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Shiri R, Mattila-Holappa P, Kauppi M, Aalto V, Oksanen T, Ervasti J. How does lowering psychosocial risks influence sickness absence? A prospective cohort study analyzed as a quasi-experiment. Eur J Public Health 2024; 34:136-142. [PMID: 38041444 PMCID: PMC10843950 DOI: 10.1093/eurpub/ckad211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND We examined how reducing work-related psychosocial stressors affected long-term sickness absence of younger and older employees. METHODS We used data from 43 843 public sector employees in Finland who participated in surveys in 2018 and 2020. We assessed psychosocial factors, such as job demands, job control, work effort, job rewards and worktime control. We obtained sickness absence data from registers for spells longer than 10 consecutive working days. We applied age-specific propensity score weighting and generalized linear models to estimate the effects of changes in psychosocial factors between 2018 and 2020 on sickness absence in 2020. RESULTS Among employees under 50 years, increasing job rewards by 1 SD reduced the risk of sickness absence by 17% [risk ratio (RR) 0.83, 95% CI 0.72-0.96]. Among employees aged 50 years or older, decreasing job demands by 1 SD reduced the risk of sickness absence by 13% (RR 0.87, 95% CI 0.78-0.98), and increasing job control by 1 SD reduced the risk by 12% (RR 0.88, 95% CI 0.76-1.01). Changes in efforts and worktime control had no significant associations with sickness absence. CONCLUSIONS Reducing psychosocial stressors can lower the occurrence of long-term sickness absence, but the associations differ by age group. Younger workers benefit more from enhancing job rewards, while older workers benefit more from lowering job demands and increasing job control. To establish the causal impact of psychosocial risk reduction on sickness absence across age groups, future research should employ randomized controlled trials as the methodological approach.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Maarit Kauppi
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ville Aalto
- Finnish Institute of Occupational Health, Turku, Finland
| | - Tuula Oksanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
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Lee S, Small BJ, Cawthon PM, Stone KL, Almeida DM. Social activity diversity as a lifestyle factor to alleviate loneliness and chronic pain. J Psychosom Res 2023; 172:111434. [PMID: 37422980 PMCID: PMC10528390 DOI: 10.1016/j.jpsychores.2023.111434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/25/2023] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE This study examined whether social activity diversity, a novel concept indicating an active social lifestyle, is associated with lower subsequent loneliness, and decreased loneliness is further associated with less chronic pain over time. METHODS 2528 adults from the Midlife in the United States Study (Mage = 54 yrs) provided data at baseline (2004-2009) and 9 years later. Social activity diversity was operationalized by Shannon's entropy that captures the variety and evenness of engagement across 13 social activities (0-1). Participants reported feelings of loneliness (1-5), presence of any chronic pain (yes/no), the degree of chronic pain-related interference (0-10), and the number of chronic pain locations. Indirect associations of social activity diversity with chronic pain through loneliness were evaluated, adjusting for sociodemographics, living alone, and chronic conditions. RESULTS Higher social activity diversity at baseline (B = -0.21, 95%CI = [-0.41, -0.02]) and an increase in social activity diversity over time (B = -0.24, 95%CI = [-0.42, -0.06]) were associated with lower loneliness 9 years later. An increase in loneliness was associated with 24% higher risk of any chronic pain (95%CI = [1.11, 1.38]), greater chronic pain-related interference (B = 0.36, 95%CI = [0.14, 0.58]), and 17% increase in the number of chronic pain locations (95%CI = [1.10, 1.25]) at the follow-up, after controlling for corresponding chronic pain at baseline and covariates. Social activity diversity was not directly was associated with chronic pain, but there were indirect associations through its association with loneliness. CONCLUSION Diversity in social life may be associated with decreased loneliness, which in turn, may be associated with less chronic pain, two of the prevalent concerns in adulthood.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, USA.
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, USA.
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco and Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco and Department of Epidemiology and Biostatistics, University of California, San Francisco, USA.
| | - David M Almeida
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, USA.
