conducted systematic searches for empirical research across bibliographic databases and searched online for clinical practice guidelines to April 2023. We were also referred to potentially relevant literature by experts in workplace trauma. Both empirical research and clinical guidelines were appraised for their quality.Results: A total of 80 research studies and 11 clinical practice guidelines were included in the review. Interventions included Critical Incident Stress Debriefing (CISD), Critical Incident Stress Management (CISM), unspecified Debriefing, Trauma Risk Management (TRiM), Psychological First Aid (PFA), EMDR, CBT and group counselling. Most research and guidance were of poor quality. The findings of this review do not demonstrate any harm caused by CISD, CISM, PFA, TRiM, EMDR, group counselling or CBT interventions when delivered in a workplace setting. However, they do not conclusively demonstrate benefits of these interventions nor do they establish superiority of any specific intervention. Generic debriefing was associated with some negative outcomes. Current clinical guidelines were inconsistent with the current research evidence base. Nevertheless, interventions were generally valued by workers.Conclusions: Better quality research and guidance is urgently needed, including more detailed exploration of the specific aspects of delivery of post-incident interventions.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, UK
| | | | - Helen Nicholls
- Division of Psychiatry, University College London, London, UK
| | - Peter Burton
- Division of Psychiatry, University College London, London, UK
| | - Maya Zosmer
- Division of Psychiatry, University College London, London, UK
| | - Idit Albert
- King’s College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Nick Grey
- University of Sussex, Falmer, UK
- Sussex Partnership NHS Foundation Trust, Worthing, West Sussex, UK
| | | | - Dominic Murphy
- King’s College London, London, UK
- Combat Stress, London, UK
| | | | - Jon Wheatley
- Homerton Healthcare NHS Foundation Trust, London, UK
| | - Michael A. P. Bloomfield
- Division of Psychiatry, University College London, London, UK
- Camden & Islington NHS Foundation Trust, London, UK
| | - Talya Greene
- Clinical, Educational and Health Psychology, University College London, London, UK
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Wizner K, Cunningham K, Gaspar FW, Dewa CS, Grunert B. Occupational posttraumatic stress disorder and workplace violence in workers' compensation claims. J Trauma Stress 2022; 35:1368-1380. [PMID: 35429412 PMCID: PMC9790626 DOI: 10.1002/jts.22836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/10/2022] [Accepted: 03/01/2022] [Indexed: 12/30/2022]
Abstract
Acts of violence are the fifth leading cause of nonfatal occupational injuries in the United States. Experiencing a traumatic event at work can have serious mental health consequences, including the development of posttraumatic stress disorder (PTSD). This study aimed to quantify the prevalence of PTSD caused by workplace violence (WPV) in a statewide workers' compensation system and compare the outcomes and treatment of WPV cases versus those caused by other traumatic events. Using a retrospective cohort study design, workers who reported PTSD as the primary reason for a workers' compensation claim and had no coexisting physical injuries were found in California during 2009-2018. A total of 3,772 PTSD cases were identified, 48.9% of which were attributed to WPV. Demographic risk factors associated with WPV PTSD included lower income, younger age, female gender, and employment in retail or finance, p < .001-p = .007. For individuals who returned to work, claims due to WPV resulted in longer medically approved time away from work than non-WPV causes (Mdn = 132.5 days vs. Mdn = 91 days, respectively), p < .001. Three of the top 10 most frequently prescribed medications were administered against evidence-based guidelines. This study found that many treatments prescribed to PTSD patients are based on insufficient evidence, and the provision of existing empirically supported treatments is needed, particularly in generalized populations. The findings support the need for additional recognition of the cause of workplace PTSD to facilitate appropriate referrals to WPV or PTSD specialists to support return-to-work efforts.
