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Taylor C, Maben J, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Care Under Pressure 2: a realist synthesis of causes and interventions to mitigate psychological ill health in nurses, midwives and paramedics. BMJ Qual Saf 2024; 33:523-538. [PMID: 38575309 PMCID: PMC11287552 DOI: 10.1136/bmjqs-2023-016468] [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: 06/23/2023] [Accepted: 02/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Nurses, midwives and paramedics comprise over half of the clinical workforce in the UK National Health Service and have some of the highest prevalence of psychological ill health. This study explored why psychological ill health is a growing problem and how we might change this. METHODS A realist synthesis involved iterative searches within MEDLINE, CINAHL and HMIC, and supplementary handsearching and expert solicitation. We used reverse chronological quota screening and appraisal journalling to analyse each source and refine our initial programme theory. A stakeholder group comprising nurses, midwives, paramedics, patient and public representatives, educators, managers and policy makers contributed throughout. RESULTS Following initial theory development from 8 key reports, 159 sources were included. We identified 26 context-mechanism-outcome configurations, with 16 explaining the causes of psychological ill health and 10 explaining why interventions have not worked to mitigate psychological ill health. These were synthesised to five key findings: (1) it is difficult to promote staff psychological wellness where there is a blame culture; (2) the needs of the system often over-ride staff psychological well-being at work; (3) there are unintended personal costs of upholding and implementing values at work; (4) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; and (5) it is challenging to design, identify and implement interventions. CONCLUSIONS Our final programme theory argues the need for healthcare organisations to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires high standards for patient care to be balanced with high standards for staff psychological well-being; professional accountability to be balanced with having a listening, learning culture; reactive responsive interventions to be balanced by having proactive preventative interventions; and the individual focus balanced by an organisational focus. PROSPERO REGISTRATION NUMBER CRD42020172420.
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Affiliation(s)
- Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | | | - Simon Briscoe
- Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Karen Mattick
- Exeter Medical School, University of Exeter, Exeter, UK
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Hassard J, Dulal-Arthur T, Bourke J, Wishart M, Roper S, Belt V, Leka S, Pahl N, Bartle C, Thomson L, Blake H. The relationship between line manager training in mental health and organisational outcomes. PLoS One 2024; 19:e0306065. [PMID: 39018274 PMCID: PMC11253945 DOI: 10.1371/journal.pone.0306065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/10/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Line manager (LM) training in mental health is gaining recognition as an effective method for improving the mental health and wellbeing of workers. However, research predominantly focuses on the impacts of training at the employee-level, often neglecting the broader organisational-level outcomes. Most studies derive insights from LMs using self-reported data, with very few studies examining impacts on organisational-level outcomes. AIM To explore the relationship between LM training in mental health and organisational-level outcomes using company-level data from a diverse range of organisations. METHODS This study is a secondary analysis of anonymised panel survey data from firms in England, with data derived from computer-assisted telephone surveys over four waves (2020, 1899 firms; 2021, 1551; 2022, 1904; and 2023, 1902). The analysis merged the four datasets to control for temporal variations. Probit regression was conducted including controls for age of organisation, sector, size, and wave to isolate specific relationships of interest. RESULTS We found that LM training in mental health is significantly associated with several organisational-level outcomes, including: improved staff recruitment (β = .317, p < .001) and retention (β = .453, p < .001), customer service (β = .453, p < .001), business performance (β = .349, p < .001), and lower long-term sickness absence due to mental ill-health (β = -.132, p < .05). CONCLUSION This is the first study to explore the organisational-level outcomes of LM training in mental health in a large sample of organisations of different types, sizes, and sectors. Training LM in mental health is directly related to diverse aspects of an organisations' functioning and, therefore, has strategic business value for organisations. This knowledge has international relevance for policy and practice in workforce health and business performance.
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Affiliation(s)
- Juliet Hassard
- Queen’s Business School, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | | | - Jane Bourke
- Cork University Business School, University College Cork, Cork, Ireland
| | - Maria Wishart
- Warwick Business School, Warwick University, Coventry, United Kingdom
| | - Stephen Roper
- Warwick Business School, Warwick University, Coventry, United Kingdom
| | - Vicki Belt
- Warwick Business School, Warwick University, Coventry, United Kingdom
| | - Stavroula Leka
- Centre for Organisational Health & Well-being, Lancaster University, Lancaster, United Kingdom
| | - Nick Pahl
- The Society of Occupational Medicine, London, United Kingdom
| | - Craig Bartle
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Louise Thomson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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Macdonald WA, Oakman J. Changes needed to reduce risk of musculoskeletal disorders. Am J Ind Med 2024; 67:575-581. [PMID: 38752696 DOI: 10.1002/ajim.23613] [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: 12/08/2023] [Revised: 05/03/2024] [Accepted: 05/06/2024] [Indexed: 06/14/2024]
Abstract
Musculoskeletal disorders (MSDs) are the main contributor to disability levels, which are rising as populations age. Workplace hazard exposures are a major source of this problem, and current workplace risk management practices require substantial changes to tackle it more effectively. Most importantly, the current focus of risk management on "manual handling" tasks must broaden to encompass the whole job. This is necessary because a wide range of psychosocial hazards, most of which operate across the whole job rather than particular tasks, are significant contributors to risk. To ensure that risk-control actions are effective, a recurring risk management cycle that includes worker participation and addresses risk from both biomechanical and psychosocial hazards will be essential. Legislation that mandates workplace management of psychosocial hazards would be helpful. Amendment by regulatory bodies of MSD-related guidance and codes of practice so that they reflect current research evidence would also be helpful in communicating the need for change to workplace stakeholders.
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Affiliation(s)
- Wendy A Macdonald
- School of Psychology and Public Health, Centre for Ergonomics and Human Factors, La Trobe University, Melbourne, Victoria, Australia
| | - Jodi Oakman
- School of Psychology and Public Health, Centre for Ergonomics and Human Factors, La Trobe University, Melbourne, Victoria, Australia
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Aust B, Leduc C, Cresswell-Smith J, O'Brien C, Rugulies R, Leduc M, Dhalaigh DN, Dushaj A, Fanaj N, Guinart D, Maxwell M, Reich H, Ross V, Sadath A, Schnitzspahn K, Tóth MD, van Audenhove C, van Weeghel J, Wahlbeck K, Arensman E, Greiner BA. The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review. Int Arch Occup Environ Health 2024; 97:485-522. [PMID: 38695906 PMCID: PMC11130054 DOI: 10.1007/s00420-024-02065-z] [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: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. METHODS Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. RESULTS We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. CONCLUSION Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Clíodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Arilda Dushaj
- Community Centre for Health and Wellbeing, Tirana, Albania
| | - Naim Fanaj
- Per Mendje Te Shendoshe (PMSH), Prizren, Kosovo
- Alma Mater Europaea Campus Rezonanca, Pristina, Kosovo
| | - Daniel Guinart
- CIBERSAM, Hospital del Mar Research Institute, Barcelona, Spain
- Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Hanna Reich
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Anvar Sadath
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Chantal van Audenhove
- KU Leuven, Louvain, Belgium
- Center for Care Research and Consultancy, LUCAS, Louvain, Belgium
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
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Vitrano G, Urso D, Micheli GJ, Guglielmi A, De Merich D, Pellicci M. Enabling Effective Implementation of Occupational Safety and Health Interventions. Saf Health Work 2024; 15:213-219. [PMID: 39035805 PMCID: PMC11255946 DOI: 10.1016/j.shaw.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 07/23/2024] Open
Abstract
Background The design, implementation, and evaluation are three important stages of occupational safety and health (OSH) interventions. Historically, there has been a tendency to prioritize implementation, often neglecting detailed design and rigorous outcome evaluation. Currently, much has changed, and contemporary approaches recognize the interdependence of these stages, considering them integral to the success of any intervention. This work presents a comprehensive procedure for implementing interventions, not only to ensure short-term effectiveness but also their long-term sustainability through continuous monitoring. The focus is on a national OSH project introducing a near-miss management system (NMS) in Italy. Methods Initial meetings were convened among project partners, complemented by interviews with diverse stakeholders, to plan implementation steps and test the NMS. Tailored questionnaires were designed for diverse stakeholder groups - initial promoters, company managers and employers, and employees - facilitating targeted implementation, and three case studies were started in Italian regions to assess the structured implementation, involving intervention promoters and collaborating companies. Results The primary outcome is the development of practical tools, specifically three questionnaires, which are considered valuable for establishing an effective human-centered implementation strategy, meticulously designed to facilitate ongoing monitoring of processes and continual enhancement of instruments intended for NMS integration within companies. Conclusions This work lays the foundation for successful NMS implementation in Italy and, although the outlined procedure had specific objectives, it also provides valuable insights applicable in enhancing the effectiveness and sustainability of interventions across diverse contexts. It underscores the importance of comprehensive planning, stakeholder engagement, and continuous evaluation in achieving lasting OSH interventions.
