The association between poor organizational climate and high work commitments, and sickness absence in a general population of women and men

Exploring the impact of mental and work-related stress on sick leave among middle-aged women: observations from the population study of women in Gothenburg, Sweden

OBJECTIVE

To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women.

DESIGN

The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline.

SUBJECTS

A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure.

METHODS

We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity.

RESULTS

Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment.

CONCLUSION

Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.

Pre-job loss grief reactions and work attachment among sick-listed employees: Introduction of the imminent Job Loss Scale

BACKGROUND

With this study, we aimed to explore the emotional experiences of sick-listed employees facing imminent job loss, as this emotional distress may hinder successful job search outcomes. The study had two objectives: (1) to develop and validate the Imminent Job Loss Scale (IJLS) for assessing pre-job loss grief reactions and (2) to examine its relationship to work attachment.

METHODS

Development of the 9-item IJLS was carried out using feedback from an expert panel, consisting of five academic experts in grief and labour, five re-integration specialists, and five sick-listed employees facing imminent job loss. The psychometric properties of the IJLS were evaluated, and its association with work attachment was examined using data from 200 sick-listed employees facing imminent job loss.

RESULTS

The IJLS demonstrated strong internal consistency and temporal stability, distinctiveness from depression and anxiety symptoms, and solid convergent validity. Work-centrality and organizational commitment were positively related to pre-job loss grief reactions, while work engagement and calling showed no significant associations.

CONCLUSION

This study provides valuable insights into pre-job loss grief reactions and shows the potential utility of the IJLS for screening and monitoring purposes. Understanding pre-job loss grief reactions can improve the re-integration and job prospects of sick-listed employees. In future research, explorations of these dynamics should continue to provide better support to sick-listed employees during this challenging period.

Work-related stress, reason for consultation and diagnosis-specific sick leave: How do they add up?

Work-related stress is common in Western society and disorders associated with stress are often managed in primary health care. This study was set to increase the understanding of the relationship between reason for consultation, work-related stress and diagnosis-specific sick leave for primary health care patients. The longitudinal observational study included 232 employed non-sick listed patients at seven primary health care centres in Sweden. Of these patients, 102 reported high work-related stress, as measured with the Work Stress Questionnaire, and 84 were on registered sick leave within one year after inclusion. The study showed that, compared to those who did not report high work-related stress, highly stressed patients more often sought care for mental symptoms (60/102 versus 24/130), sleep disturbance (37/102 versus 22/130) and fatigue (41/102 versus 34/130). The risk for sick leave with a mental diagnosis within a year after base-line was higher among patients reporting high work-related stress than among those who did not (RR 2.97, 95% CI 1.59;5.55). No such association was however found for the risk of sick leave with a musculoskeletal diagnosis (RR 0.55, 95% CI 0.22;1.37). Seeking care for mental symptoms, sleep disturbance and fatigue were associated with having a future mental sick leave diagnosis (p-values < 0.001), while seeking care for musculoskeletal symptoms was associated with having a future musculoskeletal sick leave diagnosis (p-value 0.009). In summary, compared to those who did not report high work-related stress, patients with high work-related stress more often sought care for mental symptoms, sleep disturbance and fatigue which lead to a mental sick leave diagnosis. Reporting high work-related stress was, however, not linked to having sought care for musculoskeletal symptoms nor future sick leave due to a musculoskeletal diagnosis. Hence, both patients and general practitioners seem to characterize work-related stress as a mental complaint.

Psychosocial resources predict frequent pain differently for men and women: A prospective cohort study

INTRODUCTION

Psychosocial resources, psychological and social factors like self-efficacy and social support have been suggested as important assets for individuals with chronic pain, but the importance of psychosocial resources for the development of pain is sparsely examined, especially sex and gender differences. The aim of this study was to investigate associations between psychosocial resources and sex on the development of frequent pain in a general population sample, and to deepen the knowledge about sex and gender patterns.

