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Tiwa Diffo E, Lavigne-Robichaud M, Milot A, Brisson C, Gilbert-Ouimet M, Vézina M, Talbot D, Trudel X. Psychosocial Stressors at Work and Atrial Fibrillation Incidence: An 18-Year Prospective Study. J Am Heart Assoc 2024:e032414. [PMID: 39140284 DOI: 10.1161/jaha.123.032414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/30/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Psychosocial stressors at work, defined by the job strain and effort-reward imbalance at work (ERI) models, were shown to increase coronary heart disease risk. No previous study has examined the adverse effect of psychosocial stressors at work from both models on atrial fibrillation (AF) incidence. The objective of this study was to examine the separate and combined effect of psychosocial stressors at work from the job strain and ERI models on AF incidence in a prospective cohort study. METHODS AND RESULTS A total of 5926 white-collar workers (3021 women and 2905 men) free of cardiovascular disease at baseline were followed for an average of 18 years. Job strain (high psychological demands combined with low decision latitude) and ERI were assessed using validated instruments. AF events were identified in medical databases with universal coverage. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression models, controlling for socioeconomic characteristics and lifestyle-related and clinical risk factors. A total of 186 AF incident events were identified over 18 years. Workers exposed to job strain (HR, 1.83 [95% CI, 1.14-2.92]) and ERI (HR, 1.44 [95% CI, 1.05-1.98]) had a higher risk of AF in fully adjusted models. Combined exposure to job strain and ERI was associated with a 2-fold AF risk increase (HR, 1.97 [95% CI, 1.26-3.07]). CONCLUSIONS Psychosocial stressors at work from the job strain and ERI models are associated with an increased risk of AF, separately and in combination. Workplace prevention strategies targeting these psychosocial stressors at work may be effective to reduce the burden associated with AF.
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Affiliation(s)
- Edwige Tiwa Diffo
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada
| | - Mathilde Lavigne-Robichaud
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada
| | - Alain Milot
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Department of Medicine Laval University Quebec City Quebec Canada
| | - Chantal Brisson
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada
| | - Mahée Gilbert-Ouimet
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Department of Health Science Université du Québec à Rimouski Lévis Canada
- Canada Research Chair in Sex and Gender in Occupational Health Lévis Canada
| | - Michel Vézina
- Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada
| | - Denis Talbot
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada
| | - Xavier Trudel
- Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada
- Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada
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Pena-Gralle APB, Talbot D, Trudel X, Milot A, Gilbert-Ouimet M, Lavigne-Robichaud M, Ndjaboué R, Lesage A, Lauzier S, Vézina M, Siegrist J, Brisson C. Socioeconomic inequalities, psychosocial stressors at work and physician-diagnosed depression: Time-to-event mediation analysis in the presence of time-varying confounders. PLoS One 2023; 18:e0293388. [PMID: 37878641 PMCID: PMC10599565 DOI: 10.1371/journal.pone.0293388] [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] [Received: 02/05/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVES There is evidence that both low socioeconomic status (SES) and psychosocial stressors at work (PSW) increase risk of depression, but prospective studies on the contribution of PSW to the socioeconomic gradient of depression are still limited. METHODS Using a prospective cohort of Quebec white-collar workers (n = 9188 participants, 50% women), we estimated randomized interventional analogues of the natural direct effect of SES indicators at baseline (education level, household income, occupation type and a combined measure) and of their natural indirect effects mediated through PSW (job strain and effort-reward imbalance (ERI) measured at the follow-up in 1999-2001) on incident physician-diagnosed depression. RESULTS During 3 years of follow-up, we identified 469 new cases (women: 33.1 per 1000 person-years; men: 16.8). Mainly in men, low SES was a risk factor for depression [education: hazard ratio 1.72 (1.08-2.73); family income: 1.67 (1.04-2.67); occupational type: 2.13 (1.08-4.19)]. In the entire population, exposure to psychosocial stressors at work was associated with increased risk of depression [job strain: 1.42 (1.14-1.78); effort-reward imbalance (ERI) 1.73 (1.41-2.12)]. The estimated indirect effects of socioeconomic indicators on depression mediated through job strain ranged from 1.01 (0.99-1.03) to 1.04 (0.98-1.10), 4-15% of total effects, and for low reward from 1.02 (1.00-1.03) to 1.06 (1.01-1.11), 10-15% of total effects. DISCUSSION Our study suggests that PSW only slightly mediate the socioeconomic gradient of depression, but that socioeconomic inequalities, especially among men, and PSW both increase the incidence of depression.