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Affiliation(s)
- Gaia Vitrano
- Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Davide Urso
- Local Health Unit, ASL, ATS Insubria, Varese, Italy
| | - Guido J.L. Micheli
- Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
| | - Armando Guglielmi
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for Insurance Against Accidents at Work (INAIL), Rome, Italy
| | - Diego De Merich
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for Insurance Against Accidents at Work (INAIL), Rome, Italy
| | - Mauro Pellicci
- Department of Medicine, Epidemiology, Occupational & Environmental Hygiene, National Institute for Insurance Against Accidents at Work (INAIL), Rome, Italy
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Shaw E, Nunns M, Spicer SG, Lawal H, Briscoe S, Melendez‐Torres GJ, Garside R, Liabo K, Coon JT. What is the volume, quality and characteristics of evidence relating to the effectiveness and cost-effectiveness of multi-disciplinary occupational health interventions aiming to improve work-related outcomes for employed adults? An evidence and gap map of systematic reviews. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1412. [PMID: 38751859 PMCID: PMC11094349 DOI: 10.1002/cl2.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
Background In the UK, tens of millions of working days are lost due to work-related ill health every year, costing billions of pounds. The role of Occupational Health (OH) services is vital in helping workers to maintain employment when they encounter injury or illness. OH providers traditionally rely on a clinical workforce to deliver these services, particularly doctors and nurses with OH qualifications. However, the increasing demand for OH services is unlikely to be met in the future using this traditional model, due to the declining number of OH-trained doctors and nurses in the UK. Multi-disciplinary models of OH delivery, including a more varied range of healthcare and non-healthcare professionals, could provide a way to meet this new demand for OH services. There is a need to identify collaborative models of OH service delivery and review their effectiveness on return-to work outcomes. There is an existing pool of systematic review evidence evaluating workplace based, multi-disciplinary OH interventions, but it is difficult to identify which aspects of the content and/or delivery of these interventions may be associated with improved work-related outcomes. Objectives The aim of this evidence and gap map (EGM) was to provide an overview of the systematic review evidence that evaluates the effectiveness and cost-effectiveness of multi-disciplinary OH interventions intending to improve work-related outcomes. Search Methods In June 2021 we searched a selection of bibliographic databases and other academic literature resources covering a range of relevant disciplines, including health care and business studies, to identify systematic review evidence from a variety of sectors of employment. We also searched Google Search and a selection of topically relevant websites and consulted with stakeholders to identify reports already known to them. Searches were updated in February 2023. Selection Criteria Systematic reviews needed to be about adults (16 years or over) in employment, who have had absence from work for any medical reason. Interventions needed to be multi-disciplinary (including professionals from different backgrounds in clinical and non-clinical professions) and designed to support employees and employers to manage health conditions in the workplace and/or to help employees with health conditions retain and/or return to work following medical absence. Effectiveness needed to be measured in terms of return to work, work retention or measures of absence, or economic evaluation outcomes. These criteria were applied to the title and abstract and full text of each systematic review independently by two reviewers, with disagreements resolved through discussion. We awarded each systematic review a rating of 'High', 'Medium' or 'Low' relevance to indicate the extent to which the populations, interventions and their contexts synthesised within the review were consistent with our research question. We also recorded the number of primary studies included within each of the 'High' and 'Medium' reviews that were relevant to research question using the same screening process applied at review level. Data Collection and Analysis Summary data for each eligible review was extracted. The quality of the systematic reviews, rated as 'High' or 'Medium' relevance following full text screening, was appraised using the AMSTAR-2 quality appraisal tool. All data were extracted by one reviewer and checked by a second, with disagreements being settled through discussion. Summary data for all eligible systematic reviews were tabulated and described narratively. The data extracted from reviews of 'High' and 'Medium' relevance was imported into EPPI-Mapper software to create an EGM. Stakeholder Involvement We worked alongside commissioners and policy makers from the Department of Health and Social Care (DHSC) and Department of Work and Pensions (DWP), OH personnel, and people with lived experience of accessing OH services themselves and/or supporting employees to access OH services. Individuals contributed to decision making at all stages of the project. This ensured our EGM reflects the needs of individuals who will use it. Main Results We identified 98 systematic reviews that contained relevant interventions, which involved a variety of professionals and workplaces, and which measured effectiveness in terms of return to work (RTW). Of these, we focused on the 30 reviews where the population and intervention characteristics within the systematic reviews were considered to be of high or medium relevance to our research questions. The 30 reviews were of varying quality, split evenly between High/Moderate quality and Low/Critically-Low quality ratings. We did not identify any relevant systematic review evidence on any other work-related outcome of interest. Interventions were heterogenous, both within and across included systematic reviews. The EGM is structured according to the health condition experienced by participants, and the effectiveness of the interventions being evaluated, as reported within the included systematic reviews. It is possible to view (i) the quality and quantity of systematic review evidence for a given health condition, (ii) how review authors assessed the effectiveness or cost-effectiveness of the interventions evaluated. The EGM also details the primary studies relevant to our research aim included within each review. Authors’ Conclusions This EGM map highlights the array of systematic review evidence that exists in relation to the effectiveness or cost-effectiveness of multi-disciplinary, workplace-based OH interventions in supporting RTW. This evidence will allow policy makers and commissioners of services to determine which OH interventions may be most useful for supporting different population groups in different contexts. OH professionals may find the content of the EGM useful in identifying systematic review evidence to support their practice. The EGM also identifies where systematic review evidence in this area is lacking, or where existing evidence is of poor quality. These may represent areas where it may be particularly useful to conduct further systematic reviews.
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Affiliation(s)
- Elizabeth Shaw
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Michael Nunns
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Stuart G. Spicer
- NIHR Applied Research CollaborationUniversity of PlymouthPlymouthUK
| | - Hassanat Lawal
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Simon Briscoe
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - G. J. Melendez‐Torres
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Ruth Garside
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Kristin Liabo
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter Policy Research Programme Evidence Review Facility, Faculty of Health and Life SciencesUniversity of ExeterExeterUK
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Schulte PA, Sauter SL, Pandalai SP, Tiesman HM, Chosewood LC, Cunningham TR, Wurzelbacher SJ, Pana-Cryan R, Swanson NG, Chang CC, Nigam JAS, Reissman DB, Ray TK, Howard J. An urgent call to address work-related psychosocial hazards and improve worker well-being. Am J Ind Med 2024; 67:499-514. [PMID: 38598122 DOI: 10.1002/ajim.23583] [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: 10/05/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 04/11/2024]
Abstract
Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.
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Affiliation(s)
- Paul A Schulte
- Advanced Technologies and Laboratories International Inc., Gaithersburg, Maryland, USA
| | - Steven L Sauter
- Advanced Technologies and Laboratories International Inc., Gaithersburg, Maryland, USA
| | - Sudha P Pandalai
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Hope M Tiesman
- Division of Safety Research, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Lewis C Chosewood
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas R Cunningham
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Steven J Wurzelbacher
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Rene Pana-Cryan
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, DC, USA
| | - Naomi G Swanson
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Chia-Chia Chang
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeannie A S Nigam
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Dori B Reissman
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, DC, USA
| | - Tapas K Ray
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - John Howard
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, DC, USA
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Pearson A, Carrieri D, Melvin A, Bramwell C, Scott J, Hancock J, Papoutsi C, Pearson M, Wong G, Mattick K. Developing a typology of interventions to support doctors' mental health and wellbeing. BMC Health Serv Res 2024; 24:573. [PMID: 38702774 PMCID: PMC11067176 DOI: 10.1186/s12913-024-10884-6] [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: 08/07/2023] [Accepted: 03/20/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The problem of mental ill-health in doctors is complex, accentuated by the COVID-19 pandemic, and impacts on healthcare provision and broader organisational performance. There are many interventions to address the problem but currently no systematic way to categorise them, which makes it hard to describe and compare interventions. As a result, implementation tends to be unfocussed and fall short of the standards developed for implementing complex healthcare interventions. This study aims to develop: 1) a conceptual typology of workplace mental health and wellbeing interventions and 2) a mapping tool to apply the typology within research and practice. METHODS Typology development was based on iterative cycles of analysis of published and in-practice interventions, incorporation of relevant theories and frameworks, and team and stakeholder group discussions. RESULTS The newly developed typology and mapping tool enable interventions to be conceptualised and/or mapped into different categories, for example whether they are designed to be largely preventative (by either improving the workplace or increasing personal resources) or to resolve problems after they have arisen. Interventions may be mapped across more than one category to reflect the nuance and complexity in many mental health and wellbeing interventions. Mapping of interventions indicated that most publications have not clarified their underlying assumptions about what causes outcomes or the theoretical basis for the intervention. CONCLUSION The conceptual typology and mapping tool aims to raise the quality of future research and promote clear thinking about the nature and purpose of interventions, In doing so it aims to support future research and practice in planning interventions to improve the mental health and wellbeing of doctors.
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Affiliation(s)
- Alison Pearson
- Department of Health & Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
| | - Daniele Carrieri
- Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Anna Melvin
- Department of Health & Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Charlotte Bramwell
- Department of Health & Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Jessica Scott
- Department of Health & Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | - Chrysanthi Papoutsi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mark Pearson
- Institute of Clinical & Applied Health Research, Hull York Medical School, University of Hull, Hull, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Karen Mattick
- Department of Health & Community Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
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9
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Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K. Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-171. [PMID: 38662367 DOI: 10.3310/twdu4109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Cath Taylor
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Justin Jagosh
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Daniele Carrieri
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Simon Briscoe
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Naomi Klepacz
- School of Health Sciences, University of Surrey, Guildford, UK
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Karen Mattick
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Watanabe K, Hikichi H, Imamura K, Sakuraya A, Yoshikawa T, Izawa S, Eguchi H, Inoue A, Yoshida K, Orihashi Y, Tsutsumi A. Multifaceted ORganizational InterventiONs (M-ORION) project for prevention of depression and anxiety among workers: study protocol for a five-arm cluster randomized controlled trial. BMC Public Health 2024; 24:601. [PMID: 38402156 PMCID: PMC10894478 DOI: 10.1186/s12889-024-18112-w] [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: 11/10/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Depression and anxiety are the most common mental health issues experienced by workers. Although organizational intervention has been extensively evaluated as a primary prevention of depression and anxiety, the corresponding scientific evidence remains limited because of the lack of cluster randomized controlled trials (cRCT) and failure to detect organizational-level effects. Therefore, the present study aims to assess the preventive effects of four types of interventions on depression and anxiety among workers in an open, five-arm, parallel-group cRCT. METHODS Overall, 140 worksites and 18,200 nested employees will be recruited from September 2023. The eligible worksites will be randomly assigned to each of the five arms, and programs will be offered for 6-12 months. The five arms are 1) psychoeducation for workers, 2) psychoeducation for supervisors, 3) work environment improvement, 4) physical activity promotion, and 5) active control. The primary outcomes of interest are depression and anxiety. We will also assess psychosocial factors at work, work engagement, health-related quality of life, well-being, economic outcomes, physiological outcomes of health checkups, cortisol levels extracted from fingernails, and indices representing the process and implementation outcomes, including program completion rates. Follow-up surveys will be conducted at 6, 12, and 18 months from baseline, and the primary endpoint is set at the 6-month follow-up. Repeated-measures multi-level mixed modeling will be used to evaluate the effect of each intervention compared with the control. ETHICS AND DISSEMINATION The study protocol was approved by the Research Ethics Committee of the Kitasato University Medical Ethics Organization (C22-082). The results and findings of this study will be published in a scientific journal and disseminated to companies that participate in the study. TRIAL REGISTRATION NUMBER UMIN000050949.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-Ku, Sagamihara, 252-0374, Japan
| | - Hiroyuki Hikichi
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-Ku, Sagamihara, 252-0374, Japan
| | - Kotaro Imamura
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Asuka Sakuraya
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Toru Yoshikawa
- Research Center for Overwork-Related Disorders (RECORDs), National Institute of Occupational Safety and Health, Japan, 6-21-1 Nagao, Tama-Ku, Kawasaki, 214-8585, Japan
| | - Shuhei Izawa
- Occupational Stress and Health Management Research Group, National Institute of Occupational Safety and Health, Japan, 6-21-1 Nagao, Tama-Ku, Kawasaki, 214-8585, Japan
| | - Hisashi Eguchi
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, 807-8555, Japan
| | - Akiomi Inoue
- Institutional Research Center, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, 807-8555, Japan
| | - Kengo Yoshida
- IID Co. Ltd, 4-1-11 Yushima, Bunkyo-Ku, Tokyo, 113-0034, Japan
| | - Yasushi Orihashi
- Clinical Research Center in Hiroshima, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-Ku, Sagamihara, 252-0374, Japan.