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Zhang M, Ma Y, Xie X, Sun M, Huang Z, Zhao Z, Zhang X, Li C, Gao X, Wu J, Wang L, Zhou M, Wen D. Trends in insufficient physical activity among adults in China 2010-18: a population-based study. Int J Behav Nutr Phys Act 2023; 20:87. [PMID: 37460936 DOI: 10.1186/s12966-023-01470-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/19/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The global prevalence of insufficient physical activity (PA) was reported to be 27.5% in 2016, and there were stable levels of insufficient PA worldwide between 2001 and 2016. The global target of a 10% reduction in insufficient PA by 2025 will not be met if the trends remain. The relevant data for trends in China were still scarce. This study aimed to determine nationwide temporal trends in insufficient PA among adults in China from 2010 to 2018. METHODS 645 903 adults aged 18 years or older were randomly selected from four nationally representative cross-sectional surveys of the China Chronic Disease and Risk Factor Surveillance conducted in 2010, 2013, 2015, and 2018. PA was measured using the Global Physical Activity Questionnaire. Temporal changes in insufficient PA prevalence and participation of domain-specific moderate- to vigorous-intensity PA (MVPA) were analyzed using logistic regression. RESULTS From 2010 to 2018, the age-adjusted prevalence of insufficient PA in China increased from 17.9% (95% confidence interval 16.3% to 19.5%) in 2010 to 22.3% (20.9% to 23.8%) in 2018 (P for trend < 0.001). By age group, with a significant increase in insufficient PA in adults aged 18-34 years (P for trend < 0.001), which rose more rapidly than in adults aged ≥ 35 years (P for interaction < 0.001). Insufficient PA has increased significantly among adults engaged in agriculture-related work, non-manual work, and other manual work (all P for trend < 0.05). And among the occupational groups, those engaged in agriculture-related work had the fastest increase (P for interaction = 0.01). The percentage of adults participating in work-related MVPA decreased from 79.6% (77.8% to 81.5%) to 66.8% (64.9% to 68.7%) along with a decrease in time spent on work-related MVPA, while percentages of adults participating in recreation-related MVPA increased from 14.2% (12.5% to 15.9%) to 17.2% (16.0% to 18.4%) (all P for trend < 0.05). CONCLUSIONS Among Chinese adults, an increasing trend was found in insufficient PA from 2010 to 2018, with more than one-fifth of adults failing to achieve the recommendation of adequate PA. More targeted PA promotion strategies should be developed to improve population health.
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Affiliation(s)
- Mei Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
- Health Sciences Institute, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, No. 77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Xili Xie
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Ming Sun
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China
| | - Zhengjing Huang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Zhenping Zhao
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Xiao Zhang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Chun Li
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Xingxing Gao
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Jing Wu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China
| | - Limin Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China.
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No.27 Nanwei Road, Xicheng District, Beijing, 100050, People's Republic of China.
| | - Deliang Wen
- Health Sciences Institute, China Medical University, No.77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China.
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, China Medical University, No. 77 Puhe Road, Shenyang, Liaoning Province, 110122, People's Republic of China.
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Peltzer K. Lifestyle factors, mental health, and incident and persistent intrusive pain among ageing adults in South Africa. Scand J Pain 2023; 23:161-167. [PMID: 35467093 PMCID: PMC10249480 DOI: 10.1515/sjpain-2022-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/13/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate longitudinal associations with incident and persistent intrusive pain among rural South Africans. METHODS Longitudinal data from two consecutive waves in 2014/2015 and 2018/2019 in Agincourt, South Africa, were analysed. Pain was assessed with the Brief Pain Inventory. RESULTS In all, 683 adults of 3,628 participants without intrusive pain in Wave 1 (19.1%) had incident intrusive pain in Wave 2, 94 adults of 254 participants who had intrusive pain in Wave 1 (38.3%) had intrusive pain at both Wave 1 and 2 (persistent intrusive pain). Furthermore, 358 (7.2%) participants had intrusive pain at baseline. In the fully adjusted model for people without intrusive pain at baseline, the study found that obesity (AOR: 1.31, 95% CI: 1.05-1.63), depressive symptoms (AOR: 1.67, 95% CI: 1.34-2.08), PTSD (AOR: 1.71, 95% CI: 1.19-2.45), and poor sleep quality (AOR: 1.30, 95% CI: 1.04-1.62) were positively associated with incident intrusive pain. Older age was positively, and male sex and daily alcohol use were negatively associated with incident intrusive pain. Furthermore, in the final adjusted logistic regression model, this study found that older age was positively, and underweight, overweight, and high sedentary behavior were negatively associated with persistent intrusive pain. CONCLUSIONS Several modifiable risk factors for incident and/or persistent intrusive pain were identified.
