Total workload and recovery in relation to worktime reduction: a randomised controlled intervention study with time-use data

The effect of mandatory post-call relief on sleep and wellness in ophthalmology residents

BACKGROUND

Multiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call.

METHODS

We conducted a two group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021.

RESULTS

Of twenty total residents participating in the survey portion, 18 residents participated in the sleep and activity tracking portion of the study, 9 in in the optional post-call relief cohort, and 9 in the mandatory post-call relief cohort. The mandatory post-call relief group recorded longer total sleep on call than the optional post-call relief group (p < 0.001). There was no difference in overnight sleep recorded on call (median 3.4 h), but residents recorded more time napping in the mandatory post-call relief cohort (p < 0.001). There was no significant difference between cohorts in amount of sleep while not on call. Residents in the mandatory post-call relief cohort recorded higher average daily steps, higher exercise time, and lower sedentary time than residents in the optional post-call relief cohort (p < 0.001). They also recorded lower median emotional exhaustion on the Maslach Burnout Inventory and lower stress in the Depression and Anxiety Stress Scale in the mandatory post-call relief cohort (p = 0.008).

CONCLUSIONS

Implementation of mandatory post-call relief policies with a partial night-float system among PGY-2 residents was associated with more post-call naps with more overall physical activity, lower emotional exhaustion scores, and lower stress scores, despite no changes to overnight sleep on call or total sleep. Although sample size limits interpretation of data, implementation of mandatory post call relief could be considered to improve post-call sleep in programs with home call.

Working time reduction, mental health, and early retirement among part-time teachers at German upper secondary schools - a cross-sectional study

Objective

Many secondary school teachers work part-time in order to cope with the high workload and to remain as healthy as possible until regular retirement. However, due to the acute shortage of teachers, the increase in the teaching obligation for part-time teachers (PTT) has become a topic of discussion in Germany. Whether a reduction in teaching hours is associated with benefits for mental health has not yet become evident. Therefore, this study investigated the relationship between the real working hours of PTT and their mental health as well as individual pension prognosis.

Methods

The cross-sectional study included 5,905 PTT at German upper secondary schools (female proportion: 81%, average age: 44 ± 9 years) who logged their working hours over four weeks. Four part-time groups (PTG) were formed based on the proportion of a full-time position worked: maximum (<100-90% = PTGmax - reference group - 17%), high (<90-75% = PTGhigh - 34%), medium (<75-50% = PTGmed - 40%) and low (<50% = PTGlow - 9%) teaching commitment. These groups were compared in terms of their average weekly working hours, mental health (inability to recover, risk of burnout) and predicted retirement age.

Results

The contractually agreed working time is exceeded to a relevant extent for PTT. The extent of unpaid overtime increases significantly the lower the teaching obligation is and lies on average between -0.4 (PTGmax) and 7.3 (PTGlow) hours/week. A reduction in teaching hours is neither related to the mental health of teachers nor to their decision to retire early (42%) or regularly (58%). However, predicted retirement is mainly explained by mental health status, gender and age (variance explanation: 24%, OR of predictors: maximum 2.1). One third of PTT reported inability to recover, 47% burnout symptoms and 3% a burnout syndrome.

Conclusion

Mental health is also a risk for PTT; reducing teaching hours alone does not improve it. However, good mental health increases the chance of regular retirement. Therefore, instead of a legal obligation, PTT should be encouraged to increase the number of teaching hours voluntarily in order to counteract the general shortage of teachers.

A narrative review of the physiology and health effects of burnout associated with veterinarian-pertinent occupational stressors

Chronic workplace stress and burnout are serious problems in veterinary medicine. Although not classified as a medical condition, burnout can affect sleep patterns and contributes to chronic low grade systemic inflammation, autonomic imbalance, hormonal imbalances and immunodeficiencies, thereby increasing the risks of physical and psychological ill health in affected individuals. Cultural misconceptions in the profession often lead to perceptions of burnout as a personal failure, ideas that healthcare professionals are somehow at lower risk for suffering, and beliefs that affected individuals can or should somehow heal themselves. However, these concepts are antiquated, harmful and incorrect, preventing the design of appropriate solutions for this serious and growing challenge to the veterinary profession. Veterinarians must first correctly identify the nature of the problem and understand its causes and impacts before rational solutions can be implemented. In this first part of two companion reviews, burnout will be defined, pathophysiology discussed, and healthcare and veterinary-relevant occupational stressors that lead to burnout identified.