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11
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Erschens R, Adam SH, Schröpel C, Diebig M, Rieger MA, Gündel H, Zipfel S, Junne F. Improving Well-Being and Fostering Health-Oriented Leadership among Leaders in Small and Medium-Sized Enterprises (SMEs): A Systematic Review. Healthcare (Basel) 2024; 12:486. [PMID: 38391861 PMCID: PMC10888323 DOI: 10.3390/healthcare12040486] [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: 01/12/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Leaders of small and medium-sized enterprises (SMEs) are often confronted with specific burdens, which frequently result in increased levels of stress. Leadership behaviour, in turn, has a significant impact on employees' health and performance. Using the Population, Intervention, Comparison, Outcome (PICO) method, we conducted a systematic literature search covering publications from 2002 to 2023 using PubMed, PsycInfo and Business Source Premier on stress-reducing and well-being-improving interventions for SME leaders. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess the methodological quality and risk of bias of the included studies regarding selection bias, study design, confounders, blinding, data collection, withdrawal and drop-out. Of the 3150 identified publications, 6 were included after screening. The studies varied in content (cognitive behavioural therapy [CBT]-based, psychoeducation, and mixed interventions) and approach (individual- and organisation-centred). Not all of the examined interventions provided significant outcomes. However, CBT-based and individualised approaches showed a positive trend in reducing SME leaders' psychosocial stress and improving their well-being. Despite the limited data, it can be concluded that such interventions are beneficial for leaders and their specific needs. Future research should focus on tailored approaches, derived from well-founded theories and integrative interventions addressing SME leaders.
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Affiliation(s)
- Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Baden-Wuerttemberg, Germany
| | - Sophia Helen Adam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Baden-Wuerttemberg, Germany
| | - Carla Schröpel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Baden-Wuerttemberg, Germany
| | - Mathias Diebig
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Duesseldorf, Moorenstraße 5, 40225 Duesseldorf, Nordrhein-Westfalen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tuebingen, Wilhelmstraße 27, 72074 Tuebingen, Baden-Wuerttemberg, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Saxony-Anhalt, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Baden-Wuerttemberg, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Osianderstr. 5, 72076 Tuebingen, Baden-Wuerttemberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Saxony-Anhalt, Germany
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Iida M, Sakuraya A, Imamura K, Asaoka H, Arima H, Ando E, Inoue A, Inoue R, Iwanaga M, Eguchi H, Otsuka Y, Kobayashi Y, Komase Y, Kuribayashi K, Sasaki N, Tsuno K, Hino A, Watanabe K, Ebara T, Shimazu A, Kawakami N, Tsutsumi A. Effects of participatory organizational interventions on mental health and work performance: a protocol for systematic review and meta-analysis. J Occup Health 2024; 66:uiae028. [PMID: 38805736 PMCID: PMC11272038 DOI: 10.1093/joccuh/uiae028] [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: 09/10/2023] [Revised: 04/15/2024] [Accepted: 05/25/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION Participatory organizational interventions to improve psychosocial working conditions are important for a safe and healthy work environment. However, there are few systematic reviews or meta-analyses investigating the effects of these interventions on workers' mental health and work-related outcomes. We intend to apply the protocol for systematic review and meta-analysis to examine the effect of participatory organizational intervention on mental health and work performance. METHODS AND ANALYSIS The participants, interventions, comparisons, and outcomes (PICO) of the studies in this systematic review and meta-analysis are defined as follows: (P) inclusion of all workers, (I) participatory organizational intervention, (C) treatment as usual or no intervention (including waitlist control), and (O) mental health and work performance. Published studies will be searched using the following electronic databases: PubMed, Embase, PsycINFO, PsycArticles, and Japan Medical Abstracts Society. Studies that (1) include participatory organizational intervention, (2) include participants who were working as of the baseline survey period, (3) assess mental health or work performance outcomes, (4) use a cluster randomized controlled trials design, (5) are published in English or Japanese, and (6) are published in peer-reviewed journals (including advanced online publication) will be included. Study selection and the risk-of-bias assessment will be performed independently by 2 reviewers. A meta-analysis will be performed to statistically synthesize the included studies. Publication bias will be assessed for meta-bias using Egger's test as well as visually on a funnel plot. We will assess heterogeneity by using the Q statistic.
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Affiliation(s)
- Mako Iida
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Asuka Sakuraya
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kotaro Imamura
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroki Asaoka
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideaki Arima
- Department of Psychiatry, Shinagawa Ekimae Mental Clinic, Tokyo, Japan
| | | | - Akiomi Inoue
- Institutional Research Center, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Reiko Inoue
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Mai Iwanaga
- Department of Community Mental Health & Law, National Center of Neurology and Psychiatry, National Institute of Mental Health, Tokyo, Japan
| | - Hisashi Eguchi
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yasumasa Otsuka
- Institute of Human Sciences, University of Tsukuba, Tokyo, Japan
| | - Yuka Kobayashi
- Department of Clinical Psychology, Faculty of Social Policy & Administration, Hosei University, Tokyo, Japan
| | - Yu Komase
- Healthcare Development Division, Fujitsu Japan Limited, Tokyo, Japan
| | - Kazuto Kuribayashi
- Department of Psychiatric Nursing, Faculty of Chiba Nursing, Tokyo Healthcare University, Chiba, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Takeshi Ebara
- Department of Ergonomics, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, Fujisawa, Japan
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
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Doran K, Witmer S, Yoon KL, Fischer ER, Ebangwese A, Sharma S, Duggirala GSC, Chen LK. Gauging the stress of long-term care nursing assistants using ecological momentary assessment, wearable sensors and end of day reconstruction. Int J Older People Nurs 2024; 19:e12592. [PMID: 38098142 DOI: 10.1111/opn.12592] [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: 07/07/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Nursing assistants working in long-term care (LTC) often report that their job is stressful. To reduce their work stress, a better understanding of their stress profile is needed. OBJECTIVE We aimed to pilot test methods to identify and understand stressors that LTC nursing assistants experience. METHODS We asked each participant to provide wearable sensor/watch data, ecological momentary assessment (EMA) surveys and end of day review data over two eight-hour working shifts. RESULTS Eight nursing assistants participated. All participants worked in a common continuing care retirement community in Maryland, United States of America. Our stress assessment method revealed 83 stressful events that were classified under 10 categories. Most of the reported events were rated as having a mild to low-moderate intensity. The three most common causes of stress were work demands and pressure (28.35%), heavy workload and staffing (19.69%), and safety issues and COVID-19 concerns (17.32%). We also explored the difference between stress events and intensity among different shifts. Disrespect from residents (22.73%) was the most commonly reported stressor during day shifts. Feeling rushed was the most commonly reported stressor during the evening (22.47%) and the night (38.46%) shifts. CONCLUSIONS We found stress was commonly reported. Stress intensity conflicted with prior literature, and we explored possible explanations. IMPLICATIONS FOR PRACTICE We discuss potential implications for these findings, modification of our methods to increase feasibility, the utility of these data collection methods for future work and suggest next steps.
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Affiliation(s)
- Kelly Doran
- University of Maryland, Baltimore School of Nursing In Baltimore, Baltimore, Maryland, USA
| | - Susanna Witmer
- University of Maryland, Baltimore School of Nursing In Baltimore, Baltimore, Maryland, USA
| | - K Lira Yoon
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
| | - Ethan Ray Fischer
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
| | - Abaneh Ebangwese
- University of Maryland, Baltimore School of Nursing In Baltimore, Baltimore, Maryland, USA
| | - Shifali Sharma
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
| | | | - Lujie Karen Chen
- University of Maryland, Baltimore County In Baltimore, Baltimore, Maryland, USA
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Leka S, Torres L, Jain A, Di Tecco C, Russo S, Iavicoli S. Relationship Between Occupational Safety and Health Policy Principles, Organizational Action on Work-related Stress and the Psychosocial Work Environment in Italy. Saf Health Work 2023; 14:425-430. [PMID: 38187203 PMCID: PMC10770050 DOI: 10.1016/j.shaw.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 01/09/2024] Open
Abstract
Background It is acknowledged that legislation acts as a motivator for organizational action on psychosocial risks. Our study aims to provide evidence on the relationship between key occupational safety and health (OSH) policy principles and organizational action on work-related stress, and, in turn, with reported employee job demands and resources and their experience of work-related stress. We focus on Italy where specific legislation and practices on work-related stress were introduced in 2008 which are underpinned by these key OSH policy principles. Methods Secondary analysis of the Italian samples from the employer ESENER-2 and employee 6th EWCS surveys was conducted, using path analysis in structural equation modeling (SEM) linking the two datasets. Results We found a strong statistically significant relationship between OSH policy principles and organizational action on work-related stress (C.I. = .62-.78 p < .001). The existence of an organizational action plan on work-related stress was found to be significantly associated with more reported job resources (C.I. = .02-.24, p < .05) but these were not found to be significantly associated with less work-related stress. No significant association was found between having an organizational action plan for work-related stress and reported job demands. However, job demands were significantly related to reported work-related stress (C.I. = .27-.47, p < .001). Conclusions Findings add support to the call for specific legislation on work-related psychosocial risks and highlight how an organizational OSH culture underpinned by key OSH principles, and awareness/competence development on psychosocial risk management can have a positive effect on organizational action. However, further support needs to be provided to organizations around developing primary prevention interventions at the organizational level with the aim of reducing job demands.
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Affiliation(s)
- Stavroula Leka
- Centre for Organizational Health & Well-being, Lancaster University, Lancaster, UK
- University of Nottingham, Jubilee Campus, UK
| | - Luis Torres
- Nottingham University Business School, Jubilee Campus, Nottingham, UK
| | - Aditya Jain
- Nottingham University Business School, Jubilee Campus, Nottingham, UK
| | - Cristina Di Tecco
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers' Compensation Authority, Rome, Italy
| | - Simone Russo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers' Compensation Authority, Rome, Italy
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers' Compensation Authority, Rome, Italy
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Nigam JAS, Barker RM, Cunningham TR, Swanson NG, Chosewood LC. Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health - Quality of Worklife Survey, United States, 2018-2022. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:1197-1205. [PMID: 37917563 PMCID: PMC10629752 DOI: 10.15585/mmwr.mm7244e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Introduction Health workers faced overwhelming demands and experienced crisis levels of burnout before the COVID-19 pandemic; the pandemic presented unique challenges that further impaired their mental health. Methods Data from the General Social Survey Quality of Worklife Module were analyzed to compare self-reported mental health symptoms among U.S. adult workers from 2018 (1,443 respondents, including 226 health workers) and 2022 (1,952, including 325 health workers). Logistic regression was used to examine associations between health workers' reported perceptions of working conditions and anxiety, depression, and burnout. Results From 2018 to 2022, health workers reported an increase of 1.2 days of poor mental health during the previous 30 days (from 3.3 days to 4.5 days); the percentage who reported feeling burnout very often (11.6% to 19.0%) increased. In 2022, health workers experienced a decrease in odds of burnout if they trusted management (odds ratio [OR] = 0.40), had supervisor help (OR = 0.26), had enough time to complete work (OR = 0.33), and felt that their workplace supported productivity (OR = 0.38), compared with those who did not. Harassment at work was associated with increased odds of anxiety (OR = 5.01), depression (OR = 3.38), and burnout (OR = 5.83). Conclusions and implications for public health practice Health workers continued to face a mental health crisis in 2022. Positive working conditions were associated with less burnout and better mental health. CDC's National Institute for Occupational Safety and Health has developed a national campaign, Impact Wellbeing, to provide employers of health workers with resources to improve the mental health of these workers.
