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Adams R, Jordan R, Adab P, Barrett T, Bevan S, Cooper L, DuRand I, Hardy P, Heneghan N, Jolly K, Jowett S, Marshall T, O'Hara M, Rai K, Rickards H, Riley R, Sadhra S, Tearne S, Walters G, Sapey E. Enhancing the health of NHS staff: eTHOS - protocol for a randomised controlled pilot trial of an employee health screening clinic for NHS staff to reduce absenteeism and presenteeism, compared with usual care. Pilot Feasibility Stud 2022; 8:155. [PMID: 35897113 PMCID: PMC9326142 DOI: 10.1186/s40814-022-01095-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staff absenteeism and presenteeism incur high costs to the NHS and are associated with adverse health outcomes. The main causes are musculoskeletal complaints and mental ill-health, which are potentially modifiable, and cardiovascular risk factors are also common. We will test the feasibility of an RCT to evaluate the clinical and cost-effectiveness of an employee health screening clinic on reducing sickness absenteeism and presenteeism. METHODS This is an individually randomised controlled pilot trial aiming to recruit 480 participants. All previously unscreened employees from four hospitals within three UK NHS hospital Trusts will be eligible. Those randomised to the intervention arm will be invited to attend an employee health screening clinic consisting of a screening assessment for musculoskeletal (STarT MSK and STarT Back), mental (PHQ-9 and GAD-7) and cardiovascular (NHS Health Check if aged ≥ 40, lifestyle check if < 40 years) health. Screen positives will be given advice and/or referral to recommended services. Those randomised to the control arm will receive usual care. Participants will complete a questionnaire at baseline and 26 weeks; anonymised absenteeism and staff demographics will also be collected from personnel records. The co-primary outcomes are as follows: recruitment, referrals and uptake of recommended services in the intervention arm. Secondary outcomes include the following: results of screening assessments, uptake of individual referrals, reported changes in health behaviours, acceptability and feasibility of intervention, indication of contamination and costs. Outcomes related to the definitive trial include self-reported and employee records of absenteeism with reasons. Process evaluation to inform a future trial includes interviews with participants, intervention delivery staff and service providers receiving referrals. Analyses will include presentation of descriptive statistics, framework analysis for qualitative data and costs and consequences presented for health economics. DISCUSSION The study will provide data to inform the design of a definitive RCT which aims to find an effective and cost-effective method of reducing absenteeism and presenteeism amongst NHS staff. The feasibility study will test trial procedures, and process outcomes, including the success of strategies for including underserved groups, and provide information and data to help inform the design and sample size for a definitive trial. TRIAL REGISTRATION ISRCTN reference number 10237475 .
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Affiliation(s)
- Rachel Adams
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Rachel Jordan
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Peymané Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Tim Barrett
- Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Sheriden Bevan
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Lucy Cooper
- Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
| | - Ingrid DuRand
- Hereford County Hospital, Stonebow Road, Hereford, HR1 2ER, UK
| | - Pollyanna Hardy
- National Perinatal Epidemiology Unit Clinical Trials Unit, University of Oxford, Oxford, UK
| | - Nicola Heneghan
- School of Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, B15 2TT, UK
| | - Kate Jolly
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Margaret O'Hara
- Public and Patient Involvement and Engagement, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK
| | - Kiran Rai
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Hugh Rickards
- Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK.,National Centre for Mental Health, Barberry Building, 25 Vincent Drive, Birmingham, B15 2FG, UK
| | - Ruth Riley
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Steven Sadhra
- Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Sarah Tearne
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Gareth Walters
- Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK
| | - Elizabeth Sapey
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, B15 2TT, UK.,Respiratory Medicine and General Internal Medicine, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, UK
