The Effects of Psychosocial Work Factors on Production Loss, and the Mediating Effect of Employee Health

Associations between Coping Profile and Work Performance in a Cohort of Japanese Employees

This study aimed to investigate the effects of coping profiles on work performance. Data were collected during a 2-year prospective cohort study of 1359 employees in Japan. Participants completed a self-administered questionnaire in 2018 (T1; baseline) and again in 2020 (T2; followup; followup rate: 69.8%) to enable the assessment of work performance, perceived stress, and stress coping profiles at T1 and T2. Multivariate logistic regression models and causal mediation analysis were performed to identify the effects of coping profiles on work performance. Covariates included age, sex, company, job type, employment status, working hours, holidays, and lifestyle behaviors (e.g., smoking, sleep duration). A dysfunctional coping profile (β = −1.17 [95% CI, −2.28 to −0.06], p = 0.039) was negatively associated with work performance. Coping profiles of planning (β = 0.86 [95% CI, 0.07−1.66]) and self-blame (β = −1.33 [95% CI, −1.96 to −0.70], p < 0.001) were significantly associated with work performance. Dysfunctional coping, specifically, self-blame (β = −1.22 [95% CI, −1.83 to −0.61]), mediated the association between stress and work performance. Thus, some coping profiles may lead to an increase or decrease in work performance. The possible impact of coping strategies on workers’ productivity requires further exploration. Furthermore, information on effective coping profiles should be incorporated into occupational health examinations.

Revisiting presenteeism to broaden its conceptualization: A qualitative study

BACKGROUND

Presenteeism is generally viewed as a symptom of organizational or individual dysfunction and is rarely considered as a behavioral response to positive triggering factors. Our study examines this issue in small enterprises (SEs), which are an unexplored environment in terms of presenteeism.

OBJECTIVE

Through in-depth analysis, this study aims to understand the positive and negative factors that impact presenteeism in the context of small and medium enterprises (SMEs), with a particular focus on SEs.

METHODS

We adopt a qualitative methodological approach in which we conducted 17 semi-structured interviews with employees and owner-managers of SEs with between 20 and 49 employees.

RESULTS

Our thematic analysis shows that presenteeism can be explained by factors related to pressure to attend work, by individuals' constraints and commitment, by organizational and individual characteristics and by a congenial work environment. Presenteeism can also be a type of "therapy" which helps individuals to avoid focusing on being sick and enables them to stay active and avoid social isolation.

CONCLUSIONS

Our study differs from earlier research by providing a more in-depth analysis of the positive and negative factors that trigger presenteeism. This article will help to expand the current theoretical knowledge about presenteeism and encourage a more holistic interpretation of the phenomenon.

Attending work with chronic pain is associated with higher levels of psychosocial stress

Background and Aims: Much is known about the impact of pain in terms of medical costs and missed work. Less is known about its associations when individuals are present for work. This study examines "presenteeism" by analyzing the psychosocial costs of pain in the workplace, using the 2015 European Working Conditions Survey (EWCS). Methods: We conducted cross-sectional analysis of 2384 individuals with chronic pain and 2263 individuals without pain (matched by age and sex) using data from the 2015 EWCS. We compared groups in terms of the following psychosocial factors: supervisor support, job responsibility, team cohesion, discrimination, threats/abuse, job competency, job reward, sexual harassment, stress, and job security. The groups were also compared in terms of days lost due to illness. Results: People with pain were 64% less likely to view their job as rewarding (odds ratio [OR] = 0.61; 95% confidence interval [CI], 0.57-0.65), 47% more likely to be subjected to threats/abuse in the workplace (OR = 0.68; 95% CI, 0.63-0.73), 30% more likely to report poor supervisor support (OR = 0.77; 95% CI, 0.73-0.82), and 28% more likely to perceive discrimination in the workplace (OR = 0.78; 95% CI, 0.71-0.85). People with pain missed approximately nine more days of work per year than respondents without pain. Conclusions: Chronic pain was associated with lower vocational fulfillment and feelings of being ostracized in the workplace. These findings suggest that the presence of pain in the workplace goes well beyond lost productivity due to absenteeism.

