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Emery RJ, Gutierrez JM, Zwick MK. A Compendium of Radiation Safety Practices That Can Complement Organizational Worker Well-being Initiatives. HEALTH PHYSICS 2024; 127:539-542. [PMID: 39190884 DOI: 10.1097/hp.0000000000001835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
ABSTRACT Organizations are learning that efforts to protect the health and safety of their workers from risks both at work and outside of work yield great dividends in the form of increased productivity, morale, and reduced healthcare costs. This realization has given rise to a variety of worker well-being initiatives that span far beyond the typical boundaries of traditional workplace health and safety programs. Examples include providing information and services on diet, exercise, personal habits, and mental health issues. Interestingly, the radiation safety profession has been historically involved with a series of progressive worker well-being practices that perhaps are not fully appreciated by the broader well-being community. These include the ability to comprehensively track occupational doses, training regarding doses arising from outside the workplace (such as medical procedures and environmental exposures), and fetal protection policies, to name a few. Described here is the shift in perspective from health and safety merely for the workplace to a more holistic approach, but the degree to which the actions may be implemented varies. Included then is a compendium of radiation safety practices that may be possibly folded into the discussion of larger organizational well-being efforts.
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Affiliation(s)
| | - J M Gutierrez
- The University of Texas Health Science Center at Houston, Environmental Health & Safety, 1851 Crosspoint Avenue, OCB 1.330, Houston, TX, 77054
| | - M K Zwick
- The University of Texas School of Public Health, 1200 Pressler St, Houston, TX 77030
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Howe AS, Tan J, Yuen B, Saini H, Saade-Cleves N, Obeidat D, Shahzad M, Chattu VK, Fatemi AB, Nowrouzi-Kia B. Physical and Psychosocial Correlates of Occupational Physical Injury in the Global Construction Industry: A Scoping Review. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241270371. [PMID: 39188508 PMCID: PMC11345736 DOI: 10.1177/11786302241270371] [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: 03/28/2024] [Accepted: 07/02/2024] [Indexed: 08/28/2024]
Abstract
Purpose The construction industry is a diverse sector with exposure to multiple psychosocial and environmental workplace hazards that increase the risk of injury. This scoping review aims to consolidate the existing literature on the physical and psychosocial determinants influencing the risk of occupational physical injuries among construction workers globally. Methods A scoping review was conducted using the PRISMA extension checklist guided. Literature searches were performed between June and October 2023 in electronic academic databases. Results A total of 77 studies were identified, encompassing various geographical regions, including North America (n = 29), Africa (n = 18), Europe (n = 12), Asia (n = 9), the Middle East (n = 5), and Oceania (n = 4). The review identified physical and psychosocial factors in 3 domains influencing occupational physical injuries: workplace physical environment (eg, exposure to physical hazards, availability and utilization of personal protective equipment, company size, and job type), workplace culture (eg, psychosocial stressors, gender-related barriers, migrant and ethnic disparities, educational background), and physical wellbeing, health and aging (eg, age, obesity, sleep quality, marital stats, and physical health status). Notably, workers from social minority groups (eg, women, ethnic and migrant workers) of young (<25 years old) or older ages (45-55 years old) employed in smaller construction companies are vulnerable to increased injury risk and exposure to physical and psychosocial hazards in the workplace. Conclusion The review emphasizes a global paucity of research examining the implications of physical and psychosocial factors on injury risk within the construction industry. Future research should prioritize investigating the impact of psychosocial hazards on younger and older workers to detect age-related differences in injury rate, treatment access, and work-related health outcomes.
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Affiliation(s)
- Aaron S Howe
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jeremy Tan
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Beatrice Yuen
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Harseerat Saini
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Natalia Saade-Cleves
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Donia Obeidat
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Rehabilitation Science, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Maryam Shahzad
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vijay Kumar Chattu
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
| | - Ali-Bani Fatemi
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Behdin Nowrouzi-Kia
- Restore Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Speck PM, Sanchez RV, Montgomery AP, Mitchell SA, Ekroos RA, Loan LA, Ladores S, Milstead JA. Labor trafficking of migrant registered nurses. Nurs Outlook 2024; 72:102226. [PMID: 39116650 DOI: 10.1016/j.outlook.2024.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 06/09/2024] [Accepted: 06/22/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Labor trafficking of registered nurses (RNs) in the USA impedes justice by denying inalienable human rights and equal economic opportunities. Nursing shortages in developed countries, poverty, social upheaval, and government actions influence migration, as do other factors related to determinants of health. Migrant RNs are visa workers, displaced, refugees, immigrants, or asylum seekers. Labor traffickers target vulnerable migrant RNs seeking employment outside their home country. Unlike ethical recruiters, traffickers lure migrant RNs into indentured contracts in work environments that result in health-threatening conditions, long shifts, and exorbitant fines that threaten families with financial retribution. PURPOSE The purpose of the paper is to raise awareness. METHODS Authors explain the background of influences and nuances in migrant RN labor trafficking. DISCUSSION Identifying labor traffickers' deceitful, coercive, fraudulent, and illegal methods, assist organizational approaches for establishing Total Worker Health, trauma-informed care, coordinated community response, and No Door Closed actions when wanting to mitigate or eradicate labor trafficking of migrant RNs.
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Affiliation(s)
- Patricia M Speck
- Department of Family, Community, & Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, AL.
| | - Rosario V Sanchez
- Human Trafficking and Social Justice Institute, University of Toledo, Toledo, OH
| | - Aoyjai P Montgomery
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Stacey A Mitchell
- Center of Excellence in Forensic Nursing, College of Nursing, Texas A&M University, College Station, TX
| | - Rachell A Ekroos
- Center for Forensic Nursing Excellence International (CFNEI), Las Vegas, NV
| | - Lori A Loan
- Department of Family, Community, & Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, AL
| | - Sigrid Ladores
- Department of Family, Community, & Health Systems, University of Alabama at Birmingham School of Nursing, Birmingham, AL
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Leso V, Carugno M, Carrer P, Fusco F, Mendola M, Coppola M, Zaffina S, Di Prinzio RR, Iavicoli I. The Total Worker Health® (TWH) approach: a systematic review of its application in different occupational settings. BMC Public Health 2024; 24:2037. [PMID: 39080673 PMCID: PMC11287918 DOI: 10.1186/s12889-024-19500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/16/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND The National Institute for Occupational Safety and Health (NIOSH), in 2011, developed the "Total Worker Health®" (TWH) as a holistic approach to protect and promote the workers' safety, health, and well-being. After over ten years from the TWH development, the aim of the present systematic review is to provide a comprehensive overview of the worldwide TWH initiatives. METHODS PubMed, Scopus and ISI Web of Science were searched for TWH studies published up to the 31st of July 2023, and 43 investigations could be included. The review was registered on the International prospective register of systematic reviews PROSPERO with the reference number CRD42023416972. RESULTS Issues that emerged as relevant for the TWH operationalization were the awareness about the TWH approach and fundamentals, the leadership commitment, and a participatory engagement of the workforce: these aspects all contributed to acceptable and effective setting oriented TWH plans, specifically tailored on the peculiarities of the workplace, including small enterprises and multiemployer worksites. Evaluation and continual improvement were reported as fundamental for the successful implementation of TWH initiatives. Limited resources for safety and health initiatives, in terms of time, people, and funds, together with difficulties in the identification of safety and health priorities and a poor participatory culture were recognized as obstacles to the TWH application. Training resulted the core component of the TWH leadership and workforce preparedness, with beneficial results in terms of safety culture and adoption of preventive measures. CONCLUSIONS Although interesting aspects emerged from our review, future longitudinal investigations should confirm the effectiveness, easy integration, and long-term sustainability of TWH models in different workplaces, in order to effectively support safe and health-enhancing works able to improve innovation and productivity.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122, Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122, Milan, Italy
| | - Paolo Carrer
- Occupational Health Unit, Fatebenefratelli-Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Fabio Fusco
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Marco Mendola
- Occupational Health Unit, Fatebenefratelli-Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Mariagaia Coppola
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Salvatore Zaffina
- Occupational Medicine Unit, IRCCS Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, Rome, 00165, Italy
| | - Reparata Rosa Di Prinzio
- Occupational Medicine Unit, IRCCS Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, Rome, 00165, Italy
- Alta Scuola Di Economia E Management Dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, 00168, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
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Scoglio AAJ, Stelson EA, Becene I, Marquez CI, Rich-Edwards JW. A mixed-methods analysis of moral injury among healthcare workers during the COVID-19 pandemic. PLoS One 2024; 19:e0304620. [PMID: 38959222 PMCID: PMC11221684 DOI: 10.1371/journal.pone.0304620] [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: 11/29/2023] [Accepted: 05/14/2024] [Indexed: 07/05/2024] Open
Abstract
During the COVID-19 pandemic, healthcare workers faced grave responsibilities amidst rapidly changing policies and material and staffing shortages. Moral injury, psychological distress following events where actions transgress moral beliefs/ expectations, increased among healthcare workers. We used a sequential mixed methods approach to examine workplace and contextual factors related to moral injury early in the pandemic. Using a Total Worker Health® framework, we 1) examined factors associated with moral injury among active healthcare professionals (N = 14,145) surveyed between May-August 2020 and 2) qualitatively analyzed open-ended responses from 95 randomly selected participants who endorsed moral injury on the survey. Compared to inpatient hospital, outpatient (OR = 0.74 [0.65, 0.85]) or school clinic settings (OR = 0.37 [0.18, 0.75]) were associated with lower odds of moral injury; while group care settings increased odds (OR = 1.36 [1.07, 1.74]). Working with COVID+ patients (confirmed+ OR = 1.27 [1.03, 1.55]), PPE inadequacy (OR = 1.54 [1.27, 1.87]), and greater role conflict (OR = 1.57 [1.53, 1.62]) were associated with greater odds of moral injury. Qualitative findings illustrate how outside factors as well as organizational policies and working conditions influenced moral injury. Moral injury experiences affected staff turnover and patient care, potentially producing additional morally injurious effects. Worker- and patient-centered organizational policies are needed to prevent moral injury among healthcare workers. The generalizability of these findings may be limited by our predominantly white and female sample. Further research is indicated to replicate these findings in minoritized samples.
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Affiliation(s)
- Arielle A. J. Scoglio
- Department of Natural and Applied Sciences, Bentley University, Waltham, MA, United States of America
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Elisabeth A. Stelson
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Iris Becene
- Department of Medicine, Division of Women’s Health, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Camille Ianne Marquez
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Janet W. Rich-Edwards
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
- Department of Medicine, Division of Women’s Health, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States of America
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Neidlinger SM, Peters SE, Gundersen DA, Felfe J. Thriving from work questionnaire: German translation and validation. BMC Public Health 2024; 24:1634. [PMID: 38898482 PMCID: PMC11186060 DOI: 10.1186/s12889-024-19037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The Thriving from Work questionnaire is a comprehensive indicator of positive well-being for employees, applicable in both research and practical contexts. Current discussions underline the crucial impact that employment should have in enriching workers' lives positively and meaningfully, along with the necessity for accurate and dependable tools to assess employee well-being. This study investigated the reliability, validity, and dimensionality of the translated German adaptation of the Thriving from Work questionnaire developed by Peters and colleagues [1, 2]. The questionnaire assesses work-related well-being with 30 items clustered in six domains: emotional and psychological well-being, social well-being, work-life integration, physical and mental well-being, basic needs for thriving, and experiences of work. METHODS This study aimed to convert the Thriving at Work Questionnaire from English into German. We assessed the psychometric characteristics of the German version of the questionnaire by using item response theory with a sample of 567 German employees and examined its criterion validity. RESULTS We found that the long and short German Thriving from Work questionnaire versions are reliable with good construct validity. Criterion validity was demonstrated by relationships with important work and life outcomes, such as life satisfaction, trust in the organizations' management, general well-being, work-related fatigue, and work stress. CONCLUSIONS The current study demonstrated that the German language version of the questionnaire is both a reliable and valid measure of employee well-being. We discuss recommendations for further adaptation and future research.