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Andersen LN, Stochkendahl MJ, Roessler KK. En route to flourishing - a longitudinal mixed methods study of long-term unemployed citizens in an interdisciplinary rehabilitation program. BMC Public Health 2022; 22:675. [PMID: 35392873 PMCID: PMC8988354 DOI: 10.1186/s12889-022-13060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interdisciplinary rehabilitation programmes (IRP) are used in municipality settings to assist unemployed citizens with complex health and/or life issues. Individually tailored IRP activities help people develop their personal working life skills and increase their chances of re-entering the work force. The aims of this paper were to describe citizens' wellbeing in terms of health aspects, explore the impact of stressful life events on wellbeing and obtain understanding of how IRP activities affect the participants' development towards future employment. METHODS A mixed methods exploratory approach has been used. For data collection a quantitative longitudinal survey (baseline and 1-year follow-up) and qualitative interviews were conducted. Descriptive statistics were used for the analysis of survey data, while the data material from interviews was analysed using directed content analysis. Results were discussed with the theory of flourishing as a framework to develop understanding. RESULTS At baseline, 146 respondents (71% females) filled in the survey and seven participants were interviewed. The analysis of survey data and interviews revealed five themes: (1) Stressful life events, (2) Positive emotions - how IRP-activities positively impacted wellbeing and physical capacity, (3) Appreciation of engagement, (4) Relationships, and (5) Meaning and optimal functioning. Results showed that IRP participants from the outset experienced high general pain intensity as well as distress, anxiety and depression. Life events relating both to physical health and work life were significant for their wellbeing. IRP activities supported participants' positive development towards future employment in ways that were specific to each individual. CONCLUSIONS From this study it can be derived that participants' development took place around self-acceptance, acceptance by others, physical capacity, psychological resources and capacity to balance engagement to cultivate the best version of themselves. In future programmes, it may be emphasized that participants' interest may be an important driver for wellbeing and future employment. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02641704, date of registration December 29, 2015.
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Affiliation(s)
- Lotte Nygaard Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Mette Jensen Stochkendahl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Chiropractic Knowledge Hub, Odense, Denmark
| | - Kirsten K Roessler
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Wåhlin C, Stigmar K, Strid EN. A systematic review of work interventions to promote safe patient handling and movement in the healthcare sector. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2520-2532. [PMID: 34789085 DOI: 10.1080/10803548.2021.2007660] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPUSE The aim of this systematic review was to describe interventions which promote safe patient handling and movement (PHM) among workers in healthcare by reviewing the literature of their effectiveness for work and health-related outcomes. METHODS Data bases were searched for studies published 1997‒2018. Measures was operationalised broadly, capturing outcomes of work and health. Only Randomized controlled trials (RCTs) and cohort studies with control group were included. Quality was assessed using evidence-based checklists by Swedish Agency for Health Technology Assessment and Assessment of Social Services. RESULTS The systematic review included 10 RCTs and 19 cohort. Providing work equipment and training workers is effective: it can increase usage. Training workers to be peer coaches is associated with fewer injuries. Other effective strategies are participatory ergonomics and management engagement in collaboration with workers, facilitating safe PHM. CONCLUSIONS This systematic review suggests interventions for safe PHM with an impact of health-related outcomes should include access to work equipment, training as well as employer and employee engagement. The additional impact of multifaceted interventions is inconclusive. PRACTITIONER SUMMARY In clinical practice, there is a need for employers in healthcare to; 1) provide healthcare workers access to suitable work equipment. 2) provide training on how to use work equipment to prevent work-related injuries. Furthermore, the study also indicates that 3) training and appointing peer coaches can facilitate safe manual handling and movement (PHM) and, 4) It can be beneficial to involve workers in a participatory approach.