Association of long working hours and health-related productivity loss, and its differential impact by income level: A cross-sectional study of the Korean workers

OBJECTIVES

We aimed to explore the association between long working hours and health-related productivity loss (HRPL), due to either sickness, absenteeism or presenteeism, stratified by household income level.

METHODS

From January 2020 to February 2020, data were collected using a web-based questionnaire. A total of 4197 participants were randomly selected using the convenience sampling method. The nonparametric association between weekly working hours and HRPL was determined. Subsequently, a stratified analysis was conducted according to household income (1st, 2nd, and 3rd tertiles). Finally, the differences in HRPL of the different working hour groups (<40, 40, 40-51, and ≥52 hours) were investigated using a multivariate linear regression model.

RESULTS

Long working hours were more significantly associated with HRPL, as compared to the 'standard' working hours (40 hours/week). A larger proportion of productivity loss was associated with the presenteeism of workers, rather than absenteeism. The relationship between HRPL and weekly working hours was more prominent in the lower household income group.

CONCLUSIONS

The results of our study indicate that HRPL is associated with long working hours, especially in the lower household income group. Reducing the workload for the individual employee to a manageable level and restructuring sick leave policies to effectively counteract absenteeism and presenteeism may be a feasible option for better labor productivity and employee health.

A Preliminary Investigation of Health and Work-Environment Factors on Presenteeism in the Workplace

OBJECTIVE

This study investigates the health and work-environment factors that are associated with presenteeism.

METHOD

A self-report survey that measured presenteeism, 13 health conditions (eg, stress and allergies), and nine work-environment factors (eg, job strain and leadership) was completed by 229 workers.

RESULTS

The most common health condition was stress, while the most common work-environment factor was job strain. Allergies, asthma, and high blood pressure along with work-life imbalance, poor leadership, and a lack of development opportunities were associated with presenteeism. Finally, several inter-relationships between the health and work-environment factors were also reported.

CONCLUSION

Interventions targeted at the points of intersection among the health conditions and work-environment factors could be a cost-effective way to improve employees' overall well-being at work, and thus reduce presenteeism.

Behavior Change Techniques in mHealth Apps for the Mental and Physical Health of Employees: Systematic Assessment

Background

Employees remain at risk of developing physical and mental health problems. To improve the lifestyle, health, and productivity many workplace interventions have been developed. However, not all of these interventions are effective. Mobile and wireless technology to support health behavior change (mobile health [mHealth] apps) is a promising, but relatively new domain for the occupational setting. Research on mHealth apps for the mental and physical health of employees is scarce. Interventions are more likely to be useful if they are rooted in health behavior change theory. Evaluating the presence of specific combinations of behavior change techniques (BCTs) in mHealth apps might be used as an indicator of potential quality and effectiveness.

Objective

The aim of this study was to assess whether mHealth apps for the mental and physical health of employees incorporate BCTs and, if so, which BCTs can be identified and which combinations of BCTs are present.

Methods

An assessment was made of apps aiming to reduce the risk of physical and psychosocial work demands and to promote a healthy lifestyle for employees. A systematic search was performed in iTunes and Google Play. Forty-five apps were screened and downloaded. BCTs were identified using a taxonomy applied in similar reviews. The mean and ranges were calculated.

Results

On average, the apps included 7 of the 26 BCTs (range 2-18). Techniques such as “provide feedback on performance,” “provide information about behavior-health link,” and “provide instruction” were used most frequently. Techniques that were used least were “relapse prevention,” “prompt self-talk,” “use follow-up prompts,” and “provide information about others’ approval.” “Stress management,” “prompt identification as a role model,” and “agree on behavioral contract” were not used by any of the apps. The combination “provide information about behavior-health link” with “prompt intention formation” was found in 7/45 (16%) apps. The combination “provide information about behavior-health link” with “provide information on consequences,” and “use follow-up prompts” was found in 2 (4%) apps. These combinations indicated potential effectiveness. The least potentially effective combination “provide feedback on performance” without “provide instruction” was found in 13 (29%) apps.