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Bes I, Shoman Y, Al-Gobari M, Rousson V, Guseva Canu I. Organizational interventions and occupational burnout: a meta-analysis with focus on exhaustion. Int Arch Occup Environ Health 2023; 96:1211-1223. [PMID: 37758838 PMCID: PMC10560169 DOI: 10.1007/s00420-023-02009-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE To assess whether organizational interventions are effective to prevent or reduce exhaustion, the core dimension of occupational burnout. METHODS We searched in PubMed, EMBASE, PsycINFO, and Cochrane Library databases randomized and non-randomized controlled trials conducted among active workers and reporting the outcome as exhaustion score. We calculated the effect sizes using the pre-test-post-test control group design's estimate. We used the random effects model in meta-analysis and Cochrane collaboration's tool for interventions to assess the risk of bias. Overall quality of evidence was appraised using the GRADE. RESULTS From the 2425 identified records, we assessed 228 full texts for eligibility and included 11 original articles describing 13 studies, 11 on organizational interventions, and 2 on combined inventions. The interventions were participatory (n = 9), focused on workload (n = 2), or on work schedule (n = 2). The overall effect size was - 0.30 ((95% CI = - 0.42; - 0.18), I2 = 62.28%), corresponding to a small reduction in exhaustion with a very low quality of evidence. Combined interventions had a larger effect (- 0.54 (95% CI = - 0.76; - 0.32)) than organizational interventions. When split by type of intervention, both participatory interventions and interventions focused on workload had a benefic effect of exhaustion reduction, with an estimated effect size of - 0.34 (95% CI = - 0.47; - 0.20) and - 0.44 (95% CI = - 0.68, - 0.20), respectively. CONCLUSION Interventions at combined level in workplaces could be helpful in preventing exhaustion. However, the evidence is still limited, due to a high heterogeneity between studies, bias potential, and small number of eligible studies. This calls for further research, using workload interventions at organizational level, especially in sectors with high risk of job stress and exhaustion.
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Affiliation(s)
- Isabelle Bes
- Department of Occupational and Environmental Health, Center for Primary Cary and Public Health (Unisanté), University of Lausanne, Epalinges, Switzerland
| | - Yara Shoman
- Department of Occupational and Environmental Health, Center for Primary Cary and Public Health (Unisanté), University of Lausanne, Epalinges, Switzerland
| | - Muaamar Al-Gobari
- Department of Occupational and Environmental Health, Center for Primary Cary and Public Health (Unisanté), University of Lausanne, Epalinges, Switzerland
| | - Valentin Rousson
- Quantitative Research Secteur, Unisanté, University of Lausanne, Lausanne, Switzerland
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Cary and Public Health (Unisanté), University of Lausanne, Epalinges, Switzerland.
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Rugulies R, Aust B, Greiner BA, Arensman E, Kawakami N, LaMontagne AD, Madsen IEH. Work-related causes of mental health conditions and interventions for their improvement in workplaces. Lancet 2023; 402:1368-1381. [PMID: 37838442 DOI: 10.1016/s0140-6736(23)00869-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 02/11/2023] [Accepted: 04/27/2023] [Indexed: 10/16/2023]
Abstract
Mental health problems and disorders are common among working people and are costly for the affected individuals, employers, and whole of society. This discussion paper provides an overview of the current state of knowledge on the relationship between work and mental health to inform research, policy, and practice. We synthesise available evidence, examining both the role of working conditions in the development of mental disorders, and what can be done to protect and promote mental health in the workplace. We show that exposure to some working conditions is associated with an increased risk of the onset of depressive disorders, the most studied mental disorders. The causality of the association, however, is still debated. Causal inference should be supported by more research with stronger linkage to theory, better exposure assessment, better understanding of biopsychosocial mechanisms, use of innovative analytical methods, a life-course perspective, and better understanding of the role of context, including the role of societal structures in the development of mental disorders. There is growing evidence for the effectiveness of interventions to protect and promote mental health and wellbeing in the workplace; however, there is a disproportionate focus on interventions directed towards individual workers and illnesses, compared with interventions for improving working conditions and enhancing mental health. Moreover, research on work and mental health is mainly done in high-income countries, and often does not address workers in lower socioeconomic positions. Flexible and innovative approaches tailored to local conditions are needed in implementation research on workplace mental health to complement experimental studies. Improvements in translating workplace mental health research to policy and practice, such as through workplace-oriented concrete guidance for interventions, and by national policies and programmes focusing on the people most in need, could capitalise on the growing interest in workplace mental health, possibly yielding important mental health gains in working populations.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland; National Suicide Research Foundation, University College Cork, Cork, Ireland; Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Junpukai Foundation, Okayama, Japan
| | - Anthony D LaMontagne
- School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Deady M, Collins DAJ, Lavender I, Mackinnon A, Glozier N, Bryant R, Christensen H, Harvey SB. Selective Prevention of Depression in Workers Using a Smartphone App: Randomized Controlled Trial. J Med Internet Res 2023; 25:e45963. [PMID: 37616040 PMCID: PMC10485707 DOI: 10.2196/45963] [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: 01/25/2023] [Revised: 06/27/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND There is increasing evidence that depression can be prevented; however, universal approaches have had limited success. Appropriate targeting of interventions to at-risk populations has been shown to have potential, but how to selectively determine at-risk individuals remains unclear. Workplace stress is a risk factor for depression and a target for intervention, but few interventions exist to prevent depression among workers at risk due to heightened stress. OBJECTIVE This trial aimed to evaluate the efficacy of a smartphone-based intervention in reducing the onset of depression and improving related outcomes in workers experiencing at least moderate levels of stress. METHODS A randomized controlled trial was conducted with participants who were currently employed and reported no clinically significant depression and at least moderate stress. The intervention group (n=1053) were assigned Anchored, a 30-day self-directed smartphone app-based cognitive behavioral- and mindfulness-based intervention. The attention-control group (n=1031) were assigned a psychoeducation website. Assessment was performed via web-based self-report questionnaires at baseline and at 1-, 3-, and 6-month postbaseline time points. The primary outcome was new depression caseness aggregated over the follow-up period. The secondary outcomes included depressive and anxiety symptoms, stress, well-being, resilience, work performance, work-related burnout, and quality of life. Analyses were conducted within an intention-to-treat framework using mixed modeling. RESULTS There was no significant between-group difference in new depression caseness (z score=0.69; P=.49); however, those in the Anchored arm had significantly greater depressive symptom reduction at 1 month (Cohen d=0.02; P=.049) and 6 months (Cohen d=0.08; P=.03). Anchored participants also showed significantly greater reduction in anxiety symptoms at 1 month (Cohen d=0.07; P=.04) and increased work performance at 1 month (Cohen d=0.07; P=.008) and 6 months (Cohen d=0.13; P=.01), compared with controls. Notably, for Anchored participants completing at least two-thirds of the intervention, there was a significantly lower rate of depression onset (1.1%, 95% CI 0.0%-3.7%) compared with controls (9.0%, 95% CI 6.8%-12.3%) at 1 month (z score=4.50; P<.001). Significant small to medium effect sizes for most secondary outcomes were seen in the highly engaged Anchored users compared with controls, with effects maintained at the 6-month follow-up for depressive symptoms, well-being, stress, and quality of life. CONCLUSIONS Anchored was associated with a small comparative reduction in depressive symptoms compared with controls, although selective prevention of case-level depression was not observed in the intention-to-treat analysis. When users adequately engaged with the app, significant findings pertaining to depression prevention, overall symptom reduction, and functional improvement were found, compared with controls. There is a need for a greater focus on engagement techniques in future research. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000178943; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378592.
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Affiliation(s)
- Mark Deady
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Daniel A J Collins
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Isobel Lavender
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Andrew Mackinnon
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Nicholas Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Helen Christensen
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
| | - Samuel B Harvey
- Black Dog Institute, Faculty of Medicine and Health, University of New South Wales, Randwick, Australia
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Dahlqvist I, Ståhl C, Severin J, Akerstrom M. Shifting from an individual to an organizational perspective in work environment management - a process evaluation of a six-year intervention program within the Swedish public sector. BMC Public Health 2023; 23:1108. [PMID: 37291519 PMCID: PMC10248951 DOI: 10.1186/s12889-023-16059-y] [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: 03/14/2023] [Accepted: 06/06/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Working systematically with the work environment, particularly the organizational and psychosocial work environment entails several challenges for employers. There is a lack of knowledge on how to best undertake this work. Thus, the aim of this study is to evaluate the process of a six-year organizational-level intervention program where workplaces could apply for additional funds to implement preventive intervention measures, with the intention of improving working conditions and reducing sickness absence within the Swedish public sector. METHODS The program management process was studied using a mixed-method approach combining qualitative document and content analyses based on process documentation produced between 2017 and 2022 (n = 135), interviews with internal occupational health services professionals in 2021 (n = 9) and quantitative descriptive analyses of submitted applications with decisions from 2017 to 2022 (n = 621). RESULTS Qualitative analyses of the process documentation revealed concerns from the project group regarding access to sufficient competence and resources among stakeholders and participating workplaces, and role conflicts and ambiguities between the program and everyday operations. To address these challenges, the application process was developed over time using the knowledge gained from previous years. A change in the mental models in work environment management, from an individual to an organizational perspective, was seen among the project group and the internal occupational health services responsible for implementing most of the granted intervention measures. In addition, the proportion of granted intervention measures on an organizational level increased throughout the years from 39% in 2017 to 89% in 2022. The changes in the application process were believed to be the main contributor to the change among the applying workplaces. CONCLUSIONS Results indicate that a long-term organizational-level workplace intervention program may be used, by the employer, as a tool for shifting from an individual- to an organizational perspective in the work environment management. However, additional measures on multiple levels need to be implemented to secure a sustainable shift in perspective within the organization.
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Affiliation(s)
- I Dahlqvist
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
| | - C Ståhl
- Department of Behavioural Sciences and Learning, Division of Education and Sociology, Linköping University, Linköping, Sweden
| | - J Severin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottbergs gata 22B, Gothenburg, 413 19, Sweden.
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20
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Ryan E, Hore K, Power J, Jackson T. The relationship between physician burnout and depression, anxiety, suicidality and substance abuse: A mixed methods systematic review. Front Public Health 2023; 11:1133484. [PMID: 37064688 PMCID: PMC10098100 DOI: 10.3389/fpubh.2023.1133484] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction The World Health Organization defines burnout as a problem associated with employment, a category distinct from psychological disorders such as depression, anxiety, suicidality and disorders of substance abuse. Evaluating the association between burnout as an occupational exposure and psychological morbidity may indicate that burnout can act as an occupational risk factor for mental ill-health. The systematic review explores this relationship in physicians due to the increased risk in this population and the implications for healthcare delivery. Methods A mixed methods systematic review of the literature was conducted across Medline, Cinahl Plus, PsycInfo, Web of Science and The Cochrane Library. Databases were systematically searched using keywords relating to physician burnout and depression, anxiety, suicidality and substance abuse. Identified articles were screened for eligibility by two independent researchers. Data extraction was performed and studies assessed for risk of bias. Quantitative and qualitative results were integrated using a convergent segregated approach and results portrayed as a narrative synthesis. Results Sixty-one articles were included in the review. There was notable heterogeneity in the measurement and criteria used to define burnout limiting the assimilation of results. Despite this, all studies that measured the association between depression and burnout reported a significant association. Studies that reported association between burnout and anxiety were similarly uniformly consistent. Most studies that reported the association between burnout and suicidality indicated that a significant association exists however difficulty in measurement of suicidality may have influenced variability of results. The reported association between substance abuse and burnout was more variable, suggesting that any association is likely to be weak or influenced by other variables. Qualitative studies described the manifestations of chronic workplace stress as well as perceived links with psychological morbidity. These included lack of time for work-life balance, the contribution of professional relationships and a culture of invulnerability that exists among physicians. Conclusion The systematic review cannot conclude causality but suggests that physician burnout is associated with depression, anxiety and suicidality. Qualitative data provides insight into the nature of this association. The review indicates the need for longitudinal research and provides considerations for intervention strategies to prevent the development and progression of burnout. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172938, identifier: CRD42020172938.