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Affiliation(s)
- Ana Paula Bruno Pena-Gralle
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
- VITAM – Centre de Recherche en Santé Durable, Québec, Québec, Canada
| | - Denis Talbot
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Xavier Trudel
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Alain Milot
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Mahée Gilbert-Ouimet
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Department of Health Sciences, Université du Québec à Rimouski, Lévis, Québec, Canada
| | - Mathilde Lavigne-Robichaud
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
| | - Ruth Ndjaboué
- School of Social Work, Sherbrooke University, Sherbrooke, Québec, Canada
| | - Alain Lesage
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Sophie Lauzier
- Faculty of Pharmacy, Laval University, Québec, Québec, Canada
| | - Michel Vézina
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Institut National de Santé Publique du Québec, Québec, Canada
| | - Johannes Siegrist
- Faculty of Medicine, Department of Medical Sociology, Heinrich-Heine-University, Duesseldorf, Germany
| | - Chantal Brisson
- Centre hospitalier universitaire (CHU) de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, Québec, Canada
- Faculty of Medicine, Laval University, Québec, Québec, Canada
- VITAM – Centre de Recherche en Santé Durable, Québec, Québec, Canada
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Massamba VK, Talbot D, Milot A, Trudel X, Dionne CE, Vézina M, Mâsse B, Gilbert-Ouimet M, Dagenais GR, Pearce N, Brisson C. Association between psychosocial work-related factors at midlife and arterial stiffness at older age in a prospective cohort of 1736 white-collar workers. BMJ Open 2023; 13:e073649. [PMID: 37758677 PMCID: PMC10537828 DOI: 10.1136/bmjopen-2023-073649] [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: 03/26/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE Arterial stiffness and exposure to psychosocial work-related factors increase the risk of developing cardiovascular disease. However, little is known about the relationship between psychosocial work-related factors and arterial stiffness. We aimed to examine this relationship. DESIGN Prospective cohort study. SETTING Public organisations in Quebec City, Canada. PARTICIPANTS The study included 1736 white-collar workers (women 52%) from 19 public organisations. PRIMARY AND SECONDARY OUTCOME MEASURES Association between psychosocial work-related factors from the job strain and effort-reward imbalance (ERI) models assessed at study baseline (1999-2001) with validated instruments and arterial stiffness assessed using carotid-femoral pulse wave velocity at follow-up, on average 16 years later (2015-2018). Generalised estimating equations were used to estimate differences in arterial stiffness between exposed and unexposed participants. Subgroup analyses according to sex, age, blood pressure (BP), cardiovascular risk score and employment status were conducted. RESULTS Among participants with high diastolic BP (≥90 mm Hg) at baseline, aged 47 on average, those exposed to high job strain had higher arterial stiffness (1.38 m/s (95% CI: 0.57 to 2.19)) at follow-up, 16 years later, following adjustment for a large set of potential confounders. The trend was similar in participants with high systolic BP (≥140 mm Hg) exposed to high job strain (0.84 m/s (95% CI: -0.35 to 2.03)). No association was observed for ERI in the total sample and counterintuitive associations were observed in subgroup analyses. CONCLUSIONS Job strain may have a long-term deleterious effect on arterial stiffness in people with high BP. Interventions at midlife to reduce job strain may mitigate arterial stiffness progression.
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Affiliation(s)
- Victoria K Massamba
- Department of Social and Preventive Medicine, Université Laval, Quebec, Quebec, Canada
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Denis Talbot
- Department of Social and Preventive Medicine, Université Laval, Quebec, Quebec, Canada
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Alain Milot
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
- Department of Medicine, Université Laval, Quebec, Quebec, Canada
| | - Xavier Trudel
- Department of Social and Preventive Medicine, Université Laval, Quebec, Quebec, Canada
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Clermont E Dionne
- Department of Social and Preventive Medicine, Université Laval, Quebec, Quebec, Canada
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
| | - Michel Vézina
- Institut national de sante publique du Quebec, Quebec, Quebec, Canada
| | - Benoit Mâsse
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mahée Gilbert-Ouimet
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Gilles R Dagenais
- Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Quebec, Canada
| | - Neil Pearce
- Departments of Medical Statistics and Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Chantal Brisson
- Department of Social and Preventive Medicine, Université Laval, Quebec, Quebec, Canada
- Centre de recherche du CHU de Québec-Université Laval, Quebec, Quebec, Canada
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Duchaine CS, Brisson C, Diorio C, Talbot D, Maunsell E, Carmichael PH, Giguère Y, Gilbert-Ouimet M, Trudel X, Ndjaboué R, Vézina M, Milot A, Mâsse B, Dionne CE, Laurin D. Work-Related Psychosocial Factors and Global Cognitive Function: Are Telomere Length and Low-Grade Inflammation Potential Mediators of This Association? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4929. [PMID: 36981836 PMCID: PMC10049148 DOI: 10.3390/ijerph20064929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
The identification of modifiable factors that could maintain cognitive function is a public health priority. It is thought that some work-related psychosocial factors help developing cognitive reserve through high intellectual complexity. However, they also have well-known adverse health effects and are considered to be chronic psychosocial stressors. Indeed, these stressors could increase low-grade inflammation and promote oxidative stress associated with accelerated telomere shortening. Both low-grade inflammation and shorter telomeres have been associated with a cognitive decline. This study aimed to evaluate the total, direct, and indirect effects of work-related psychosocial factors on global cognitive function overall and by sex, through telomere length and an inflammatory index. A random sample of 2219 participants followed over 17 years was included in this study, with blood samples and data with cognitive function drawn from a longitudinal study of 9188 white-collar workers (51% female). Work-related psychosocial factors were evaluated according to the Demand-Control-Support and the Effort-Reward Imbalance (ERI) models. Global cognitive function was evaluated with the validated Montreal Cognitive Assessment (MoCA). Telomere length and inflammatory biomarkers were measured using standardised protocols. The direct and indirect effects were estimated using a novel mediation analysis method developed for multiple correlated mediators. Associations were observed between passive work or low job control, and shorter telomeres among females, and between low social support at work, ERI or iso-strain, and a higher inflammatory index among males. An association was observed with higher cognitive performance for longer telomeres, but not for the inflammatory index. Passive work overall, and low reward were associated with lower cognitive performance in males; whereas, high psychological demand in both males and females and high job strain in females were associated with a higher cognitive performance. However, none of these associations were mediated by telomere length or the inflammatory index. This study suggests that some work-related psychosocial factors could be associated with shorter telomeres and low-grade inflammation, but these associations do not explain the relationship between work-related psychosocial factors and global cognitive function. A better understanding of the biological pathways, by which these factors affect cognitive function, could guide future preventive strategies to maintain cognitive function and promote healthy aging.