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Affiliation(s)
- Stephanie M Neidlinger
- Department of Work, Organizational, and Business Psychology, Helmut-Schmidt University, 22043, Hamburg, Germany.
- Center for Work, Health, and Well-being, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Susan E Peters
- Center for Work, Health, and Well-being, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Daniel A Gundersen
- Center for Work, Health, and Well-being, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Rutgers Institute for Nicotine and Tobacco Studies, New Brunswick, NJ, 08901, USA
- Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA
| | - Jörg Felfe
- Department of Work, Organizational, and Business Psychology, Helmut-Schmidt University, 22043, Hamburg, Germany
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Hammer LB, Dimoff J, Mohr CD, Allen SJ. A Framework for Protecting and Promoting Employee Mental Health through Supervisor Supportive Behaviors. OCCUPATIONAL HEALTH SCIENCE 2024; 8:243-268. [PMID: 39042735 PMCID: PMC10962005 DOI: 10.1007/s41542-023-00171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 07/25/2024]
Abstract
The attention to workplace mental health is timely given extreme levels of burnout, anxiety, depression and trauma experienced by workers due to serious extraorganizational stressors - the COVID-19 pandemic, threats to climate change, and extreme social and political unrest. Workplace-based risk factors, such as high stress and low support, are contributing factors to poor mental health and suicidality (Choi, 2018; Milner et al., 2013, 2018), just as low levels of social connectedness and belonging are established risk factors for poor mental health (Joiner et al., 2009), suggesting that social support at work (e.g., from supervisors) may be a key approach to protecting and promoting employee mental health. Social connections provide numerous benefits for health outcomes and are as, or more, important to mortality as other well-known health behaviors such as smoking and alcohol consumption (Holt-Lundstad et al., 2015), and can serve as a resource or buffer against the deleterious effects of stress or strain on psychological health (Cohen & Wills, 1985). This manuscript provides an evidence-based framework for understanding how supervisor supportive behaviors can serve to protect employees against psychosocial workplace risk factors and promote social connection and belongingness protective factors related to employee mental health. We identify six theoretically-based Mental Health Supportive Supervisor Behaviors (MHSSB; i.e., emotional support, practical support, role modeling, reducing stigma, warning sign recognition, warning sign response) that can be enacted and used by supervisors and managers to protect and promote the mental health of employees. A brief overview of mental health, mental disorders, and workplace mental health is provided. This is followed by the theoretical grounding and introduction of MHSSB. Suggestions for future research and practice follow, all with the focus of developing a better understanding of the role of supervisors in protecting and promoting employee mental health in the workplace.
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Affiliation(s)
- Leslie B. Hammer
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Jennifer Dimoff
- Telfer School of Management, University of Ottawa, Ottawa, Canada
| | - Cynthia D. Mohr
- Department of Psychology, Portland State University, Portland, OR, USA
| | - Shalene J. Allen
- Department of Psychology, Portland State University, Portland, OR, USA
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Keller EG, Hittle BM, Boch SJ, Davis KG, Gillespie GL. Unlocking Prevalence Data: Describing the Job Stress and Well-being of U.S. Correctional Nurses. Workplace Health Saf 2024; 72:210-222. [PMID: 38217448 DOI: 10.1177/21650799231207977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Little is known about the health and well-being of U.S. correctional nurses. To protect correctional nurses, a better understanding of organizational characteristics, job stress, and well-being must be undertaken. METHOD A cross-sectional design was used in the form of an online survey. Correctional nurses were conveniently recruited using national listservs and snowball sampling. Variables were measured with the Health & Safety Executive Management Standards Indicator Tool, Nurse Wellbeing Index, and the Perceived Stress Scale. Data were analyzed using descriptive statistics and analyses of variance. FINDINGS Two hundred seventy participants (142 registered nurses, 83 licensed practical nurses/licensed vocational nurses, and 42 advanced practice nurses) completed the survey. Job stress scored moderate (M = 16.26, SD = 7.14), and well-being levels were just below the risk for adverse events (M = 1.8, SD = 3.06). Lower scores were noted for managerial support (M = 3.13, SD = 0.35) and job demands (M = 3.56, SD = 0.92), but slightly better for job control (M = 3.57, SD = 0.77), peer support (M = 3.85, SD = 0.64), and workplace relationships (M = 3.73, SD = 0.95). CONCLUSIONS Significant differences between organizational characteristics, job stress, and well-being were found across nursing licensure, workplace environments, biological sex, and employment through state or private agencies. Registered nurses working in U.S. prisons experienced the highest job stress and worse well-being. APPLICATION TO PRACTICE This work is an essential next step in promoting healthy workspaces, urging the need for further research establishing the impact of organizational characteristics and job stress on nurse well-being.
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Affiliation(s)
| | | | - Samantha J Boch
- College of Nursing, University of Cincinnati
- James M. Anderson Center for Health Systems Excellence
| | - Kermit G Davis
- Department of Environmental and Public Health Sciences, University of Cincinnati
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Nobrega S, Zhang Y. Let's Learn Together! A Mixed-Methods Study to Assess Readiness for Interprofessional Education on Total Worker Health® Practice. Workplace Health Saf 2024; 72:223-233. [PMID: 38217437 PMCID: PMC11132934 DOI: 10.1177/21650799231217320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
BACKGROUND Occupational safety and health (OSH) professionals increasingly need interdisciplinary collaborative practice competencies to respond to complex worker safety, health, and well-being risks. Effective collaboration with non-OSH-trained professionals (e.g., health promotion, human resources) is critical for planning integrated interventions that address work and non-work risks, consistent with a "Total Worker Health" (TWH) approach. Interprofessional education (IPE) pedagogy offers skill-building for interdisciplinary collaboration, but little attention has been given to IPE in OSH education and training literature. The goal of this study was to assess OSH professionals' perceptions about IPE to guide application in postgraduate TWH education. METHODS The mixed-methods study involved 210 U.S. professionals in safety (31%), industrial hygiene (16%), occupational nursing (12%) and medicine (11%), and related disciplines (30%). Participants completed a 12-item Readiness for Interprofessional Education Scale (RIPLS) adapted for TWH. Nineteen survey-takers also participated in virtual focus groups to share opinions about IPE benefits, barriers, and desirable course features. FINDINGS Occupational safety and health professionals reported high overall readiness for IPE (RIPLS, 4.45 ± 0.47), endorsing IPE for interdisciplinary skill-building. Salient IPE motivators were learning new perspectives from diverse disciplines and industries; gaining new subject expertise; developing common ground across disciplines; and learning TWH best practices. Participants recommended case studies to practice interdisciplinary problem-solving through group work. CONCLUSIONS/APPLICATION TO PRACTICE Interprofessional education is a promising pedagogy for OSH continuing education to promote interdisciplinary collaboration skills needed for TWH practice in the workplace. Occupational safety and health educators need to build competency in IPE pedagogical theory and practice to ensure effective training design and evaluation.
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Cavallari JM, Trudel SM, Miskovsky MN, Laguerre RA, Dugan AG. Life satisfaction and job and personal resources among public workers with non-standard work schedules. BMC Public Health 2024; 24:1133. [PMID: 38654243 DOI: 10.1186/s12889-024-18575-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND While the link between non-standard work schedules and poor health outcomes is established, few studies have examined how resources both in and outside of work can support the well-being of workers with non-standard work schedules. METHODS Using a cross-sectional survey, we assessed the association between one facet of well-being, life satisfaction, and job and personal resources. In 2019, an electronic survey was administered to two unionized, public service populations who work non-standard work schedules: transportation maintainers and correctional supervisors. We assessed life satisfaction with a 10-item scale; a broad set of job resources (reward satisfaction, supervisor support, co-worker support, schedule satisfaction, and working hours fit); and a broad set of personal resources (health status, sleep, physical activity, and finances). We used log-binomial regression models to estimate prevalence ratios and 95% confidence intervals among statistically significant univariate predictors. RESULTS Of the 316 workers surveyed, the majority were male (86%), White (68%), and reported positive life satisfaction (56%). In multivariate models, the prevalence of positive life satisfaction was higher in workers reporting reward satisfaction (PR:1.35, 95% CI: 1.11, 1.65; p = 0.003), good work schedule fit (PR:1.43, 95% CI: 1.12, 1.83; p = 0.004), good health (PR:2.92, 95% CI: 1.70, 4.99; p < 0.0001), and good finances (PR:1.32, 95% CI: 1.01, 1.72; p = 0.04). CONCLUSION Employers should consider increasing work recognition, as well as improving schedule fit, financial well-being, and overall good health in support of worker life satisfaction and ultimately well-being.
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Affiliation(s)
- Jennifer M Cavallari
- UConn School of Medicine, Farmington, CT, USA.
- Department of Public Health Sciences, UConn School of Medicine, 263 Farmington Avenue, MC 6325, 06030-6325, Farmington, CT, USA.
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O'Donnell S, Hayden J, Quigley E, Adamis D, Gavin B, McNicholas F. "We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response. Res Social Adm Pharm 2024; 20:389-400. [PMID: 38350789 DOI: 10.1016/j.sapharm.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future. AIM(S) To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response. METHOD 11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis. RESULTS Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives. CONCLUSIONS The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.
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Affiliation(s)
- Shane O'Donnell
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland.
| | - John Hayden
- RCSI School of Pharmacy and Biomolecular Sciences (PBS), Royal College of Surgeons in Ireland, Ireland
| | - Etain Quigley
- National University of Ireland, Maynooth (Maynooth University) - Department of Law, Ireland
| | | | - Blánaid Gavin
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland
| | - Fiona McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland; Children Health Ireland, Crumlin, Dublin 12, Ireland; Lucena Clinic Rathgar, Dublin 6, Ireland
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12
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Florez A, Villar-Hoz E. Role of motivation and well-being indicators in interventions to improve well-being at work among primary care physicians: a systematic review. BMJ Open 2024; 14:e075799. [PMID: 38503419 PMCID: PMC10952968 DOI: 10.1136/bmjopen-2023-075799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVE The well-being of primary care physicians (PCPs) has become an object of concern for governments due to staff shortages and high staff turnover. The objective of this study was to carry out a systematic review of individualised interventions aimed at improving the well-being of PCPs, which allowed us to determine (1) the type of interventions being carried out; (2) the well-being indicators being used and the instruments used to assess them; (3) the theories proposed to support the interventions and the mechanisms of action (MoA) put forward to explain the results obtained and (4) the role that individual motivation plays in the interventions to improve well-being among PCPs. DESIGN Systematic review. ELIGIBILITY CRITERIA Clinical trials on interventions aimed at improving the well-being of PCPs. INFORMATION SOURCES a search of studies published between 2000 and 2022 was carried out in MEDLINE/PubMed, SCOPUS and Web of Science (WOS). RESULTS From the search, 250 articles were retrieved. The two authors each reviewed the articles independently, duplicate articles and those that did not meet the inclusion criteria were discarded. A total of 14 studies that met the criteria were included: 6 randomised clinical trials, 4 controlled clinical trials and 4 unique cohorts, with a before-and-after assessment of the intervention, involving a total of 655 individuals participating in the interventions. A meta-analysis was not possible due to the heterogeneity of the studies. CONCLUSIONS The information evaluated is insufficient to accurately assess which outcomes are the best indicators of PCPs well-being or what role plays in the individual motivation in the results of the interventions. More studies need to be carried out on the subject to determine the MoA of the different interventions on the results and the motivation of the participating PCPs.