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Affiliation(s)
- Kerri Wizner
- MDGuidelinesReedGroup Ltd.WestminsterColoradoUSA
| | - Katherine Cunningham
- Mental Health and Behavioral MedicineVeterans Affairs Texas Valley Coastal Bend Health Care SystemHarlingenTexasUSA
| | | | - Carolyn S. Dewa
- Department of Psychology and Behavioral SciencesUniversity of CaliforniaDavis; SacramentoCaliforniaUSA
| | - Brad Grunert
- Departments of Plastic Surgery and Psychiatry and Behavioral MedicineMedical College of WisconsinMilwaukeeWisconsinUSA
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Prevalence and Consequences of Verbal Aggression among Bank Workers: A Survey into an Italian Banking Institution. ADMINISTRATIVE SCIENCES 2022. [DOI: 10.3390/admsci12030078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Robberies and other violent acts by strangers and intruders are common in banks, which can lead to post-traumatic stress disorder in employees. However, the literature indicates that more subtle and less measurable forms of violence, such as psychological violence, can also cause discomfort among employees. The aim of the present work is to investigate the prevalence of verbal aggression and its consequences among 311 Italian bank employees. A self-administered questionnaire was completed by 197 employees. The results showed a high prevalence of verbal aggression in the sample. It is important to investigate and find the causes and effects of verbal aggression in order to understand the phenomenon in this workplace. Cases of verbal aggression need to be prevented and responded to appropriately. In addition, it should be noted that the effects of verbal aggression do not only affect the victim, but also the workplace, as productivity decreases, and the feeling of a safe environment is missing.
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Orellana JDY, Murray J, Lima NP, Pinheiro RT, Horta BL. Robbery Victimization in Early Adulthood, and Depression and Anxiety at Age 30 Years: Results From the 1982 Pelotas (Brazil) Birth Cohort Study. Front Public Health 2022; 10:821881. [PMID: 35757622 PMCID: PMC9218107 DOI: 10.3389/fpubh.2022.821881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
Robbery is one of the most common urban crimes, but little is known about its relationship with mental disorders in young adults. This study aimed to assess the relationship between robbery victimization and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD) and comorbidity between MDD and GAD at 30 years of age. A birth cohort study has followed all children born in the city of Pelotas, southern Brazil, since 1982. At ages 23 and 30 years, participants were interviewed and asked about lifetime and recent experiences of robbery. Covariates were measured in interviews between birth and age 30 years. MDD and GAD were measured using the MINI-International Neuropsychiatric Interview. Adjusted prevalence ratio (aPR) and corresponding 95% confidence interval (CI) for associations between robbery and mental disorders were calculated using Poisson regression with robust standard error. Of 3,701 cohort members interviewed at age 30 years, 42% reported robbery victimization during their lifetime. Victimization across three periods (lifetime, past 10 years, past 12 months) was associated with increased occurrence of MDD, GAD, as well as the MDD and GAD comorbidity. The strongest associations were found to robbery occurring in the previous 12 months with the MDD and GAD comorbidity, both for burglary at home (aPR 2.52; 95% CI 1.52-4.22) or community family victimization (aPR 2.10; 95% CI 1.34-3.27). These findings highlight the importance of community violence for mental health in young adulthood, and the need for public policies to prevent violence as well as support services for victims to mitigate its adverse health consequences.
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Affiliation(s)
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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de la Cruz López MP, Cartelle Barros JJ, Del Caño Gochi A, Garaboa Fernández MC, Blanco Leis J. Assessing the risk of robbery in bank branches to reduce impact on personnel. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2022; 42:385-405. [PMID: 34101880 DOI: 10.1111/risa.13761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/24/2021] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
According to existing literature, bank robberies can have a considerable impact on the people involved (employees, customers, and police officers), even if the direct economic losses are negligible. Consequently, this article presents a model to assess the risk of bank robbery, with the aim of reducing the impact on the people and prioritizing the investments in security measures. It is based on the MIVES (Spanish acronym for the Integrated Value Model for Sustainability Assessment) method and it was combined with Monte Carlo simulation as a way of taking into account the uncertainty. Correlations were also modeled, for simulation purposes. Indicators for addressing issues related to security features, employees, operational procedures, and physical and social environment were defined. The model was applied to two fictitious but realistic sets of cases. The first simulation provides a quick overview of the risk level of a fictitious bank, before collecting the full set of data from hundreds or thousands of branches. The second simulation analyzes the risk variation of a specific bank branch over time. The model was also used to assess the risk index of 636 real branches belonging to a Spanish bank. All the results are presented and discussed in depth. The model allows the user to identify the weak points of a branch, so that corrective measures can be taken.