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Affiliation(s)
- Emer Ryan
- Department of Cardiothoracic Anaesthesia, Auckland City Hospital, Auckland, New Zealand
- Usher Institute, University of Edinburgh, Scotland, United Kingdom
- College of Anaesthesiologists of Ireland, Dublin, Ireland
| | - Kevin Hore
- College of Anaesthesiologists of Ireland, Dublin, Ireland
- Department of Anaesthesia, Great Ormonde Street Children's Hospital, London, United Kingdom
| | - Jessica Power
- Centre for Global Health, Trinity College, Dublin, Ireland
| | - Tracy Jackson
- Usher Institute, University of Edinburgh, Scotland, United Kingdom
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Zahlquist L, Hetland J, Notelaers G, Rosander M, Einarsen SV. When the Going Gets Tough and the Environment Is Rough: The Role of Departmental Level Hostile Work Climate in the Relationships between Job Stressors and Workplace Bullying. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4464. [PMID: 36901473 PMCID: PMC10002256 DOI: 10.3390/ijerph20054464] [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: 01/11/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
In line with the work environment hypothesis, the present study investigates whether department-level perceptions of hostile work climate moderate the relationship between psychosocial predictors of workplace bullying (i.e., role conflicts and workload) and exposure to bullying behaviours in the workplace. The data were collected among all employees in a Belgian university and constitutes of 1354 employees across 134 departments. As hypothesized, analyses showed positive main effects of role conflict and workload on exposure to bullying behaviours. In addition, the hypothesized strengthening effect of department-level hostile work climate on the relationship between individual-level job demands and individual exposure to bullying behaviours was significant for role conflict. Specifically, the positive relationship between role conflict and exposure to bullying behaviours was stronger among employees working in departments characterized by a pronounced hostile work climate. In contrast to our predictions, a positive relationship existed between workload and exposure to bullying behaviours, yet only among individuals in departments with low hostile work climate. These findings contribute to the bullying research field by showing that hostile work climate may strengthen the impact of role stress on bullying behaviours, most likely by posing as an additional distal stressor, which may fuel a bullying process. These findings have important theoretical as well as applied implications.
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Affiliation(s)
- Lena Zahlquist
- BI Norwegian Business School, Kong, Chr. Frederiks gate 5, 5006 Bergen, Norway
| | - Jørn Hetland
- BI Norwegian Business School, Kong, Chr. Frederiks gate 5, 5006 Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5020 Bergen, Norway
| | - Guy Notelaers
- Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5020 Bergen, Norway
| | - Michael Rosander
- Department of Behavioural Sciences and Learning, Linköping University, 581 83 Linköping, Sweden
| | - Ståle Valvatne Einarsen
- Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5020 Bergen, Norway
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Lim MH, Yoon JH, Lee WT, Kim MS, Baek SU, Won JU. Performance-Based Pay System and Job Stress Related to Depression/Anxiety in Korea: Analysis of Korea Working Condition Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4065. [PMID: 36901074 PMCID: PMC10002074 DOI: 10.3390/ijerph20054065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The adoption rate of performance-based pay systems has increased in recent years, and the adverse effects of systems have been emphasized. However, no study has analyzed the increase in the risk of depression/anxiety symptoms caused by the pay system in Korea. This study aimed to reveal the association between performance-based pay systems and symptoms of depression/anxiety, using data from the fifth Korean Working Conditions Survey. Depressive/anxiety symptoms were assessed using "yes" or "no" questions regarding medical problems related to depression/anxiety. The performance-based pay system and job stress were estimated using self-response answers. Logistic regression analyses were conducted to determine the association between performance-based pay systems, job stress, and symptoms of depression/anxiety using data from 27,793 participants. The performance-based pay system significantly increased the risk of the symptoms. Additionally, risk increments were calculated after grouping by pay system and job stress. Workers with two risk factors had the highest risk of symptoms of depression/anxiety for both sexes (male: OR 3.05; 95% CI 1.70-5.45; female: OR 2.15; 95% CI 1.32-3.50), implying synergistic effect of performance-based pay system and job stress on depression/anxiety symptoms. Based on these findings, policies should be established for early detection and protection against the risk of depression/anxiety.
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Affiliation(s)
- Myeong-Hun Lim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jin-Ha Yoon
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Won-Tae Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Min-Seok Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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23
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Kurisu K, Song YH, Yoshiuchi K. Developing Action Plans Based on Machine Learning Analysis to Prevent Sick Leave in a Manufacturing Plant. J Occup Environ Med 2023; 65:140-145. [PMID: 36075358 PMCID: PMC9897279 DOI: 10.1097/jom.0000000000002700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We aimed to develop action plans for employees' health promotion based on a machine learning model to predict sick leave at a Japanese manufacturing plant. METHODS A random forest model was developed to predict sick leave. We developed plans for workers' health promotion based on variable importance and partial dependence plots. RESULTS The model showed an area under the receiving operating characteristic curve of 0.882. The higher scores on the Brief Job Stress Questionnaire stress response, younger age, and certain departments were important predictors for sick leave due to mental disorders. We proposed plans to effectively use the Brief Job Stress Questionnaire and provide more support for younger workers and managers of high-risk departments. CONCLUSIONS We described a process of action plan development using a machine learning model, which may be beneficial for occupational health practitioners.
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Huynh TB, McClure LA, Howard VJ, Stafford MM, Judd SE, Burstyn I. Duration of employment within occupations and incident stroke in a US general population cohort 45 years of age or older (REGARDS study). Am J Ind Med 2023; 66:142-154. [PMID: 36440885 DOI: 10.1002/ajim.23446] [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: 05/12/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The work environment can contribute to the risk of cardiovascular diseases (CVD) including stroke. Our objective was to identify occupations with elevated risk of stroke within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. METHODS We analyzed incident stroke outcomes (ischemic and hemorrhagic strokes) from 2003 to 2020 and employment characteristics of 13,659 adults aged ≥45 years enrolled in a national population-based cohort study. Using a modified Poisson regression approach, we estimated the relative risks (RRs) and the associated 95% confidence intervals (CI) of stroke in relation to years of employment within each occupation coded using the US Census two-digit Standard Occupation Code. Models were adjusted for Framingham Stroke Risk Score, region, race, age, and body mass index. We conducted stratified analysis by sex, employment time period (pre-1975 vs. post-1975), and region. RESULTS Workers in the following occupations had a greater risk of stroke with longer duration of employment (per decade): protective service (RR: 2.35, 95% CI: 1.11, 4.97), food preparation and service (RR: 1.51, 95% CI: 1.05, 2.19), and transportation and material moving (RR: 1.30, 95% CI: 1.00, 1.69). The stroke risk in these occupations was disproportionately elevated in men, and differed by region and employment time period. CONCLUSIONS Longer employment in protective service, food preparation and serving, and transportation and materials moving occupations may increase the risk of stroke. Surveillance may uncover specific work-related risk factors in these occupations, leading to interventions to reduce the burden of stroke among US workers.
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Affiliation(s)
- Tran B Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Monika M Stafford
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne E Judd
- Graduate School of Medical Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Igor Burstyn
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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25
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Bonnesen CT, Thygesen LC, Rod NH, Toftager M, Madsen KR, Jensen MP, Rosing JA, Wehner SK, Due P, Krølner RF. Preventing Stress among High School Students in Denmark through the Multicomponent Healthy High School Intervention-The Effectiveness at First Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1754. [PMID: 36767122 PMCID: PMC9914335 DOI: 10.3390/ijerph20031754] [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: 12/02/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
Stress is a widespread phenomenon and young people especially are experiencing high levels of stress. School-related factors are the most frequently self-reported stressors among adolescents, but few interventions have targeted the school environment. This study evaluated the effectiveness of the Healthy High School (HHS) intervention on stress at a 9-month follow-up. The study included 5201 first-year high school students (~16 years) in Denmark. Participating schools were randomized into the HHS intervention (N = 15) or control group (N = 15). Baseline measurements were conducted in August 2016 and the follow-up was conducted in May 2017. The intervention was designed to promote well-being (primary outcome) by focusing on physical activity, meals, sleep, sense of security, and stress (secondary outcomes). The intervention comprised: structural initiatives at the school level; a teaching material; peer-led innovation workshops; and a smartphone app. The 10-item Perceived Stress Scale was used to measure stress. Intervention effects on perceived stress were estimated using an intention-to-treat approach with multiple imputations of missing data and multilevel general linear regression modelling. A total of 4577 students answered the baseline questionnaire. No statistically significant difference was found in stress between students at intervention and control schools at the follow-up (mean score: 16.7 versus 16.7, adjusted b = 0.42, 95% CI: -0.16;1.00). The HHS Study is one of the first large randomized controlled trials targeting school environmental stressors. Potential implementation failures and the failures of the program theory are discussed.
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Affiliation(s)
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Mette Toftager
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Katrine Rich Madsen
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Marie Pil Jensen
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Johanne Aviaja Rosing
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Stine Kjær Wehner
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
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Nebbs A, Martin A, Neil A, Dawkins S, Roydhouse J. An Integrated Approach to Workplace Mental Health: A Scoping Review of Instruments That Can Assist Organizations with Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1192. [PMID: 36673948 PMCID: PMC9859114 DOI: 10.3390/ijerph20021192] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to identify instruments that may assist organizations with implementing an integrated approach to workplace mental health using three activities from the knowledge to action (KTA) framework. A scoping review of published and grey literature, supported by stakeholder (business end-user and researcher) consultation, identified work-specific instruments that were relevant to at least one of the three domains of an integrated approach to workplace mental health: 'prevent harm', 'promote the positive', and 'respond to problems'. A total of 207 instruments were located, and 109 instruments met eligibility criteria. 10 instruments were located that were relevant to multiple domains, however most instruments (n = 72) were relevant to the 'prevent harm' domain. Instruments relevant to the 'promote the positive' (n = 14) and 'respond to problems' (n = 13) domains were limited. Most instruments found were suitable for the 'monitor, review and improve' KTA activity. Further development of instruments that can assist with 'promote the positive' and 'respond to problems' strategies are required, specifically those instruments that can assist organizations with the 'identify gaps and opportunities' and 'identify priorities and design new/enhanced interventions' KTA activities.