Taking control of one's everyday life - a qualitative study of experiences described by participants in an occupational intervention

BACKGROUND

Sick leave due to stress-related ill-health is increasing and is often caused by occupational imbalance. These types of issues tend to affect both the ability to work and cope with everyday life, as well as the overall experience of health, negatively. There is still little knowledge on how to prepare people and workplaces for the return-to-work process after participation in a work rehabilitation program due to stress and occupational ill-health. Therefore, this study aimed to describe what is needed to achieve a balanced everyday life that includes paid work as experienced by individuals who had participated in a ReDO® intervention due to occupational imbalance and ill-health.

METHODS

The concluding notes from 54 informants' medical records were used for qualitative content analysis. The informants had participated in an occupational therapy group intervention to promote occupational health and regain full work capacity.

RESULTS

The analysis resulted in one major theme and four categories describing how the informants perceive that they must take control of their everyday life as a whole. By doing so, they need to work with structurization and prioritization, social interaction, boundary setting, and occupational meaningfulness.

CONCLUSION

The study indicates a highly relational process, where it is impossible to divide life into private and work, and presupposes balance in everyday life in multiple dimensions. Its contribution includes the formulation of perceived needs in the transition between intervention and return to work and could, through further research, be used to generate a more effective and sustainable return- and rehabilitation models.

Spillover and crossover effects of working time demands on work-life balance satisfaction among dual-earner couples: the mediating role of work-family conflict

To examine the spillover and crossover effects of working time demands (specifically, work contact in leisure time, evening work, and long work hours) on satisfaction with work-life balance among dual-earner couples, path analyses were conducted using data from the 2017/2018 German Family Panel (pairfam; N = 1,053 dual-earner couples). Working time demands were measured based on (a) answering work emails/phone calls in leisure time, (b) evening work, and (c) weekly work hours. High working time demands impaired workers' work-life balance satisfaction due to higher levels of work-life conflict. They indirectly affected partners' work-life balance satisfaction through two pathways: (a) workers' and partners' work-life conflict and (b) workers' work-life conflict and work-life balance satisfaction. These findings indicate that high working time demands negatively impact the work-life balance satisfaction of workers and their partners because of work-life conflict experienced either by the workers only or by both partners. In an increasingly digitalized labor market, measures are needed to reduce working time demands-and thus work-life conflict-for workers and their partners.

Effectiveness of Workplace Interventions for Improving Working Conditions on the Health and Wellbeing of Fathers or Parents: A Systematic Review

Evidence on the effectiveness of workplace interventions for improving working conditions on the health and wellbeing of fathers is scarce. We reviewed studies on the effectiveness of various workplace interventions designed to improve working conditions for the health and wellbeing of employed fathers and their families. Randomized controlled trials (RCTs) and quasi-randomized controlled trials of workplace interventions applied to employees with the aim of improving working conditions of employed parents, compared with no intervention, other active arms, placebo, wait list, or usual practice were included. Studies involving only women were excluded. An electronic search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, ERIC and SSCI was done for eligible studies. Studies were screened against predetermined criteria and assessment of risk of bias done using the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and the Risk of Bias Assessment tool for Non-randomized Studies for non-RCTs. Of the 8229 records identified, 19 reports were included in this review: 14 reports from five RCTs and five reports from two quasi-RCT studies. The studies were conducted in four different countries among working populations from various sectors. Studies addressing issues related to improving working conditions of fathers alone were lacking. All included studies assessed intervention effects on various health-related outcomes, the most common being sleep disturbances and mental health outcomes. Interventions administered yielded positive effects on various health outcomes across all seven studies. All included studies had methodological limitations, while study designs and methodologies lacked comparability. Consequently, a narrative synthesis of evidence is provided. Based on our findings, providing workplace interventions for improving working conditions may improve some aspects of the health and wellbeing of employed parents, including fathers.

Differences in Visual Working and Mobile Phone Usage Distance according to the Job Profile

PURPOSE

To analyze and characterize the pattern of visual working distance (WD) and mobile phone usage distance (MPD) in a large population, analyzing the differences in these parameters according to the job profile.

METHODS

Cross-sectional study consisting of a screening campaign evaluating the visual status of professionals from seven different environments. A total of 454 participants with a mean age of 41.5 years (range, 22-64 years) were revised. The screening campaign consisted of several rapid tests performed in a single session in the usual work environment of each participant, including measurement of WD, arm length, and MPD (VisionApp, VisionApp Solutions S.L.).