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Affiliation(s)
- María Pilar de la Cruz López
- Departamento de Ingeniería Civil, Escuela Politécnica Superior (EPS), Universidade da Coruña (UDC), Campus de Esteiro, C/Mendizábal s/n, Ferrol (A Coruña), Ferrol, 15403, Spain
| | - Juan José Cartelle Barros
- Escuela Politécnica Superior (EPS), Universidade da Coruña (UDC), Campus de Esteiro, C/Mendizábal s/n, Ferrol (A Coruña), Ferrol, 15403, Spain
| | - Alfredo Del Caño Gochi
- Departamento de Ingeniería Civil, Escuela Politécnica Superior (EPS), Universidade da Coruña (UDC), Campus de Esteiro, C/Mendizábal s/n, Ferrol (A Coruña), Ferrol, 15403, Spain
| | | | - Jesús Blanco Leis
- ABANCA Corporación Bancaria S.A., C/ Olmos 26, Coruña, A Coruña, 15003, Spain
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Coenen P, van der Molen HF. What work-related exposures are associated with post-traumatic stress disorder? A systematic review with meta-analysis. BMJ Open 2021; 11:e049651. [PMID: 34433603 PMCID: PMC8388294 DOI: 10.1136/bmjopen-2021-049651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Although there is evidence that work-related exposures cause post-traumatic stress disorder (PTSD), there are few quantitative studies assessing the degree to which these factors contribute to PTSD. This systematic review with meta-analysis identified work-related exposures associated with PTSD, and quantified their contribution to this disorder. METHODS We searched Medline, PsycINFO, Embase, PILOTS and Web of Science (2005-10 September 2019) for longitudinal studies on work-related exposures and PTSD. We described included articles, and conducted meta-analyses for exposures with sufficient homogeneous information. We performed subgroup analyses for risk of bias, study design and PTSD ascertainment. We assessed evidence quality using Grades of Recommendations, Assessment, Development and Evaluation, and estimated population attributable fractions. RESULTS After screening 8590 records, we selected 33 studies (n=5 719 236). From what was moderate quality evidence at best, we identified various work-related exposures that were associated with PTSD, mainly involving individuals in the military and first responder (eg, police or fire brigade) occupations. These exposures included the number of army deployments (OR: 1.15 (95% CI 1.14 to 1.16)), combat exposure (OR 1.89 (95% CI 1.46 to 2.45)), army deployment (OR 1.79 (95% CI 1.45 to 2.21)) and confrontation with death (OR 1.63 (95% CI 1.41 to 1.90)). Effects were robust across subgroups and exposures attributed modestly (7%-34%) to PTSD. We identified additional exposures in other occupations, including life threats, being present during an attack, and hearing about a colleague's trauma. CONCLUSIONS We identified various work-related exposures associated with PTSD and quantified their contribution. While exposure assessment, PTSD ascertainment and inconsistency may have biased our findings, our data are of importance for development of preventive interventions and occupational health guidelines.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henk F van der Molen
- Department of Public and Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Van Eerd D, Irvin E, Harbin S, Mahood Q, Tiong M. Occupational exposure and post-traumatic stress disorder: A rapid review. Work 2021; 68:721-731. [PMID: 33612516 DOI: 10.3233/wor-203406] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Post-Traumatic Stress Disorder (PTSD) can result from occupational exposures and poses a considerable burden to workers, their families, workplaces and to society in general. OBJECTIVE Our objective was to conduct a rapid review of the literature to answer the question: "Which occupations have exposures that may lead to a PTSD diagnosis?" METHODS A rapid review was conducted in six steps: review question development, literature search, study selection (inclusion/exclusion), study characterization, data extraction, and data synthesis. RESULTS The search identified 3428 unique references which were reviewed to find 16 relevant studies in 23 articles. The articles revealed associations between PTSD and rescue workers (police, firefighters, etc.), health care professionals, transit drivers, and bank employees which seem well supported by the literature. Some studies also suggest potential associations with PTSD and construction and extraction, electricians, manufacturing, installation, maintenance and repair, transportation and material moving, and clerical workers. CONCLUSIONS A rapid review of the peer-reviewed scientific literature of PTSD prevalence or treatment suggests many occupations have exposures that could be associated with PTSD. Occupational traumatic events were most often associated with PTSD diagnosis. More research is needed to better understand the association between occupation and PTSD.
