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Mathisen J, Nguyen TL, Madsen IEH, Xu T, Jensen JH, Sørensen JK, Rugulies R, Rod NH. Associations between psychosocial work environment factors and first-time and recurrent treatment for depression: a prospective cohort study of 24,226 employees. Epidemiol Psychiatr Sci 2024; 33:e13. [PMID: 38494988 PMCID: PMC10951797 DOI: 10.1017/s2045796024000167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 02/18/2024] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
AIMS Adverse factors in the psychosocial work environment are associated with the onset of depression among those without a personal history of depression. However, the evidence is sparse regarding whether adverse work factors can also play a role in depression recurrence. This study aimed to prospectively examine whether factors in the psychosocial work environment are associated with first-time and recurrent treatment for depression. METHODS The study included 24,226 participants from the Danish Well-being in Hospital Employees study. We measured ten individual psychosocial work factors and three theoretical constructs (effort-reward imbalance, job strain and workplace social capital). We ascertained treatment for depression through registrations of hospital contacts for depression (International Statistical Classification of Diseases and Related Health Problems version 10 [ICD-10]: F32 and F33) and redeemed prescriptions of antidepressant medication (Anatomical Therapeutic Chemical [ATC]: N06A) in Danish national registries. We estimated the associations between work factors and treatment for depression for up to 2 years after baseline among those without (first-time treatment) and with (recurrent treatment) a personal history of treatment for depression before baseline. We excluded participants registered with treatment within 6 months before baseline. In supplementary analyses, we extended this washout period to up to 2 years. We applied logistic regression analyses with adjustment for confounding. RESULTS Among 21,156 (87%) participants without a history of treatment for depression, 350 (1.7%) had first-time treatment during follow-up. Among the 3070 (13%) participants with treatment history, 353 (11%) had recurrent treatment during follow-up. Those with a history of depression generally reported a more adverse work environment than those without such a history. Baseline exposure to bullying (odds ratio [OR] = 1.72, 95% confidence interval [95% CI]: 1.30-2.32), and to some extent also low influence on work schedule (OR = 1.27, 95% CI: 0.97-1.66) and job strain (OR = 1.24, 95% CI: 0.97-1.57), was associated with first-time treatment for depression during follow-up. Baseline exposure to bullying (OR = 1.40, 95% CI: 1.04-1.88), lack of collaboration (OR = 1.31, 95% CI: 1.03-1.67) and low job control (OR = 1.27, 95% CI: 1.00-1.62) were associated with recurrent treatment for depression during follow-up. However, most work factors were not associated with treatment for depression. Using a 2-year washout period resulted in similar or stronger associations. CONCLUSIONS Depression constitutes a substantial morbidity burden in the working-age population. Specific adverse working conditions were associated with first-time and recurrent treatment for depression and improving these may contribute to reducing the onset and recurrence of depression.
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Affiliation(s)
- J. Mathisen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Stress Research Center, Copenhagen, Denmark
| | - T.-L. Nguyen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - I. E. H. Madsen
- Copenhagen Stress Research Center, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
- The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - T. Xu
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - J. H. Jensen
- Copenhagen Stress Research Center, Copenhagen, Denmark
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - J. K. Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - R. Rugulies
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Stress Research Center, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - N. H. Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Chiou PZ, Herring RP, Oh J, Medina E. Health impacts in pathology workforce during mergers and acquisitions (M&A). J Clin Pathol 2024; 77:98-104. [PMID: 37914381 DOI: 10.1136/jcp-2023-209124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/22/2023] [Indexed: 11/03/2023]
Abstract
AIMS To compare burn-out in laboratory professionals (LPs) with exposure to consolidation to those without, and to investigate the role of social support as a moderator in the exposure to mergers and acquisitions (M&A). METHODS Surveys were sent to the clinical LPs, including 732 with exposure to M&A and 819 without. The dependent variable was burn-out, and the independent variable was exposure to M&A. In investigating the role of social support in exposure group, a logistic regression was used with education, time since M&A, gender, merger types, practice setting, lab hierarchy and race as covariates. RESULTS Exposure to M&A was associated with higher levels of burn-out (p<0.05). In logistic regression of the workforce exposed to M&A, the odds for LP developing a high level of burn-out are lowered by 7.1% for every unit of increase in social support (OR 0.93; 95% CI 0.88 to 0.98; p=0.004). CONCLUSION LPs exposed to M&A are more likely to experience higher levels of burn-out but having social support can protect against burn-out, which has policy implications for leadership managing laboratories in times of M&A.
