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Yu S, Zhao M, Li Y, Liu C, Fu Y, Jiang Y, Guan S. The interaction of occupational stress and job burnout on depressive symptoms in railway workers in Fuzhou city. BMC Public Health 2024; 24:1432. [PMID: 38811897 PMCID: PMC11134703 DOI: 10.1186/s12889-024-18902-2] [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: 11/08/2023] [Accepted: 05/21/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND To explore the relationship between occupational stress, burnout and depressive symptoms among railroad workers in Fuzhou, and to analyze the interaction of burnout and occupational stress on depressive symptoms. METHODS In this study, 861 railway employees of Fuzhou railway bureau were randomly selected from January to April, 2022. Occupational stress inventory revised edition (OSI-R), China job burnout inventory (CMBI) and Symptom Checklist-90 (SCL-90) were used to investigate the occupational stress, job burnout and depressive symptoms of railway workers. Interactions associated with depressive symptoms were assessed by linear hierarchical regression analysis and SPSS macros (PROCESS). RESULTS Occupational stress, job burnout and depressive symptoms accounted for 50.58%, 93.47%, and 11.19% of the study population, respectively. There were intergroup differences between age, marriage status, and length of service (P < 0.05). Occupational stress and job burnout are the main risk factors for depressive symptoms (OR: 2.01, 95% CI: 1.17-3.45; 1.94, 1.69-2.23, respectively). More importantly, further analysis of the interaction between occupational stress and job burnout showed that those with high levels of job burnout had a high-risk effect on depressive symptoms at high levels of occupational stress. CONCLUSION Occupational stress and job burnout are risk factors for depressive symptoms among railroad workers in Fuzhou City. The interaction of job burnout and occupational stress increases the risk of depressive symptoms.
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Affiliation(s)
- Shuangjie Yu
- School of Public Health, The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Min Zhao
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, China
| | - Ye Li
- School of Public Health, The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Can Liu
- School of Public Health, The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Youjuan Fu
- School of Public Health, The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Ningxia Medical University, Yinchuan, Ningxia, 750004, China
| | - Yu Jiang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, China.
| | - Suzhen Guan
- School of Public Health, The Key Laboratory of Environmental Factors and Chronic Disease Control of Ningxia, Ningxia Medical University, Yinchuan, Ningxia, 750004, China.
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Yinghao Z, Dan Z, Qi L, Yu W, Xiaoying W, Ao F, Lin Z. A cross-sectional study of clinical emergency department nurses' occupational stress, job involvement and team resilience. Int Emerg Nurs 2023; 69:101299. [PMID: 37269628 DOI: 10.1016/j.ienj.2023.101299] [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: 09/03/2022] [Revised: 04/03/2023] [Accepted: 04/24/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The occupational stress of clinical nurses has drawn increasing attention. It has been proven that occupational stress is related to job involvement, and job involvement affects team resilience. However, research on the relationship between emergency nurses' occupational stress, job involvement and team resilience is lacking. AIM To explore relationships between occupational stress, job involvement, and team resilience among a sample of emergency nurses and determined significant influencing factors of occupational stress in emergency departments. METHODS In four hospitals in Shandong, China, 187 emergency room nurses participated in a study. The Utrecht Work Engagement Scale, the Chinese version of the Stressors Scale for Emergency Nurses, and a scale for evaluating the team resilience of medical professionals were used to collect data. RESULTS The overall occupational stress score of nurses working in the emergency departments in Shandong province was 81.07 ± 25.80. The results of Single-factor analysis demonstrated that the scores indicating the occupational stress for emergency nurses differed significantly with respect to age, education level, marital status, children, professional title, work experience and work shift (P < 0.05). Additionally, there is a negative correlation between job involvement and team resilience and occupational stress. Multiple linear regression results showed that the job involvement, team resilience and work shift were statistically significant influencing factors of the level of occupational stress (change R2 = 17.5 %, F = 5.386, P < 0.001). CONCLUSIONS Stronger team resilience and more active job involvement resulted in lower occupational stress levels experienced by emergency nurses.
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Affiliation(s)
- Zhou Yinghao
- Affiliated Hospital of Qingdao University, China
| | - Zhou Dan
- Affiliated Hospital of Qingdao University, China
| | - Li Qi
- School of Nursing, Qingdao University, China
| | - Wu Yu
- School of Nursing and Rehabilitation, Shandong University, China
| | | | - Feng Ao
- School of Nursing, Qingdao University, China
| | - Zhao Lin
- Affiliated Hospital of Qingdao University, China.