METHODS

A sample from the Swedish Health Assets Project, a longitudinal cohort study, included self-reported data from 2263 participants, 53% women, with no frequent pain at baseline. The outcome variable was frequent pain at 18-months follow-up. Psychosocial resources studied were general self-efficacy, instrumental and emotional social support. Log binomial regressions in a generalised linear model were used to calculate risk ratios (RRs), comparing all combinations of men with high psychosocial resources, men with low psychosocial resources, women with high psychosocial resources and women with low psychosocial resources.

RESULTS

Women with low psychosocial resources had higher risk of frequent pain at follow-up compared to men with high resources: general self-efficacy RR 1.82, instrumental social support RR 2.33 and emotional social support RR 1.94. Instrumental social support was the most important protective resource for women, emotional social support was the most important one for men. Results were discussed in terms of gender norms.

CONCLUSIONS

The psychosocial resources general self-efficacy, instrumental and emotional support predicted the risk of developing frequent pain differently among and between men and women in a general population sample. The results showed the importance of studying sex and gender differences in psychological and not least social predictors for pain.

General self-efficacy and social support in men and women with pain - irregular sex patterns of cross-sectional and longitudinal associations in a general population sample

BACKGROUND

The study of sex and gender patterns in psychosocial resources is a growing field of interest in pain research with importance for pain rehabilitation and prevention. The aims of this study were first, to estimate cross-sectional differences in psychosocial resources (general self-efficacy and social support) across men and women in a population with frequent musculoskeletal pain (pain in the back or neck/shoulder nearly every day or now and again during the week for the last 12 months) and to compare these differences with a population with no frequent pain. Second, to examine if psychosocial resources at baseline were associated with pain at follow-up among men and women in the frequent pain population.

METHODS

This study was based on survey data from the Swedish Health Assets Project, including The General Self-Efficacy Scale and social support questions. Participants (n = 4010, 55% women) were divided into no frequent pain (n = 2855) and frequent pain (n = 1155). General self-efficacy and social support were analyzed (cross-sectional and longitudinal data) with linear and logistic regressions.

RESULTS

Men, with and without frequent pain, had higher general self-efficacy than the corresponding groups in women. Women, with and without frequent pain, had stronger emotional social support than the corresponding groups in men. Men with no frequent pain had weaker instrumental social support than women with no frequent pain (OR = 0.64 (95% CI 0.47-0.87)), men with frequent pain did not (OR = 1.32 (95% CI 0.86-2.01)). In the frequent pain population, the interaction between sex and strong (compared to weak) emotional social support was statistically significant (p = 0.040) for no frequent pain at follow-up, with women having OR = 1.81 and men OR = 0.62. Among women, strong emotional social support was associated with no frequent pain at follow-up. Among men, strong emotional social support was associated with frequent pain at follow-up.

CONCLUSION

Some of the associations between general self-efficacy, social support and musculosceletal pain showed unexpected sex patterns. Gendered expectations might have relevance for some of the results.

Work-related stress and future sick leave in a working population seeking care at primary health care centres: a prospective longitudinal study using the WSQ

Background

Studying the relationship between work-related stress and sick leave is valuable in identifying and assessing employees at risk of sick leave, but also in developing interventions and taking actions for workers’ health. The overall aim of this study was to analyse the association between work-related stress, measured with the work stress questionnaire (WSQ), and registered sick leave in a working population seeking care at primary health care centres in Sweden.

Methods

A prospective longitudinal study was performed with 232 employed patients aged 18–64 years seeking care for mental and/or physical health complaints at seven primary health care centres. Bivariate logistic regression analysis adjusted for educational level, occupational class and marital status was performed using questionnaire data on work-related stress and sociodemographic factors collected between May 2015 until January 2016 together with registered sick leave data from a national database.