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Affiliation(s)
- Adam Nebbs
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart 7000, Australia
| | - Angela Martin
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart 7000, Australia
| | - Amanda Neil
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart 7000, Australia
| | - Sarah Dawkins
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart 7000, Australia
| | - Jessica Roydhouse
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart 7000, Australia
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Gilbert-Ouimet M, Zahiriharsini A, Biron C, Langlois L, Ménard C, Lebel M, Pelletier J, Duchaine C, Beaulieu M, Truchon M. Predict, prevent and manage moral injuries in Canadian frontline healthcare workers and leaders facing the COVID-19 pandemic: Protocol of a mixed methods study. SSM - MENTAL HEALTH 2022; 2:100124. [PMID: 35669531 PMCID: PMC9158246 DOI: 10.1016/j.ssmmh.2022.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 05/24/2022] [Accepted: 05/28/2022] [Indexed: 11/20/2022] Open
Abstract
Moral injuries can occur when perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. The COVID-19 crisis highlighted the fact that psychosocial stressors at work, such as high emotional demands, are placing Canadian healthcare workers at risk of moral injuries. Evidence linking psychosocial stressors at work to moral injuries are needed to better predict, prevent and manage moral injuries, as these stressors are frequent and modifiable occupational risk factors. This protocol presents a study aiming to: 1) understand workplace events having the potential to either cause or reduce moral injuries, 2) predict the risk and severity of moral injuries using a disease prevention model, 3) identify biological signatures (biomarkers) associated with psychosocial stressors at work and moral injuries and 4) elaborate preliminary guidelines of organizational practices for frontline healthcare workers to reduce and manage moral injuries. This study is a mixed methods research with three components: qualitative, quantitative and biological. The data collection has been completed and because of the COVID-19 pandemic, it was adjusted to allow for gathering qualitative and quantitative data remotely. Frontline healthcare workers and leaders were included. Through focus groups and individual interviews, and an online questionnaire, events and psychosocial working conditions that may increase the risk of moral injuries will be documented. In addition, blood samples which were collected from a sub-sample of volunteer participants will measure an innovative set of biomarkers associated with vulnerability to stress and mental health. Data analyses are ongoing. We anticipate to identify workplace events that may trigger moral injuries. We expect that potential predictors of moral injury risk occurrence and severity will be identified from psychosocial stressors at work that can be improved by implementing organizational practices. We also expect to observe a different mental health state and biological inflammation signature across workers exposed compared to workers not exposed to psychosocial stressors at work. Based on these future findings, we intend to develop preliminary recommendations of organizational practices for managers. This research will contribute to expand our knowledge of the events in the workplace likely to generate or lessen the impact moral injuries, to build a model for predicting the risk of moral injuries at work, all in the specific context of the COVID-19 health crisis among healthcare workers.
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Affiliation(s)
- Mahée Gilbert-Ouimet
- Department of Health Sciences, Université du Québec à Rimouski, 1595 Boulevard Alphonse-Desjardins, Lévis, QC, G6V 0A6, Canada
- CHU de Québec-Laval University Research Center, 1050 Chemin Ste-Foy, Quebec City, QC, G1S 4L8, Canada
| | - Azita Zahiriharsini
- Department of Health Sciences, Université du Québec à Rimouski, 1595 Boulevard Alphonse-Desjardins, Lévis, QC, G6V 0A6, Canada
- CHU de Québec-Laval University Research Center, 1050 Chemin Ste-Foy, Quebec City, QC, G1S 4L8, Canada
| | - Caroline Biron
- Department of Management, Laval University, Quebec City, QC, G1V 0A6, Canada
| | | | - Caroline Ménard
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University and CERVO Brain Research Center, Quebec City, QC, G1V 0A6, Canada
| | - Manon Lebel
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Laval University and CERVO Brain Research Center, Quebec City, QC, G1V 0A6, Canada
| | - Jérôme Pelletier
- Department of Health Sciences, Université du Québec à Rimouski, 1595 Boulevard Alphonse-Desjardins, Lévis, QC, G6V 0A6, Canada
| | - Caroline Duchaine
- Faculty of Medicine, Laval University, 1050 ave de la Médecine, Quebec City, QC, G1V 0A6, Canada
- CHU de Québec-Laval University Research Center, 1050 Chemin Ste-Foy, Quebec City, QC, G1S 4L8, Canada
| | | | - Manon Truchon
- School of Psychology, Laval University, Quebec City, QC, G1V 0A6, Canada
- Centre de recherche interdisciplinaire en réadaptation et intégration sociale(CIRRIS), Quebec City, QC, G1M 2S8, Canada
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Stelson EA, Sabbath-Clayton LL, Sorensen G, Kubzansky LD, Berkman LF, Sabbath EL. Residential addiction treatment providers: Identifying the role of social context in worker health and turnover. Soc Sci Med 2022; 314:115462. [PMID: 36327634 DOI: 10.1016/j.socscimed.2022.115462] [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: 06/22/2022] [Revised: 09/26/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
Increased lethality and availability of addictive substances has strained US addiction treatment services, further exacerbating workforce shortages in these settings. The emotional and physical health toll of providing treatment may contribute to shortages. This community-initiated qualitative study aimed to identify conditions that affect provider health and turnover in residential addiction treatment from a Total Worker Health® perspective. Providers (direct service, supervisors, leaders) working in nonprofit residential treatment facilities in Massachusetts were recruited by role and geography to participate in interviews and focus groups. NVivo12 facilitated coding and analysis. 25% of transcripts were double coded to assess interrater reliability and coding consistency (mean Kappa = 0.82). Providers (N = 49) participated in 33 interviews and 4 focus groups. Many participants reported personal addiction histories. Analysis revealed how socio-contextual factors originating outside of residential facilities were dominant influences on "downstream" working conditions, worker health, staff turnover, and by extension, client care. Four primary socio-contextual themes surfaced:1) Changes in type and potency of substances and client need not reliably accompanied by shifts in treatment practices; 2) challenges balancing state requirements and state-provided resources; 3) influence of structural discrimination and addiction stigma on pay and professional advancement; and 4) geographic location of facilities shape work and quality of life. Results were used to develop a conceptual model for residential addiction treatment to illustrate pathways by which ecological factors interact to affect provider health and turnover. Findings indicate that protecting health and wellbeing of providers-many of whom are in addiction recovery themselves- is integral to improving addiction treatment. From this workforce's perspective, recent changes in socio-contextual factors have intensified already challenging working conditions (job demands, pay, advancement), negatively impacting worker health, turnover, and client care. Any interventions to improve treatment outcomes or working conditions in nonprofit addiction facilities must consider larger socio-contextual factors influencing these organizations.
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Affiliation(s)
- Elisabeth A Stelson
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA.
| | | | - Glorian Sorensen
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA; Dana-Farber Cancer Institute, Boston, MA, USA
| | - Laura D Kubzansky
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA
| | - Lisa F Berkman
- Harvard T.H. Chan School of Public Health, Dept. of Social and Behavioral Sciences, 677 Huntington Ave., Boston, MA, 02115, USA
| | - Erika L Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, USA
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Toscano F, Tommasi F, Giusino D. Burnout in Intensive Care Nurses during the COVID-19 Pandemic: A Scoping Review on Its Prevalence and Risk and Protective Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12914. [PMID: 36232211 PMCID: PMC9564773 DOI: 10.3390/ijerph191912914] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND The COVID-19 pandemic has strained hospitals and healthcare workers engaged in combating the virus with limited knowledge and resources. Intensive care unit (ICU) nurses are among the healthcare workers most affected by the pandemic and are at risk for developing burnout syndrome. OBJECTIVE The present study aims to explore burnout symptoms prevalence among ICU nurses and to identify the individual, organizational, and contextual risk, and protective factors of burnout in ICU nurses during the COVID-19 pandemic. METHODS A scoping review was conducted by searching PubMed, Scopus, and Web of Science. Only papers with empirical data and referred to ICU nurses were included. A total of 350 initial results were yielded, and 40 full texts were screened. Twelve papers constituted the final sample in the analysis. RESULTS High levels of symptoms of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) were registered among ICU nurses during the COVID-19 pandemic. Increased workload, lack of equipment, social stigma, and fear of contagion emerged as key risk factors. Social support from leaders and colleagues, professional recognition, use of personal protective tools, and witnessing patients' successful recovery emerged as major protective factors. CONCLUSIONS The results may inform the development of timely actions to counter burnout in ICU nurses during this COVID-19 pandemic and in a post-COVID-19 scenario.
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Affiliation(s)
| | - Francesco Tommasi
- Department of Human Sciences, University of Verona, 37129 Verona, Italy
| | - Davide Giusino
- Department of Psychology, University of Bologna, 40127 Bologna, Italy
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Ersel RP, Pauli R, Gaum PM, Lang J. Sustainable return to work after depression - A comparative study among occupational physicians and affected employees. Front Public Health 2022; 10:946396. [PMID: 36276364 PMCID: PMC9583521 DOI: 10.3389/fpubh.2022.946396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/13/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction The number of sick days taken from work due to depression is steadily rising. A successful return to work (RTW) is essential for sustainable reintegration. This study aims to identify factors to optimize RTW and to investigate approaches for sustainable RTW (sRTW) after depressive episodes. Methods Semi-structured expert interviews with senior occupational physicians (OPs, N = 5) served to develop two surveys among OPs (N = 180) and employees after depressive episode (N = 192). Predictors of RTW rating, workplace-based RTW interventions and sRTW interventions were analyzed using multiple hierarchical regression, chi-square difference and t-tests. Results For OPs, employee training on mental illness prevention was found to be the strongest predictor of overall RTW rating, whereas understanding and appreciation in conversations and stigmatization were strongest predictors of overall RTW rating by the employees. Compared to the employees, OPs reported significantly more availability of workplace-based interventions. To prevent relapse, the employees prioritized sufficient time and financial security during the RTW process more than OPs. Conclusions The study identified facilitating and hindering factors that can inform further research and practice to improve RTW after depressive episodes. To redress the awareness gap about the availability of workplace-based interventions, regular contact between OPs and employees is crucial. Several factors were considered to be of varying importance for relapse prevention by the two groups. Multiple perceptions and needs ought to be taken into account during RTW.
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Llorens-Serrano C, Salas-Nicás S, Navarro-Giné A, Lluís SM. Delegation and consultation on operational and tactical issues: Any difference in their potentialities for a healthier psychosocial work environment? Am J Ind Med 2022; 65:800-812. [PMID: 35938976 PMCID: PMC9544612 DOI: 10.1002/ajim.23414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/11/2022]
Abstract
Background Despite the growing number of studies on direct participation labor‐management practices, little is known about the role of their different discretionary degrees (delegation or consultation) and topics in their relationship with the psychosocial work environment by occupational groups. Methods Cross‐sectional study on the relationship between direct participation and work‐related psychosocial risks (using COPSOQ‐ISTAS21 v3) on a representative sample of the salaried and wage‐earning employees in Spain (n = 1807). Prevalence ratios were calculated using adjusted Poisson regression models, controlling for 10 other labor‐management practices, sex, and age, and stratified by occupational group. Results The use of direct participation was either associated consistently with a healthier psychosocial work environment (mostly in manual occupations, which presented twice as many positive associations as nonmanual occupations, and of greater strength, mostly in the control and social support dimensions) or there were no significant associations (mostly among nonmanual occupations and in relation to work pace). More frequent and stronger associations were observed when consultation and delegation were used in combination. If used separately, consultation achieved better results among manual occupations and delegation among nonmanual occupations. Direct participation topics were not important for results in manual occupations whereas results were better on tactical (vs. operational) issues in nonmanual occupations. Conclusions Direct participation does not change power structure, but it may be a useful intervention at the company level to reduce work‐related psychosocial exposures and associated diseases among workers in manual occupations, and consequently for decreasing occupational exposures and health inequalities.