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Affiliation(s)
- Caroline S. Duchaine
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
- VITAM, Centre de Recherche en santé Durable, Québec, QC G1S 4L8, Canada
- Institut sur le Vieillissement et la Participation Sociale des Aînés, Université Laval, Québec, QC G1S 4L8, Canada
| | - Chantal Brisson
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
- VITAM, Centre de Recherche en santé Durable, Québec, QC G1S 4L8, Canada
| | - Caroline Diorio
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
| | - Denis Talbot
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
| | - Elizabeth Maunsell
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
| | - Pierre-Hugues Carmichael
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
| | - Yves Giguère
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
| | - Mahée Gilbert-Ouimet
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
- Canada Research Chair in Sex and Gender in Occupational Health, Université du Québec à Rimouski, Campus de Lévis, Lévis, QC G6V 0A6, Canada
| | - Xavier Trudel
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
- VITAM, Centre de Recherche en santé Durable, Québec, QC G1S 4L8, Canada
| | - Ruth Ndjaboué
- School of Social Work, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Michel Vézina
- Institut National de Santé Publique du Québec (INSPQ), Québec, QC G1V 5B3, Canada
| | - Alain Milot
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
| | - Benoît Mâsse
- École de Santé Publique de l’Université de Montréal, Montréal, QC H3N 1X9, Canada
| | - Clermont E. Dionne
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
- VITAM, Centre de Recherche en santé Durable, Québec, QC G1S 4L8, Canada
- Institut sur le Vieillissement et la Participation Sociale des Aînés, Université Laval, Québec, QC G1S 4L8, Canada
| | - Danielle Laurin
- Centre d’excellence sur le vieillissement de Québec (CEVQ), CIUSSS-Capitale Nationale, Québec, QC G1S 4L8, Canada
- Centre de Recherche du CHU de Québec—Université Laval, Québec, QC G1S 4L8, Canada
- VITAM, Centre de Recherche en santé Durable, Québec, QC G1S 4L8, Canada
- Institut sur le Vieillissement et la Participation Sociale des Aînés, Université Laval, Québec, QC G1S 4L8, Canada
- Faculty of Pharmacy, Université Laval, Québec, QC G1V 0A6, Canada
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AbuAlSamen MM, El-Elimat T. Understanding Reciprocity Among University Students in Low-Resource Settings: Validation and Measurement Using a Mixed-Methods Approach. Front Public Health 2022; 10:922892. [PMID: 35719638 PMCID: PMC9204171 DOI: 10.3389/fpubh.2022.922892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/05/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aimed to investigate reciprocity among university students in low-resource settings using a convergent mixed-methods approach in Jordan. The study operationalized the effort-reward imbalance (ERI) model which is a sociological framework used to predict occupational-related health outcomes. The basic theory of ERI model assumes that an imbalance of effort and reward predicts adverse health outcomes. Methods The research involved two studies, Study I (n = 833) to quantitatively measure ERI and Study II to collect qualitative data (n = 44) on the drivers of ERI among university students. In Study I, a modified Arabic version of the ERI questionnaire was used. The study measured ERI and investigated the reliability and validity of the Arabic version of the ERI model questionnaire. In Study II, data were collected from focus groups and personal interviews and thematic analysis was used. Results The results suggested that ERI was associated with poor academic performance (OR=2.31, 95% CI 1.60–3.32), absenteeism (OR=1.66, 95% CI 1.21–2.27), low exercise level (OR=2.02, 95% CI 1.49–2.74) and poor self-reported health (OR=1.12, 95% CI 1.08–1.30). Three major themes emerged, namely high academic load, financial pressures and negative influence on the students' performance, wellbeing and health to explain effort-reward imbalance. Conclusions Results suggest that ERI among university students is multi-faceted and is not bound only to academic-related demands and that the extrinsic factors such as the economic context of Jordan is among drivers of ERI.