RESULTS

WD was significantly longer than MPD (82.5 ± 150.6 vs. 31.9 ± 6.3 cm, p < .001), whereas no significant differences were found between arm length (74.3 ± 4.8 cm) and WD (p = .493). WD was below 80 cm in 89.6% (407/454) of participants, whereas MPD was below 40 cm in 89.0% (404/454). No significant correlation was found between WD and MPD (r = 0.126, p = .117). Statistically significant differences were detected among job profile subgroups in WD (p < .001), with military personnel showing significantly longer WD than other professionals (p ≤ 0.018). Significant differences were also found between job profile subgroups in MPD (p = .006), with shorter MPDs for shoe factory professionals compared to sellers (p = .046).

CONCLUSIONS

WD and MPD vary significantly among individuals, but always showing a shorter MPD. WD varies significantly also according to the job profile, being necessary to consider this information when selecting the most optimal optical aid in each case, especially for the compensation of presbyopia.

Arbeitszeitgestaltung in der digitalisierten Arbeitswelt: Ein systematisches Literatur Review zur Wirkung von Arbeitszeitverkürzung in Bezug auf die psychische Gesundheit

Dieser Beitrag der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) stellt ein systematisches Review zum Zusammenhang der Arbeitszeitverkürzung (bei vollem Gehalt) und psychischen Gesundheit auf der Grundlage vorhandener Studien vor, um Chancen und Risiken besser einschätzen und beurteilen zu können. Die Diskussion über die Verkürzung von Arbeitszeiten wird nicht zuletzt durch die vielfältigen Möglichkeiten der Digitalisierung der Arbeit verstärkt. Die Literatursuche ergab insgesamt 114 Artikel, wovon drei qualitative, neun quantitative Studien und eine Mixed Method Studie in die Analyse aufgenommen wurden. Aus den Ergebnissen wurde deutlich, dass eine verkürzte Arbeitszeit bei gleichbleibendem Lohn zu einer Verringerung von arbeitsbedingten Belastungen bei Beschäftigten beitragen. Die Umsetzung der Verkürzung erfolgte auf drei unterschiedliche Weisen: I. ohne Veränderung der Arbeitsprozesse, II. ohne Veränderung der Arbeitsprozesse, jedoch mit zusätzlichen Beschäftigten oder III. mit einer vorhergehenden Veränderung der Arbeitsprozesse, ohne zusätzliche Angestellte. Zwar gibt es bis dato noch keine allgemeingültige Empfehlung für die Umsetzung in die Praxis, allerdings wird für eine erfolgreiche Umsetzung empfohlen, die Reduktion der Arbeitszeit vorab zu planen und Optimierungsmöglichkeiten für die Ausführung von Tätigkeiten und Arbeitsprozessen zu identifizieren (III.).

The effect of occupational stress on depression and insomnia: a cross-sectional study among employees in a Ghanaian telecommunication company

BACKGROUND

Depression and insomnia are major psychiatric conditions predicted by occupational stress. However, the influence of occupational stress on these two conditions is under-explored in telecommunication companies, especially in Africa. This research was conducted to assess occupational stress in a Ghanaian telecommunication company and its effect on depression and insomnia.

METHODS

An analytical cross-sectional study was conducted among employees at a telecommunication company in Accra. Structured self-administered questionnaires were used in collecting data from 235 respondents using simple random sampling. The Chi-square test of independence and Wilcoxon Rank-Sum test were employed to assess the significance of associations with subsequent sensitivity analysis using Multiple logistic, Poisson and Probit regression models. Occupational stress was matched on four variables: age of the workers, marital status, responsibility for dependents and work experience, to improve on the estimation of its impact on symptomatic depression and insomnia using the coarsened exact matching procedure.

RESULTS

More males (52.8%) than females participated in this study. The age range for study participants was 20-49 years with a mean of 30.8 ± 6.9 years. The prevalence of excessive occupational stress reported by the employees was 32.8% (95% CI = 26.7-38.8). More than half of respondents (51%) reported depressive symptoms in the past week and only a few (6%) reported being diagnosed with insomnia in the past year. Age, responsibility for dependents and work experience were the only background characteristics that were significantly associated with excessive occupational stress. After controlling for background characteristics, the estimated risk of reporting symptoms of depression among employees who reported excessive stress from work was only 5% higher [ARR; 95% CI = 1.05 (0.94-1.17)] whereas it was 2.58 times the risk of reporting insomnia [ARR; 95% CI = 2.58(0.83-8.00)] compared to those who did not report excessive stress from their jobs. The relative risk reduced to 2.46[ARR; 95% CI = 2.46(0.77-7.87)] and 1.03[ARR; 95% CI = 1.03(0.91-1.17)] for insomnia and depression respectively after employing Poisson regression with CEM.

CONCLUSION

The study found a higher risk of insomnia among employees who reported excessive occupational stress compared to those who did not. However, this study did not find a statistically significant relationship between depression and occupational stress.