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Affiliation(s)
- Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, Lund, Sweden.,Skåne University Hospital, Region Skåne, Lund, Sweden
| | - Emma Nilsing Strid
- University Health Care Research Center, Region Örebro County, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Mahmoudi D, Nazari S, Castellucci HI, Dianat I. Perception of just culture and its association with work-related psychosocial factors in an Iranian industrial setting: Implications for prevention of errors. Work 2021; 68:1179-1186. [PMID: 33867377 DOI: 10.3233/wor-213447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND A just culture is one in which the reporting of errors and near misses is supported without fear of retribution. The relationship of just culture and psychosocial factors at work has not been explored sufficiently in the literature. OBJECTIVE To investigate the perception of just culture and its association with socio-demographic and work-related psychosocial factors among 302 employees in an industrial setting in Iran. METHODS Just culture was assessed using the Just Culture Assessment Tool, and the Copenhagen Psychosocial Questionnaire was used for evaluation of psychosocial work factors (including influence at work, meaning of work, commitment to the workplace, predictability, rewards, quality of leadership, social support from supervisors, trust, and justice and respect). Data were analysed using t test, analysis of variance (ANOVA), and general linear regression analysis. RESULTS The results indicated that the employees had a fairly positive view on their organisation's just culture, though there were some areas such as trust and balance that needed further attention. The psychosocial issues (particularly commitment to the workplace, meaning of work, social support from supervisors, and rewards) were not adequate from the employees' perspective. Predictability, rewards, and quality of leadership, were the significant psychosocial predictors of just culture in a multivariate regression model. CONCLUSIONS The findings highlight the areas that need to be considered to improve the experience of organisational just culture, which is important from the point of view of prevention of safety errors and incidents.
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Affiliation(s)
- Davoud Mahmoudi
- Department of Occupational Health and Ergonomics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Nazari
- Health and Safety Department, Farab Group's Civil and Construction Company, Tehran, Iran
| | - Héctor Ignacio Castellucci
- Centro de Estudio del Trabajo y Factores Humanos, Escuela de Kinesiología, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Iman Dianat
- Department of Occupational Health and Ergonomics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Effects of a Physical Therapist Led Workplace Personal-Fitness Management Program for Manufacturing Industry Workers. J Occup Environ Med 2019; 61:e445-e451. [DOI: 10.1097/jom.0000000000001712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Henriksson P, Henriksson H, Tynelius P, Berglind D, Löf M, Lee IM, Shiroma EJ, Ortega FB. Fitness and Body Mass Index During Adolescence and Disability Later in Life: A Cohort Study. Ann Intern Med 2019; 170:230-239. [PMID: 30743265 PMCID: PMC6814012 DOI: 10.7326/m18-1861] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Low physical fitness, obesity, and the combination of the two in adolescence may be related to risk for disability in adulthood, but this has rarely been studied. OBJECTIVE To examine individual and combined associations of cardiorespiratory fitness and obesity in male adolescents with later receipt of a disability pension due to all and specific causes. DESIGN Population-based cohort study. SETTING Sweden. PARTICIPANTS 1 079 128 Swedish adolescents aged 16 to 19 years who were conscripted into the military between 1972 and 1994. MEASUREMENTS Cardiorespiratory fitness and body mass index (BMI) were measured at conscription and were related to information on later receipt of a disability pension obtained from the Social Insurance Agency. RESULTS Over a median follow-up of 28.3 years, 54 304 men were granted a disability pension. Low cardiorespiratory fitness was strongly associated with later receipt of a disability pension due to all causes (hazard ratio, 3.74 [95% CI, 3.55 to 3.95] for lowest vs. highest fitness decile) and specific causes (psychiatric, musculoskeletal, injuries, nervous system, circulatory, and tumors). Obesity was associated with greater risk for receipt of a disability pension due to all and specific causes, with the greatest risks observed for class II and III obesity. Compared with being unfit, being moderately or highly fit was associated with attenuated risk for receipt of a disability pension across BMI categories. LIMITATION The cohort did not include women, had data on smoking and alcohol intake only in a subsample, and lacked repeated measures of exposures and covariates. CONCLUSION Low cardiorespiratory fitness, obesity, and the combination of the two were strongly associated with later chronic disability due to a wide range of diseases and causes. Although additional well-designed studies are required, these findings support the importance of high cardiorespiratory fitness and healthy body weight during adolescence to prevent later chronic disease. PRIMARY FUNDING SOURCE Karolinska Institutet.