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Ramírez-Moreno J, Muñoz Vega P, Espada S, Bartolomé Alberca S, Aguirre J, Peral D. Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: a case–control study. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Aalberg AL, Saksvik-Lehouillier I, Vaag JR. Demands and resources associated with mental health among Norwegian professional musicians. Work 2019; 63:39-47. [PMID: 31127743 DOI: 10.3233/wor-192906] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous studies indicate a variety of health challenges among musicians. Despite this, less is known concerning the roles of work-related and personal factors associated with the musicians' mental health. OBJECTIVE We wanted to investigate personal and work-related demands and resources associated with psychological distress in professional musicians. METHODS Based on a sample of 1,607 of professional Norwegian musicians, we conducted a hierarchical multiple regression analysis. RESULTS We found that personal factors such as level of neuroticism and sense of mastery had the strongest association with PD. Extraversion, openness to experience, conscientiousness, job demands and social support did also contribute to distress in our final statistical model, but to a lesser degree. Somewhat surprisingly, work-family conflict, effort-reward imbalance and job control were not associated with PD in our final model. CONCLUSIONS Our results show that both work-related factors (job demands and social support) and personal resources (personality and sense of mastery) are associated with PD among musicians in this cross-sectional study. Prospective research is needed in order to investigate these associations further. Meanwhile, we suggest to emphasize early development of sense of mastery and social support in music education and industry.
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Affiliation(s)
- A L Aalberg
- Safetec Nordic, Trondheim, Norway.,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - I Saksvik-Lehouillier
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - J R Vaag
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
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Ramírez-Moreno JM, Muñoz Vega P, Espada S, Bartolomé Alberca S, Aguirre J, Peral D. Association between self-perceived psychological stress and transitory ischaemic attack and minor stroke: A case-control study. Neurologia 2017; 35:556-562. [PMID: 29277523 DOI: 10.1016/j.nrl.2017.09.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/16/2017] [Accepted: 09/22/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Stroke has a complex aetiopathogenesis influenced by numerous risk factors. There is growing interest in the study of the pathophysiological changes associated with stress and their potential relationship with cerebrovascular disease. The purpose of this paper is to assess the strength of association between exposure to stress and stroke. METHODS We conducted a case-control study (1:1) to compare exposure to stress in a group of patients with a history of a first transient ischaemic attack (TIA) or minor stroke and in a control group. Participants were asked a subjective question about their perception of stress in the previous months and completed the standardised Effort-Reward Imbalance (ERI) questionnaire. Logistic regression models were used for data analysis. RESULTS The study included data on 50 cases and 50 controls. There were no significant differences in demographic variables and economic, social, and employment status between cases and controls. Fifty percent of the cases reported moderate to severe stress, compared to 30% of controls (OR: 2.33; 95% CI: 1.02-5.30; P=.041). ERI questionnaire results found that greater effort at work (OR: 1.48; 95% CI: 1.19-1.83) and greater commitment is associated with stroke (OR: 1.34; 95% CI: 1.17-1.54), while higher reward constitutes a protective factor against the disease (OR: 0.71; 95% CI: 0.61-0.82). CONCLUSIONS There is a strong association between self-perceived psychological stress and TIA. The imbalance between effort and reward at work is also clearly related to TIA.
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Affiliation(s)
- J M Ramírez-Moreno
- Departamento de Ciencias Biomédicas, Universidad de Extremadura, Badajoz, España; Centro de ictus, Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España; Grupo de Investigación Multidisciplinar de Extremadura GRIMEX.
| | - P Muñoz Vega
- Centro de ictus, Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España
| | - S Espada
- Departamento de Ciencias Biomédicas, Universidad de Extremadura, Badajoz, España
| | - S Bartolomé Alberca
- Centro de ictus, Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España
| | - J Aguirre
- Departamento de Ciencias Biomédicas, Universidad de Extremadura, Badajoz, España; Centro de ictus, Sección de Neurología, Hospital Universitario Infanta Cristina, Badajoz, España
| | - D Peral
- Departamento de Terapéutica Médico-quirúrgica, Universidad de Extremadura, Badajoz, España
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Richter JG, Muth T, Li J, Brinks R, Chehab G, Koch T, Siegrist J, Angerer P, Huscher D, Schneider M. Elevated Psychosocial Stress at Work in Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis. J Rheumatol 2017; 45:227-234. [DOI: 10.3899/jrheum.170233] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2017] [Indexed: 01/03/2023]
Abstract
Objective.Psychosocial stress at work not only affects the healthy working population, but also workers with chronic diseases. We aimed to investigate the psychosocial work stress levels in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).Methods.A cross-sectional study applied the Effort-Reward Imbalance (ERI) questionnaire — an internationally established instrument that measures work stress — to patients with SLE and RA who were capable of work and to a group of controls without these diseases. Participants were recruited through rheumatologists in private practices, hospitals, and from self-help groups by personal communication, paper-based flyers, and online advertisements. Because very few studies tested the ERI’s applicability in patient groups, with a lack of evidence in patients with inflammatory rheumatic diseases, internal consistency and construct validity of the ERI measure were evaluated.Results.Data came from 270 patients with RA and 247 with SLE, and 178 controls. Patients showed elevated psychosocial stress at work compared to controls. Across the total sample and all groups, satisfactory internal consistencies of the scales effort, reward, and overcommitment were obtained (Cronbach’s alpha coefficients > 0.70), and confirmatory factor analysis replicated the theoretical structure of the ERI model (goodness-of-fit index > 0.80).Conclusion.We found elevated psychosocial stress at work in patients with SLE and RA compared to controls by applying the ERI model. Despite some heterogeneity in the sample, we achieved satisfactory psychometric properties of the ERI questionnaire. Our results suggest that the ERI questionnaire is a psychometrically useful tool to be implemented in epidemiological studies of employed patients with SLE and RA.