Results

High stress due to indistinct organization and conflicts was reported by 21% (n = 49), while 45% (n = 105) reported high stress due to individual demands and commitment. Thirty-six percent were on sick leave for 15 days or more during 12 months after baseline. The odds of being on registered sick leave during this period was approximately twice as high for patients perceiving high stress due to indistinct organization and conflicts (OR 2.25, 95% CI 1.18;4.26), high stress due to individual demands and commitment (OR 2.21, 95% CI 1.28;3.82), low influence at work (OR 2.07, 95% CI 1.20;3.57), or high interference between work and leisure time (OR 2.19, 95% CI 1.27;3.80). Perceiving high stress due to both indistinct organization and conflicts as well as individual demands and commitment quadrupled the odds of sick leave, OR 4.15 (95% CI 1.84; 9.38).

Conclusions

Work-related stress and sick leave were prevalent among the patients. Perceiving one or more of the work-related stressors and stress increased the odds of registered sick leave between two to four times. Hence, to capture the dynamic interaction between the individual and the work environment, a wide spectrum of factors must be considered. In addition, primary health care could be a suitable arena for preventing sick leave due to work-related stress.

Trial registration

ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13269-8.

Sex and Gender Differences in Occupational Hazard Exposures: a Scoping Review of the Recent Literature

PURPOSE OF REVIEW

Comparative research on sex and/or gender differences in occupational hazard exposures is necessary for effective work injury and illness prevention strategies. This scoping review summarizes the peer-reviewed literature from 2009 to 2019 on exposure differences to occupational hazards between men and women, across occupations, and within the same occupation.

RECENT FINDINGS

Fifty-eight studies retrieved from eight databases met our inclusion criteria. Of these, 30 studies were found on physical hazards, 38 studies on psychological/psychosocial hazards, 5 studies on biological hazards, and 17 studies on chemical hazards. The majority of studies reported that men were exposed to noise, vibration, medical radiation, physically demanding work, solar radiation, falls, biomechanical risks, chemical hazards, and blood contamination; while women were exposed to wet work, bullying and discrimination, work stress, and biological agents. Within the same occupations, men were more likely to be exposed to physical hazards, with the exception of women in health care occupations and exposure to prolonged standing. Women compared to men in the same occupations were more likely to experience harassment, while men compared to women in the same occupations reported higher work stress. Men reported more exposure to hazardous chemicals in the same occupations as women. The review suggests that men and women have different exposures to occupational hazards and that these differences are not solely due to a gendered distribution of the labor force by occupation. Findings may inform prevention efforts seeking to reduce gender inequalities in occupational health. Future research is needed to explain the reasons for sex/gender inequality differences in exposures within the same occupation.

Poorer mental well-being and prior unmet need for mental healthcare: a longitudinal population-based study on men in Sweden

Background

Depression and anxiety disorder contribute to a significant part of the disease burden among men, yet many men refrain from seeking care or receive insufficient care when they do seek it. This is plausibly associated with poorer mental well-being, but there is a lack of population-based research. This study investigated 1) if men who had refrained from seeking mental healthcare at any time in life had poorer mental well-being than those who sought care, 2) if those who had sought care but perceived it as insufficient had poorer mental well-being than those who had perceived care as sufficient, and 3) if these differences persisted after 1 year.

Methods

This longitudinal study used questionnaire data from a population-based sample of 1240 men, aged 19–64 years, in Sweden. Having refrained from seeking mental healthcare, or perceiving the care as insufficient, at any time in life, was assessed in a questionnaire, 2008. Current mental well-being was assessed in 2008 and 2009 using mean scores on the WHO (Ten) Well-being Index. Lower scores indicate poorer mental well-being. Group differences were calculated using t-tests and multivariable linear regression analysis.

Results

Of the men who had perceived a need for mental healthcare, 37% had refrained from seeking such care. They had lower mental well-being scores in 2008, compared to those who sought care. Of those seeking care, 29% had perceived it as insufficient. They had lower mental well-being scores in 2008, compared to those who perceived the care as sufficient, but this was not statistically significant when controlling for potential confounders. There were no differences in mental well-being scores based on care-seeking or perceived care-sufficiency in 2009.