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Wash A, Moczygemba LR, Brown CM, Crismon ML, Whittaker TA. A narrative review of the well-being and burnout of U.S. community pharmacists. J Am Pharm Assoc (2003) 2024; 64:337-349. [PMID: 37967722 DOI: 10.1016/j.japh.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The purpose of this narrative review is to summarize the literature on well-being and burnout among community pharmacists in the U.S. and provide recommendations for future research. METHODS Relevant literature was identified by searching PubMed for combinations of keywords such as "burnout" and "well-being" combined with "pharmacists." Titles and abstracts were reviewed for relevancy, and full text articles were reviewed when applicable. RESULTS While burnout is defined by its 3 core symptoms of emotional exhaustion, depersonalization, and low personal accomplishment, well-being is more challenging to define and measure, which has led to it being less studied. Community pharmacists faced high rates of burnout, low quality of life (QOL), and extreme fatigue prior to the COVID-19 pandemic, a situation that has likely only worsened. Factors such as workload, the type of community pharmacy, the level of education or training of the pharmacist, and stress may be some of the contributors to high rates of burnout. Clinician burnout may be related to high rates of mental health disorders seen in pharmacists, may impact patient safety and satisfaction, and may affect productivity and costs to employers and the healthcare system overall. There has been no research into interventions or strategies to support well-being and reduce burnout among community pharmacists, but having a workplace that is perceived as supporting well-being may have some impact. Recommendations for future research include the following: (1) define well-being, (2) explore why various factors support well-being or contribute to burnout, (3) determine the impact of community pharmacists experiencing well-being or burnout, and (4) develop strategies to support well-being and reduce burnout that are specific to community pharmacy. CONCLUSION There is a sparsity of evidence regarding community pharmacist well-being and burnout. Further research is needed to generate the evidence needed to support interventions that are specific to the unique work setting of community pharmacists.
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Gomes Souza L, Bouba DA, Corôa RDC, Dofara SG, Robitaille V, Blanchette V, Kastner K, Bergeron F, Guay-Bélanger S, Izumi SS, Totten AM, Archambault P, Légaré F. The Impact of Advance Care Planning on Healthcare Professionals' Well-being: A Systematic Review. J Pain Symptom Manage 2024; 67:173-187. [PMID: 37827454 DOI: 10.1016/j.jpainsymman.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/08/2023] [Accepted: 09/16/2023] [Indexed: 10/14/2023]
Abstract
CONTEXT Advance care planning (ACP) improves care for patients with chronic illnesses and reduces family stress. However, the impact of ACP interventions on healthcare professionals' well-being remains unknown. OBJECTIVE To systematically review the literature evaluating the impact of ACP interventions on healthcare professionals' well-being. METHODS We followed the Joanna Briggs Institute methodology for systematic reviews and registered the protocol in PROSPERO (CRD42022346354). We included primary studies in all languages that assessed the well-being of healthcare professionals in ACP interventions. We excluded any studies on ACP in psychiatric care and in palliative care that did not address goals of care. Searches were conducted on April 4, 2022, and March 6, 2023 in Embase, CINAHL, Web of Science, and PubMed. We used the Mixed Methods Appraisal Tool for quality analysis. We present results as a narrative synthesis because of their heterogeneity. RESULTS We included 21 articles published in English between 1997 and 2021 with 17 published after 2019. All were conducted in high-income countries, and they involved a total of 1278 participants. Three reported an interprofessional intervention and two included patient partners. Studies had significant methodological flaws but most reported that ACP had a possible positive impact on healthcare professionals' well-being. CONCLUSION This review is the first to explore the impact of ACP interventions on healthcare professionals' well-being. ACP interventions appear to have a positive impact, but high-quality studies are scarce. Further research is needed, particularly using more rigorous and systematic methods to implement interventions and report results.
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Affiliation(s)
- Lucas Gomes Souza
- Department of Social and Preventive Medicine (L.G.S., D.A.B.), Faculty of Medicine, Université Laval, Québec, Canada, and VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Dalil Asmaou Bouba
- Department of Social and Preventive Medicine (L.G.S., D.A.B.), Faculty of Medicine, Université Laval, Québec, Canada, and VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Roberta de Carvalho Corôa
- Department of Family Medicine and Emergency Medicine (R.C.C.), VITAM, Centre de recherche en santé durable, Unité de soutien au système de santé apprenant, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Suélène Georgina Dofara
- VITAM, Centre de recherche en santé durable (S.G.B., S.G.D.), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | - Vincent Robitaille
- Faculty of Medicine, Université Laval (V.R.), VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - Virginie Blanchette
- Department of Human Kinetics and Podiatric Medicine (V.B.), Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | | | | | - Sabrina Guay-Bélanger
- VITAM, Centre de recherche en santé durable (S.G.B., S.G.D.), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada
| | | | - Annette M Totten
- Department of Medical Informatics and Clinical Epidemiology (A.M.T.), School of Medicine, Oregon Health & Science University, Portland, OR
| | - Patrick Archambault
- Department of Family Medicine and Emergency Medicine (P.A.), Faculty of Medicine, Université Laval, VITAM, Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Québec, QC, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine (F.L.), Faculty of Medicine, Université Laval, VITAM, Centre de recherche en santé durable, Researcher, Centre de recherche du CHU de Québec, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec, QC, Canada.
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15
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Sears JM, Rundell SD, Fulton-Kehoe D, Hogg-Johnson S, Franklin GM. Using the Functional Comorbidity Index with administrative workers' compensation data: Utility, validity, and caveats. Am J Ind Med 2024; 67:99-109. [PMID: 37982343 PMCID: PMC10824282 DOI: 10.1002/ajim.23550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Chronic health conditions impact worker outcomes but are challenging to measure using administrative workers' compensation (WC) data. The Functional Comorbidity Index (FCI) was developed to predict functional outcomes in community-based adult populations, but has not been validated for WC settings. We assessed a WC-based FCI (additive index of 18 conditions) for identifying chronic conditions and predicting work outcomes. METHODS WC data were linked to a prospective survey in Ohio (N = 512) and Washington (N = 2,839). Workers were interviewed 6 weeks and 6 months after work-related injury. Observed prevalence and concordance were calculated; survey data provided the reference standard for WC data. Predictive validity and utility for control of confounding were assessed using 6-month work-related outcomes. RESULTS The WC-based FCI had high specificity but low sensitivity and was weakly associated with work-related outcomes. The survey-based FCI suggested more comorbidity in the Ohio sample (Ohio mean = 1.38; Washington mean = 1.14), whereas the WC-based FCI suggested more comorbidity in the Washington sample (Ohio mean = 0.10; Washington mean = 0.33). In the confounding assessment, adding the survey-based FCI to the base model moved the state effect estimates slightly toward null (<1% change). However, substituting the WC-based FCI moved the estimate away from null (8.95% change). CONCLUSIONS The WC-based FCI may be useful for identifying specific subsets of workers with chronic conditions, but less useful for chronic condition prevalence. Using the WC-based FCI cross-state appeared to introduce substantial confounding. We strongly advise caution-including state-specific analyses with a reliable reference standard-before using a WC-based FCI in studies involving multiple states.
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Affiliation(s)
- Jeanne M. Sears
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention and Research Center, Seattle, WA, USA
| | - Sean D. Rundell
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
- The Clinical Learning, Evidence And Research (CLEAR) Center for Musculoskeletal Disorders; University of Washington, Seattle, WA, USA
| | - Deborah Fulton-Kehoe
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Sheilah Hogg-Johnson
- Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Gary M. Franklin
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
- Washington State Department of Labor and Industries, Tumwater, WA, USA
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16
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Kirsten W. The Evolution from Occupational Health to Healthy Workplaces. Am J Lifestyle Med 2024; 18:64-74. [PMID: 39184266 PMCID: PMC11339767 DOI: 10.1177/15598276221113509] [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: 08/27/2024] Open
Abstract
Occupational health has evolved as a field over the last 20 years, most significantly over the last 2 years. The COVID-19 pandemic has increased the amount and complexity of challenges for occupational health professionals and at the same time provided a unique opportunity for the field in light of the heightened focus on health at the workplace. Responsibilities have become broader and more multi-faceted including areas such as mental wellbeing and psychosocial risk factors. The pandemic has shown us that the workplace is an essential setting to promote health with a growing number of employers investing in policies and programs for their employees. However, many global health campaigns and large scale national initiatives do not include the workplace setting in their strategy to the detriment of the their effectiveness. In addition to the pressing global health needs, two recent developments have propelled workplace health to the forefront and are asking questions of employers. The Sustainable Development Goals as well as the ESG (Environment, Social, Governance) agenda on behalf of the financial sector are pushing the corporate sector to act responsibly beyond seeking profits and disclose related policies and actions. Healthy workplaces are essential for global development and progress.
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Affiliation(s)
- Wolf Kirsten
- Wolf Kirsten, MSc, International Health Consulting, 4500 E Sunrise Drive, Tucson AZ 85718, USA; e-mail:
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17
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Wickstrom R, Wang I. Reliability and concurrent validity of the Active Movement Scale (AMS) in adults with musculoskeletal disorders. Work 2024; 78:1173-1186. [PMID: 39121151 DOI: 10.3233/wor-230626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2024] Open
Abstract
BACKGROUND The Active Movement Scale (AMS) is a brief screen for identifying movement impairments affecting functional task performance. OBJECTIVE To assess inter-rater reliability, test-retest reliability, floor and ceiling effects, and concurrent validity of the AMS in adults with musculoskeletal disorders. METHODS Fifty-five subjects (mean age: 61.3±15.3 years) transitioning from physical therapy attended two sessions. The 14-item AMS was assessed by two therapists, resulting in a total score (AMST) and two sub-scores: upper body (AMSU) and lower body (AMSL). Moreover, subjects completed PROMIS Physical Function-10a (PPF), Lifestyle Physical Function (LPF), Cardio Activity Level (CAL) surveys, Two Square Agility Test (TSAT), WorkAbility Rate of Manipulation Turning (WRMT) and Placing (WRMP), Grip Strength (GS), 10-Meter Walk Usual (GSU) and Fast (GSF) pace, and Grooved Pegboard Placing (GPP) and Remove (GPR) tests. RESULTS Inter-rater reliability coefficients for AMST, AMSU, and AMSL were 0.96, 0.92, and 0.96, respectively, with individual item reliability ranging from 0.58 to 1.0. Test-retest reliability for these assessments yielded coefficients of 0.93, 0.84, and 0.94, with individual item reliability ranging from 0.47 to 0.88. No floor effects were observed, but mild ceiling effects were noted. AMST showed a high correlation with LPF (r = 0.72) and moderate correlation with PPF (r = 0.64) surveys. AMSU had moderate correlations with GPP (r = 0.61) and WRMP (r = 0.57) tests, while AMSL correlated moderately with GSF (r = 0.55) and TSAT (r = 0.50) tests. CONCLUSIONS This study provides evidence of the reliability and validity of AMS in adults with musculoskeletal disorders to support transitions between rehabilitation and fitness programs.