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Affiliation(s)
- Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa; and Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
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Vartiainen P, Roine RP, Kalso E, Heiskanen T. Worse health‐related quality of life, impaired functioning and psychiatric comorbidities are associated with excess mortality in patients with severe chronic pain. Eur J Pain 2022; 26:1135-1146. [PMID: 35278251 PMCID: PMC9310830 DOI: 10.1002/ejp.1938] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/08/2022]
Abstract
Background Severe chronic pain that interferes with daily activities is associated with an increased risk of mortality. We assessed the overall mortality of tertiary chronic pain patients in comparison with the general population, with a special aim to analyse the association of health‐related quality of life (HRQoL) and its dimensions with the risk of death. Methods In this prospective observational follow‐up study, patients with non‐cancer chronic pain attended an outpatient multidisciplinary pain management (MPM) episode in a tertiary pain clinic in 2004–2012 and were followed until May 2019. Mortality between the patients and the general population was compared with standardized mortality ratios (SMR) in different age groups. Causes of death and comorbidities were compared among the deceased. Association of mortality and HRQoL and its dimensions, measured with the 15D instrument, was studied with Cox proportional hazards model. Results During a mean of 10.4‐year follow‐up of 1498 patients, 296 died. The SMR in the youngest age group (18–49 years) was significantly higher than that of the general population: 2.6 for males and 2.9 for females. Even elderly females (60–69 years) had elevated mortality (SMR 2.3). Low baseline HRQoL at the time of MPM, as well as poor ratings in the psychosocial dimensions of HRQoL, was associated with an increased risk of death. Conclusions Our results support the role of HRQoL measurement by a validated instrument such as the 15D in capturing both the physical and the psychological symptom burden, and consequently, an elevated risk of death, in patients with chronic pain. Significance Severe chronic pain is associated with elevated mortality. In patients in chronic pain under 50 years old, the mortality was 2.5–3 times higher than in the general population. Psychological distress appears to contribute to the increased mortality. Regular follow‐up by health‐related quality of life (HRQoL) measurement could be useful in identifying patients in chronic pain who are in need of intensive symptom management and to prevent early death.
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Affiliation(s)
- P Vartiainen
- Division of Pain Medicine Department of Anaesthesiology, Intensive Care, and Pain Medicine Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - R P Roine
- Division of Pain Medicine Department of Anaesthesiology, Intensive Care, and Pain Medicine Helsinki University Hospital and University of Helsinki Helsinki Finland
| | - E Kalso
- Division of Pain Medicine Department of Anaesthesiology, Intensive Care, and Pain Medicine Helsinki University Hospital and Department of Pharmacology and SleepWell Research Programme, Faculty of Medicine, University of Helsinki Helsinki Finland
| | - T Heiskanen
- Division of Pain Medicine Department of Anaesthesiology, Intensive Care, and Pain Medicine Helsinki University Hospital and University of Helsinki Helsinki Finland
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Shiri R, Karhula K, Turunen J, Koskinen A, Ropponen A, Ervasti J, Kivimäki M, Härmä M. The Effect of Using Participatory Working Time Scheduling Software on Employee Well-Being and Workability: A Cohort Study Analysed as a Pseudo-Experiment. Healthcare (Basel) 2021; 9:healthcare9101385. [PMID: 34683065 PMCID: PMC8544422 DOI: 10.3390/healthcare9101385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Shift workers are at increased risk of health problems. Effective preventive measures are needed to reduce the unfavourable effects of shift work. In this study we explored whether use of digital participatory working time scheduling software improves employee well-being and perceived workability by analysing an observational cohort study as a pseudo-experiment. Participants of the Finnish Public Sector cohort study with payroll records available between 2015 and 2019 were included (N = 2427). After estimating the propensity score of using the participatory working time scheduling software on the baseline characteristics using multilevel mixed-effects logistic regression and assigning inverse probability of treatment weights for each participant, we used generalised linear model to estimate the effect of using the participatory working time scheduling software on employees’ control over scheduling of shifts, perceived workability, self-rated health, work-life conflict, psychological distress and short sleep (≤ 6 h). During a 2-year follow-up, using the participatory working time scheduling software reduced the risk of employees’ low control over scheduling of shifts (risk ratio [RR] 0.34; 95% CI 0.25–0.46), short sleep (RR 0.70; 95% CI 0.52–0.95) and poor workability (RR 0.74; 95% CI 0.55–0.99). The use of the software was not associated with changes in psychological distress, self-rated health and work-life conflict. In this observational study, we analysed as a pseudo-experiment, the use of participatory working time scheduling software was associated with increased employees’ perceived control over scheduling of shifts and improved sleep and self-rated workability.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
- Correspondence:
| | - Kati Karhula
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Jarno Turunen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Aki Koskinen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Annina Ropponen
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, 00250 Helsinki, Finland; (K.K.); (J.T.); (A.K.); (A.R.); (J.E.); (M.K.); (M.H.)
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