Conclusions

This population-based study indicates that men who have previously refrained from seeking mental healthcare, or perceived the care as insufficient, have poorer mental well-being. However, the lack of differences at the one-year follow-up contradicts these results. The results highlight the need for larger longitudinal studies, measuring care-seeking within a more specified time frame. This should be combined with efforts to increase men’s mental healthcare-seeking and to provide mental healthcare that is perceived as sufficient.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13690-021-00706-0.

Self-reported sick leave following a brief preventive intervention on work-related stress: a randomised controlled trial in primary health care

OBJECTIVES

To evaluate the effectiveness of a brief intervention about early identification of work-related stress combined with feedback at consultation with a general practitioner (GP) on the number of self-reported sick leave days.

DESIGN

Randomised controlled trial. Prospective analyses of self-reported sick leave data collected between November 2015 and January 2017.

SETTING

Seven primary healthcare centres in western Sweden.

PARTICIPANTS

The study included 271 employed, non-sick-listed patients aged 18-64 years seeking care for mental and/or physical health complaints. Of these, 132 patients were allocated to intervention and 139 patients to control.

INTERVENTIONS

The intervention group received a brief intervention about work-related stress, including training for GPs, screening of patients' work-related stress, feedback to patients on screening results and discussion of measures at GP consultation. The control group received treatment as usual.

OUTCOME MEASURES

The number of self-reported gross sick leave days and the number of self-reported net sick leave days, thereby also considering part-time sick leave.

RESULTS

At 6 months' follow-up, 220/271 (81%) participants were assessed, while at 12 months' follow-up, 241/271 (89%) participants were assessed. At 6-month follow-up, 59/105 (56%) in the intervention group and 61/115 (53%) in the control group reported no sick leave. At 12-month follow-up, the corresponding numbers were 61/119 (51%) and 57/122 (47%), respectively. There were no statistically significant differences between the intervention group and the control group in the median number of self-reported gross sick leave days and the median number of self-reported net sick leave days.

CONCLUSIONS

The brief intervention showed no effect on the numbers of self-reported sick leave days for patients seeking care at the primary healthcare centres. Other actions and new types of interventions need to be explored to address patients' perceiving of ill health due to work-related stress.

TRIAL REGISTRATION NUMBER

NCT02480855.

Implementing Organizational WHP Into Practice: Obstructing Paradoxes in the Alignment and Distribution of Empowerment

Background: According to policy and theory, there is need for organizational workplace health promotion (WHP) to strengthen working conditions for all employees. However, earlier studies show it is hard to implement in practice. The aim was to critically analyze and identify interacting mechanisms and obstacles behind failures of organizational WHP projects from system perspectives. Methods: A holistic case study was performed, to critically analyze data from an organizational WHP project approach at a public health care organization. The qualitative data was collected over 5 years and included interviews with key actors (n = 80), focus groups (n = 59 managers), structured observations (n = 250 hours), continuous field observations and documents (n = 180). Questionnaires to employees (n = 2,974) and managers (n = 140) was complementing the qualitative-driven mixed method approach. Results: The analysis shows obstructing paradoxes of alignment and distribution of empowerment during the process of implementation into practice. The obstacles were interacting over system levels and were identified as: Governance by logics of distancing and detaching, No binding regulation of WHP, Separated responsibility of results, Narrow focus on delegated responsibilities, Store-fronting a strategic model, Keeping poor organizational preconditions and support for developments and Isolate WHP from other organizational developments. Conclusions: The following premises can be formulated regarding successful organizational WHP programs. Consider (1) the uncertainty a distributed empowerment to all system levels may create; (2) the distributed impact to define the target and allow broader areas to be included in WHP; and (3) the integration into other development processes and not reducing the organizational WHP to the form of a project.