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Affiliation(s)
| | - Inga Wang
- School of Rehabilitation Sciences & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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18
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Stelson EA, Dash D, McCorkell L, Wilson C, Assaf G, Re'em Y, Wei H. Return-to-work with long COVID: An Episodic Disability and Total Worker Health® analysis. Soc Sci Med 2023; 338:116336. [PMID: 37918226 DOI: 10.1016/j.socscimed.2023.116336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 09/10/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023]
Abstract
A growing number of working individuals have developed long COVID (LC) after COVID-19 infection. Economic analyses indicate that workers' LC symptoms contribute to workforce shortages. However, factors that affect return-to-work from perspectives of people with LC remain largely underexplored. This qualitative study of people with LC conducted by researchers living with LC aimed to identify participants' return-to-work experiences using Total Worker Health® and Episodic Disability frameworks. 10% of participants who participated in a mixed-method global internet survey, had LC symptoms >3 months, and responded in English were randomly selected for thematic analysis using NVivo12. 15% of responses were independently double-coded to identify coding discrepancies. Participants (N = 510) were predominately white and had at least a baccalaureate degree. Four primary work-related themes emerged: 1) strong desire and need to return to work motivated by sense of purpose and financial precarity; 2) diverse and episodic LC symptoms intersect with organization of work and home life; 3) pervasiveness of LC disbelief and stigma at work and in medical settings; and 4) support of medical providers is key to successful return-to-work. Participants described how fluctuation of symptoms, exacerbated by work-related tasks, made returning to work challenging. Participants' ability to work was often predicated on job accommodations and support. Non-work factors were also essential, especially being able to receive an LC medical diagnosis (key to accessing leave and accommodations) and help at home to manage non-work activities. Many participants described barriers accessing these supports, illuminating stigma and disbelief in LC as a medical condition. Qualitative findings indicate needs for workplace accommodations tailored to fluctuating symptoms, continuously re-evaluated by workers and supervisors together. Reductions in medical barriers to access work accommodations is also critical since many medical providers remain unaware of LC, and workers may lack a positive COVID test result.
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Affiliation(s)
- Elisabeth A Stelson
- Harvard University, T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave, Boston, MA, 02115, USA; Patient Led Research Collaborative, Calabasas, CA, USA.
| | - Devanshi Dash
- University of Szeged, Albert Szent-Györgyi Medical School, Szeged, Hungary.
| | | | - Cali Wilson
- Patient Led Research Collaborative, Calabasas, CA, USA.
| | - Gina Assaf
- Patient Led Research Collaborative, Calabasas, CA, USA.
| | - Yochai Re'em
- Patient Led Research Collaborative, Calabasas, CA, USA.
| | - Hannah Wei
- Patient Led Research Collaborative, Calabasas, CA, USA.
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Urban RW, Martin SD, Foglia DC, Henson JS, Belz JN, Bilton VR. Acute care nurse managers' definitions of and barriers to well-being: A thematic analysis of open-ended survey questions. Worldviews Evid Based Nurs 2023; 20:525-531. [PMID: 37905584 DOI: 10.1111/wvn.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/06/2023] [Accepted: 09/17/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, acute care nurse managers functioned in a critical role by helping to advance the mission and goals of their organization while navigating a rapidly evolving healthcare landscape. This resulted in high levels of ongoing job-related stress which is linked to negative physical, psychological, and job-related outcomes. Little is known about the perceptions regarding their own professional well-being during this time. AIM The aim of this study was to qualitatively describe acute care nurse managers' perceptions of and barriers to their professional well-being. METHODS Using a qualitative descriptive approach, nurse managers from a hospital system in the southwestern United States responded to two short-answer, survey-based questions in 2022: (1) "Describe the definition of nurse-manager well-being in your own words" and (2) "What do you feel is your biggest barrier to professional well-being?" Reflexive thematic analysis was utilized to analyze participant responses (N = 80). RESULTS Professional well-being is a complex concept influenced by the nurse manager's ability to navigate work-life balance; care for their own physical, emotional, and spiritual selves; give and receive support from stakeholders; and manage feelings of thriving vs. struggling in the role. Barriers most cited as influencing well-being included having too little time to get things done coupled with increasing workloads, feeling stuck in the middle among stakeholders, and coping with ongoing staffing challenges. LINKING EVIDENCE TO ACTION The definition of and barriers to well-being are influenced by the specific needs and experiences of the nurse manager. While not all barriers can be immediately removed, the identification of individual and organization-specific barriers needs to be taken seriously, reviewed by those who can promote change, and evidence-based solutions for improvement piloted or implemented when feasible.
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Affiliation(s)
| | - Shirley D Martin
- Texas Health Harris Methodist Fort Worth, Fort Worth, Texas, USA
| | | | | | - Joni N Belz
- Texas Health Arlington Memorial, Arlington, Texas, USA
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20
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Beardsley E, Daugherty M, Lewis B, Patton L. Integrating resilience factors into nursing professional governance culture. J Pediatr Nurs 2023; 73:228-230. [PMID: 37730442 DOI: 10.1016/j.pedn.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Affiliation(s)
- Elaine Beardsley
- Children's Medical Center Dallas, Dallas, TX, United States of America
| | - Misty Daugherty
- Children's Medical Center Dallas, Dallas, TX, United States of America
| | - Brennan Lewis
- Children's Medical Center Dallas, Dallas, TX, United States of America
| | - Lindsey Patton
- Children's Medical Center Dallas, Dallas, TX, United States of America
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21
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Keller EG, Hittle BM, Boch S, Davis K, Gillespie GL. Modeling wellbeing for U.S. correctional nurses: A cross sectional survey. Int J Nurs Stud 2023; 147:104589. [PMID: 37741259 DOI: 10.1016/j.ijnurstu.2023.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Nurses work in stressful environments, and this stress has negative consequences on health. Correctional nurses experience unique job stress in their roles. However, there has been limited research exploring how the correctional environment impacts nurse health and wellbeing. OBJECTIVE This study aimed to evaluate the relationship between the variables of organizational characteristics (i.e., job demands, job control, manager support, peer support, workplace relationships), job stress, and wellbeing levels in a sample of U.S. correctional nurses, while exploring socio-demographic covariates. METHODS Using a convenience sampling method, 270 U.S. correctional nurses completed a cross-sectional online survey. Informed by the Job Demands-Resources Theory, a conceptual model was created and tested in this sample. Analysis involved multiple linear regression and structural equation modeling. RESULTS The model significantly fit the data (CI: 0.71-0.83, CFI = 0.51, SRMR: 0.37, and RMSEA = 0.08) revealing the direct relationship between job stress, job demands, job control, and workplace relationships and wellbeing. This study also provided evidence that job stress mediates the relationship of job control and job demands with wellbeing. CONCLUSION Results underscore the opportunity for correctional organizations to consider targeting job demands, job control, workplace relationships, and job stress in future interventions to improve the correctional nursing work environment and support correctional nurse wellbeing. TWEETABLE ABSTRACT A recent study found evidence for a relationship between organizational characteristics & job stress and U.S. correctional nurse wellbeing.
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Affiliation(s)
- Elizabeth G Keller
- University of Cincinnati, College of Nursing, Cincinnati, OH 45221, USA.
| | - Beverly M Hittle
- University of Cincinnati, College of Nursing, Cincinnati, OH 45221, USA
| | - Samantha Boch
- University of Cincinnati, College of Nursing, Cincinnati, OH 45221, USA; James M. Anderson Center for Health Systems Excellence, Cincinnati, OH 45229, USA
| | - Kermit Davis
- University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
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22
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Bautista TG, Roman G, Khan M, Lee M, Sahbaz S, Duthely LM, Knippenberg A, Macias-Burgos MA, Davidson A, Scaramutti C, Gabrilove J, Pusek S, Mehta D, Bredella MA. What is well-being? A scoping review of the conceptual and operational definitions of occupational well-being. J Clin Transl Sci 2023; 7:e227. [PMID: 38028344 PMCID: PMC10643923 DOI: 10.1017/cts.2023.648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Well-being is a multifaceted construct that is used across disciplines to portray a state of wellness, health, and happiness. While aspects of well-being seem universal, how it is depicted in the literature has substantial variation. The aim of this scoping review was to identify conceptual and operational definitions of well-being within the field of occupational health. Broad search terms were used related to well-being and scale/assessment. Inclusion criteria were (1) peer-reviewed articles, (2) published in English, (3) included a measure of well-being in the methods and results section of the article, and (4) empirical paper. The searches resulted in 4394 articles, 3733 articles were excluded by reading the abstract, 661 articles received a full review, and 273 articles were excluded after a full review, leaving 388 articles that met our inclusion criteria and were used to extract well-being assessment information. Many studies did not define well-being or link their conceptual definition to the operational assessment tool being used. There were 158 assessments of well-being represented across studies. Results highlight the lack of a consistent definitions of well-being and standardized measurements.
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Affiliation(s)
| | - Gretchen Roman
- University of Rochester Medical Center, Rochester, NY, USA
| | - Munziba Khan
- National Center for Advancing Translational Sciences, Bethesda, MD, USA
| | - Michele Lee
- Northern Arizona University, Flagstaff, AZ, USA
| | | | | | | | | | | | | | | | - Susan Pusek
- University of North Carolina School of Medicine, St. Chapel Hill, NC, USA
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Crowe L, Young J, Smith AC, Haydon HM. Factors that may threaten or protect the wellbeing of staff working in paediatric intensive care environments. Intensive Crit Care Nurs 2023; 78:103476. [PMID: 37379677 DOI: 10.1016/j.iccn.2023.103476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/25/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE This study explored the risk and protective factors for wellbeing from the perspectives of multidisciplinary paediatric intensive care unit staff. DESIGN Using a qualitative, descriptive study design we purposively recruited a sample of nurses, physicians, and allied health professionals to participate in semi-structured interviews which explored staff perceptions of risk and protective factors relating to their daily paediatric intensive care roles. Data was analysed using thematic analysis. SETTING Four paediatric intensive care units in Australia. FINDINGS Twenty staff were recruited. Braun and Clarke's thematic analysis approach identified perceived risks for wellbeing included a lack of preparation for the role, and clinical situations that contributed to psychological distress, including perceived worst shift, moral distress, non-accidental injuries, and isolation. Themes perceived as protective to wellbeing included: finding the work stimulating and meaningful, belonging to the team, and using humour. CONCLUSION Staff perceptions of wellbeing in the paediatric intensive care unit suggested that risk factors often co-existed simultaneously with protective factors. These results are not consistent with the notion that wellbeing as a phenomenon can be considered on a risk-protection continuum. Strategies that enhance this work as meaningful and stimulating, promote a sense of belonging to the team, and support the use of humour, may assist health professionals to achieve a balance between risk and protective factors for wellbeing. IMPLICATIONS FOR CLINICAL PRACTICE Education and training on end-of-life care, and how to have difficult conversations and manage the consistent psychological distress of intensive care work, is essential at orientation and requires regular formal interventions. Experiencing the work as stimulating highlights the need for advanced scope of practice work. Opportunities for individual and team reflection about the meaning and purpose of their work, and ensuring staff feel valued and experience a sense of belonging to the team, are critical to the intensive care context.
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Affiliation(s)
- Liz Crowe
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
| | - Jeanine Young
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia; School of Health, University of the Sunshine Coast, Australia.