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3
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Gerich J, Lehner R. Escape or activate? Pathways of work stress on substance use. Work 2023; 74:193-206. [PMID: 36245352 DOI: 10.3233/wor-211281] [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: 11/07/2022] Open
Abstract
BACKGROUND Research on the spillover effects of work stress on substance use have mainly focused on the concept of escapist substance. OBJECTIVE Building on the concept of self-endangering work behavior, we expand this stress-theoretic view with a presenteeism path of work-induced substance use. Contrary to emotion-based disengaging coping strategies associated with escapist use, we argue that high job demands may also promote problem-focused engagement coping, where substances are used for activation. METHODS A structural equation model was used to analyze both assumed pathways of stress-induced substance use with survey data from a random sample of n = 411 employees. RESULTS We confirmed that high job demands are directly related to escapist substance use, but indirectly related to activating substance use, mediated by presenteeism behavior. Both types of substance use are reduced in organizations with high psychosocial safety climate, but increase with higher competitive climate. Social support is related to reduced activating substance use. Males show a stronger tendency for the escapist path, whereas the presenteeism path is more prevalent in women. CONCLUSION Work stress may not only induce substance use as a disengaging emotional coping strategy, but also as an active problem-focused coping strategy, where employees engage in substance use to continue their efforts necessary for work-related goal attainment. A psychosocial safety climate may provide opportunities for intervening on the "cause of causes" of substance use. Moreover, due to the higher prevalence for activating substance use in female workers, previous research may have underestimated women's risks for work-induced substance use.
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Affiliation(s)
- Joachim Gerich
- Department of Sociology, Johannes Kepler University, Linz, Austria
| | - Roland Lehner
- Institute for the Prevention of Addictions and Drug Abuse, Linz, Austria
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Yinghao Z, Dan Z, Ao F, Lin Z. Chinese version of the stressor scale for emergency nurse: A methodological study design. Nurs Open 2022; 10:2999-3010. [PMID: 36484242 PMCID: PMC10077376 DOI: 10.1002/nop2.1546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
AIM The aim of this study was to modify and test the psychometric properties of the Chinese version of the stressor scale for emergency nurses. DESIGN The methodological design was carried out in two phases: (a) form the Chinese version by Delphi method and (b) test the psychometric properties by cross-sectional survey. METHODS The translated scale was administered to 420 nurses in Qingdao. Validity was assessed in terms of content validity, calibration correlation validity and construct validity using exploratory factor analysis and confirmatory factor analysis. Internal consistency was estimated using Cronbach α coefficients. RESULTS The Chinese version of the SSEN retains 27 items, four common factors were extracted by exploratory factor analysis, and the factor cumulative variance contribution rate was 78.463%. The fitting indexes of the four-factor model of CFA were all in the acceptable range[χ2 = 711.30, df = 312, p < 0.001, χ2 /df = 2.280, CFI = 0.933, TLI = 0.924, IFI = 0.933, RMSEA = 0.079 (90% confidence interval = 0.071-0.086)].The item-level content validity index of the Chinese SSEN is 0.89 ~ 1.00; the scale-level content validity index is 0.98; the Cronbach α coefficient of the total table is 0.971 and the split-half reliability is 0.877. PATIENT OR PUBLIC CONTRIBUTION The C-SSEN can be used to help nursing managers accurately formulate management measures to improve the stress coping ability of nurses in the ED, stabilize the nursing team and ensure nursing safety.
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Affiliation(s)
- Zhou Yinghao
- Affiliated Hospital of Qingdao University Qingdao China
- School of Nursing Qingdao University Qingdao China
| | - Zhou Dan
- Affiliated Hospital of Qingdao University Qingdao China
| | - Feng Ao
- School of Nursing Qingdao University Qingdao China
| | - Zhao Lin
- Affiliated Hospital of Qingdao University Qingdao China
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5
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Parsons MA. Thinking about Social Determinants of Health through the Relationality of Work and Drug Use. Med Anthropol Q 2022; 36:272-289. [PMID: 35107184 DOI: 10.1111/maq.12690] [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: 05/07/2021] [Revised: 12/08/2021] [Accepted: 12/17/2021] [Indexed: 11/27/2022]
Abstract
Public health often frames drug use and addiction as destructive and antithetical to productive citizenship, particularly formal employment. Anthropologists show how drug use emerges in specific institutional, social, and political economic contexts. This attention to context suggests that the relationship between drug use and work may not be as stable as epidemiology models it. There is a multiplicity to the relationality of work and drug use. These results are based on in-depth interviews conducted in 2018 and 2019 with 16 individuals undergoing addiction treatment at a residential facility in northern Arizona. In some cases, drug and alcohol use led to losing work. In other cases, drug and alcohol use made work more possible. The entanglements between work and drug use fluctuated through time. Social determinants of health are relationally brought into being, part of larger assemblages, and dynamic.