Does early identification of high work related stress affect pharmacological treatment of primary care patients? - analysis of Swedish pharmacy dispensing data in a randomised control study

Background

The study is part of a randomised controlled trial with the overall aim to evaluate if use of the Work Stress Questionnaire (WSQ), combined with feedback at consultation, can be used by healthcare professionals in primary health care to prevent sickness absence. The specific aim of the present study was to investigate whether there were differences in pharmacy dispensing of prescription medications between the intervention group and the control group.

Methods

The study was a randomized controlled trial. Non-sick-listed employed women and men, aged 18 to 64 years, seeking care at primary health care centres (PHCCs) were eligible participants. The intervention included early identification of work-related stress by the WSQ, general practitioner (GP) training and GP feedback at consultation. Pharmacy dispensing data from the Swedish Prescription Drug Register for a period of 12 months following the intervention was used. Primary outcomes were the number of different medications used, type of medication and number of prescribing clinics. Data was analysed using Mann Whitney U tests and chi-square tests.

Results

The study population included 271 individuals (132 in the intervention group and 139 in the control group). The number of different medications used per individual did not differ significantly between the control group (median 4.0) and the intervention group (median 4.0, p-value 0.076). The proportion of individuals who collected more than 10 different medications was higher in the control group than in the intervention group (15.8% versus 4.5%, p = 0.002). In addition, the proportion of individuals filling prescriptions issued from more than three different clinics was higher in the control group than in the intervention group (17.3% versus 6.8%, p = 0.007).

Conclusion

Systematic use of the WSQ combined with training of GPs and feedback at consultation may affect certain aspects of pharmacological treatment in primary health care patients. In this randomised control trial, analysis of pharmacy dispensing data show that patients in the intervention group had less polypharmacy and filled prescriptions issued from a smaller number of different clinics.

Trial registration

ClinicalTrials.gov. Identifier: NCT02480855. Registered 20 May 2015.

The Work Stress Questionnaire (WSQ) - reliability and face validity among male workers

BACKGROUND

The Work Stress Questionnaire (WSQ) was developed as a self-administered questionnaire with the purpose of early identification of individuals at risk of being sick-listed due to work-related stress. It has previously been tested for reliability and face validity among women with satisfying results. The aim of the study was to test reliability and face validity of the Work Stress Questionnaire (WSQ) among male workers.

METHOD

For testing reliability, a test-retest study was performed where 41 male workers filled out the questionnaire on two occasions at 2 weeks intervals. For evaluating face validity, seven male workers filled out the questionnaire and gave their opinions on the questions, scale steps and how the items corresponded to their perception of stress at work.

RESULTS

The WSQ was, for all but one item, found to be stable over time. The item Supervisor considers one's views showed a systematic disagreement, i.e. there was a change common to the group for this item. Face validity was confirmed by the male pilot group.

CONCLUSION

Reliability and face validity of the WSQ was found to be satisfying when used on a male population. This indicates that the questionnaire can be used also for a male target group.

A prospective study on self-assessed mental well-being and work capacity as determinants of all-cause sickness absence

PURPOSE

The aim of the present study was to estimate whether self-assessed mental well-being and work capacity determines future sickness absence (SA).

METHODS

A questionnaire was sent to employed individuals (n = 6,140), aged 19-64 years, who were registered as sick-listed with a new sick-leave spell in 2008. The response rate was 54 %. In this study we included individuals with a single sick-leave spell in 2008 (n = 2,502). The WHO (Ten) Well-Being Index and four dimensions of self-assessed work capacity (knowledge, mental, collaborative, physical) were used as determinants. Future sickness absence was identified through national register in 2009. Outcome was defined as no sickness benefit compensated days (no SBCD) and at least one sickness benefit compensated day (SBCD). Logistic regression analyses were used to estimate odds ratios (OR) with 95 % confidence intervals (CI) for the likelihood of SBCD.