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Vastamäki H, Vastamäki M, Laimi K, Saltychev M. Confirmatory Factor Analysis of the Finnish Job Content Questionnaire (JCQ) in 590 Professional Musicians. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2017; 8:174-180. [PMID: 28689214 PMCID: PMC6679628 DOI: 10.15171/ijoem.2017.1055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/09/2017] [Indexed: 11/27/2022]
Abstract
Background: Poorly functioning work environments may lead to dissatisfaction for the employees and financial loss for the employers. The Job Content Questionnaire (JCQ) was designed to measure social and psychological characteristics of work environments. Objective: To investigate the factor construct of the Finnish 14-item version of JCQ when applied to professional orchestra musicians. Methods: In a cross-sectional survey, the questionnaire was sent by mail to 1550 orchestra musicians and students. 630 responses were received. Full data were available for 590 respondents (response rate 38%).The questionnaire also contained questions on demographics, job satisfaction, health status, health behaviors, and intensity of playing music. Confirmatory factor analysis of the 2-factor model of JCQ was conducted. Results: Of the 5 estimates, JCQ items in the "job demand" construct, the "conflicting demands" (question 5) explained most of the total variance in this construct (79%) demonstrating almost perfect correlation of 0.63. In the construct of "job control," "opinions influential" (question 10) demonstrated a perfect correlation index of 0.84 and the items "little decision freedom" (question 14) and "allows own decisions" (question 6) showed substantial correlations of 0.77 and 0.65. Conclusion: The 2-factor model of the Finnish 14-item version of JCQ proposed in this study fitted well into the observed data. The "conflicting demands," "opinions influential," "little decision freedom," and "allows own decisions" items demonstrated the strongest correlations with latent factors suggesting that in a population similar to the studied one, especially these items should be taken into account when observed in the response of a population.
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Affiliation(s)
- Heidi Vastamäki
- Orton Research Institute, Orton Foundation, Helsinki, Finland
| | | | - Katri Laimi
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Michail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
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Ndjaboue R, Brisson C, Talbot D, Vézina M. Chronic exposure to adverse psychosocial work factors and high psychological distress among white-collar workers: A 5-year prospective study. J Psychosom Res 2017; 94:56-63. [PMID: 28183403 DOI: 10.1016/j.jpsychores.2017.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/13/2016] [Accepted: 01/03/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Prospective studies which evaluated whether the effects of chronic exposure to psychosocial work factors on mental health persisted over time are scarce. For the first time, this study evaluated: 1) the effect of chronic exposure to effort-reward imbalance over 5years on the prevalence of high psychological distress among men and women, and 2) the persistence of this effect over time. METHODS Overall, 1747 white-collar workers from three public organizations participated in a prospective study. Psychological distress and effort-reward imbalance were measured using validated questionnaires at baseline, and at 3- and 5-year follow-ups. Prevalence ratios (PRs) of high psychological distress were estimated using log-binomial regression according to baseline and repeated exposure. RESULTS Compared to unexposed workers, those with repeated exposure to effort-reward imbalance had a higher prevalence of high psychological distress. Workers exposed only at some time-points also had a higher prevalence. The deleterious effect of repeated exposure observed at the 3-year follow-up persisted at the 5-year follow-up among women (PR=2.48 95% confidence interval (CI) 1.97-3.11) and men (PR=1.91 95% CI 1.20-3.04). These effects were greater than those found using a single baseline measurement. CONCLUSION The current study supported a deleterious effect of repeated exposure to effort-reward imbalance on psychological distress, and a lack of adaptation to these effects over time among men and women. Since psychological distress may later lead to severe mental problems, current results highlight the need to consider exposure to these adverse work factors in primary and secondary preventions aimed at reducing mental health problems at work.
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Affiliation(s)
- Ruth Ndjaboue
- Centre de Recherche du CHU de Québec- Université Laval, Quebec, Canada.