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Affiliation(s)
- D Van Eerd
- Institute for Work & Health, Toronto, ON, Canada
| | - E Irvin
- Institute for Work & Health, Toronto, ON, Canada
| | - S Harbin
- Institute for Work & Health, Toronto, ON, Canada
| | - Q Mahood
- Institute for Work & Health, Toronto, ON, Canada
| | - M Tiong
- Institute for Work & Health, Toronto, ON, Canada
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Lee W, Lee YR, Yoon JH, Lee HJ, Kang MY. Occupational post-traumatic stress disorder: an updated systematic review. BMC Public Health 2020; 20:768. [PMID: 32448255 PMCID: PMC7245752 DOI: 10.1186/s12889-020-08903-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/12/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although numerous studies on occupational post-traumatic stress disorder (PTSD) have been conducted prior to the 1950-2010 seminal systematic review by Skogstad et al., the prevalence, risk factors, and impact of this disorder following traumatic events in occupational settings remain unclear. This study aims to address this knowledge gap by reviewing the literature published after 2010. METHODS We reviewed literature from databases such as PubMed and Google Scholar using PRISMA guidelines to identify studies that address occupational PTSD and examined the status (prevalence or incidence), the risk factors, and the health effects of PTSD among workers. RESULTS In total, 123 articles were identified, and finally, 31 (25.2%) articles were selected after excluding duplicates. Various occupational traumatic physical events were reported such as natural or manmade disaster, explosion, accident, handling refugee corpses, or bullying at work. Risk of PTSD was closely associated with working conditions, severity of injury, history of mental disorder, occurrence of psychiatric symptoms at the time of the event, personality, interpersonal relationships, etc. Workers with PTSD were likely to experience a deterioration of physical and psychological health and impairment of social and occupational functioning. CONCLUSIONS Our review suggests that many workers remain highly vulnerable to occupational PTSD and its consequences.
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Affiliation(s)
- Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yi-Ryoung Lee
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye-Ji Lee
- Occupational Safety and Health Research Institute, Ulsan, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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Giorgi G, Ariza Montes A, Rapisarda V, Campagna M, Garzaro G, Arcangeli G, Mucci N. Work-related stress in the banking sector: a study on an Italian aged population of over 2,000 workers. LA MEDICINA DEL LAVORO 2019; 110:11-21. [PMID: 30794244 PMCID: PMC7810003 DOI: 10.23749/mdl.v110i1.7125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 09/26/2018] [Accepted: 12/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION In the European Union, the employment rate for the population in the age group 55-64 years has greatly increased in the last two decades. Companies, especially in sectors such as banking, are looking for new strategies to improve the productivity of workers in this age group. OBJECTIVES This study was conceived with the purpose of exploring the associations between job characteristics that could influence stress and certain organizational aspects in a large population of banking workers. METHODS More than 2,000 workers over 50 years of age of an Italian banking group participated in the study. Work-related stress was measured with the Stress Questionnaire (SQ). Organizational aspects of work were measured with a dedicated scale included in the SQ. Demographic aspects were detected by specific questions. Structural equation modelling was used and correlation coefficients were calculated. RESULTS The results from the structural equation modeling supported the theoretical model. Organizational policies are associated with both stress correlated factors (β=0.468) and perceptions of supervisor support and social support (β=0.710). The perception of both parameters is associated with stress outcomes (β=0.365). The proposed model offered better results than a competitive model, on which a total mediation was tested, rather than a partial one (p<0.001). CONCLUSIONS The results highlight the importance of an integrated assessment of the effects of organizational aspects of work and stress factors to implement the protection of physical and mental health. Further research will help to understand more thoroughly if the issues emerged are effectively related to age. This can be assessed through a case-control study that also includes younger workers.