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Affiliation(s)
- Paul Zone Chiou
- Clinical Laboratory Science, Rutgers Biomedical and Health Sciences, Newark, New Jersey, USA
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - R Patti Herring
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Jisoo Oh
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Ernest Medina
- Loma Linda University School of Public Health, Loma Linda, California, USA
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Mensah A, Toivanen S, Diewald M, Ul Hassan M, Nyberg A. Workplace gender harassment, illegitimate tasks, and poor mental health: Hypothesized associations in a Swedish cohort. Soc Sci Med 2022; 315:115520. [PMID: 36413856 DOI: 10.1016/j.socscimed.2022.115520] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/05/2022] [Accepted: 11/05/2022] [Indexed: 11/09/2022]
Abstract
Workers exposed to gender harassment and illegitimate tasks may experience adverse mental health outcomes such as depression and burnout. However, the longitudinal effects and the complex interrelationships between these variables remain largely unexplored. We investigated the cross-lagged relationships between gender harassment, illegitimate tasks, and mental health outcomes among working adults in Sweden over a period of two years, as well as the gender differences in the cross-lagged effects. Additionally, the study examined whether illegitimate tasks mediated the relationship between gender harassment and negative mental health outcomes over time. Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH), covering 2796 working men and 4110 working women in a two-wave analysis from 2018 to 2020. We employed a structural equation model to examine the cross-lagged effects and the mediating effect between gender harassment, illegitimate tasks, and mental health outcomes over time. Furthermore, we applied a multigroup analysis to determine gender differences in the cross-lagged effects. The results showed statistically significant cross-lagged relationships (forward, reverse, and reciprocal) between gender harassment, illegitimate tasks, and mental ill-health. There were statistically significant gender differences in these cross-lagged relationships (burnout: △χ2(47)=106.21, p < 0.01; depression: △χ2(47)=80.5, p < 0.01). Initial illegitimate tasks mediated the relationship between gender harassment and mental ill-health outcomes over time. The gender differences in the interrelationships between gender harassment, illegitimate tasks, and mental ill-health outcomes among workers in Sweden indicate that policies, regulations, and interventions that address these exposures in organisations must be tailored to benefit both men and women.
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Affiliation(s)
- Aziz Mensah
- Bielefeld Graduate School in History and Sociology (BGHS), Bielefeld University, Germany; School of Health, Care, and Social Welfare, Mälardalen University, Sweden.
| | - Susanna Toivanen
- School of Health, Care, and Social Welfare, Mälardalen University, Sweden
| | - Martin Diewald
- Bielefeld Graduate School in History and Sociology (BGHS), Bielefeld University, Germany
| | | | - Anna Nyberg
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, Uppsala, Sweden
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Maciel DP, Giannini R, Sá EC, Sznelwar LI. Impacts of organizational restructuring on the health of ambulance drivers from a university hospital. CIENCIA & SAUDE COLETIVA 2021; 26:5935-5944. [PMID: 34909986 DOI: 10.1590/1413-812320212612.14972021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 07/22/2021] [Indexed: 11/22/2022] Open
Abstract
The transport of patients by ambulance is part of the services offered by a Hospital and its importance lies in facilitating the connection between the institutes involved in patient care. However, a significant amount of complaints about irritability and aggressiveness of drivers was registered after a strategic change in the organizational structure that directly affected these professionals. This study aimed to survey the health issues of ambulance drivers at this hospital, from the reorganization of work, through an ergonomic analysis of work. The data were obtained through observation and interviews with managers, leaders, and drivers of the transport sector of the hospital. The main results found were: 1) the key performance measurement is time, which is a measure that does not consider all variabilities that occur during transport, 2) prescribed work of drivers only considers the task of driving an ambulance, while their real work includes taking care and paying attention to the needs of the patient and other professionals, 3) after the restructuring and centralization of the transport sector, drivers stopped feeling as part of the team of health professionals and started to feel like a "shared service".