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia; School of Health, University of the Sunshine Coast, Australia; Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark.
| | - Helen M Haydon
- Centre for Online Health, The University of Queensland, Brisbane, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
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Aryal A, Janssen B, Casteel C, Fethke NB, Buikema B, Cho H, Rohlman DS. Applying the Worker Well-Being Framework to Identify Factors that Impact Turnover Among Long-Haul Truck Drivers. Workplace Health Saf 2023; 71:419-428. [PMID: 37387518 DOI: 10.1177/21650799231178636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
BACKGROUND Drivers in the long-haul trucking industry have chronic health conditions, engage in unhealthy behaviors, and leave the industry at high rates. Previous work has not considered the health and safety outcomes resulting from the conditions of work in the trucking industry and their role in turnover. The goal of this study was to understand the expectations of an incoming workforce, explore how work conditions impact their well-being, and identify strategies for retention. METHODS Semi-structured interviews were conducted among current long-haul drivers and supervisors at trucking companies, and students and instructors at trucking schools (n = 33). Participants were asked about why they decided to enter the industry, their health challenges related to being in the trucking industry and whether these challenges were related to turnover, and strategies for retention. FINDINGS Health conditions, differences in job expectations, and work demands were associated with leaving the industry. Workplace policies and culture (e.g., lack of supervisor support, schedules that limited home time, company size, and lack of benefits) were associated with workers' intention to leave an organization. Strategies identified to improve retention included integrating health and wellness into onboarding, creating realistic job expectations for those entering the industry, establishing relationships with drivers and dispatchers, and developing policies to limit time away from family. CONCLUSION/APPLICATION TO PRACTICE Turnover in the trucking industry is a persistent problem and leads to a shortage of skilled workers, increases the workload, and reduces productivity. Understanding the relationship between the conditions of work and well-being provides a more holistic approach to address the health, safety, and well-being of long-haul truck drivers. Health conditions, differences in job expectations, and work demands were associated with leaving the industry. Workplace policies and culture (e.g., supervisor support, schedules that limited home time, lack of benefits) were associated with workers' intention to leave an organization. These conditions provide an opportunity for occupational health interventions to promote the physical as well as psychological health of long-haul truck drivers.
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Affiliation(s)
- Ashamsa Aryal
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
- Arkansas Department of Health
| | - Brandi Janssen
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
| | - Carri Casteel
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
| | - Nathan B Fethke
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
| | - Brenda Buikema
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
| | - Hyunkeun Cho
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
| | - Diane S Rohlman
- College of Public Health, Department of Occupational and Environmental Health, University of Iowa
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Lemke MK, Hege A, Crizzle AM. An Agenda for Advancing Research and Prevention at the Nexus of Work Organization, Occupational Stress, and Mental Health and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6010. [PMID: 37297614 PMCID: PMC10252625 DOI: 10.3390/ijerph20116010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/19/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
Work characteristics and worker well-being are inextricably connected. In particular, the characteristics of work organization shape and perpetuate occupational stress, which contributes to worker mental health and well-being outcomes. Consequently, the importance of understanding and addressing connections between work organization, occupational stress, and mental health and well-being-the focus of this Special Issue-increasingly demand attention from those affected by these issues. Thus, focusing on these issues in the long-haul truck driver (LHTD) sector as an illustrative example, the purpose of this commentary is as follows: (1) to outline current research approaches and the extant knowledge base regarding the connections between work organization, occupational stress, and mental health; (2) to provide an overview of current intervention strategies and public policy solutions associated with the current knowledge base to protect and promote worker mental health and well-being; and (3) to propose a two-pronged agenda for advancing research and prevention for workers during the 21st century. It is anticipated that this commentary, and this Special Issue more broadly, will both echo numerous other calls for building knowledge and engaging in this area and motivate further research within complementary current and novel research frameworks.
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Affiliation(s)
- Michael K. Lemke
- Department of Social Sciences, University of Houston-Downtown, Houston, TX 77002, USA
| | - Adam Hege
- Department of Public Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA;
| | - Alexander M. Crizzle
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada;
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AIUM Practice Principles for Work-Related Musculoskeletal Disorder. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1139-1157. [PMID: 36691912 DOI: 10.1002/jum.16124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 06/17/2023]
Abstract
The prevalence of Work-Related Musculoskeletal Disorders (WRMSDs) among ultrasound professionals has been significant. National and international efforts to create industry standards have focused primarily on injuries in sonographers. In addition, the Centers for Disease Control and Prevention (CDC) and National Institute for Occupational Safety & Health (NIOSH) have published documents related to this occupational exposure. There has also been significant attention on equipment utilization and design to help reduce the prevalence of WRMSDs. The American Institute of Ultrasound in Medicine (AIUM) developed the AIUM Practice Principles for Work-Related Musculoskeletal Disorder in collaboration with other organizations whose members use ultrasound [see Collaborating Societies and Representatives]. This document supports the "Industry Standards for the Prevention of Work-Related Musculoskeletal Disorders in Sonography" and aims to expand on these Standards to include safety practices for all health care professionals who utilize ultrasound. These professionals include members of the scientific community, a wide variety of medical professionals, and dental professionals. These ultrasound users and operators will collectively be referred to in this document as "operator(s)" except in those instances where data addressed those holding a specific job title, such as sonographer. In addition, this document will support guidance for quality improvement specific to preventing and reducing injury rates.
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Martin SD, Urban RW, Foglia DC, Henson JS, George V, McCaslin T. Well-being in acute care nurse managers: A risk analysis of physical and mental health factors. Worldviews Evid Based Nurs 2023; 20:126-132. [PMID: 37031350 DOI: 10.1111/wvn.12646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 04/10/2023]
Abstract
BACKGROUND Nurse managers have experienced tremendous stress during the COVID-19 pandemic, contributing to negative psychological outcomes. Positive professional well-being is a construct that can be promoted to mitigate poor psychological outcomes and burnout in nurses. Little is known about the health, healthy behaviors, effects of stress on homelife, and well-being of nurse managers in the United States (U.S.). AIMS The aims of the study were to explore nurse managers' well-being related to self-reported stress and health perceptions and habits. METHODS A sample of 80 (41% response rate) nurse managers responded to a cross-sectional web-based survey sent via email in a southwestern U.S. 13-hospital system. Nurses answered 39 quantitative questions about demographics, well-being (9-item Well-Being Index [WBI]), perceptions of stress affecting homelife, and perceptions of health and health-related behaviors. RESULTS Mean WBI (2.9 [2.7]) indicated risk for poor psychological outcomes. Managers (75%) reported stress from work affected their personal lives and a decline in overall health during the pandemic. Most (80%) reported burnout and emotional problems. Nurse managers had 8.1 times increased risk of poor WBI scores if stress from work affected their personal life than if they reported no spillover stress into their personal life (OR = 8.1, 95% CI [2.6, 25.0]). LINKING EVIDENCE TO ACTION Findings from this study add a nuanced understanding of nurse managers' well-being. The strongest risk factor for poor WBI scores was stress levels affecting personal life. Interventions to improve well-being in nurse managers are needed. Limitations are the convenience sampling, limited geographic location, and response rate of <50%. Further research is needed to support nurse managers in stress reduction and development of boundaries that prohibit the spillover effect of workplace stress. Organizations may consider a combination of administrative support and changes as well as provision of on-the-job training of interventions that support individual well-being.
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Affiliation(s)
- Shirley D Martin
- Texas Health Harris Methodist Fort Worth, Fort Worth, Texas, USA
| | | | | | | | - Viji George
- Department of Clinical Excellence, Nursing Professional Practice, Texas Health Resources, Plano, Texas, USA
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Peters SE, Gundersen DA, Katz JN, Sorensen G, Wagner GR. Thriving from Work Questionnaire: Dimensionality, reliability, and validity of the long and short form questionnaires. Am J Ind Med 2023; 66:281-296. [PMID: 36748853 DOI: 10.1002/ajim.23465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Thriving from Work is defined as the state of positive mental, physical, and social functioning in which workers' experiences of their work and working conditions enable them to thrive in their overall lives, contributing to their ability to achieve their full potential at work, at home, and in the community. The purpose of this study was to develop a psychometrically-sound questionnaire measuring the positive contribution that work can have on one's well-being both at, and outside of, their work. METHODS We used both a qualitative and quantitative approach of item reduction, domain mapping dimensionality testing, development of "long-" and "short-" versions of the questionnaire, reliability, and construct and criterion validity testing. This was established in two independent online samples of US based workers (n = 1550, n = 500). RESULTS We developed a bi-factor model 30-item long-form and a uni-factorial 8-item short-version. The long-form measures both the latent construct of Thriving from Work and six domains (psychological/emotional; work-life integration; social; experience of work; basic needs; health). Both long- and short- forms were found to have high empirical reliability (0.93 and 0.87 respectively). The short-form captures 94% of variance of the long-form. Construct and criterion validity were supported. Test-retest reliability was high. CONCLUSIONS The Thriving from Work Questionnaire appears to be a valid and reliable measure of work-related well-being in United States workers. Further testing is needed to refine and test the instrument in specific industries, unique worker populations, and across geographic regions.
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Affiliation(s)
- Susan E Peters
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Daniel A Gundersen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Survey and Qualitative Methods Core, Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jeffrey N Katz
- Departments of Orthopedic Surgery and Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Glorian Sorensen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Gregory R Wagner
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Rodríguez-Modroño P. Digital Stress. Effects of Different Intensities of Working From Home on Workers' Health. J Occup Environ Med 2023; 65:e240-e245. [PMID: 36728093 DOI: 10.1097/jom.0000000000002796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Because hybrid and remote work models have exponentially expanded with digitalization and the COVID-19 pandemic, this study examines how different intensities of WFH impact workers' health. METHODS Drawing on the job demands-resources model, we applied two-way analysis of variance and regression models to the sixth European Working Conditions Survey to examine how the type and magnitude of WFH effects on health depend on its intensity. RESULTS A key aspect in relation to remote work is the frequency with which the worker carries out this type of work, with best results among those WFH only several times a month, for women, and several times a week, for men. CONCLUSIONS Reasonable intensity of WFH may have beneficial effects on health, but these positive effects are reduced when working fully home-based.
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Affiliation(s)
- Paula Rodríguez-Modroño
- From the Department of Economics, Quantitative Methods and Economic History, Pablo de Olavide University, Seville, Spain
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30
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Hernandez R, Jin H, Pyatak EA, Roll SC, Schneider S. Workers' whole day workload and next day cognitive performance. CURRENT PSYCHOLOGY 2023; 43:1-14. [PMID: 37359695 PMCID: PMC9982770 DOI: 10.1007/s12144-023-04400-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/06/2023]
Abstract
Workload experienced over the whole day, not just work periods, may impact worker cognitive performance. We hypothesized that experiencing greater than typical whole day workload would be associated with lower visual processing speed and lower sustained attention ability, on the next day. To test this, we used dynamic structural equation modeling to analyze data from 56 workers with type 1 diabetes. For a two-week period, on smartphones they answered questions about whole day workload at the end of each day, and completed cognitive tests 5 or 6 times throughout each day. Repeated smartphone cognitive tests were used, instead of traditional one- time cognitive assessment in the laboratory, to increase the ecological validity of the cognitive tests. Examples of reported occupations in our sample included housekeeper, teacher, physician, and cashier. On workdays, the mean number of work hours reported was 6.58 (SD 3.5). At the within-person level, greater whole day workload predicted decreased mean processing speed the next day (standardized estimate=-0.10, 95% CI -0.18 to -0.01) using a random intercept model; the relationship was not significant and only demonstrated a tendency toward the expected effect (standardized estimate= -0.07, 95% CI -0.15 to 0.01) in a model with a random intercept and a random regression slope. Whole day workload was not found to be associated with next-day mean sustained attention ability. Study results suggested that just one day of greater than average workload could impact next day processing speed, but future studies with larger sample sizes are needed to corroborate this finding.