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Affiliation(s)
- Clara Llorens-Serrano
- Sociology Department, Faculty of Sociology and Political Sciences, Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain.,Union Institute of Work, Environment and Health (ISTAS), Reference Centre on Work Organization and Health, Barcelona, Spain.,Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Sergio Salas-Nicás
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Albert Navarro-Giné
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain.,Biostatistics Unit, Faculty of Medicine, Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Salvador Moncada Lluís
- Union Institute of Work, Environment and Health (ISTAS), Reference Centre on Work Organization and Health, Barcelona, Spain
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Loeb C, von Thiele Schwarz U, Hasson H, Tafvelin S. Congruence Rules! Increased Self-efficacy after Occupational Health Interventions—if Leaders and Teams Agree on the Participative Safety Climate. SCANDINAVIAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2022. [DOI: 10.16993/sjwop.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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A Qualitative Analysis of the Mental Health Training and Educational Needs of Firefighters, Paramedics, and Public Safety Communicators in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126972. [PMID: 35742221 PMCID: PMC9222833 DOI: 10.3390/ijerph19126972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/30/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023]
Abstract
Background—Public safety personnel (PSP) are at heightened risk of developing mental health challenges due to exposures to diverse stressors including potentially psychologically traumatic experiences. An increased focus on protecting PSP mental health has prompted demand for interventions designed to enhance resilience. While hundreds of available interventions are aimed to improve resilience and protect PSPs’ mental health, research evidence regarding intervention effectiveness remains sparse. Methods—Focus groups with PSP elicited a discussion of psychoeducational program content, preferred modes of program delivery, when such training should occur, and to whom it ought to be targeted. Results—The results of thematic analyses suggest that PSP participants feel that contemporary approaches to improving mental health and resilience are lacking. While welcomed, the provision of sporadic one-off mental health and resilience programs by organizations was seen as insufficient, and the available organizational mental health supports were perceived as being questionable. The available programs also left participants feeling insufficiently prepared to deal with personal mental health problems and in discussing mental health concerns with co-workers. Conclusions—Participants reported needing more engaging methods for delivering information, career-long mental health knowledge acquisition, and a systems approach to improve the workplace culture, particularly regarding mental health.
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Nielsen K, De Angelis M, Innstrand ST, Mazzetti G. Quantitative process measures in interventions to improve employees’ mental health: A systematic literature review and the IPEF framework. WORK AND STRESS 2022. [DOI: 10.1080/02678373.2022.2080775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Karina Nielsen
- Institute for Work Psychology, Sheffield University Management School, University of Sheffield, Sheffield, UK
| | - Marco De Angelis
- Department of Psychology “Renzo Canestrari”, University of Bologna, Bologna, Italy
| | - Siw Tone Innstrand
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Greta Mazzetti
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, Bologna, Italy
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35
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Shernoff ES, Ruork AK, Nadeem E, Rizvi SL. The feasibility and promise of Dialectical Behavior Therapy Skills Training with teachers and school personnel in high‐poverty schools. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elisa S. Shernoff
- School Psychology Department Rutgers University Piscataway New Jersey USA
| | - Allison K. Ruork
- School Psychology Department Rutgers University Piscataway New Jersey USA
| | - Erum Nadeem
- School Psychology Department Rutgers University Piscataway New Jersey USA
| | - Shireen L. Rizvi
- School Psychology Department Rutgers University Piscataway New Jersey USA
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Sanetti LMH, Pierce AM, Gammie L, Dugan AG, Cavallari JM. Scale-out of a Total Worker Health® approach for designing interventions to reduce teacher stress: pilot implementation evaluation. BMC Public Health 2022; 22:814. [PMID: 35461229 PMCID: PMC9034693 DOI: 10.1186/s12889-022-13241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Teachers have high rates of daily stress and the majority of available interventions are focused at the teacher-level. Yet, best practices in Total Worker Health® approaches indicate organization-level interventions identified using a participatory approach are most effective. We conducted an exploratory scale-out pilot study to examine the adoption of the Healthy Workplace Participatory Program (HWPP), an evidence-based, Total Worker Health approach to engage employees (e.g., teachers) and supervisory personnel (e.g., administrators) in the design and implementation of workplace well-being interventions within two elementary schools. METHODS We evaluated the program both quantitatively and qualitatively collecting implementation outcome data (i.e., fidelity, acceptability, understanding, feasibility, system alignment) as well as data-driven adaptations using the Framework for Reporting Adaptations and Modifications-Expanded. Data from the first school informed scale-out adaptation of the HWPP intervention, HWPP-Education, within the second school. We compared implementation outcomes between Pilot Schools 1 and 2 to evaluate improvements in the adapted HWPP. RESULTS Adaptations to HWPP program content and process were suggested to increase feasibility and contextual fit. Acceptability, understanding, and feasibility ratings showed statistically significant improvements comparing School 1 to School 2 which implemented the improved HWPP-Education. Furthermore, users reported adaptations including shorter meeting design and faster process were feasible within their work context. CONCLUSION This pilot study is the first attempt to scale out the HWPP to educators, and while not intended to confirm efficacy, it showed promising results for scale-out. Results from Pilot Schools 1 and 2 suggest systematic use of quantitative and qualitative implementation data can effectively inform scale-out efforts that increase critical outcomes such as fidelity, acceptability, understanding, feasibility, system alignment, and leader engagement as well as decrease the extent of system resources needed. As such, this scale-out process may be a feasible approach on which to base large-scale implementation efforts of the HWPP among educators.
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Affiliation(s)
- Lisa M H Sanetti
- Neag School of Education, Department of Educational Psychology, University of Connecticut, Storrs, CT, 06269, USA.
| | - Alexandra M Pierce
- Neag School of Education, Department of Educational Psychology, University of Connecticut, Storrs, CT, 06269, USA
| | - Lauren Gammie
- Neag School of Education, Department of Educational Psychology, University of Connecticut, Storrs, CT, 06269, USA
| | - Alicia G Dugan
- School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut Health Center, Farmington, USA
| | - Jennifer M Cavallari
- School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut Health Center, Farmington, USA
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Prudenzi A, Graham CD, Flaxman PE, Wilding S, Day F, O’Connor DB. A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial. PLoS One 2022; 17:e0266357. [PMID: 35442963 PMCID: PMC9020690 DOI: 10.1371/journal.pone.0266357] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 03/02/2022] [Indexed: 11/20/2022] Open
Abstract
The levels of psychological distress and burnout among healthcare staff are high, with negative implications for patient care. A growing body of evidence indicates that workplace programmes based on Acceptance and Commitment Therapy (ACT) are effective for improving employees' general psychological health. However, there is a paucity of research examining the specific psychological and/or behavioural processes through which workplace ACT programmes transmit their beneficial effects. The aim of this randomised controlled trial was to investigate the outcomes and putative processes of change in a 4-session ACT training programme designed to reduce psychological distress among healthcare staff (n = 98). Ninety-eight employees of a healthcare organisation were randomly allocated to the ACT intervention or to a waiting list control group. Study measures were administered on four occasions (baseline, mid-intervention, post-intervention, and follow-up) over a three-month evaluation period. Results showed that the ACT intervention led to a significant decrease in symptoms of psychological distress and a less pronounced reduction in burnout. These effects were mediated primarily via an improvement in mindfulness skills and values-based behaviour and moderated by participants' initial levels of distress. At four-week post-intervention, 48% of participants who received the ACT intervention showed reliable improvements in psychological distress, with just under half of the aforementioned improvements (46.15%) meeting criteria for clinically significant change. The results advance ACT as an effective stress management intervention for healthcare staff. The findings should be confirmed in a large scale randomised controlled trial with longer follow-up and cost-effectiveness analyses.
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Affiliation(s)
- Arianna Prudenzi
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Christopher D. Graham
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Paul E. Flaxman
- Department of Psychology, University of London, London, United Kingdom
| | - Sarah Wilding
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Fiona Day
- Fiona Day Consulting LTD, Leeds, United Kingdom
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Bakhuys Roozeboom MC, Niks IMW, Schelvis RMC, Wiezer NM, Boot CRL. Design of a Participatory Organizational-Level Work Stress Prevention Approach in Primary Education. Front Psychol 2022; 13:827278. [PMID: 35432065 PMCID: PMC9006983 DOI: 10.3389/fpsyg.2022.827278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background Work stress is a serious problem in primary education. Decades of research underline the importance of participatory, organizational-level work stress prevention approaches. In this approach, measures are planned to tackle causes of work stress in a participatory manner and implemented by a working group consisting of members of the organization. This approach can only be effective if the measures contain effective ingredients to decrease work stress risks and are successfully implemented. The aim of this paper is to present an outline of a work stress prevention approach that is evaluated in primary education. To ensure the appropriateness of measures, a logic model of change is built as part of the risk assessment to facilitate the selection of appropriate measures. Progression on target behaviors as well as implementation factors are real-time monitored during implementation and fed back to the working groups, to provide the opportunity to adjust action plans when needed to optimize implementation. Methods The approach consists of five steps: (1) preparation: installing an advisory board and working groups, (2) risk assessment: inventory of work stress risks (questionnaires and focus groups). In addition, a behavioral analysis is performed to build a logic model of change to facilitate selection of measures, (3) action planning: conducting an action plan with appropriate measures (focus groups), (4) implementation: implementing the action plan. During implementation progression on target behaviors and implementation factors are monthly monitored and fed back to the working groups, and (5) evaluation: effects of the approach are studied in a controlled trial with measurements at baseline (T0), 1 year (T1), and 2 years (T2) follow-up. A process evaluation is carried out using quantitative (questionnaires and real-time monitoring data) and qualitative (interviews and data logs) data to study the implementation process of all steps of the work stress approach. Discussion We believe that building a logic model of change and real-time monitoring of implementation could be of added value to improve the success of the work stress prevention approach. With this study, we aim to provide more insights into work stress intervention research, especially in primary education. Clinical Trial Registration The study is registered in Netherlands Trial Register (ClinicalTrials.gov #NL9797, October 18, 2021).
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Affiliation(s)
- Maartje C Bakhuys Roozeboom
- TNO (The Netherlands Organization for Applied Scientific Research), Leiden, Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam, Netherlands
| | - Irene M W Niks
- TNO (The Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | - Roosmarijn M C Schelvis
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Academic Medical Center, Amsterdam, Netherlands
| | - Noortje M Wiezer
- TNO (The Netherlands Organization for Applied Scientific Research), Leiden, Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam, Netherlands
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de Wijn AN, van der Doef MP. Reducing Psychosocial Risk Factors and Improving Employee Well-Being in Emergency Departments: A Realist Evaluation. Front Psychol 2022; 12:728390. [PMID: 35185666 PMCID: PMC8850266 DOI: 10.3389/fpsyg.2021.728390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, the study aims to assess potential moderators including the level of intervening (organization-directed or multilevel), process variables (the number and fit of actions to risk factors, communication and employee participation) and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity (based on the number of actions implemented) and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions (including professional support for employees with stress-related complaints) seem essential to also improve well-being.