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Frans Ö, Åhs J, Bihre E, Åhs F. Distance to threat and risk of acute and posttraumatic stress disorder following bank robbery: A longitudinal study. Psychiatry Res 2018; 267:461-466. [PMID: 29980125 DOI: 10.1016/j.psychres.2018.06.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 05/17/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
Abstract
Identifying pathways through which environmental risk factors influence PTSD is important for understanding PTSD etiology. Here, we hypothesized that the physical proximity to threat influences PTSD risk by increasing ASD following trauma. One hundred six bank employees who had experienced a bank robbery participated in the study. A longitudinal design assessing ASD at day 2 and PTSD at day 30 was used to test the hypothesis. Participants also indicated their location in the bank at the time of the robbery. ASD was identified in 40 (38%) and PTSD in 16 (15%) of the robbery victims. Distance to the robber had a strong effect on ASD (OR 3.51, 95% CI 1.94-6.34) and a somewhat lesser effect on PTSD (OR 2.15, 95% CI 1.04-4.46), indicating that the effect of proximity to threat on PTSD 1 month following trauma could be mediated by its effect on ASD 2 days following trauma. Using structural equation modeling, we confirmed that the effect of distance on PTSD was fully mediated by ASD. These findings suggest that proximity to threat may increase PTSD risk by enhancing the acute stress response following trauma.
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Affiliation(s)
- Örjan Frans
- Department of Psychology, Uppsala University, Box 1225, Uppsala S-752 43, Sweden.
| | - Jill Åhs
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Eva Bihre
- Department of Psychology, Uppsala University, Box 1225, Uppsala S-752 43, Sweden
| | - Fredrik Åhs
- Department of Psychology, Uppsala University, Box 1225, Uppsala S-752 43, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Neri L, Peris K, Longo C, Calvieri S, Frascione P, Parodi A, Eibenschuz L, Bottoni U, Pellacani G. Physician-patient communication and patient-reported outcomes in the actinic keratosis treatment adherence initiative (AK-TRAIN): a multicenter, prospective, real-life study of treatment satisfaction, quality of life and adherence to topical field-directed therapy for the treatment of actinic keratosis in Italy. J Eur Acad Dermatol Venereol 2018; 33:93-107. [PMID: 29920789 DOI: 10.1111/jdv.15142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 05/22/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Patients with multiple actinic keratoses (AKs) should be treated with field-directed therapy. Such treatments challenge patients' adherence due to out-of-pocket costs, length of treatment and severity of local skin reactions (LSRs). Effective physician-patient communication (PPC) may buffer therapy-related distress, thus improving quality of life, treatment satisfaction and adherence. OBJECTIVES We evaluated the interplay between PPC, LSR intensity (safety) and lesion clearance rates (effectiveness) on treatment satisfaction, quality of life and treatment adherence among patients with multiple AKs receiving topical field-directed therapies. METHODS In this observational, multicentre, longitudinal, cohort study, we included 1136 adult patients with discrete, clinically detectable, visible, multiple (three or more lesions in a 25 cm2 area), Grade I/II AKs, for whom the attending dermatologist has prescribed treatment with a topical field-directed therapy. We matched self-reported data and medical information recorded by dermatologists in standard clinical forms. Patients were followed up at two time points (T1: 8 days; T2: 25-30 days) RESULTS: Most patients were elderly, married, men with poor socio-economic status and multiple lesions of the scalp or face. The majority (n = 961) had a prescription of ingenol mebutate (IMB) and 175 received either diclofenac 3% in hyaluronic acid (DHA) or imiquimod 5% (IMQ). Clearance rate at 1 month was 84%. Most patients felt very supported (n = 819, 73%) and rated dermatologist's explanations very clear (n = 608, 54%). Treatment satisfaction (effectiveness and convenience scales) increased along the follow-up, especially for those on IMB (Δpre-post = -4.00; other: Δpre-post = -0.25; interaction P < 0.001). Communication clarity was associated with higher treatment satisfaction scores (β = 0.4-0.6, P < 0.01) and lower risk of non-adherence among IMB patients (risk difference: 16%, P < 0.01). CONCLUSION Communication clarity was associated with patient-reported outcomes and adherence beyond AK-related clinical parameters. Our study questions the current episodic approach to AK management and provides the rationale to develop chronic care models fostering patients' engagement and treatment alliance.