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Affiliation(s)
- Raymond Hernandez
- Dornsife Center for Economic & Social Research, University of Southern California, 90089 Los Angeles, CA USA
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 90089 Los Angeles, CA USA
- USC Center for Economic & Social Research, 635 Downey Way, VPD 405 Los Angeles, CA USA
| | - Haomiao Jin
- Dornsife Center for Economic & Social Research, University of Southern California, 90089 Los Angeles, CA USA
- School of Health Sciences, University of Surrey, GU2 7YH Guildford, UK
| | - Elizabeth A. Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 90089 Los Angeles, CA USA
| | - Shawn C. Roll
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 90089 Los Angeles, CA USA
| | - Stefan Schneider
- Dornsife Center for Economic & Social Research, University of Southern California, 90089 Los Angeles, CA USA
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Mharapara TL, Clemons JH, Greenslade-Yeats J, Ewertowska T, Staniland NA, Ravenswood K. Toward a contextualized understanding of well-being in the midwifery profession: An integrative review. JOURNAL OF PROFESSIONS AND ORGANIZATION 2023. [DOI: 10.1093/jpo/joac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Abstract
Our integrative review synthesizes and evaluates two decades of empirical research on well-being in the midwifery profession to reveal (1) how researchers have studied midwives’ well-being; (2) key findings of research on midwives’ well-being; (3) underlying assumptions of this research; and (4) limitations of this research. We find that research on midwives’ well-being is disproportionately focused on individual midwives, who are assumed to be largely responsible for their own well-being, and that well-being in the midwifery profession is generally equated with the absence of mental health problems such as burnout, anxiety, and stress. Researchers have largely taken a narrow and instrumental approach to study midwives’ well-being, focusing on work-related antecedents and consequences, and overlooking the influence of nonwork factors embedded in the broader socioeconomic and cultural environment. Drawing on more comprehensive and contextualized well-being frameworks, we propose a research model that (1) expands the well-being construct as it applies to midwives and (2) situates midwives’ well-being in broader social, economic, political, and cultural contexts. Although developed in the midwifery context, our proposed research model can be applied to a host of professions.
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Affiliation(s)
- Tago L Mharapara
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Janine H Clemons
- Midwifery Department , MH Building 640 Great South Road, Manukau, 2025 , New Zealand
| | - James Greenslade-Yeats
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Tanya Ewertowska
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Nimbus Awhina Staniland
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
| | - Katherine Ravenswood
- Management Department, Auckland University of Technology , 120 Mayoral Drive, Auckland, 1010 , New Zealand
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Critical care staff wellbeing: A new paradigm for understanding burnout. Aust Crit Care 2023; 36:59-65. [PMID: 36437163 DOI: 10.1016/j.aucc.2022.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The wellbeing of paediatric intensive care unit (PICU) staff members influences their engagement with work and the quality of care they provide to patients. Baseline burnout measures in research provide inconclusive evidence of the determinants of burnout and how to target interventions to promote staff wellbeing. OBJECTIVES The objectives of this study were to determine the prevalence of burnout using the Maslach Burnout Inventory (MBI) burnout-engagement workplace profiles in a sample of Australian PICU staff and investigate associations between demographic characteristics, meaningful work, satisfaction with life, and psychological distress on burnout. METHODS A cross-sectional survey was administered to a multidisciplinary sample of PICU staff (target n = 464) from three tertiary paediatric hospitals in Australia. The survey tool was comprised of the MBI, Work and Meaning Inventory, Satisfaction with Life Scale, Kessler Psychological Distress Scale, and demographic questions. Hierarchical multiple regressions examined the relationships between burnout and these variables of interest. RESULTS A sample of 258 participants (56%) completed the survey. For most respondents, burnout was scored as a low to moderate risk, with over half the participants scoring low risk for emotional exhaustion (EE) (56%) and depersonalisation (DP) (54%). Personal accomplishment (PA) was more evenly distributed (range of burnout risk: low, 32%; moderate, 32%; high, 36%). MBI scores were classified using the burnout-engaged workplace profile system, identifying low levels of burnout (8% burnout, 3% disengaged, 21% overextended, 29% ineffective, and 39% engaged). Psychological distress significantly increased burnout risk across all three dimensions EE (β = 0.253, p < 0.001), DP (β = 0.145, p < 0.05), and PA (β = -0.13, p < 0.05), and being aged between 41 and 55 years was protective of depersonalisation (β = -0.214, p < 0.05). CONCLUSION Utilising MBI workplace profiles, this study has built upon the demand for a more comprehensive assessment of burnout. Research that helps improve our understanding of contributory factors to burnout and wellbeing will inform the development of effective interventions that promote wellbeing of staff.
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Olson R, Cunningham TR, Nigam JAS, Anger WK, Rameshbabu A, Donovan C. Total Worker Health® and Organizational Behavior Management: Emerging Opportunities for Improving Worker Well-being. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2022. [DOI: 10.1080/01608061.2022.2146256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ryan Olson
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
- Oregon Health & Science University-Portland State University, School of Public Health, Portland, Oregon, USA
- Portland State University, Department of Psychology, Portland, Oregon, USA
| | - Thomas R. Cunningham
- Division of Science Integration, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health,Cincinnati, USA
| | - Jeannie A. S. Nigam
- Division of Science Integration, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health,Cincinnati, USA
| | - W. Kent Anger
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Anjali Rameshbabu
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Courtney Donovan
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
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Stelson EA, Sabbath-Clayton LL, Sorensen G, Kubzansky LD, Berkman LF, Sabbath EL. Residential addiction treatment providers: Identifying the role of social context in worker health and turnover. Soc Sci Med 2022; 314:115462. [PMID: 36327634 DOI: 10.1016/j.socscimed.2022.115462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
Increased lethality and availability of addictive substances has strained US addiction treatment services, further exacerbating workforce shortages in these settings. The emotional and physical health toll of providing treatment may contribute to shortages. This community-initiated qualitative study aimed to identify conditions that affect provider health and turnover in residential addiction treatment from a Total Worker Health® perspective. Providers (direct service, supervisors, leaders) working in nonprofit residential treatment facilities in Massachusetts were recruited by role and geography to participate in interviews and focus groups. NVivo12 facilitated coding and analysis. 25% of transcripts were double coded to assess interrater reliability and coding consistency (mean Kappa = 0.82). Providers (N = 49) participated in 33 interviews and 4 focus groups. Many participants reported personal addiction histories. Analysis revealed how socio-contextual factors originating outside of residential facilities were dominant influences on "downstream" working conditions, worker health, staff turnover, and by extension, client care. Four primary socio-contextual themes surfaced:1) Changes in type and potency of substances and client need not reliably accompanied by shifts in treatment practices; 2) challenges balancing state requirements and state-provided resources; 3) influence of structural discrimination and addiction stigma on pay and professional advancement; and 4) geographic location of facilities shape work and quality of life. Results were used to develop a conceptual model for residential addiction treatment to illustrate pathways by which ecological factors interact to affect provider health and turnover. Findings indicate that protecting health and wellbeing of providers-many of whom are in addiction recovery themselves- is integral to improving addiction treatment. From this workforce's perspective, recent changes in socio-contextual factors have intensified already challenging working conditions (job demands, pay, advancement), negatively impacting worker health, turnover, and client care. Any interventions to improve treatment outcomes or working conditions in nonprofit addiction facilities must consider larger socio-contextual factors influencing these organizations.
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Affiliation(s)
- Elisabeth A Stelson
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA.
| | | | - Glorian Sorensen
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA; Dana-Farber Cancer Institute, Boston, MA, USA
| | - Laura D Kubzansky
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA
| | - Lisa F Berkman
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA
| | - Erika L Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, USA
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Vossen E, van der Gulden JWJ, van Genabeek JA, Schaap R, Anema JR, Schaafsma FG. Process evaluation of the 'Grip on Health' intervention in general and occupational health practice. BMC Health Serv Res 2022; 22:1459. [PMID: 36451237 PMCID: PMC9713133 DOI: 10.1186/s12913-022-08801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND For working patients with a lower socioeconomic position, health complaints often result from a combination of problems on multiple life domains. To prevent long-term health complaints and absence from work, it is crucial for general and occupational health professionals to adopt a broad perspective on health and to collaborate when necessary. This study aimed to evaluate how the 'Grip on Health' intervention is implemented in general and occupational health practice to address multi-domain problems and to promote interprofessional collaboration. METHOD A process evaluation was performed among 28 general and occupational health professionals, who were trained and implemented the Grip on Health intervention during a six-month period. The 'Measurement Instrument for Determinants of Innovations' was used to evaluate facilitators and barriers for implementing Grip on Health. Data included three group interviews with 17 professionals, a questionnaire and five individual interviews. RESULTS While most health professionals were enthusiastic about the Grip on Health intervention, its implementation was hindered by contextual factors. Barriers in the socio-political context consisted of legal rules and regulations around sickness and disability, professional protocols for interprofessional collaboration, and the Covid-19 pandemic. On the organizational level, lack of consultation time was the main barrier. Facilitators were found on the level of the intervention and the health professional. For instance, professionals described how the intervention supports addressing multi-domain problems and has created awareness of work in each other's healthcare domain. They recognized the relevance of the intervention for a broad target group and experienced benefits of its use. The intervention period was, nevertheless, too short to determine the outcomes of Grip on Health. CONCLUSION The Grip on Health intervention can be used to address problems on multiple life domains and to stimulate interprofessional collaboration. Visualizing multi-domain problems appeared especially helpful to guide patients with a lower socioeconomic position, and a joint training of general and occupational health professionals promoted their mutual awareness and familiarity. For a wider implementation, stakeholders on all levels, including the government and professional associations, should reflect on ways to address contextual barriers to promote a broad perspective on health as well as on collaborative work.
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Affiliation(s)
- Emma Vossen
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands ,grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, Laan van Scheut 10, 6525 EM Nijmegen, The Netherlands
| | - Joost W. J. van der Gulden
- grid.10417.330000 0004 0444 9382Department of Primary and Community Care, Radboudumc, Geert Grooteplein Noord 21, 6525 EZ Nijmegen, The Netherlands
| | | | - Rosanne Schaap
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Johannes R. Anema
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- grid.16872.3a0000 0004 0435 165XDepartment of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, Amsterdam, The Netherlands
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Cezar-Vaz MR, Xavier DM, Bonow CA, Vaz JC, Cardoso LS, Sant’Anna CF, da Costa VZ, Nery CHC, Loureiro HMAM. Occupational Well-Being of Multidisciplinary PHC Teams: Barriers/Facilitators and Negotiations to Improve Working Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15943. [PMID: 36498016 PMCID: PMC9737019 DOI: 10.3390/ijerph192315943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/04/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Well-being at work is one of the factors determining healthy work conditions and is perceived by workers as a positive psychological state. In this study, the concept of well-being at work was used together with occupational functionality (i.e., current health state, current work environment, and barriers/facilitators to implementing well-being at work), occupational risk perception, and proactivity/negotiations held by workers to improve working conditions. In this context, the objectives were to identify the socio-demographic and occupational characteristics independently associated with levels of well-being at work of the multidisciplinary PHC health team; detect barriers or facilitators resulting from the attitudes of colleagues, community members, and managers that influence the well-being at work of the multidisciplinary health team; and identify with whom and what reasons led health workers to become proactive and negotiate improved working conditions. This cross-sectional study addressed 338 health workers from the multidisciplinary teams of PHC outpatient services in the extreme south of Brazil. Multivariate linear regression models were adopted to analyze data. The results show various independent associations with levels of well-being at work. Nursing workers (technicians and nurses) more frequently expressed job commitment and job satisfaction. Difficulties in solving problems and performing work routines, and co-workers' attitudes directly influence the well-being of the PHC team members. Risk perception (physical and chemical) also influences well-being. Negotiations in which PHC managers engaged to improve working conditions appeared as a significant predictor of job commitment, job satisfaction, and job involvement. The results reveal that well-being at work is an important indicator of the potential of workers' proactivity in negotiating improved working conditions.