RESULTS

In 2009, 28 % of the women and 22 % of the men had SBCD; the median was 59 and 66 benefit days, respectively. Individuals with low mental well-being had higher odds for SBCD with OR 1.29 (95 % CI 1.01-1.65) in the fully adjusted model. Participants reporting low work capacity in relation to knowledge (OR 1.55, 95 % CI 1.13-2.13), collaborative (OR 1.36, 95 % CI 1.03-1.79) and physical (OR 1.50, 95 % CI 1.22-1.86) demands at work had higher odds for SBCD after adjustments for all covariates; no relation was demonstrated with mental work capacity (OR 0.99, 95 % CI 0.76-1.27).

CONCLUSION

Mental well-being and work capacity emerged as determinants of future SA. Screening in health care could facilitate early identification of persons in need of interventions to prevent future SA.

Previous sickness absence and current low perceived social support at work among employees in the general population: a historical cohort study

OBJECTIVE

Although sickness absence often is a process over time, most studies have treated the phenomenon as a discrete event and focused more on its causes than its consequences. We aimed to examine whether various patterns of previous long-term sickness absence were associated with current low perceived social support at work.

METHOD

This is a historical cohort study based on data from a population-based survey among Swedish employees (n=2581). The survey data were linked to official registries yielding data on sickness absence 1-7 years prior to the survey.

RESULTS

The main finding was that previous sickness absence was associated with current low perceived social support at work. The highest odds for low social support were found among those who had a stable high level of sickness absence. The two indicators of perceived social support employed were somewhat differently associated with previous sickness absence: Recency of absence showed to be of importance for general support at the workplace and the relationship with colleagues and superiors. Experiencing that one's immediate superior rarely or never regards one's view was, on the other hand, mainly related to having had a high level of sickness absence, irrespective of recency.

CONCLUSIONS

Our results indicate that recency and extent of previous sickness absence are related to perceived social support at work. Future research on the relationship between social support and sickness absence should use repeated measurements and acknowledge the possible bidirectional relationship.

General self-efficacy and its relationship to self-reported mental illness and barriers to care: a general population study

Given the prevalence of mental illness worldwide, it is important to better understand the dynamics of mental health help-seeking behavior to improve access to care. The aim of this study was to investigate if general self-efficacy (GSE) was associated with self-reported mental illness and help-seeking behavior and barriers to care in a randomized population. This study utilized a mailed questionnaire completed by 3,981 persons aged 19-64 years who resided in Western Sweden. GSE was measured and logistic regression models calculated, controlling for various sociodemographic variables. Results showed that 25% of men and 43% of women reported a lifetime prevalence of mental illness that they felt could have benefitted from treatment. Of those, 37% of the men and 27% of the women reported barriers to care. Men and women with low GSE were more likely to suffer from mental illness compared with persons high in GSE, but GSE did not enhance help-seeking behavior or perceived barriers to care. The most prevalent barriers to care for both sexes were beliefs that the illness will pass by itself, doubt whether treatment works, lack of knowledge of where to go and feelings of shame. Overall, GSE scores did not differ among those who experienced various barriers to care with the exception of two barriers only among women.

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.

Remain in work--what work-related factors are associated with sustainable work attendance: a general population-based study of women and men

OBJECTIVE

To analyze if organizational climate and work commitment, demand and control, job strain, social support, and physical demands at work are associated with remain in work (RIW), that is, work attendance without sick leave over 15 days per year.

METHODS

This Swedish cross-sectional study was based on 4013 workers (aged 19 to 64 years), randomly selected from a general population. Data were collected (2008) through postal questionnaire and registers.

RESULTS

Fair organizational climate, the combination of fair organizational climate and fair work commitment, high control, and low physical demands were associated with RIW for women and men.

CONCLUSIONS

This study adds to the rather scarce research findings on factors that promote RIW by identifying work organizational factors and physical prerequisites as being important. Preventive work to create a healthy work environment could be directed at improving organizational climate and reducing physical demands.