Conclusions

Apps for the occupational setting might be substantially improved to increase potential since results showed a limited presence of BCTs in general, limited use of potentially successful combinations of BCTs in apps, and use of potentially unsuccessful combinations of BCTs. Increasing knowledge on the effectiveness of BCTs in apps might be used to develop guidelines for app developers and selection criteria for companies and individuals. Also, this might contribute to decreasing the burden of work-related diseases. To achieve this, app developers, health behavior change professionals, experts on physical and mental health, and end-users should collaborate when developing apps for the working context.

Marginal socio-economic effects of an employer's efforts to improve the work environment

Background

Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed.

Methods

Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money.

Results

The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL.

Conclusion

Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.

The reciprocal relationship between sickness presenteeism and psychological distress in response to job stressors: evidence from a three-wave cohort study

OBJECTIVES

Sickness presenteeism (SP) is postulated as workers' response to their general state of health; hence, SP is expected to affect workers' future health. In the present study, we examined the reciprocal relationship between SP and health in response to job stressors, with specific reference to psychological distress (PD) as workers' state of health.

METHODS

We conducted mediation analysis, using data from a three-wave cohort occupational survey conducted at 1-year intervals in Japan; it involved 1,853 employees (1,661 men and 192 women) of a manufacturing firm. We measured SP and PD, using the World Health Organization Health and Work Performance Questionnaire and Kessler 6 score, respectively. For job stressors, we considered job demands and control, effort and reward, and procedural and interactional justice.

RESULTS

PD mediated 11.5%-36.2% of the impact of job control, reward, and procedural and interactional justice on SP, whereas SP mediated their impact on PD, albeit to a much lesser extent in the range of 3.4%-11.3%. Unlike in the cases of these job stressors related to job resources, neither SP nor PD mediated the impact of job demands or effort.

CONCLUSIONS

Our results confirmed the reciprocal relationship between SP and PD in response to selected types of job stressors, emphasizing the need for more in-depth analysis of the dynamics of these associations.

Social support and its interrelationships with demand-control model factors on presenteeism and absenteeism in Japanese civil servants

OBJECTIVES

To elucidate the impact of social support and its interrelations with other demand-control-support (DCS) model factors on presenteeism and absenteeism, and to determine which DCS factors were most influential.

METHODS

Questionnaires from 2535 local government employees were analyzed. The Brief Job Stress Questionnaire (BJSQ) was used to assess DCS factors including job demand, job control, and social support from supervisors and coworkers. The Stanford Presenteeism Scale 13-item version (SPS-13) was used to evaluate both absenteeism (absent days) and presenteeism. For the latter, the Work Impairment Score (WIS) and the Work Output Score (WOS) were also used. Possible confounder-adjusted logistic and negative binomial regression analyses were performed to obtain odds ratios (ORs) for WIS and WOS and relative risks (RRs) for absenteeism according to DCS factors.

RESULTS

Higher job control had a significantly protective effect on higher WIS in both males and females and a lower WOS in males. Based on a point estimate of an OR per 1 standard deviation change of each DCS factor, job control had the strongest effect on higher WIS in both males and females and a lower WOS in males. Higher job demand resulted in significantly higher ORs for both male and female WIS, and a lower WOS in females. Support from supervisors had a significantly protective effect on higher WIS in females and a lower WOS in males. Support from coworkers had a significantly protective effect on higher WIS in males. Higher support from coworkers had a significantly protective effect on absenteeism among both males and females, and higher job control had a significantly protective effect in females. The combination of high job strain and low support from supervisors had a significantly worsening effect, except for absenteeism in females. High job strain and low support from coworkers had a significantly worsening effect except for WOS in males.