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Affiliation(s)
| | | | - Clarice Alves Bonow
- Faculty of Nursing, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | | | | | | | | | - Carlos Henrique Cardona Nery
- Institute of Human and Information Sciences—ICHI, Federal University of Rio Grande—Santa Vitória do Palmar Campus, Santa Vitória do Palmar 96230-000, Brazil
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Hult M, Saaranen T, Lindström PN. Calling as a resource for health and occupational wellbeing among the care sector workers in Finland. Work 2022; 74:723-732. [PMID: 36314183 DOI: 10.3233/wor-211326] [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: 11/05/2022] Open
Abstract
BACKGROUND The salutogenic approach in workplace health promotion emphasizes resources to gain and maintain good health and wellbeing. One of these resources could be calling, but its relation to the salutogenic approach is unknown. OBJECTIVE To explore the associations between salutogenic measures of health and occupational wellbeing and calling among workers from the care and educational sectors. METHODS A cross-sectional survey was conducted in Autumn 2020 among Finnish public and private sector care workers. A total of 7925 workers responded. Descriptive analyses and analysis of variance were used for the data analysis. RESULTS Salutogenic measures of health and occupational wellbeing correlated strongly mutually, and both correlated moderately with calling. Workers aged over 55 years, workers acting in the education sector, workers with superior positions and temporary workers had the highest scores on health, occupational wellbeing and calling. When comparing occupational wellbeing dimensions by profession, managers had the highest scores and nurses the lowest. CONCLUSIONS This study provides knowledge of promotive factors and health and occupational wellbeing resources for workplace health promotion in the care sector. Perceived calling in work can be considered a salutogenic resource for overall health and wellbeing; however, these connections should be further studied.
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Affiliation(s)
- Marja Hult
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Terhi Saaranen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Haas EJ, Cauda E. Using Core Elements of Health and Safety Management Systems to Support Worker Well-Being during Technology Integration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13849. [PMID: 36360729 PMCID: PMC9654975 DOI: 10.3390/ijerph192113849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Research studying the intersection of occupational safety and health (OSH) and direct reading and sensor technologies (DRST) is sparse, with a specific lack of research available that has empirically considered ways that DRST may impact worker well-being. In this paper, the authors examine how organizations could utilize core elements of their health and safety management system (HSMS) to coordinate and execute DRST in the workplace to support worker well-being. National Institute for Occupational Safety and Health (NIOSH) researchers developed a 39-item questionnaire targeting OSH professionals to understand attitudes toward DRST and the current and intended uses of DRST at their place of employment. Eighty-eight OSH professionals completed the questionnaire between August and December 2021. Descriptive results of the study sample are provided but the focus of the study applies the open-ended responses to two questions, which was deductively analyzed. Descriptive results show that reliability and validity of data was a top concern while the open-ended qualitative feedback revealed three primary themes: (1) acceptability and trust in technology; (2) ease of use; and (3) support and guidelines. Results provide an opening to use core HSMS elements (i.e., management commitment and leadership, communication and coordination, and employee involvement) during DRST integration to demonstrate support for workers during times of ambiguity and change.
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Affiliation(s)
- Emily J. Haas
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, PA 15236, USA
| | - Emanuele Cauda
- Pittsburgh Mining Research Division, National Institute for Occupational Safety and Health, Pittsburgh, PA 15236, USA
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Mercado M, Wachter K, Schuster RC, Mathis CM, Johnson E, Davis OI, Johnson-Agbakwu CE. A cross-sectional analysis of factors associated with stress, burnout and turnover intention among healthcare workers during the COVID-19 pandemic in the United States. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2690-e2701. [PMID: 35037346 DOI: 10.1111/hsc.13712] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/11/2021] [Accepted: 12/23/2021] [Indexed: 05/07/2023]
Abstract
In 2020, healthcare workers faced the COVID-19 pandemic amidst other salient sociopolitical stressors. This study, therefore, set out to examine associations between personal, work-related and contextual factors and three outcomes - stress, burnout and turnover intention - at a critical juncture in the pandemic. In December 2020, we recruited a broad array of healthcare workers (n = 985) in a public safety net healthcare system serving socially and economically marginalised communities in the Southwest region of the United States using a cross-sectional online survey. The results indicated that more health problems were associated with higher stress and burnout symptoms. While seeking emotional support and using drugs or alcohol to cope were associated with higher stress, a positive social outlook was associated with lower stress. Lower quality of work-life was associated with higher burnout symptoms and turnover intention. Negative effects of the pandemic on wellbeing and higher number of COVID-19-related concerns were associated with higher stress and burnout symptoms. Contrary to the original hypotheses, self-care was not associated with any of the three outcomes, and effects of the political climate and issues of racism on wellbeing were not associated with stress, burnout or turnover intention. However, identifying as a Person of Colour was associated with higher stress, as well as lower burnout. The findings on worker health, social outlook, quality of work-life and race/ethnicity, in particular, suggest a critical need for healthcare systems to address the wellbeing of workers through equitable organisational policy and practice.
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Affiliation(s)
- Micaela Mercado
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Watts College, School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Karin Wachter
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Watts College, School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Roseanne C Schuster
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- School of Human Evolution & Social Change, Arizona State University, Tempe, Arizona, USA
| | - Cherra M Mathis
- Watts College, School of Social Work, Arizona State University, Phoenix, Arizona, USA
| | - Emma Johnson
- School of Human Evolution & Social Change, Arizona State University, Tempe, Arizona, USA
- Barretts Honors College, Arizona State University, Tempe, Arizona, USA
| | - Olga Idriss Davis
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Barretts Honors College, Arizona State University, Tempe, Arizona, USA
- Hugh Downs School of Human Communication, Arizona State University, Tempe, Arizona, USA
| | - Crista E Johnson-Agbakwu
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona, USA
- Department of Obstetrics & Gynecology and Women's Health, Refugee Women's Health Clinic, Valleywise Health, Phoenix, Arizona, USA
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Chari R, Sauter SL, Petrun Sayers EL, Huang W, Fisher GG, Chang CC. Development of the National Institute for Occupational Safety and Health Worker Well-Being Questionnaire. J Occup Environ Med 2022; 64:707-717. [PMID: 35673249 PMCID: PMC9377498 DOI: 10.1097/jom.0000000000002585] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This article describes development of the National Institute for Occupational Safety and Health (NIOSH) Worker Well-Being Questionnaire (WellBQ). METHODS The NIOSH WellBQ was developed through literature reviews and expert panel recommendations. We drew from a representative sample of the civilian, noninstitutionalized, US working population to pilot the questionnaire. Psychometric analyses were performed on data from 975 respondents to finalize items and optimize the NIOSH WellBQ's psychometric properties. RESULTS The final questionnaire consists of 16 scales, 5 indices, and 31 single items across 5 domains: (1) work evaluation and experience; (2) workplace policies and culture; (3) workplace physical environment and safety climate; (4) health status; and (5) home, community, and society (experiences and activities outside of work). The instrument demonstrated adequate reliability and validity. CONCLUSIONS The NIOSH WellBQ is a reliable and valid instrument that comprehensively measures worker well-being.
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The Quality of Life and the Bio-Molecular Profile in Working Environment: A Systematic Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14138100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Working life is characterised by various requirements and degrees of control in meeting these demands. The imbalance of these elements with workers’ resources can result in work-related stress involving the repeated activation of stress response systems. Modifications in the bio-molecular profile may represent a biological signature of individuals’ life experiences and provide evidence on pathways through which such stressors can result in health outcomes. The aim of our systematic review is to characterize the quality of life (QOL) and the bio-molecular profile in the working population, to highlight if the alteration observed might be related to the working conditions. The article query was performed on PubMed, Embase, and Cochrane CENTRAL and results have been presented according to three molecular pathways involved in the stress response: oxidative stress, inflammation, and neuroendocrine activation. The epidemiological sample has been sub-grouped into “clinical” and “non-clinical” populations according to the presence of a diagnosis of psychological disorders. Besides some critical issues, the review highlights the importance of developing a valid array of biological indicators, measurable in non-invasive matrices, sensitive to both derangements from physiological conditions and stress reduction, useful for identifying those groups at higher risk of health outcomes and, eventually, promoting workers’ wellbeing.
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Hernandez R, Roll SC, Jin H, Schneider S, Pyatak EA. Validation of the National Aeronautics and Space Administration Task Load Index (NASA-TLX) adapted for the whole day repeated measures context. ERGONOMICS 2022; 65:960-975. [PMID: 34766872 PMCID: PMC9124236 DOI: 10.1080/00140139.2021.2006317] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Our objective was to investigate the validity of four-item and six-item versions of the National Aeronautics and Space Administration Task Load Index (NASA-TLX, or TLX for short) for measuring workload over a whole day in the repeated measures context. We analysed data on 51 people with type 1 diabetes from whom we collected ecological momentary assessment and daily diary data over 14 days. The TLX was administered at the last survey of every day. Confirmatory factor analysis fit statistics indicated that neither the TLX-6 nor TLX-4 were a unidimensional representation of whole day workload. In exploratory analyses, another set of TLX items we refer to as TLX-4v2 was sufficiently unidimensional. Raw sum scores from the TLX-6 and TLX-4v2 had plausible relationships with other measures, as evidenced by intra-person correlations and mixed-effects models. TLX-6 appears to capture multiple factors contributing to workload, while TLX-4v2 assesses the single factor of 'mental strain'. Practitioner Summary: Using within-person longitudinal data, we found evidence supporting the validity of a measure evaluating whole-day workload (i.e. workload derived from all sources, not only paid employment) derived from the NASA-TLX. This measure may be useful to assess how day-to-day variations in workload impact quality of life among adults.Abbreviations: NASA-TLX or TLX: National Aeronautics and Space Administration Task Load Index; TLX-6: six item version of the NASA-TLX; TLX-4: four item version of the NASA-TLX, TLX-4v2: four item NASA-TLX version two; NIOSH: National Institute for Occupational Safety and Health; CFA: confirmatory factor analysis; T1D: type 1 diabetes; EMA: ecological momentary assessment; BG: blood glucose; SD: standard deviation; CV: coefficient of variation; RMSEA: root mean square error of approximation; CFI: comparative fit index; TLI: Tucker-Lewis Index; SRMR: standardized root mean square residual; AIC: Akaike information criterion; BIC: Bayesian information criterion; χ2: Chi-square statistic.