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Affiliation(s)
- Daniele Pimentel Maciel
- Programa de Pós-Graduação em Engenharia de Produção, Escola Politécnica, Universidade de São Paulo.
| | - Ruri Giannini
- Programa de Pós-Graduação em Engenharia de Produção, Escola Politécnica, Universidade de São Paulo.
| | - Eduardo Costa Sá
- Faculdade de Medicina, Universidade de São Paulo. São Paulo SP Brasil
| | - Laerte Idal Sznelwar
- Programa de Pós-Graduação em Engenharia de Produção, Escola Politécnica, Universidade de São Paulo.
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Cerezo-Espinosa de los Monteros J, Castro-Torres A, Gómez-Salgado J, Fagundo-Rivera J, Gómez-Salgado C, Coronado-Vázquez V. Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4051. [PMID: 33921426 PMCID: PMC8069692 DOI: 10.3390/ijerph18084051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Abstract
Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.
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Affiliation(s)
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador
| | - Javier Fagundo-Rivera
- Health Sciences Doctorate School, University of Huelva, 21007 Huelva, Spain;
- Centro Universitario de Enfermería Cruz Roja, University of Seville, 41009 Seville, Spain
| | | | - Valle Coronado-Vázquez
- Illescas Health Centre, Castilla-La Mancha Health Service, 45200 Toledo, Spain;
- Health Science Institute of Aragon, 50009 Zaragoza, Spain
- Department of Health Sciences, Santa Teresa de Jesus Catholic University of Avila, 05005 Avila, Spain
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Jensen JH, Flachs EM, Török E, Rod NH, Madsen IEH, Rugulies R, Kawachi I. Work-unit social capital and incident purchase of psychotropic medications: A longitudinal cohort-study of healthcare workers. J Affect Disord 2020; 276:53-61. [PMID: 32697716 DOI: 10.1016/j.jad.2020.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/03/2020] [Accepted: 07/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Whether workplace social capital affects employees' mental health is debated. We examined the association between work-unit aggregated social capital and incident purchase of psychotropic medications among employees. METHODS We used data from the WHALE (Well-being in Hospital Employees) cohort study. The study population comprised 21,711 employees without recent psychotropic purchase-history nested within 2283 work units in the Capital Region of Denmark. Employees were invited to participate in a survey in March 2014 (86% response). We assessed workplace social capital by eight items (covering trust/justice and collaboration) and aggregated the mean of responses up to each work unit and categorized the scores into quartiles. Data on psychotropic purchases (antidepressants and anxiolytics/hypnotics/sedatives) were extracted via linkage to national registers. Using two-level mixed-effects survival models, we analyzed the association between work-unit social capital and psychotropic purchases during a one-year follow-up period adjusting for individual-level workplace social capital. RESULTS Low work-unit social capital was associated with higher purchases of overall psychotropic medications in a dose-response manner (low-versus-high: HR=1.32, 95% CI=1.05-1.65), but this effect attenuated after adjusting for individual-level workplace social capital (HR=1.14, 95% CI=0.88-1.46). Low work-unit social capital was associated with higher purchases of antidepressants (HR=1.78, 95% CI=1.16-2.73) even after adjusting for individual-level workplace social capital (HR=1.69, 95% CI=1.05-2.73). LIMITATIONS Medical doctors/dentists were underrepresented in the data on workplace social capital. CONCLUSIONS Low work-unit social capital may be associated with higher use of antidepressants among healthcare employees. Interventions to improve social capital could potentially promote mental health at work in the healthcare setting.
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Affiliation(s)
- Johan Høy Jensen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark; Copenhagen Stress Research Center, Copenhagen, Denmark; Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States.