| | - Chantal Brisson
- Centre de Recherche du CHU de Québec- Université Laval, Quebec, Canada
| | - Denis Talbot
- Centre de Recherche du CHU de Québec- Université Laval, Quebec, Canada
| | - Michel Vézina
- Institut National de Santé Publique du Québec, Canada
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Systematic Review of Health-Related Work Outcome Measures and Quality Criteria-Based Evaluations of Their Psychometric Properties. Arch Phys Med Rehabil 2017; 98:534-560. [DOI: 10.1016/j.apmr.2016.06.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/14/2016] [Accepted: 06/22/2016] [Indexed: 01/12/2023]
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Work stress and the risk of recurrent coronary heart disease events: A systematic review and meta-analysis. Int J Occup Med Environ Health 2016; 28:8-19. [PMID: 26159942 DOI: 10.2478/s13382-014-0303-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Though much evidence indicates that work stress increases the risk of incident of coronary heart disease (CHD), little is known about the role of work stress in the development of recurrent CHD events. The objective of this study was to review and synthesize the existing epidemiological evidence on whether work stress increases the risk of recurrent CHD events in patients with the first CHD. A systematic literature search in the PubMed database (January 1990 - December 2013) for prospective studies was performed. Inclusion criteria included: peer-reviewed English papers with original data, studies with substantial follow-up (> 3 years), end points defined as cardiac death or nonfatal myocardial infarction, as well as work stress assessed with reliable and valid instruments. Meta-analysis using random-effects modeling was conducted in order to synthesize the observed effects across the studies. Five papers derived from 4 prospective studies conducted in Sweden and Canada were included in this systematic review. The measurement of work stress was based on the Demand- Control model (4 papers) or the Effort-Reward Imbalance model (1 paper). According to the estimation by meta-analysis based on 4 papers, a significant effect of work stress on the risk of recurrent CHD events (hazard ratio: 1.65, 95% confidence interval: 1.23-2.22) was observed. Our findings suggest that, in patients with the first CHD, work stress is associated with an increased relative risk of recurrent CHD events by 65%. Due to the limited literature, more well-designed prospective research is needed to examine this association, in particular, from other than western regions of the world.
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Psychosocial job conditions, fear avoidance beliefs and expected return to work following acute coronary syndrome: a cross-sectional study of fear-avoidance as a potential mediator. BMC Public Health 2015; 15:1263. [PMID: 26689711 PMCID: PMC4687316 DOI: 10.1186/s12889-015-2599-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 12/11/2015] [Indexed: 11/22/2022] Open
Abstract
Background Despite improvements in treatment, acute coronary syndrome remains a substantial cause for prolonged sick absences and premature retirement. Knowledge regarding what benefits return to work is limited, especially the effect of psychological processes and psychosocial work factors. The purposes of this cross-sectional study were two-fold: to examine associations between adverse psychosocial job conditions and fear-avoidance beliefs towards work, and to determine whether such beliefs mediated the relationship between work conditions and expected return to work in acute coronary syndrome survivors. Methods Study inclusion criteria: acute myocardial infarction or unstable angina diagnosis, below 65 years of age, being a resident in the West county of Sweden and currently working. In all, 509 individuals (21.8 % women) accepted study participation and for whom all data of study interest were available for analysis. Psychosocial work variables; job demand-control and effort-reward imbalance, were assessed with standard questionnaire batteries. Linear regression models were used to investigate relationships between psychosocial factors and fear-avoidance, and to evaluate mediator effects for fear-avoidance. Both total sample and gender stratified analyses were calculated. Results Fear-avoidance beliefs about work were associated to psychosocial job environments characterized by high strain (β 1.4; CI 1.2–1.6), active and passive work and high effort-reward imbalance (β 0.6; CI 0.5–0.7). Further, such beliefs also mediated the relationship between adverse work conditions and expected time for return to work. However, these results were only observed in total sample analyses or among or male participants. For women only high strain was linked to fear-avoidance, and these relationships became non-significant when entering chosen confounders. Conclusions This cross-sectional study showed that acute coronary syndrome survivors, who laboured under adverse psychosocial work conditions, held fear-avoidance beliefs towards their workplace. Furthermore, these beliefs mediated the relationships between - high strained or high effort-reward imbalanced work - and expected return to work. However, mentioned results were primarily found among men, which could results from few female study participants or gender differences in return to work mechanisms. Still, an earlier return to work might be promoted by interventions focusing on improved psychosocial work conditions and cognitive behavioural therapy targeting fear-avoidance beliefs.
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Prevalence of risk factors for cardiovascular disease in paramedics. Int Arch Occup Environ Health 2015; 88:973-80. [DOI: 10.1007/s00420-015-1028-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 01/27/2015] [Indexed: 11/30/2022]
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Muckenhuber J, Burkert N, Großschädl F, Freidl W. Income inequality as a moderator of the relationship between psychological job demands and sickness absence, in particular in men: an international comparison of 23 countries. PLoS One 2014; 9:e86845. [PMID: 24505271 PMCID: PMC3914810 DOI: 10.1371/journal.pone.0086845] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 12/14/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate whether more sickness absence is reported in countries with higher income inequality than elsewhere, and whether the level of income inequality moderates the association between psycho-social job demands and sickness absence. METHODS Our analysis is based on the Fifth European Working Conditions Survey that compared 23 European countries. We performed multi-level regression analysis. On the macro-level of analysis we included the Gini-Index as measure of inequality. On the micro-level of analysis we followed the Karasek-Theorell model and included three scales for psychological job demands, physical job demands, and decision latitude in the model. The model was stratified by sex. RESULTS We found that, in countries with high income inequality, workers report significantly more sickness absence than workers in countries with low income inequality. In addition we found that the level of income inequality moderates the relationship between psychological job demands and sickness absence. High psychological job demands are significantly more strongly related to more days of sickness absence in countries with low income inequality than in countries with high income inequality. CONCLUSIONS As the nature and causal pathways of cross-level interaction effects still cannot be fully explained, we argue that future research should aim to explore such causal pathways. In accordance with WHO recommendations we argue that inequalities should be reduced. In addition we state that, particularly in countries with low levels of income inequality, policies should aim to reduce psychological job demands.