Work and sleep quality in railway employees: an actigraphy study

This actigraphy study tests whether daily work stressors (time pressure, social stressors), work resources (control, social support) and mental detachment from work predict sleep quality, when controlling for demands and control after work. Fifty-two railway employees participated during five consecutive workdays by completing diary questionnaires and wearing an actigraphy device. The results confirmed that social stressors from supervisors predicted more frequent sleep fragmentation and lower sleep efficiency the following night. Higher levels of daily time control at work predicted shorter sleep-onset latency and better self-reported sleep quality. Leisure time control as a covariate turned out to be a private resource, followed by fewer awakenings the following night. Detachment after work related negatively to social stressors and time pressure at work but was unrelated to indicators of sleep quality; detachment after work neither mediated nor moderated the relationship between social stressors from supervisors and sleep quality. Work redesign to increase time control and reduce social stressors is recommended to preserve daily recovery in railway employees. Practitioner summary: Sleep is important to renew health- and safety-related resources in railway employees. This diary and actigraphy study shows that higher daily work stressors were antecedents of lower sleep quality the following night, while more time control was followed by better sleep quality. Work redesign could promote health and safety by improving sleep quality.

Reduction in sleep disturbances at retirement: evidence from the Swedish Longitudinal Occupational Survey of Health

Although retirement involves a radical change in daily activities, income, social roles and relationships, and the transition from paid work into retirement can, therefore, be expected to affect sleep, little is known about the effects of old-age retirement on changes in sleep disturbances, and how the impact of retirement may vary by gender, age and prior working conditions. This study modelled reported sleep disturbances up to nine years before to nine years following retirement in a sample of 2,110 participants from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Sleep disturbances over the retirement transition were modelled using repeated-measures regression analysis with Generalized Estimating Equations (GEE) in relation to gender, age at retirement, working patterns (night work, full-time/part-time work), control over work hours, and psychological and physical working conditions. The analyses controlled for civil status, education level, income obtained from registers and self-rated health. Retiring from paid work was associated with decreased sleep disturbances. Greater reductions in sleep disturbances were reported by women, as well as by participants who retired before age 65 years, who were working full-time, who lacked control over their work hours and who had high psychological demands. These results, suggesting that old-age retirement from paid work is associated with reductions in disturbed sleep, pose a challenge for governments seeking to increase retirement ages.

Relationship between Job Stress and 5-HT2A Receptor Polymorphisms on Self-Reported Sleep Quality in Physicians in Urumqi (Xinjiang, China): A Cross-Sectional Study

The serotonin receptor (5-HTR) plays a key role in sleep quality regulation. Job-related stress is an important factor that influences sleep quality. However, few reports on the interaction between 5-HTR2A polymorphisms and job stress, and how they may impact upon sleep quality are available. Therefore this study investigated the effects of job stress, 5-HTR2A polymorphisms, and their interaction on sleep quality, in physicians. Using a two-stage stratified sampling method, 918 participants were initially invited to participate in the study. After screening for study inclusion and exclusion criteria, 504 subjects were eventually included in the study. Job stress and sleep quality were assessed using the Job Stress Survey (JSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. The 5-HTR2A receptor gene polymorphisms T102C and -1438G/A of were determined using polymerase chain reaction-restriction fragment length polymorphism. Job stress was significantly associated with sleep quality. High levels of job stress were linked to a higher risk of poor sleep quality compared to low or moderate levels [odds ratio (OR) = 2.909, 95% confidence interval (CI): 1.697–4.986]. High levels of stress may reduce subjects’ sleep quality, leading to an increase the likelihood of sleep disturbances and subsequent daytime dysfunction. The 5-HTR2A receptor gene polymorphism T102C was not significantly associated with sleep quality in this study, however, the -1438G/A polymorphism was significantly associated with sleep quality. The GG genotype of the -1438G/A polymorphism was linked to poorer sleep quality. When compared with subjects with low job-related stress levels×AG/AA genotype (OR = 2.106, 95% CI: 1.278–3.471), physicians with high job-related stress levels×GG genotype had a higher risk of experiencing poor sleep quality (OR = 13.400, 95% CI: 3.143–57.137). The findings of our study indicate that job stress and 5-HTR2A receptor gene polymorphisms are associated with sleep quality in physicians. Subjects with high job stress level or/and the -1438G/A GG genotype were more likely to report poor sleep quality, and furthermore, their combination effect on sleep quality was higher than their independent effects, so it may be suggested that job-related stress and genes have a cumulative effect on sleep quality; that is, stress can increase the risk of poor sleep quality, but this effect is worse in a group of people with specific gene polymorphisms.