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Eszter Török
- Copenhagen Stress Research Center, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Copenhagen Stress Research Center, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ida E H Madsen
- Copenhagen Stress Research Center, Copenhagen, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- Copenhagen Stress Research Center, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, United States
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Grønstad A, Kjekshus LE, Tjerbo T, Bernstrøm VH. Work-related moderators of the relationship between organizational change and sickness absence: a longitudinal multilevel study. BMC Public Health 2020; 20:1218. [PMID: 32770987 PMCID: PMC7414577 DOI: 10.1186/s12889-020-09325-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 08/02/2020] [Indexed: 02/01/2023] Open
Abstract
Background A sizeable body of research has demonstrated a relationship between organizational change and increased sickness absence. However, fewer studies have investigated what factors might mitigate this relationship. The aim of this study was to examine if and how the relationship between unit-level downsizing and sickness absence is moderated by three salient work factors: temporary contracts at the individual-level, and control and organizational commitment at the work-unit level. Methods We investigated the association between unit-level downsizing, each moderator and both short- and long-term sickness absence in a large Norwegian hospital (n = 21,085) from 2011 to 2016. Data pertaining to unit-level downsizing and employee sickness absence were retrieved from objective hospital registers, and moderator variables were drawn from hospital registers (temporary contracts) and the annual work environment survey (control and organizational commitment). We conducted a longitudinal multilevel random effects regression analysis to estimate the odds of entering short- (< = 8 days) and long-term (> = 9 days) sickness absence for each individual employee. Results The results showed a decreased risk of short-term sickness absence in the quarter before and an increased risk of short-term sickness absence in the quarter after unit-level downsizing. Temporary contracts and organizational commitment significantly moderated the relationship between unit-level downsizing in the next quarter and short-term sickness absence, demonstrating a steeper decline in short-term sickness absence for employees on temporary contracts and employees in high-commitment units. Additionally, control and organizational commitment moderated the relationship between unit-level downsizing and long-term sickness absence. Whereas employees in high-control work-units had a greater increase in long-term sickness absence in the change quarter, employees in low-commitment work-units had a higher risk of long-term sickness absence in the quarter after unit-level downsizing. Conclusions The results from this study suggest that the relationship between unit-level downsizing and sickness absence varies according to the stage of change, and that work-related factors moderate this relationship, albeit in different directions. The identification of specific work-factors that moderate the adverse effects of change represents a hands-on foundation for managers and policy-makers to pursue healthy organizational change.
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Affiliation(s)
- Anniken Grønstad
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, N-0373, Oslo, Norway.
| | - Lars Erik Kjekshus
- Department of Sociology and Human Geography, Faculty of Social Sciences, University of Oslo, Moltke Moes vei 31, N-0851, Oslo, Norway
| | - Trond Tjerbo
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, N-0373, Oslo, Norway
| | - Vilde Hoff Bernstrøm
- Work Research Institute, OsloMet - Oslo Metropolitan University, Stensberggata 26, N-0170, Oslo, Norway
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Work-unit organizational changes and risk of cardiovascular disease: a prospective study of public healthcare employees in Denmark. Int Arch Occup Environ Health 2019; 93:409-419. [PMID: 31781903 DOI: 10.1007/s00420-019-01493-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The impact of organizational change at work on cardiovascular disease (CVD) among employees is poorly understood. We examined the longitudinal associations between different types of work-unit organizational changes and risk of CVD among employees. METHODS We used multilevel mixed-effects parametric survival models to assess the risk of incident ischemic heart disease and stroke (72 events) during 2014 according to organizational changes in 2013 among 14,788 employees working in the same work unit from January through December 2013. We excluded employees with pre-existing CVD events between 2009 and 2013. Data on organizational changes defined as mergers, split-ups, relocations, change in management, employee layoffs, and budget cuts were obtained from work-unit managers (59% response). RESULTS There was an excess risk of CVD in the year following change in management (HR 2.04, 95% CI 1.10-3.78) and employee layoff (HR 2.44, 95% CI 1.29-4.59) in the work unit relative to no change. Exposure to any organizational change also suggested increased risk of CVD (HR 1.48, 95% CI 0.91-2.43). Including perceived stress as mediator in the regression models attenuated the point risk estimates only slightly, indicating no important mediation through this psychosocial factor. CONCLUSIONS Work-unit organizational change may be associated with excess risk of incident CVD among the employees relative to stable workplaces.