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Affiliation(s)
- L Neri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - K Peris
- Department of Dermatology, Catholic University, Rome, Italy
| | - C Longo
- Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - S Calvieri
- Department of Internal Medicine and Clinical Sciences, University of Rome 'La Sapienza', Rome, Italy
| | - P Frascione
- Department of Dermatologic Oncology, Regina Elena National Institute for Cancer Treatment and Research, Rome, Italy
| | - A Parodi
- Division of Dermatology, Università di Genova, DISEM, Genova, Italy
| | - L Eibenschuz
- Department of Dermatologic Oncology, Santa Maria and San Gallicano Dermatologic Institute, Istituto Fisioterapici Ospidalieri (IFO) of Rome, Rome, Italy
| | - U Bottoni
- Department of Health Science, University Magna Graecia, Catanzaro, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Mannocci A, Marchini L, Scognamiglio A, Sinopoli A, De Sio S, Sernia S, La Torre G. Are Bank Employees Stressed? Job Perception and Positivity in the Banking Sector: An Italian Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040707. [PMID: 29642586 PMCID: PMC5923749 DOI: 10.3390/ijerph15040707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 11/16/2022]
Abstract
Background: The epidemiology of stress on bank workers in Europe is only at the introductory stages. This study investigated for the first time the association between occupational stress level in bank-employees using the BEST8, Karasek-Model and socio-demographic and working factors in Italy. Methods: The observational pilot study involved 384 employees. Three questionnaires were adopted to collect data: Karasek-Model, BEST8 (p < 0.001) and Positivity-Scale. Results: 25% of the sample belonged to high stress group. The workers more stressed were older with a commercial role and consumer of antidepressants/sedatives. Women were much more likely to agree with the perception of feeling unsafe in a possible robbery (OR = 2.42; 95% CI: 1.50–3.91) and with that sales requests were in conflict with one’s own personal moral code (OR = 2.31; 95% CI: 1.38–3.87). Older employees declared feeling inadequate in the workplace (OR = 1.97; 95% CI: 1.07–3.65) and younger employees referred to be anxious about meeting financial budget goals. Workers who had a low positivity had a lower probability of adaptation (OR = 0.88; 95% CI: 0.83–0.93). Conclusions: The occupational stress level in the banking sector involves many aspects: gender, type of bank, role, personal morals, high job-demands, low level of decision-making. This study recommended that banks should implement strategic interventions for well-being of employees, and consequently for their productivity.