Relationships of organizational social capital with the presence of "gossip and slander," "quarrels and conflicts," sick leave, and poor work ability in nursing homes

PURPOSE

This study aimed to explore the associations of organizational social capital (OSC) with the presence of "gossip and slander," the presence of "conflicts and quarrels," sick leave prevalence, and prevalence of poor work ability in frontline working personnel of nursing homes.

METHODS

A total of 239 subjects (81 % participation), working in 11 different nursing homes, took part in a cross-sectional questionnaire study. Following end points were considered, they are as follows: prevalence of "gossip and slander," "conflicts and quarrels," sick leave, and poor work ability. Associations with OSC were explored at individual level (binomial log-linear regression analysis) and on group level (Kendall's tau correlation coefficients).

RESULTS

Significant associations were found between OSC and "gossip and slander," sick leave, and poor work ability, both in the individual- and group-level analyses. The associations showed a higher significance level in the group-level analyses, with the strongest association found between mean OSC of the workplace and the prevalence of poor work ability at the workplace (τ = -0.722; p = 0.002).

CONCLUSIONS

This study demonstrated significant associations of OSC with three end points that are relevant within the framework of well-being at work in nursing homes. The results are suggestive that OSC should be treated as a characteristic of the entire workplace, rather than as an individually experienced characteristic. The strikingly strong association between OSC and prevalence of poor work ability is suggestive for an important role of OSC within the context of maintaining work ability.

Worksite Health Promotion Program Participation

This study explores the relationship between organizational health climate and worksite health promotion program participation, specifically engaging individuals who are unlikely to make positive health behavior choices on their own. Participants consisted of employees at three separate furniture-manufacturing facilities completing a voluntary survey. Using responses ( n = 349) from the health climate instrument, which is a measure of the collective attitudes, beliefs, and readiness to change a health behavior, this study identified two factors that were significant contributors to worksite health promotion program participation. Health norms, the collective attitudes regarding healthy lifestyle, as measured by the subscales—health scale and intention to make a behavior change—and “optimistic bias,” the overassessment of one’s personal health, were found to be predictors of participation. Additionally, significant ( p < .05) predictors of self-assessed health, included perceived control to initiate, competence to carry out, and the organizational support of the health behavior change. The findings suggest that the organization’s health norms and self-assessed health are associated with the worker’s motivation to become involved with health promotion interventions. Offering worksite health screenings and advanced programming and creating a culture of health at work can help address program participation.

Self-assessed mental health problems and work capacity as determinants of return to work: a prospective general population-based study of individuals with all-cause sickness absence

BACKGROUND

Mental health problems are common in the work force and influence work capacity and sickness absence. The aim was to examine self-assessed mental health problems and work capacity as determinants of time until return to work (RTW).

METHODS

Employed women and men (n=6140), aged 19-64 years, registered as sick with all-cause sickness absence between February 18 and April 15, 2008 received a self-administered questionnaire covering health and work situation (response rate 54%). Demographic data was collected from official registers. This follow-up study included 2502 individuals. Of these, 1082 were currently off sick when answering the questionnaire. Register data on total number of benefit compensated sick-leave days in the end of 2008 were used to determine the time until RTW. Self-reported persistent mental illness, the WHO (Ten) Mental Well-Being Index and self-assessed work capacity in relation to knowledge, mental, collaborative and physical demands at work were used as determinants. Multinomial and binary logistic regression analyses were used to estimate odds ratios with 95% confidence intervals (CI) for the likelihood of RTW.

RESULTS

The likelihood of RTW (≥ 105 days) was higher among those with persistent mental illness OR= 2.97 (95% CI, 2.10-4.20) and those with low mental well-being OR= 2.89 (95% CI, 2.31-3.62) after adjusting for gender, age, SES, hours worked and sick leave 2007. An analysis of employees who were off sick when they answered the questionnaire, the likelihood of RTW (≥ 105 days) was higher among those who reported low capacity to work in relation to knowledge, mental, collaborative and physical demands at work. In a multivariable analysis, the likelihood of RTW (≥ 105 days) among those with low mental well-being remained significant OR=1.93 (95% CI 1.46-2.55) even after adjustment for all dimensions of capacity to work.