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Affiliation(s)
- Pontus Henriksson
- Linköping University, Linköping, Sweden; University of Granada, Granada, Spain; and Karolinska Institutet, Stockholm, Sweden (P.H.)
| | - Hanna Henriksson
- University of Granada, Granada, Spain, and Linköping University, Linköping, Sweden (H.H.)
| | - Per Tynelius
- Karolinska Institutet and Stockholm County Council, Stockholm, Sweden (P.T.)
| | | | - Marie Löf
- Karolinska Institutet, Stockholm, Sweden, and Linköping University, Linköping, Sweden (M.L.)
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts (I.L.)
| | - Eric J Shiroma
- National Institute on Aging, Bethesda, Maryland (E.J.S.)
| | - Francisco B Ortega
- University of Granada, Granada, Spain, and Karolinska Institutet, Stockholm, Sweden (F.B.O.)
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Merkus SL, Lunde LK, Koch M, Wærsted M, Knardahl S, Veiersted KB. Physical capacity, occupational physical demands, and relative physical strain of older employees in construction and healthcare. Int Arch Occup Environ Health 2018; 92:295-307. [PMID: 30443711 PMCID: PMC6420471 DOI: 10.1007/s00420-018-1377-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/29/2018] [Indexed: 01/22/2023]
Abstract
Purpose To assess age-related differences in physical capacity, occupational physical demands, and relative physical strain at a group level, and the balance between capacity and demands at an individual level, for construction and healthcare workers. Methods Shoulder strength, back strength, and aerobic capacity were assessed among construction (n = 62) and healthcare workers (n = 64). During a full working day, accelerometers estimated upper-arm elevation, trunk flexion, and occupational physical activity as indicators of occupational physical demands. Simultaneously, normalised surface electromyography (%sEMGmax) of the upper trapezius and erector spinae muscles, and normalised electrocardiography (percentage heart rate reserve (%HRR)) estimated relative physical strain. Differences between younger (≤ 44 years) and older (≥ 45 years) workers, as well as the moderating effect of age on the associations between capacity and demands, were analysed per sector. Results Compared to younger workers, older workers had similar strength and lower aerobic capacity; older construction workers had similar demands while older healthcare workers had higher demands. Compared to younger workers, older employees had unfavourable muscle activity patterns; %HRR had a tendency to be lower for older construction workers and higher for older healthcare workers. Among construction workers, age moderated the associations between shoulder strength and arm elevation (p = 0.021), and between aerobic capacity and occupational physical activity (p = 0.040). Age did not moderate these associations among healthcare workers. Conclusions In both sectors, the level of occupational physical demands and the higher relative physical strain in older employees require addressing to promote sustainable work participation among an aging population. Electronic supplementary material The online version of this article (10.1007/s00420-018-1377-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Suzanne L Merkus
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway.
| | - Lars-Kristian Lunde
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Markus Koch
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Morten Wærsted
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Stein Knardahl
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
| | - Kaj Bo Veiersted
- National Institute of Occupational Health, Pb 5330 Majorstuen, 0304, Oslo, Norway
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Andersen LN, Stochkendahl MJ, Roessler KK. A municipality-based vocational rehabilitation programme for occupationally marginalized citizens: a study protocol for a mixed methods study. BMC Health Serv Res 2018; 18:517. [PMID: 29970107 PMCID: PMC6029077 DOI: 10.1186/s12913-018-3322-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 06/24/2018] [Indexed: 11/28/2022] Open
Abstract
Background In 2013 vocational rehabilitation programmes (VRP) were given official and legal approval under Danish law to assist occupationally marginalized citizens in gaining general life skills, building their work ability, and increasing their chances of entering the work force. The project’s aim is to develop a detailed understanding of the health, psychosocial and work circumstances of participating citizens, and of the important processes and mechanisms underlying the potential effects of participating in the VRP. Methods This study uses an exploratory mixed methods approach with sequential use of quantitative and qualitative methods. Participants are citizens assigned to an individually tailored VRP in the municipality of Sonderborg, Denmark. The quantitative part of the study consists of a longitudinal survey in which participants complete questionnaires at baseline and at follow-up one year later. Variables include demographic and personal characteristics, the latter ascertained through validated questionnaires on well-being, physical activity, interpersonal problems, general health, work ability, kinesiophobia, self-efficacy, depression and anxiety. The qualitative part of the study consists of semi-structured interviews and observations that explore experiences related to VRP. Participants will be recruited and data collected from questionnaires, interviews and observations in the period February 2016 – March 2018. Discussion This research will assemble a unique corpus of knowledge about the characteristics, experiences and outcomes of occupationally marginalized citizens participating in a VRP. It will identify potential enablers and barriers to a successful outcome, and ultimately this knowledge will help inform the future design of individually tailored VRP’s. Trial registration ClinicalTrials.gov Identifier: NCT02641704, date of registration December 29, 2015.