CONCLUSIONS

The results suggest job control was the DCS factor most related to presenteeism. Higher support from supervisors and coworkers had a protective effect on presenteeism, and higher job demand had a worsening effect. Higher support from coworkers had a protective effect on absenteeism among both males and females. Interventions should focus on improving job control as a possible countermeasure to presenteeism, and encouraging support from coworkers as a possible countermeasure to absenteeism.

Healthy and productive workers: using intervention mapping to design a workplace health promotion and wellness program to improve presenteeism

Background

Presenteeism is a growing problem in developed countries mostly due to an aging workforce. The economic costs related to presenteeism exceed those of absenteeism and employer health costs. Employers are implementing workplace health promotion and wellness programs to improve health among workers and reduce presenteeism. How best to design, integrate and deliver these programs are unknown. The main purpose of this study was to use an intervention mapping approach to develop a workplace health promotion and wellness program aimed at reducing presenteeism.

Methods

We partnered with a large international financial services company and used a qualitative synthesis based on an intervention mapping methodology. Evidence from systematic reviews and key articles on reducing presenteeism and implementing health promotion programs was combined with theoretical models for changing behavior and stakeholder experience. This was then systematically operationalized into a program using discussion groups and consensus among experts and stakeholders.

Results

The top health problem impacting our workplace partner was mental health. Depression and stress were the first and second highest cause of productivity loss respectively. A multi-pronged program with detailed action steps was developed and directed at key stakeholders and health conditions. For mental health, regular sharing focus groups, social networking, monthly personal stories from leadership using webinars and multi-media communications, expert-led workshops, lunch and learn sessions and manager and employee training were part of a comprehensive program. Comprehensive, specific and multi-pronged strategies were developed and aimed at encouraging healthy behaviours that impact presenteeism such as regular exercise, proper nutrition, adequate sleep, smoking cessation, socialization and work-life balance. Limitations of the intervention mapping process included high resource and time requirements, the lack of external input and viewpoints skewed towards middle and upper management, and using secondary workplace data of unknown validity and reliability.

Conclusions

In general, intervention mapping was a useful method to develop a workplace health promotion and wellness program aimed at reducing presenteeism. The methodology provided a step-by-step process to unravel a complex problem. The process compelled participants to think critically, collaboratively and in nontraditional ways.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3843-x) contains supplementary material, which is available to authorized users.

Physical activity and relaxation in the work setting to reduce the need for recovery: what works for whom?

Background

To recover from work stress, a worksite health program aimed at improving physical activity and relaxation may be valuable. However, not every program is effective for all participants, as would be expected within a “one size fits all” approach. The effectiveness of how the program is delivered may differ across individuals. The aim of this study was to identify subgroups for whom one intervention may be better suited than another by using a new method called QUalitative INteraction Trees (QUINT).

Methods

Data were used from the “Be Active & Relax” study, in which 329 office workers participated. Two delivery modes of a worksite health program were given, a social environmental intervention (group motivational interviewing delivered by team leaders) and a physical environmental intervention (environmental modifications). The main outcome was change in Need for Recovery (NFR) from baseline to 12 month follow-up. The QUINT method was used to identify subgroups that benefitted more from either type of delivery mode, by incorporating moderator variables concerning sociodemographic, health, home, and work-related characteristics of the participants.

Results

The mean improvement in NFR of younger office workers in the social environmental intervention group was significantly higher than younger office workers who did not receive the social environmental intervention (10.52; 95 % CI: 4.12, 16.92). Furthermore, the mean improvement in NFR of older office workers in the social environmental intervention group was significantly lower than older office workers who did not receive the social environmental intervention ( −10.65; 95 % CI: −19.35, −1.96). The results for the physical environmental intervention indicated that the mean improvement in NFR of office workers (regardless of age) who worked fewer hours overtime was significantly higher when they had received the physical environmental intervention than when they had not received this type of intervention (7.40; 95 % CI: 0.99, 13.81). Finally, for office workers who worked more hours overtime there was no effect of the physical environmental intervention.

Conclusions

The results suggest that a social environmental intervention might be more beneficial for younger workers, and a physical environmental intervention might be more beneficial for employees with a few hours overtime to reduce the NFR.