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Affiliation(s)
- Johanna Muckenhuber
- Institute for Social Medicine and Epidemiology, Medical University Graz, Graz, Austria
| | - Nathalie Burkert
- Institute for Social Medicine and Epidemiology, Medical University Graz, Graz, Austria
| | - Franziska Großschädl
- Institute for Social Medicine and Epidemiology, Medical University Graz, Graz, Austria
| | - Wolfgang Freidl
- Institute for Social Medicine and Epidemiology, Medical University Graz, Graz, Austria
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Fekete C, Wahrendorf M, Reinhardt JD, Post MWM, Siegrist J. Work stress and quality of life in persons with disabilities from four European countries: the case of spinal cord injury. Qual Life Res 2014; 23:1661-71. [PMID: 24384737 DOI: 10.1007/s11136-013-0610-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence on the adverse effects of work stress on quality of life (QoL) is largely derived from general populations, while respective information is lacking for people with disabilities. We investigated associations between work stress and QoL and the potentially moderating role of socioeconomic circumstances in employed persons with spinal cord injury (SCI). METHODS Cross-sectional data from 386 employed men and women with SCI (≥18 work h/week) from the Netherlands, Switzerland, Denmark, and Norway were analyzed. Work stress was assessed with the 'effort-reward imbalance' (ERI) model and the control component of the 'demand/control' model. QoL was operationalized with five WHOQoL BREF items. Socioeconomic circumstances were measured by years of formal education and perception of financial hardship. We applied ordinal and linear regressions to predict QoL and introduced interaction terms to assess a potential moderation of socioeconomic circumstances. RESULTS Multivariate analyses showed consistent associations between increased ERI and decreased overall QoL (coefficient -1.55, p < 0.001), domain-specific life satisfaction (health -1.32, p < 0.001; activities of daily living -1.28, p < 0.001; relationships -0.84, p = 0.004; living conditions -1.05, p < 0.001), and the QoL sum score (-2.40, p < 0.001). Low job control was linked to decreased general QoL (0.13, p = 0.015), satisfaction with relationships (0.15, p = 0.004), and QoL sum score (0.15, p = 0.029). None of the tested interaction terms were significant. CONCLUSION ERI was consistently related to all indicators of QoL, while associations with job control were less consistent. Our results do not support the notion that unfavorable socioeconomic circumstances moderate the association between work stress and QoL among persons with SCI.
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Magnavita N, Fileni A. Work stress and metabolic syndrome in radiologists: first evidence. Radiol Med 2013; 119:142-8. [PMID: 24297580 DOI: 10.1007/s11547-013-0329-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Accepted: 09/25/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE Scientific data have amply demonstrated that work stress increases the risk of cardiovascular disease. However, less attention has been given to the association between stress and metabolic syndrome. In this study, our aim was to investigate the relationship between work stress and metabolic syndrome in a population of radiologists. MATERIALS AND METHODS Radiologists and radiotherapists taking part in scientific conferences were invited to compile a questionnaire to evaluate work stress and the main parameters for diagnosing metabolic syndrome (obesity, hypertension, elevated cholesterol level, elevated triglycerides, and hyperglycemia). RESULTS Most of the doctors taking part in the survey (n = 383, 58.6 %) were found to have at least one pathological component; 47 subjects (7.1 %) had metabolic syndrome. All the variables indicating work stress, whether derived from Karasek's demand/control model or from the effort/reward model devised by Siegrist, were significant predictors of metabolic syndrome components. Radiologists with elevated levels of stress had a significantly higher risk of being affected by metabolic syndrome than colleagues with lower stress levels, whether stress was defined as "job strain", i.e., elevated work load and reduced discretionary power (OR 4.89, 95 % CI 2.51-9.55), or as "effort reward imbalance", i.e., mismatch between effort and reward for the work performed (OR 4.66, 95 % CI 2.17-10.02). CONCLUSIONS Should the results of this cross-sectional study be confirmed by a subsequent longitudinal survey, they would indicate the need for prompt organizational intervention to reduce occupational stress in radiologists.
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Affiliation(s)
- Nicola Magnavita
- Department of Public Health, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy,
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Stress in nurses: stress-related affect and its determinants examined over the nursing day. Ann Behav Med 2013; 45:348-56. [PMID: 23355114 DOI: 10.1007/s12160-012-9458-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Nurses are a stressed group and this may affect their health and work performance. The determinants of occupational stress in nurses and other occupational groups have almost invariably been examined in between subject studies. PURPOSE This study aimed to determine if the main determinants of occupation stress, i.e. demand, control, effort and reward, operate within nurses. METHODS A real time study using personal digital-assistant-based ecological momentary assessment to measure affect and its hypothesised determinants every 90 min in 254 nurses over three nursing shifts. The measures were negative affect, positive affect, demand/effort, control and reward. RESULTS While the effects varied in magnitude between people, in general increased negative affect was predicted by high demand/effort, low control and low reward. Control and reward moderated the effects of demand/effort. High positive affect was predicted by high demand/effort, control and reward. CONCLUSIONS The same factors are associated with variations in stress-related affect within nurses as between.