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Vittrup I, Droitcourt C, Andersen YMF, Skov L, Egeberg A, Delevry D, Fenton MC, Thyssen JP. Family burden of hospital-managed pediatric atopic dermatitis: A nationwide registry-based study. Pediatr Allergy Immunol 2022; 33:e13693. [PMID: 34726312 DOI: 10.1111/pai.13693] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Parents of children with atopic dermatitis (AD) report reduced quality of life and higher stress level, which could increase risk of psychiatric and pain disorders, and medication use. METHODS By use of Danish national registries, we identified family members of all first-born Danish children born between 1 January 1995 and 31 December 2013 with a hospital diagnosis of AD, matched them 1:10 with family members of children without AD, and followed the cohorts over time. RESULTS Mothers of children with hospital-managed AD had higher risk of filling a prescription for medications for depression, anxiety, pain and sleep problems, and of consulting a psychologist, but most associations disappeared after full adjustment. Siblings had higher risk of receiving a diagnosis for adjustment disorder, and fathers showed increased risk of filling a prescription for pain medication and of divorce, in crude but not adjusted models. CONCLUSIONS The increased risk of study endpoints seen in mothers of children with hospital-managed AD was not explained by pediatric AD alone. Rather, the total burden in these families including parent and child morbidity and socioeconomic resources seems to explain these observations. The burden in families of children with AD may potentially affect the overall management of their child's AD.
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Affiliation(s)
- Ida Vittrup
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Department of Dermatology and Venereology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Catherine Droitcourt
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Department of Dermatology, CHU Rennes, Rennes, France.,University of Rennes, EA 7449 REPERES "Pharmacoepidemiology and Health Services Research", Rennes, France
| | - Yuki M F Andersen
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Copenhagen University Hospital-Herlev and Gentofte, Copenhagen, Denmark
| | | | | | - Jacob P Thyssen
- Department of Dermatology and Venereology, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Nyberg A, Peristera P, Toivanen S, Johansson G. Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:53. [PMID: 35010313 PMCID: PMC8744622 DOI: 10.3390/ijerph19010053] [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: 10/19/2021] [Revised: 12/05/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The aim of this paper was to investigate if job demands, decision authority, and workplace violence mediate the association between employment in the health and social care industry and register-based sickness absence. METHODS Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in 2006-2016 (n = 3951) were included. Multilevel autoregressive cross-lagged mediation models were fitted to the data. Employment in the health and social care industry at one time point was used as the predictor variable and register-based sickness absence >14 days as the outcome variable. Self-reported levels of job demands, decision authority, and exposure to workplace violence from the first time point were used as mediating variables. RESULTS The direct path between employment in the health and social care industry and sickness absence >14 days was, while adjusting for the reverse path, 0.032, p = 0.002. The indirect effect mediated by low decision authority was 0.002, p = 0.006 and the one mediated by exposure to workplace violence was 0.008, p = 0.002. High job demands were not found to mediate the association. CONCLUSION Workplace violence and low decision authority may, to a small extent, mediate the association between employment in the health and social care industry and sickness absence.