Trial registration

NTR2553

A job demands-resources approach to presenteeism

Purpose

Utilising the job demands-resources (JD-R) model, the purpose of this paper is to examine how aspects of the psychosocial work environment (namely, job demands and resources) are associated with presenteeism, and in particular, whether they are indirectly related via burnout and work engagement.

Design/methodology/approach

A cross-sectional survey of 980 working Australians measured the relationships between job demands (i.e. workplace bullying, time pressure and work-family conflict), resources (i.e. leadership and social support), burnout, work engagement and presenteeism. Path analysis was used to test the proposed hypotheses whilst controlling for participant demographics (i.e. sex, age, work level, duration and education).

Findings

Higher job demands (workplace bullying, time pressure, and work-family conflict) and lower job resources (leadership only) were found to be indirectly related to presenteeism via increased burnout. While increased job resources (leadership and social support) were indirectly related to presenteeism via improved work engagement.

Practical implications

The findings are consistent with the JD-R model, and suggest that presenteeism may arise from the strain and burnout associated with overcoming excessive job demands as well as the reduced work engagement and higher burnout provoked by a lack of resources in the workplace. Intervention programmes could therefore focus on teaching employees how to better manage job demands as well as promoting the resources available at work as an innovative way to address the issue of rising presenteeism.

Originality/value

This study is important as it is one of the first to examine the theoretical underpinnings of the relationship between presenteeism and its antecedents.

Validity and test-retest reliability of an at-work production loss instrument

BACKGROUND

Besides causing ill health, a poor work environment may contribute to production loss. Production loss assessment instruments emphasize health-related consequences but there is no instrument to measure reduced work performance related to the work environment.

AIMS

To examine convergent validity and test-retest reliability of health-related production loss (HRPL) and work environment-related production loss (WRPL) against a valid comparable instrument, the Health and Work Performance Questionnaire (HPQ).

METHODS

Cross-sectional study of employees, not on sick leave, who were asked to self-rate their work performance and production losses. Using the Pearson correlation and Bland and Altman's Test of Agreement, convergent validity was examined. Subgroup analyses were performed for employees recording problem-specific reduced work performance. Consistency of pairs of HRPL and WRPL for samples responding to both assessments was expressed using Intraclass Correlation Coefficient (ICC) and tests of repeatability.

RESULTS

A total of 88 employees participated and 44 responded to both assessments. Test of agreement between measurements estimates a mean difference of 0.34 for HRPL and -0.03 for WRPL compared with work performance. This indicates that the production loss questions are valid and moderately associated with work performance for the total sample and subgroups. ICC for paired HRPL assessments was 0.90 and 0.91 for WRPL, i.e. the test-retest reliability was good and suggests stability in the instrument.

CONCLUSIONS

HRPL and WRPL can be used to measure production loss due to health-related and work environment-related problems. These results may have implications for advancing methods of assessing production loss, which represents an important cost to employers.

Work organization, exposure to workplace hazards and sickness presenteeism in the European employed population

BACKGROUND

Aim of the study was to identify work organization features and workplace hazards associated with sickness presenteeism (SP) among European workers.

METHODS

The study was conducted on data from the European Working Conditions Survey 2010 and included a study population of 30,279 employees. The relationship between work-related factors and SP was assessed through Poisson multivariate robust regression models, adjusting for significant (P < 0.05) individual and work-related characteristics.

RESULTS

SP for at least 2 days in the previous year was reported by 35% of the workers. In fully adjusted model, several psychosocial (decision authority, skill discretion, reward, abuse; psychological, cognitive, and emotional demand), and organizational factors (shift work, working with clients, long work hours) were positively associated with SP, whereas job insecurity and exposure to physical factors (lifting or moving people, vibration) decreased SP risk.

CONCLUSIONS

Our results support the importance of work-related factors, especially psychosocial exposures and organizational features, in determining workers' SP.