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Muckenhuber J, Burkert N, Dorner TE, Großschädl F, Freidl W. The impact of the HDI on the association of psychosocial work demands with sickness absence and presenteeism. Eur J Public Health 2013; 24:856-61. [PMID: 24029457 DOI: 10.1093/eurpub/ckt132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine whether psychosocial work demands have a different impact on sickness absence and presenteeism in countries with a high vs. countries with a low Human Development Index (HDI). METHODS This article is based on an analysis of the fifth European Working Conditions Survey. We investigated single items as well as complex constructs and indices. Sickness absence and presenteeism were measured as outcome variables. Following the model of Karasek and Theorell, we measured the HDI at the macro level and psychosocial job demands at the micro level as independent variables. RESULTS The multivariate multilevel analysis reveals a significant association between the HDI and the number of days recorded for sickness absence. In countries with a higher HDI, people report a lower number of days with sickness absence. Higher psychosocial job demands are associated with poorer health. There are significant cross-level interaction effects between psychosocial job demands and the HDI for these associations. Psychosocial job demands are stronger associated with sickness absence and presenteeism in high-HDI than in low-HDI countries. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH We argue that Public Health Actions that are connected to work characteristics need to take into consideration the level of HDI of the countries. In low- and high-HDI countries, different actions could be necessary to reach the needs of the working population.
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Affiliation(s)
- Johanna Muckenhuber
- 1 Department of Social Medicine and Epidemiology, Medical University Graz, Universitätsstr. 6/1, A-8020 Graz, Austria
| | - Nathalie Burkert
- 1 Department of Social Medicine and Epidemiology, Medical University Graz, Universitätsstr. 6/1, A-8020 Graz, Austria
| | - Thomas E Dorner
- 2 Center for Public Health, Medical University Vienna, Währinger Straße 13a/3.Stock, A-1090 Wien, Austria
| | - Franziska Großschädl
- 1 Department of Social Medicine and Epidemiology, Medical University Graz, Universitätsstr. 6/1, A-8020 Graz, Austria
| | - Wolfgang Freidl
- 1 Department of Social Medicine and Epidemiology, Medical University Graz, Universitätsstr. 6/1, A-8020 Graz, Austria
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Social Psychiatry in the Waiting Room: What a Physician Can Learn about Occupational Stress from Workers Waiting to Be Examined. PSYCHIATRY JOURNAL 2013; 2013:701872. [PMID: 24286068 PMCID: PMC3820074 DOI: 10.1155/2013/701872] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 02/04/2013] [Indexed: 12/01/2022]
Abstract
Background. Work-related stress is a major problem for mental health. The occupational physician has the opportunity to gather information on the perception of stress from workers in the course of regular medical examinations. Method. 1,231 subjects, engaged in 6 different occupations, were invited to compile the Demand/Control/Support and the Effort/Reward/Imbalance questionnaires. Results. A specific profile of work-related stress emerged for each group of workers. Radiology physicians reported high control over work, but also exceedingly high demand and effort, high overcommitment, low social support, and low rewards from work. Health care workers were often overcommitted but had high levels of reward and social support. Low levels of social support and reward were recorded for mature workers, while special force policemen engaged in law enforcement during the G8 meeting had high levels of social support and regards, so that their resulting stress levels were closer to the reference group of employees in an insurance company with no front-office. Conclusion. The practice of administering questionnaires to groups of workers who are subject to medical surveillance is useful for monitoring mental health and well-being.
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Perceived rewards at work and cardiovascular health. Psychosom Med 2011; 73:434-5. [PMID: 21700712 DOI: 10.1097/psy.0b013e3182239af6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Effort-reward imbalance at work and recurrent coronary heart disease events: a 4-year prospective study of post-myocardial infarction patients. Psychosom Med 2011; 73:436-47. [PMID: 21705691 DOI: 10.1097/psy.0b013e318222b2d8] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Prospective studies have shown that effort-reward imbalance (ERI) at work is associated with the incidence of a first coronary heart disease (CHD) event. However, it is unknown whether ERI at work increases the risk of recurrent CHD events. The objective of this study was to determine whether ERI at work and its components (effort and reward) increase the risk of recurrent CHD in post-myocardial infarction (post-MI) workers. METHODS We carried out a prospective cohort study of 669 men and 69 women who returned to work after a first MI. ERI at work was assessed by telephone interview using validated scales of reward and psychological demands. The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina. CHD risk factors were documented in medical files and by interview. The participants were followed up for a mean period of 4.0 years (1998-2005). RESULTS During the follow-up, 96 CHD events were documented. High ERI and low reward were associated with recurrent CHD (respective adjusted hazard ratios [HRs] = 1.75, 95% confidence interval [CI] = 0.99-3.08, and HR = 1.77, 95% CI = 1.16-2.71). There was a gender interaction showing stronger effects among women (respective adjusted HRs for high ERI and low reward: HR = 3.95, 95% CI = 0.93-16.79, and HR = 9.53, 95% CI = 1.15-78.68). CONCLUSIONS Post-MI workers holding jobs that involved ERI or low reward had increased risk of recurrent CHD.
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