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Affiliation(s)
- Lotte Nygaard Andersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Mette Jensen Stochkendahl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
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Brborović H, Daka Q, Dakaj K, Brborović O. Antecedents and associations of sickness presenteeism and sickness absenteeism in nurses: A systematic review. Int J Nurs Pract 2017; 23. [PMID: 29094426 DOI: 10.1111/ijn.12598] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 08/02/2017] [Accepted: 08/28/2017] [Indexed: 11/29/2022]
Abstract
AIMS This study comprehensively analysed and systemized the elements associated with nursing sickness presenteeism (SP) and sickness absenteeism (SA). BACKGROUND Both behaviours represent a real challenge to nursing departments because they can increase costs, cause health care adverse events, and impact the quality of health care. DESIGN The systematic review of cohort studies was designed to be consistent with the PRISMA guidelines. DATA SOURCES PubMed, ProQuest, and Emerald were systematically searched for peer-reviewed articles published from the 1950s to December 2016. REVIEW METHODS Cohort studies were included (12 SA and 1 SP) in the review if they examined the association between one or more exposures and SP and/or SA in nurses. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS Twenty-three antecedents were associated with SA and grouped as work and organizational, mental and physical health, and demographic; 3 antecedents were associated with SP (job demands, burnout, and exhaustion). Exhaustion (fatigue) and job demands were associated with SA and SP. Depersonalization was an outcome of SP over time. CONCLUSION The ability to predict presenteeism and absenteeism in nursing is useful to constrain costs and ensure that quality care is delivered.
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Affiliation(s)
- Hana Brborović
- School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health and Sports Medicine, University of Zagreb, Zagreb, Croatia
| | - Qëndresë Daka
- Medical Faculty, Department of Pathophysiology, University of Prishtina, Kosovo
| | | | - Ognjen Brborović
- School of Medicine, Andrija Štampar School of Public Health, Department of Social Medicine and Organization of Health Care, University of Zagreb, Zagreb, Croatia
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The Impact of Physical Work Demands on Need for Recovery, Employment Status, Retirement Intentions, and Ability to Extend Working Careers: A Longitudinal Study Among Older Workers. J Occup Environ Med 2017; 58:e140-51. [PMID: 27058492 DOI: 10.1097/jom.0000000000000687] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Prospectively investigating whether different approaches of physical work demands are associated with need for recovery (NFR), employment status, retirement intentions, and ability to prolong working life among older employees from the industry and health care sector. METHODS A subsample from the Maastricht Cohort Study was studied (n = 1126). Poisson, Cox, and logistic regression analyses were performed to investigate outcomes. RESULTS Perceiving physical work demands as strenuous was associated with higher NFR. Continuous physical strain was associated with being out of employment 4 years later. Employees with the highest amount of physical work demands perceived they were less able to prolong working life, although no significant associations between physical work demands and retirement intentions were found. CONCLUSIONS Overall, physical work demands were associated with adverse outcomes, with divergent insights for the different approaches of physical work demands.