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Affiliation(s)
- Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, SE-113 65 Stockholm, Sweden;
| | - Paraskevi Peristera
- Department of Psychology, Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Susanna Toivanen
- School of Health, Care and Social Welfare, Mälardalen University, P.O. Box 883, SE-721 23 Vasteras, Sweden;
| | - Gun Johansson
- Institute of Environmental Medicine, Karolinska Institutet, SE-113 65 Stockholm, Sweden;
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Effort-Reward Imbalance at Work and Drug Misuse: Evidence from a National Survey in the U.S. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413334. [PMID: 34948938 PMCID: PMC8702104 DOI: 10.3390/ijerph182413334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/25/2022]
Abstract
With the rise of drug misuse among workers in recent years, preliminary research on potential risk factors in the workplace of single-type of drug misuse has been reported. This is the first study to examine cross-sectional associations of work stress, in terms of effort-reward imbalance, with multiple drug misuse (including any drug misuse, opioid misuse, sedatives misuse, cannabis misuse, and other drug misuse) during the past 12 months in a national sample of U.S. workers. Data of 2211 workers were derived from the nationally representative and population-based Midlife in the United States (MIDUS) study. Internal consistency reliability and factorial validity of a 17-item effort-reward imbalance measure were robust and satisfactory. After adjustment for relevant covariates, logistic regression analyses showed that workers experiencing effort-reward imbalance at work had significantly higher odds of any drug misuse (OR and 95% CI = 1.18 (1.03, 1.37)), especially opioid misuse (OR and 95% CI = 1.35 (1.07, 1.69)) and other drug misuse (OR and 95% CI = 1.36 (1.01, 1.83)). The findings suggest that a stressful work environment may act as a determinant of drug misuse, and further prospective evidence is needed.
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Tan EC, Pan KY, Magnusson Hanson LL, Fastbom J, Westerlund H, Wang HX. Psychosocial job strain and polypharmacy: a national cohort study. Scand J Work Environ Health 2020; 46:589-598. [PMID: 32662868 PMCID: PMC7737808 DOI: 10.5271/sjweh.3914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives Psychosocial job strain has been associated with a range of adverse health outcomes. The aim of this study was to examine the association between psychosocial job strain and prospective risk of polypharmacy (the prescription of ≥5 medications) and to evaluate whether coping strategies can modify this risk. Methods Cohort study of 9703 working adults [mean age 47.5 (SD 10.8) years; 54% female] who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH) at baseline in 2006 or 2008. Psychosocial job strain was represented by job demands and control, and measured by the Swedish version of the demand-control questionnaire. The outcome was incidence of polypharmacy over an eight-year follow-up period. Information on dispensed drugs were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to estimate the association of job strain status with polypharmacy, adjusted for a range of confounders. Results During the follow-up, 1409 people developed polypharmacy (incident rate: 20.6/1000 person-years). In comparison to workers with low-strain jobs (high control/low demands), those with high-strain jobs (low control/high demands) had a significantly higher risk of incident polypharmacy (OR 1.40, 95% CI 1.04-1.89). The impact of high-strain jobs on developing polypharmacy remained among those with covert coping strategies (ie, directed inwards or towards others) but not among those with open coping strategies (ie, primarily directed toward the stressor). Conclusions Workers in high-strain jobs may be at an increased risk of polypharmacy. Open coping strategies may reduce the negative impact of psychosocial job strain on risk of polypharmacy.
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Affiliation(s)
- Edwin Ck Tan
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
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Milner A, Scovelle AJ, King T, Marck C, McAllister A, Kavanagh A, Shields M, Török E, Maheen H, O'Neil A. Gendered working environments as a determinant of mental health inequalities: a systematic review of 27 studies. Occup Environ Med 2020; 78:oemed-2019-106281. [PMID: 32817251 DOI: 10.1136/oemed-2019-106281] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 05/12/2020] [Accepted: 06/08/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND 'Gendered working environments' describes the ways in which (1) differential selection into work, (2) variations in employment arrangements and working hours, (3) differences in psychosocial exposures and (4) differential selection out of work may produce varied mental health outcomes for men and women. The aim of this study was to conduct a systematic review to understand gender differences in mental health outcomes in relation to the components of gendered working environments. METHODS The review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in 2008-2018. The protocol for the review was prospectively registered with PROSPERO (CRD42019124066). FINDINGS Across the 27 cohort studies included in the review, we found that (1) there was inconclusive evidence on the effect of occupational gender composition on the mental health of men and women, (2) women's mental health was more likely to be affected by long working hours than men's; however, precarious employment was more likely to be negatively associated with men's mental health, (3) exposure to traditional constructs of psychosocial job stressors negatively affected the mental health of both women and men, and (4) unemployment and retirement are associated with poorer mental health in both genders. INTERPRETATION The findings from this review indicate that gendered working environments may affect the mental health of both men and women, but the association is dependent on the specific exposure examined. There is still much to be understood about gendered working environments, and future research into work and health should be considered with a gender lens.