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Affiliation(s)
- Raymond Hernandez
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089 United States
| | - Shawn C. Roll
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089 United States
| | - Haomiao Jin
- Dornsife Center for Self-Report Science and Center for Social & Economic Research, University of Southern California, Los Angeles, California, USA
| | - Stefan Schneider
- Dornsife Center for Self-Report Science and Center for Social & Economic Research, University of Southern California, Los Angeles, California, USA
| | - Elizabeth A. Pyatak
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St, Los Angeles, CA 90089 United States
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(Re-)Defining ergonomics in hand therapy: Applications for the management of upper extremity osteoarthritis. J Hand Ther 2022; 35:400-412. [PMID: 35871881 DOI: 10.1016/j.jht.2022.06.006] [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: 04/11/2022] [Accepted: 06/10/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Invited literature review BACKGROUND: Arthritis is the leading cause of disability in adults, and research shows that people living with arthritis experience work instability, loss of independence, financial difficulties, and overall decreased quality of life. Current nonpharmacological treatments can be beneficial for short term relief; however, the evidence on these long-term treatments is limited. Ergonomic modifications have been used in the workplace to address musculoskeletal conditions to ensure proper fit of one's environment, and research shows that these modifications can decrease pain and injury and increase work productivity. A broader perspective on ergonomic approaches may be important to supporting individuals with arthritis within hand therapy. PURPOSE OF THE STUDY This review proposes an expanded perspective on ergonomic approaches within hand therapy and explores published literature to identify potential benefits of applying ergonomic approaches for individuals with upper extremity arthritis. METHODS A systematic search and screening process was conducted to identify articles that implemented an ergonomic approach for the support of individuals with upper extremity osteoarthritis or rheumatoid arthritis. RESULTS A total of 34 articles described interventions that employed ergonomics including task-based or general ergonomics (n = 17), contextualized supports (n = 8), or holistic, lifestyle approaches (n = 9). Only one study focused solely on individuals with osteoarthritis, whereas interventions for individuals with rheumatoid arthritis showed positive outcomes across these categories. Situational learning, building of patient self-efficacy, and development of new habits and routines are vital for carryover and implementation to support performance in daily life. CONCLUSION There is an opportunity for hand therapists to extend the scope of interventions provided as part of an ergonomic approach to supporting patients. Specifically, therapists can consider use of emerging technologies and telehealth that promote contextualization and follow-up for long-term outcomes.
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Ray TK. Work related well-being is associated with individual subjective well-being. INDUSTRIAL HEALTH 2022; 60:242-252. [PMID: 34732595 PMCID: PMC9171114 DOI: 10.2486/indhealth.2021-0122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/26/2021] [Indexed: 06/13/2023]
Abstract
This study utilizes Gallup-ShareCare Well-being Index data to investigate the association between work-related well-being, i.e., job satisfaction, and overall subjective well-being among US workers. Subjective well-being is measured by i) daily positive and negative emotional experiences - happiness, smiles, enjoyment, sadness, anger, worry, and stress (hedonic well-being); and ii) current and future life evaluation (evaluative well-being). The study finds significant positive relationships between job satisfaction and subjective well-being both in terms of higher odds of positive hedonic experiences and increased life evaluation scores after controlling for covariates and other nonwork-related contributors to well-being. Job satisfaction accounted for a 14% increase in current and an 8% increase in future life evaluation scores. The results emphasize that not only the income generated by work but the quality of work is also important for worker well-being. In fact, those without a job had higher well-being than those workers who are dissatisfied at work. This is probably the first study that relates work-related well-being to overall well-being, using a nationally representative sample of US workers. Further, this is one of the few instances where the subjective measure of well-being is used in the occupational safety and health literature.
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Affiliation(s)
- Tapas K Ray
- Economics Research and Support Office (ERSO)
- National Institute of Occupational Safety and Health (NIOSH)
- Centers for Disease Control and Preventions (CDC)
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Working Conditions and Work Engagement by Gender and Digital Work Intensity. INFORMATION 2022. [DOI: 10.3390/info13060277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Telework and other flexible working arrangements, which have exponentially expanded with new advancements in digitalization and the impact of COVID-19, are modifying working conditions and workers’ engagement. Using the ‘job demands-resources’ model, we applied multivariate techniques to examine the different ways in which telework intensity impacts working conditions by gender. Increased intensity of remote working was positively associated with better skills and discretion and work engagement, while it was negatively associated with the other dimensions of job quality (particularly with working time quality). Even though women usually score higher than men in work intensity or working time quality, high intense female teleworkers experience a downturn with respect to these two items. Low and medium intensities of teleworking were positively associated with skills and discretion, working time quality, improved physical environment, and especially with better prospects and earnings. In conclusion, the intensity of teleworking and gender affect job quality and work engagement in different degrees, highlighting the importance of including these multiple effects on the design of flexible working arrangements.
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Teoh KRH, Vasconcelos AG, Lima EP. Work and Nonwork Contributory Factors to Health Care Workers' Mental Health. Am J Public Health 2022; 112:703-705. [PMID: 35417214 PMCID: PMC9010910 DOI: 10.2105/ajph.2022.306789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Kevin R H Teoh
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alina G Vasconcelos
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo P Lima
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Schwatka NV, Jaramillo D, Dally M, Krisher L, Dexter L, Butler-Dawson J, Clancy R, Fisher GG, Newman LS. Latin American Agricultural Workers' Job Demands and Resources and the Association With Health Behaviors at Work and Overall Health. Front Public Health 2022; 10:838417. [PMID: 35462804 PMCID: PMC9021611 DOI: 10.3389/fpubh.2022.838417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
In the present study, we describe the job demands and job resources (JD-R) experienced by agricultural workers in three Latin American countries and their relationship to proactive health behaviors at work and overall health. Following previous research on the JD-R model, we hypothesized that job demands (H1) would be negatively related to agricultural workers' self-reported overall health. On the other hand, we hypothesized that job resources (H2) would be positively related to agricultural workers' overall health. Furthermore, we hypothesized (H3) that workers' engagement in jobsite health promotion practices via their proactive health behaviors at work would partially mediate the relationship between workers' job resources and job demands and overall health. We also had a research question (R1) about whether there were differences by type of job held. The sample of workers who participated in this study (N = 1,861) worked in Mexico, Guatemala, and Nicaragua for one large agribusiness that produces sugar cane. They worked in two distinct areas: company administration and agricultural operations. We administered employee health and safety culture surveys using survey methods tailored to meet the needs of both types of workers. Stratified path analysis models were used to test study hypotheses. In general, we found support for hypotheses 1 and 2. For example, operations workers reported more physically demanding jobs and administrative workers reported more work-related stress. Regardless, the existence of high job demands was associated with poorer overall health amongst both types of workers. We found that workers in more health-supportive work environments perform more proactive health behaviors at work, regardless of their role within the organization. However, hypothesis 3 was not supported as proactive health behaviors at work was not associated with overall health. We discuss future research needs in terms of evaluating these hypotheses amongst workers employed by small- and medium-sized agribusinesses as well as those in the informal economy in Latin America. We also discuss important implications for agribusinesses seeking to develop health promotion programs that meet the needs of all workers.
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Affiliation(s)
- Natalie V. Schwatka
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Diana Jaramillo
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Miranda Dally
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Lyndsay Krisher
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Lynn Dexter
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Jaime Butler-Dawson
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Rebecca Clancy
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Gwenith G. Fisher
- Department of Psychology, Colorado State University, Fort Collins, CO, United States
| | - Lee S. Newman
- Department of Environmental & Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Sears JM, Edmonds AT, Hannon PA, Schulman BA, Fulton-Kehoe D. Workplace Wellness Program Interest and Barriers Among Workers With Work-Related Permanent Impairments. Workplace Health Saf 2022; 70:348-357. [PMID: 35382639 DOI: 10.1177/21650799221076872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Nearly half of U.S. workers have access to workplace wellness programs (WWPs), 58% of workers with access participate. The aim of this study was to assess interest in WWP participation and identify reasons for lack of interest among workers with work-related permanent impairments-a population at elevated risk of adverse health outcomes. METHODS Workers who returned to work after a work-related permanent impairment were interviewed 11 to 15 months after workers' compensation claim closure. Qualitative content analysis methods were used to code open-ended responses. FINDINGS Of 560 respondents, 51.4% expressed interest in WWP participation. Numerous adverse health and economic characteristics were associated with WWP interest, for example, interest was expressed by 63.3% of workers reporting fair/poor health status versus 47.1% reporting good/excellent; 56.9% of workers reporting moderate/severe pain versus 41.4% reporting mild/no pain; 64.7% of workers without health insurance versus 50.1% with health insurance; 69.0% of workers reporting depression versus 47.2% without depression; 70.4% of workers reporting obesity versus 48.0% without obesity; and 63.2% of workers often worried about expenses versus 46.9% reporting sometimes/never worried. Specific participation barriers were described by 34.2% of the 272 workers who were not interested. CONCLUSIONS/APPLICATIONS TO PRACTICE A majority of workers with work-related permanent impairments-particularly those with adverse health and economic characteristics-were interested in WWPs. Many workers who reported no interest cited participation barriers. Further research is needed to determine whether addressing such barriers would enhance equitable access. Those undertaking WWP planning, implementation, and outreach should ensure that WWPs are inclusive and serve workers with disabilities.
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Affiliation(s)
- Jeanne M Sears
- Department of Health Systems and Population Health, University of Washington, Seattle
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
- Harborview Injury Prevention and Research Center, Seattle
- Institute for Work and Health, Toronto
| | - Amy T Edmonds
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Peggy A Hannon
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Beryl A Schulman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
| | - Deborah Fulton-Kehoe
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
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Fadare O, Doucette WR, Gaither C, Schommer JC, Arya V, Bakken B, Kreling DH, Mott DA, Witry MJ. Exploring the moderating role of job resources in how job demands influence burnout and professional fulfillment among U.S. pharmacists. Res Social Adm Pharm 2022; 18:3821-3830. [DOI: 10.1016/j.sapharm.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/09/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
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50
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Beckel JLO, Fisher GG. Telework and Worker Health and Well-Being: A Review and Recommendations for Research and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3879. [PMID: 35409563 PMCID: PMC8998114 DOI: 10.3390/ijerph19073879] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 01/24/2023]
Abstract
Telework (also referred to as telecommuting or remote work), is defined as working outside of the conventional office setting, such as within one's home or in a remote office location, often using a form of information communication technology to communicate with others (supervisors, coworkers, subordinates, customers, etc.) and to perform work tasks. Remote work increased over the last decade and tremendously in response to the COVID-19 pandemic. The purpose of this article is to review and critically evaluate the existing research about telework and worker health and well-being. In addition, we review and evaluate how engaging in this flexible form of work impacts worker health and well-being. Specifically, we performed a literature search on the empirical literature related to teleworking and worker health and well-being, and reviewed articles published after the year 2000 based on the extent to which they had been discussed in prior reviews. Next, we developed a conceptual framework based on our review of the empirical literature. Our model explains the process by which telework may affect worker health and well-being in reference to individual, work/life/family, organizational, and macro level factors. These components are explained in depth, followed by methodological and fundamental recommendations intended to guide future research, policies, and practices to maximize the benefits and minimize the harms associated with telework, and offer recommendations for future research.
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Affiliation(s)
- Julia L. O. Beckel
- Department of Psychology, Colorado State University, Fort Collins, CO 80523, USA;
| | - Gwenith G. Fisher
- Department of Psychology, Colorado State University, Fort Collins, CO 80523, USA;
- Department of Environmental and Occupational Health, Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
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