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Effectiveness and Cost-Effectiveness of a Cluster-Randomized Prenatal Lifestyle Counseling Trial: A Seven-Year Follow-Up. PLoS One 2016; 11:e0167759. [PMID: 27936083 PMCID: PMC5147978 DOI: 10.1371/journal.pone.0167759] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022] Open
Abstract
There is a link between the pregnancy and its long-term influence on health and susceptibility to future chronic disease both in mother and offspring. The objective was to determine whether individual counseling on physical activity and diet and weight gain at five antenatal visits can prevent type 2 diabetes mellitus (T2DM) and overweight or improve glycemic parameters, among all at-risk-mothers and their children. Another objective was to evaluate whether gestational lifestyle intervention was cost-effective as measured with mother's sickness absence and quality-adjusted life years (QALY). This study was a seven-year follow-up study for women, who were enrolled to the antenatal cluster-randomized controlled trial (RCT). Analysis of the outcome included all women whose outcome was available, in addition with subgroup analysis including women adherent to all lifestyle aims. A total of 173 women with their children participated to the study, representing 43% (173/399) of the women who finished the original RCT. Main outcome measures were: T2DM based on medication use or fasting blood glucose or oral glucose tolerance test (OGTT), body mass index (BMI), glycosylated hemoglobin (HbA1c). None of the women were diagnosed to have T2DM. HbA1c or fasting blood glucose differences were not found among mothers or children. Differences in BMI were non-significant among mothers (Intervention 27.3, Usual care 28.1 kg/m2, p = 0.33) and children (I 21.3 vs U 22.5 kg/m2, p = 0.07). Children's BMI was significantly lower among adherent group (I 20.5 vs U 22.5, p = 0.04). The mean total cost per person was 30.6% lower in the intervention group than in the usual care group (I €2,944 vs. U €4,243; p = 0.74). Intervention was cost-effective in terms of sickness absence but not in QALY gained i.e. if society is willing to pay additional €100 per one avoided sickness absence day; there is a 90% probability of the intervention arm to be cost-effective. Long-term effectiveness of antenatal lifestyle counseling was not shown, in spite of possible effect on children's BMI. Cost-effectiveness of the intervention in terms of sickness absence may have larger societal impact.
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Rasmussen CDN, Holtermann A, Jørgensen MB, Ørberg A, Mortensen OS, Søgaard K. A multi-faceted workplace intervention targeting low back pain was effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence: Stepped wedge cluster randomised trial. Scand J Public Health 2016; 44:560-70. [DOI: 10.1177/1403494816653668] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/15/2022]
Abstract
Aims: The aims of this study were to test whether a multi-faceted intervention effective for low back pain was effective for physical capacity, work demands, maladaptive pain behaviours, work ability and sickness absence due to low back pain. Methods: A stepped wedge cluster randomised, controlled trial with 594 nurses’ aides was conducted. The intervention lasted 12 weeks and consisted of physical training (12 sessions), cognitive behavioural training (two sessions) and participatory ergonomics (five sessions). Occupational lifting, fear avoidance, physical exertion, muscle strength, support from management, work ability and sickness absence due to low back pain were measured every 3 months. Before and after the intervention we measured physical capacity, kinesiophobia and need for recovery. Linear mixed models adjusted for baseline values of the outcome were used to estimate the effect. Results: Significant reduction in occupational lifting (–0.35 (95% confidence interval −0.61 to −0.08)), and improvement in two measures of fear avoidance ((–0.75 (95% confidence interval −1.05 to −0.45) and −0.45 (95% confidence interval −0.80 to −0.11)) were found for the intervention group compared to the control. There were no significant effects on physical exertion, muscle strength, support from management, work ability or sickness absence due to low back pain. After the intervention, significant increased physical capacity and improvements in kinesiophobia were found, but no change in need for recovery. Conclusions: The intervention was significantly effective for physical work demands and maladaptive pain behaviours, but not for work ability and sickness absence due to low back pain. To improve work ability or reduce sickness absence due to low back pain more specific interventions should probably be developed.
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Affiliation(s)
- Charlotte Diana Nørregaard Rasmussen
- National Research Centre for the Working Environment, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | | | - Anders Ørberg
- National Research Centre for the Working Environment, Denmark
| | - Ole Steen Mortensen
- National Research Centre for the Working Environment, Denmark
- Department of Occupational Medicine, Holbæk Hospital, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
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