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Affiliation(s)
- Allison Milner
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Anna Joy Scovelle
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tania King
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Claudia Marck
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ashley McAllister
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Anne Kavanagh
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Marissa Shields
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Eszter Török
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Humaira Maheen
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Adrienne O'Neil
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Victoria, Australia
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Hannerz H, Albertsen K, Nielsen ML, Garde AH. Prospective Associations Between Working Time Arrangements and Psychiatric Treatment in Denmark: Protocol for a Cohort Study. JMIR Res Protoc 2020; 9:e18236. [PMID: 32442158 PMCID: PMC7351261 DOI: 10.2196/18236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The burden of mental ill health in working-age populations has prompted research on possible links between work-related factors and mental ill health. Long working hours and night shift work are some of the factors that have been studied in relation to the risk of developing mental ill health. Yet, previous studies have not generated conclusive evidence, and further studies of high quality are needed. OBJECTIVE This study aims to investigate the prospective association between working time arrangements and mental health in terms of psychotropic drug usage or psychiatric hospital treatment in the general working population of Denmark. METHODS Data on total weekly working hours in any job and night shift work from the Danish Labor Force Survey 2000-2013 will be linked to data from the Psychiatric Central Research Register (expected 2400 cases during 700,000 person years at risk) and National Prescription Registry (expected 17,400 cases during 600,000 person years at risk). Participants will be followed for up to 5 years. We will use Poisson regression to separately analyze incidence rates of redeemed prescriptions for psychotropic medicine and incidence rates of psychiatric hospital treatment due to mood disorders, anxiety disorders, or stress-related disorders as a function of weekly working hours and night shift work. The analyses will be controlled for sex, age, calendar time of the interview, and socioeconomic status. RESULTS This is a study protocol. Power calculations indicate that the study has sufficient statistical power to detect relatively small differences in risks and minor interactions (eg, ~90% power to detect a rate ratio of 1.1 for psychoactive medication use). We expect the analyses to be completed by the end of 2020 and the results to be published in 2021. CONCLUSIONS In this study protocol, all hypotheses and statistical models of the project have been completely defined before we link the exposure data to the outcome data. The results of the project will indicate to what extent and in what direction the national burden of mental ill health in Denmark has been influenced by long working hours and night shift work. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/18236.
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Affiliation(s)
- Harald Hannerz
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | | | | | - Anne Helene Garde
- The National Research Center for the Working Environment, Copenhagen, Denmark
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Kerr P, Lupien S, Juster RP. Rx risk or resistance? Psychotropic medication use in relation to physiological and psychosocial functioning of psychiatric hospital workers. Psychoneuroendocrinology 2020; 115:104634. [PMID: 32145569 DOI: 10.1016/j.psyneuen.2020.104634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/21/2022]
Abstract
To avoid methodological biases, psychoneuroendocrine studies have generally excluded psychotropic medication users. In workplace stress research, this has limited our ability to understand how psychotropic medication use affects many stress-related measures of interest. In this exploratory study, the effects of psychotropic medication use on stress physiology, occupational stress, and mental health were measured in a sample of healthy adult psychiatric hospital workers (N = 203, 70 % women). Diurnal cortisol was assessed on two non-consecutive work-days at five time-points (e.g., awakening, thirty minutes after awakening, 2 P M, 4 P M and bedtime). Cortisol reactivity was assessed by exposing participants to the Trier Social Stress Test. An allostatic load index was constructed using 19 neuroendocrine, immune, cardiovascular, and metabolic biomarkers. Occupational stress (e.g., job strain, effort-reward imbalance) and psychiatric symptoms (e.g., depression, burnout) were assessed with well-validated self-reports. Results showed that psychotropic medication use had no significant effects on diurnal cortisol profiles; however, psychotropic users had significantly decreased cortisol reactivity to the Trier Social Stress Test and higher allostatic load. Psychotropic users also had decreased effort-reward imbalance, but not job strain. Depressive symptoms did not differ between psychotropic medications users and non-users; however, burnout symptoms were higher among psychotropic medication users than non-users. Taken together, our findings do not warrant the systematic exclusion of psychotropic medication users from psychoneuroendocrine studies if insights into individual differences are sought among workers and other populations exposed to elevated stress.
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Affiliation(s)
- Philippe Kerr
- Center on Sex⁎Gender, Allostasis, and Resilience, Montréal, Québec, Canada; Center for Studies on Human Stress, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
| | - Sonia Lupien
- Center for Studies on Human Stress, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada
| | - Robert-Paul Juster
- Center on Sex⁎Gender, Allostasis, and Resilience, Montréal, Québec, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Quebec, Canada.
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