CONCLUSION

Self-assessed persistent mental illness, low mental well-being and low work capacity increased the likelihood of prolonged RTW. This study is unique because it is based on new sick-leave spells and is the first to show that low mental well-being was a strong determinant of RTW even after adjustment for work capacity. Our findings support the importance of identifying individuals with low mental well-being as a way to promote RTW.

The combination of work organizational climate and individual work commitment predicts return to work in women but not in men

OBJECTIVE

To analyze if the combination of organizational climate and work commitment can predict return to work (RTW).

METHODS

This prospective Swedish study was based on 2285 participants, 19 to 64 years old, consecutively selected from the employed population, newly sick-listed for more than 14 days. Data were collected in 2008 through postal questionnaire and from register data.

RESULTS

Among women, the combination of good organizational climate and fair work commitment predicted an early RTW with an adjusted relative risk of 2.05 (1.32 to 3.18). Among men, none of the adjusted variables or combinations of variables was found significantly to predict RTW.

CONCLUSIONS

This study demonstrated the importance of integrative effects of organizational climate and individual work commitment on RTW among women. These factors did not predict RTW in men. More research is needed to understand the RTW process among men.

Psychometric analysis of the Swedish translation of the WHO well-being index

PURPOSE

The purpose of this study is to validate the Swedish translation of the WHO (Ten) and WHO (Five) Well-Being Questionnaires among three samples of Swedes.

METHODS

Baseline data collected in 2008 from the Health Assets Project are the data source consisting of three cohorts of Swedes aged 19-64 years: (1) a randomized general population cohort (n = 4,027); (2) employees sick-listed reported by the employer (n = 3,310); and (3) self-certified sick-listed individuals (n = 498). The psychometric properties of the scales are assessed using factor analysis, Cronbach's alpha, and examination of the relationship between scale scores and participants' self-reported adverse health conditions.

RESULTS

Factor analysis revealed a unidimensional factor structure for both scales, and Cronbach's alphas are very good to excellent. The scales correlate in the expected direction with almost all of the adverse health conditions considered.

CONCLUSIONS

The Swedish translation of the WHO (Ten) and WHO (Five) Well-Being Questionnaires is psychometrically sound, but the first item of both scales has weaker psychometric qualities in comparison with other scale items.

Early identification of work-related stress predicted sickness absence in employed women with musculoskeletal or mental disorders: a prospective, longitudinal study in a primary health care setting

PURPOSE

The objectives were to identify work-related stress, and to analyse whether or not work-related stress served to predict sick-leave in a population of employed women who saw a doctor due to musculoskeletal or mental disorder at primary health care centres.

METHODS

This prospective study was based on data collected with the Work Stress Questionnaire (WSQ) at baseline 2008 and at follow-up 2009 in the primary health care centres in western Sweden. A total of 198 women participated.

RESULTS

High perceived stress owing to indistinct organization and conflicts at baseline increased the risk for sick-leave 8 days or longer at follow-up. The adjusted relative risk (RR) was 2.50 (1.14-5.49). The combination of high stress perception owing to indistinct organization and high stress perception owing to individual demands and commitment increased the risk for sickness absence of 8 days or longer with an adjusted RR of 4.34 (1.72-10.99).

CONCLUSIONS

Work-related stress predicted sick-leave during the follow-up at 12 months. The WSQ seemed to be useful in identifying women at risk of future sick-leave. Thus, it can be recommended to introduce questions and questionnaires on work-related stress in primary health care settings to early identify women with the need for preventive measures in order to decrease risk for sick-leave due to work-related stress.