The determinants of presenteeism: a comprehensive investigation of stress-related factors at work, health, and individual factors among the aging workforce

OBJECTIVES

The aim of this study was to identify the determinants of presenteeism, taking health and individual factors into account.

METHODS

A quantitative analysis applying structural equation modelling analysis was conducted on the basis of secondary data from the Health and Retirement Survey (2008 wave), which measured presenteeism and its determinants.

RESULTS

Stress-related factors at work (β =-0.35, p<0.001), individual factors (α =-0.27, p<0.001), and health (β =0.24, p<0.001) were significantly related to presenteeism. Individual factors were found to be directly correlated with stress-related factors at work (β =0.22, p<0.001). Significant indirect effects between stress-related factors at work and presenteeism (Sobel z=-6.61; p<0.001) and between individual factors and presenteeism (Sobel z=-4.42; p<0.001), which were mediated by health, were also found. Overall, the final model accounted for 37% (R(2)=0.37) of the variance in presenteeism.

CONCLUSIONS

Our study indicates some important and practical guidelines for employers to avoid the burdens of stress-related presenteeism among their employees. These findings could help select target factors in the design and implementation of effective presenteeism interventions in the aging working population.

Measuring production loss due to health and work environment problems: construct validity and implications

OBJECTIVE

The aim was to validate two measures of production loss, health-related and work environment-related production loss, concerning their associations with health status and work environment factors.

METHODS

Validity was assessed by evaluating the construct validity. Health problems related and work environment-related problems (or factors) were included in separate analyses and evaluated regarding the significant difference in proportion of explained variation (R) of production loss.

RESULT

health problems production loss was not found to fulfill the criteria for convergent validity in this study; however, the measure of work environment-related production loss did fulfill the criteria that were set up.

CONCLUSION

The measure of work environment-related production loss can be used to screen for production loss due to work environment problems as well as an outcome measure when evaluating the effect of organizational interventions.

Workplace health promotion and working conditions as determinants of employee health

Purpose

– The purpose of this paper is to investigate general psychosocial work conditions and specific workplace health promotion (WHP) measures in relation to employee health and sickness absence in Swedish municipal social care organizations.

Design/methodology/approach

– In a random sample of 60 out of the 290 municipalities in Sweden, 15,871 municipal social care employees working with elderly and disabled clients were sent a questionnaire concerning psychosocial work environment, WHP, and self-rated health. The responses (response rate 58.4 per cent) were complemented by register data on sickness absence (>14 days). All data were aggregated to employer level.

Findings

– A structural equation modelling analysis using employer-level data demonstrated that employers with more favourable employee ratings of the psychosocial work conditions, as well as of specific health-promoting measures, had better self-rated health and lower sickness absence level among employees.

Practical implications

– The results from this representative nationwide sample of employers within one sector indicate that employers can promote employee health both by offering various health-specific programmes and activities, such as work environment education, fitness activities, and lifestyle guidance, as well as by forming a high-quality work environment in general including developmental and supportive leadership styles, prevention of role conflicts, and a supportive and comfortable social climate.

Originality/value

– This study with a representative nationwide sample demonstrates: results in line with earlier studies and explanations to the challenges in comparing effects from specific and general WHP interventions on health.

Exploring the role of co-worker social support on health care utilization and sickness absence

OBJECTIVES

To explore the association of baseline co-worker social support with follow-up measures of health care use and sickness absence.

METHODS

Data were obtained on 1240 employees from 33 worksites, through Promoting Activity and Changes in Eating, a group randomized weight maintenance trial. Co-worker social support, health care utilization, and absenteeism were assessed via a self-reported questionnaire. Generalized Estimating Equations were employed using STATA version 10.

RESULTS

Higher baseline co-worker social support was significantly associated with a greater number of doctors' visits (P = 0.015). Co-worker social support was unrelated to number of hospitalizations, emergency department visits, or absenteeism.

CONCLUSIONS

The relationship between co-worker social support and health care utilization and absenteeism is complex and uncertain. Future studies should measure more specific outcomes, incorporate important mediating variables, and distill how social networks influence these outcomes.