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Affiliation(s)
- Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Laura Marchini
- Statistical Unit, Trade Union Fisac-CGIL, 56100 Pisa, Italy.
| | - Alfredo Scognamiglio
- National Department of Health and Safety, Trade Union Fisac-CGIL, 00100 Rome, Italy.
| | - Alessandra Sinopoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
| | - Simone De Sio
- Research Unit of Occupational Medicine, Sapienza University of Rome, 00185 Rome, Italy.
| | - Sabina Sernia
- Center of Occupational Medicine, Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
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Jones RM, Burstyn I. A conceptual model for take-home workplace exposures. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:D8-D11. [PMID: 29053939 DOI: 10.1080/15459624.2017.1392531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The boundary between occupational and environmental exposures is often artificial, as occupational hazards can readily escape the workplace. One way that this occurs is when workers "take-home" occupational hazards, exposing family members. While take-home exposures have long been recognized, there is no comprehensive framework describing the pathways by which workers bring home workplace hazards. In this article, we provide such a conceptual model that includes three pathways for take-home exposures: external contamination, internal dose, and behavior change of workers. This conceptual model should help to describe the problems of take-home exposures more comprehensively in future research.
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Affiliation(s)
- Rachael M Jones
- a Division of Environmental and Occupational Health Sciences, School of Public Health , University of Illinois at Chicago , Chicago , Illinois
| | - Igor Burstyn
- b Dornsife School of Public Health , Drexel University , Philadelphia , Pennsylvania
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14
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Murray J, Lima NP, Ruivo ACO, Ramírez Varela A, Bortolotto CC, Magalhães EIDS, Leite FMC, Xavier MO, Pingault JB, Fazel S, Mielke GI, Anselmi L, Wehrmeister FC, Gonçalves H, Menezes AMB. Lifelong robbery victimisation and mental disorders at age 18 years: Brazilian population-based study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:487-496. [PMID: 29453749 PMCID: PMC5908817 DOI: 10.1007/s00127-018-1488-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 01/21/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Urban violence is a major problem in Brazil and may contribute to mental disorders among victims. The aim of this study was to assess the association between robbery victimisation and mental health disorders in late adolescence. METHODS At age 18 years, 4106 participants in the 1993 Pelotas Birth Cohort Study were assessed. A questionnaire about history of robbery victimisation was administered, the Self-Report Questionnaire was used to screen for common mental disorders, and the Mini International Neuropsychiatric Interview was used to assess major depressive disorder and generalised anxiety disorder. Cross-sectional prevalence ratios between lifetime robbery victimisation and mental disorders were estimated using Poisson regression with robust standard errors, adjusting for socioeconomic variables measured at birth and violence in the home and maltreatment measured at age 15. RESULTS There was a dose-response relationship between frequency of lifetime robberies and risk of mental disorders. Adolescents who had been robbed three or more times had twice the risk (PR 2.04; 95% CI 1.64-2.56) for common mental disorders, over four times the risk for depression (PR 4.59; 95% CI 2.60-8.12), and twice the risk for anxiety (PR 1.93; 95% CI 1.06-3.50), compared with non-victims, adjusting for covariates. Experiencing frequent robberies had greater impact on common mental disorders than experiencing an armed robbery. Population attributable fractions with regard to robbery were 9% for common mental disorders, 13% for depression, and 8% for anxiety. CONCLUSIONS Robberies are associated with common mental disorders in late adolescence, independently of violence between family members. Reducing urban violence could significantly help in preventing common mental illnesses.
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Affiliation(s)
- Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil.
| | - Natália Peixoto Lima
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | - Andrea Ramírez Varela
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | | | | | - Mariana Otero Xavier
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Jean-Baptiste Pingault
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Gregore Iven Mielke
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | - Luciana Anselmi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
| | | | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande Do Sul, Brazil
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15
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Bosmans MW, van der Velden PG. Cross-lagged associations between posttraumatic stress symptoms and coping self-efficacy in long-term recovery: A four-wave comparative study. Soc Sci Med 2017; 193:33-40. [DOI: 10.1016/j.socscimed.2017.09.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/16/2017] [Accepted: 09/21/2017] [Indexed: 01/30/2023]
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Adisesh A. In this issue of Occupational Medicine. Occup Med (Lond) 2016; 65:265. [PMID: 25972605 DOI: 10.1093/occmed/kqv066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Psychological Injuries, Workers’ Compensation Insurance, and Mental Health Policy Issues. PSYCHOLOGICAL INJURY & LAW 2016. [DOI: 10.1007/s12207-016-9274-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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