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Grønstad A, Kjekshus LE, Tjerbo T, Bernstrøm VH. Organizational change and the risk of sickness absence: a longitudinal multilevel analysis of organizational unit-level change in hospitals. BMC Health Serv Res 2019; 19:895. [PMID: 31771576 PMCID: PMC6880570 DOI: 10.1186/s12913-019-4745-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 11/14/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Organizational change is often associated with reduced employee health and increased sickness absence. However, most studies in the field accentuate major organizational change and often do not distinguish between and compare types of change. The aim of this study was to examine the different relationships between six unit-level changes (upsizing, downsizing, merger, spin-off, outsourcing and insourcing) and sickness absence among hospital employees. METHODS The study population included employees working in a large Norwegian hospital (n = 26,252). Data on unit-level changes and employee sickness absence were retrieved from objective hospital registers for the period January 2011 to December 2016. The odds of entering short- (< = 8 days) and long-term (> = 9 days) sickness absence for each individual employee were estimated in a longitudinal multilevel random effects logistic regression model. RESULTS Unit-level organizational change was associated with both increasing and decreasing odds of short-term sickness absence compared to stability, but the direction depended on the type and stages of change. The odds of long-term sickness absence significantly decreased in relation to unit-level upsizing and unit-level outsourcing. CONCLUSIONS The results from this study suggested that certain types of change, such as unit-level downsizing, may produce greater strain and concerns among employees, possibly contributing to an increased risk of sickness absence at certain stages of the change. By contrast, changes such as unit-level insourcing and unit-level upsizing were related to decreased odds of sickness absence, possibly due to positive change characteristics.
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Affiliation(s)
- Anniken Grønstad
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, N-0373 Oslo, Norway
| | - Lars Erik Kjekshus
- Department of Sociology and Human Geography, Faculty of Social Sciences, University of Oslo, Moltke Moes vei 31, N-0851 Oslo, Norway
| | - Trond Tjerbo
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, N-0373 Oslo, Norway
| | - Vilde Hoff Bernstrøm
- Work Research Institute, OsloMet, Oslo Metropolitan University, Stensberggata 26, N-0170 Oslo, Norway
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Jensen JH, Bonde JP, Flachs EM, Skakon J, Rod NH, Kawachi I. Work-unit organisational changes and subsequent prescriptions for psychotropic medication: a longitudinal study among public healthcare employees. Occup Environ Med 2019; 76:143-150. [PMID: 30617127 PMCID: PMC6581106 DOI: 10.1136/oemed-2018-105442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/19/2018] [Accepted: 11/27/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We examined exposure to different types of organisational changes at work as risk factors for subsequent prescription for psychotropic medication among employees. METHODS The study population included 15 038 public healthcare employees nested within 1284 work units in the Capital Region of Denmark. Multilevel mixed-effects parametric survival models were developed to examine time to prescription for psychotropic medications (anxiolytics/hypnotics/sedatives/antidepressants) during the 12-month interval following exposure to organisational changes relative to no change from January to December 2013. Data on work-unit level organisational changes (including mergers, split-ups, relocation, change in management, employee lay-offs and budget cuts) were collected from work-unit managers (59% response). RESULTS Any organisational change versus no change was associated with a higher risk of psychotropic prescription (HR: 1.14, 95% CI: 1.02 to 1.26), especially change in management (HR: 1.23, 95% CI: 1.07 to 1.41). Splitting the 12-month follow-up period into two halves yielded particularly high rates of psychotropic prescription in the latter half of the follow-up, for example, any change (HR: 1.25, 95% CI: 1.11 to 1.41), change in management (HR: 1.42, 95% CI: 1.22 to 1.65), mergers (HR: 1.26, 95% CI: 1.06 to 1.50), employee lay-off (HR: 1.23, 95% CI: 1.03 to 1.46) and budget cuts (HR: 1.13, 95% CI: 1.00 to 1.41). The associations did not vary by sex. CONCLUSIONS Organisational changes in the workplace, especially change in management, may be associated with increased risk of psychotropic prescription among employees regardless of sex.
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Affiliation(s)
- Johan Høy Jensen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Janne Skakon
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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