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Affiliation(s)
- Anne Nathal de Wijn
- Institute of Psychology, Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Margot Petra van der Doef
- Institute of Psychology, Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, Netherlands
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The Cost-Effectiveness Analysis of the Productivity Measurement and Enhancement System Intervention to Reduce Employee Work-Related Stress and Enhance Work Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042431. [PMID: 35206615 PMCID: PMC8874651 DOI: 10.3390/ijerph19042431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 02/06/2023]
Abstract
Background: The study evaluates the cost-effectiveness of the Productivity Measurement and Enhancement System (ProMes) intervention to reduce employee work-related stress and enhance work performance. Methods: A prospective cohort study was used to undertake the evaluation from a business perspective. Objective workload data and stress were gathered repeatedly over a 17-month period (i.e., before and after intervention). Independent t-test and an interrupted time series (ITS) analysis were used in the analysis. The average cost-effectiveness ratio (ACER) was calculated as a ratio of the average cost of the intervention and the effect sizes of the different outcomes to reflect the average cost per clinician for each unit change in outcome. Results: Based on the results of the ITS analysis, an expenditure of EUR 41,487 was linked with no change in stress levels, according to the ACER for stress. In addition, the expenditures associated with each unit change were EUR 3319 for overall tasks per hour worked, EUR 2761 for visits per hour worked, EUR 2880 for administrative tasks, but EUR 9123 for answering phone calls. Conclusions: ProMes is not cost–effective in terms of work-related stress levels, but the intervention seemed to have increased efficiency in some objective work performance measures, albeit at a relatively high extra cost.
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Comacchio C, Antolini G, Ruggeri M, Colizzi M. Gender-Oriented Mental Health Prevention: A Reappraisal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1493. [PMID: 35162515 PMCID: PMC8835536 DOI: 10.3390/ijerph19031493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Abstract
Many studies have investigated the impact of gender on mental health, but only a few have addressed gender differences in mental health risk and prevention. We conducted a narrative review to assess the current state of knowledge on gender-specific mental health preventive interventions, along with an analysis of gender-based risk factors and available screening strategies. Out of 1598 articles screened using a comprehensive electronic search of the PubMed, Web-of-Science, Scopus, and Cochrane databases, 53 were included for review. Among risk factors for mental health problems, there are individual, familiar, social, and healthcare factors. Individual factors include childhood adversities, which show gender differences in distribution rates. However, current childhood abuse prevention programs are not gender-specific. Familiar factors for mental health problems include maternity issues and intimate partner violence, and for both, some gender-specific preventive interventions are available. Social risk factors for mental health problems are related to education, employment, discrimination, and relationships. They all display gender differences, but these differences are rarely taken into account in mental health prevention programs. Lastly, despite gender differences in mental health service use being widely known, mental health services appear to be slow in developing strategies that guarantee equal access to care for all individuals.
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Affiliation(s)
| | - Giulia Antolini
- Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, 37126 Verona, Italy;
| | - Mirella Ruggeri
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Marco Colizzi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, 33100 Udine, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK
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Qiu S, Dooley L. How servant leadership affects organizational citizenship behavior: the mediating roles of perceived procedural justice and trust. LEADERSHIP & ORGANIZATION DEVELOPMENT JOURNAL 2022. [DOI: 10.1108/lodj-04-2021-0146] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PurposeThe paper aimed (1) to examine the mediating effects of procedural justice perception and trust in leaders between servant leadership and customer-oriented organizational citizenship behavior and (2) to investigate the relationships between procedural justice perception and trust in leaders in the context of Chinese hotel industry.Design/methodology/approachThe paper opted for a quantitative study using online survey to collect data. Data screening was carried out to ensure all the data met the underlying statistical assumptions. This paper adopted structural equation modeling (SEM) to test the hypotheses.FindingsThe paper found that procedural justice perception and trust in leaders have a full mediating effect on the relationship between servant leadership and customer-oriented organizational citizenship behavior. Procedural justice perception was positively associated with trust in leaders.Originality/valueThe paper provided a framework to enhance the theoretical understanding of interconnectedness of servant-leadership-related variables. It filled a theoretical gap by proposing an integrative model that examined the relationships among the variables of interest.
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Mental Health Promotion and Intervention in Occupational Settings: Protocol for a Pilot Study of the MENTUPP Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020947. [PMID: 35055773 PMCID: PMC8775639 DOI: 10.3390/ijerph19020947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/21/2021] [Accepted: 01/10/2022] [Indexed: 01/27/2023]
Abstract
Depression and anxiety are the most prevalent mental health difficulties in the EU, causing immense suffering and costing the global economy EUR 1 trillion each year in lost productivity. Employees in construction, health and information and communications technology have an elevated risk of mental health difficulties. Most mental health interventions for the workplace have been targeted at larger companies and small and medium-sized enterprises (SMEs) are often overlooked despite most people being employed in SMEs. The MENTUPP intervention aims to improve mental health and wellbeing and reduce depression, anxiety, and suicidal behaviour. The MENTUPP project involves the development, implementation, and evaluation of a multilevel intervention targeting both clinical and non-clinical mental health issues and combating the stigma of mental (ill-)health, with a specific focus on SMEs. The intervention is underpinned by a framework of how to create a mentally healthy workplace by employing an integrated approach and has been informed by several systematic reviews designed to understand organisational mental health interventions and a consultation survey with key experts in the area. The intervention is facilitated through the MENTUPP Hub, an online platform that presents interactive psychoeducational materials, toolkits, and links to additional resources in an accessible and user-friendly manner. This paper presents the pilot study protocol for delivering the MENTUPP intervention in eight European countries and Australia. Each intervention country will aim to recruit at least 23 participants in 1-3 SMEs in one of the three high-risk sectors. The central aim of the pilot study will be to examine the feasibility, acceptability, and uptake of the MENTUPP intervention across the target SMEs. The findings will contribute to devising the protocol for a cluster randomised controlled trial (cRCT) of the MENTUPP intervention. Findings from this study will also be used to inform the optimisation phase of the MENTUPP intervention which will aim to improve the materials and the implementation of the intervention as well as enhancing the evaluation strategy which will be employed for the cRCT.
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Koch J, Schermuly CC. Managing the Crisis: How COVID‐19 Demands Interact with Agile Project Management in Predicting Employee Exhaustion. BRITISH JOURNAL OF MANAGEMENT 2021; 32:1265-1283. [PMCID: PMC8441862 DOI: 10.1111/1467-8551.12536] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 06/08/2021] [Indexed: 09/15/2023]
Abstract
AbstractAs a global pandemic, COVID‐19 impacts work‐related processes, placing strain upon many employees in project teams. Identifying process variables and potential organizational resources can play an important role in addressing employee mental health, both for the current pandemic and future crises. Based on an extension of the job demands–resources model, this paper introduces COVID‐19 demands as distal job demands, examining their influence on emotional exhaustion through proximal unfinished tasks. Furthermore, we suggest that agile project management acts as a buffering job resource in this relationship. In two studies, we drew samples from Germany (N = 168) and the USA (N = 292). Across studies, COVID‐19 demands had an indirect effect on emotional exhaustion, mediated by unfinished tasks. Furthermore, agile project management acts as a buffering job resource for individuals in Germany, attenuating the relationship between COVID‐19 demands, unfinished tasks and subsequent feelings of emotional exhaustion. In contrast, findings from Study 2 revealed that COVID‐19 demands were more strongly related to unfinished tasks and subsequent feelings of emotional exhaustion in the USA when individuals reported higher levels of agile project management. Taken together, our results indicate that project work under COVID‐19 fosters feelings of emotional exhaustion through the accumulation of unfinished tasks.
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Affiliation(s)
- Jan Koch
- SRH Berlin University of Applied Sciences Ernst‐Reuter‐Platz 10 Berlin 10587 Germany
| | - Carsten C. Schermuly
- SRH Berlin University of Applied Sciences Ernst‐Reuter‐Platz 10 Berlin 10587 Germany
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45
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Restrepo J, Lemos M. Addressing psychosocial work-related stress interventions: A systematic review. Work 2021; 70:53-62. [PMID: 34511476 DOI: 10.3233/wor-213577] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Work-related stress can be defined as an individual's reactions to work characteristics and indicates a poor relationship between coping abilities and work environment. If unmanaged, stress can impact mental and physical health (e.g., causing depression and cardiovascular disease). Many individuals use maladaptive stress-coping strategies, such as sedentary activities, unhealthy eating behaviors, and alcohol consumption, which do not contribute to long-term stress management. In contrast, stress reduction programs can help people manage and effectively reduce stress in the long term. OBJECTIVE To gather the state of the art of work-related stress interventions, their efficacy and applications. METHOD The PsycINFO and EBSCOHost databases were used. The search was carried out between January 28 and March 30, 2019. Inclusion criteria were full text available, text in English or Spanish and a study population comprising workers. RESULTS Twenty-nine articles that included interventions involving aromatherapy, bibliotherapy, cognitive-behavioral therapy, exercise, alternative medicine, mindfulness, technology, stress management and sensory intervention were analyzed. The interventions showed significant reductions in stress, anxiety, depression and burnout; however, most of the studies were not based on specific stress models, and control groups often received no intervention whatsoever. As a result, it is challenging to draw conclusions regarding the success of the interventions, especially if they are novel. CONCLUSION The results suggest that there is a broad portfolio of successful interventions regarding work-related stress. Most of the successful interventions were based on mindfulness; however, aerobic exercise and bibliotherapy may also be successful. The structure and level of evidence appear to be very relevant to the development of a successful intervention.
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Affiliation(s)
- Julia Restrepo
- Department of Psychology, EAFIT University, Medellín, Antioquia, Colombia
| | - Mariantonia Lemos
- Department of Psychology, EAFIT University, Medellín, Antioquia, Colombia
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Weigl M, Schreyer J. [Is this the parallel pandemic? : Measures to improve working conditions and stress levels among health care personnel]. Internist (Berl) 2021; 62:928-936. [PMID: 34386829 PMCID: PMC8359916 DOI: 10.1007/s00108-021-01120-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 01/08/2023]
Abstract
Employee health and ability to perform is essential to a functioning health care system. Even before the coronavirus disease 2019 (COVID-19) pandemic, a substantial proportion of employees reported impaired mental health at work. This paper outlines the state of knowledge and evidence on interventions to promote mental health in the workplace, with particular focus on the organization of work and activities. In addition to an initial review of approaches, the factors facilitating successful and effective approaches are addressed.
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Affiliation(s)
- Matthias Weigl
- Institut für Patientensicherheit, Medizinische Fakultät, Universität Bonn, Gebäude 02 (Auenbruggerhaus), Venusberg-Campus 1, 53127, Bonn, Deutschland.
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, München, Deutschland.
| | - Julia Schreyer
- Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, Klinikum der Universität München, München, Deutschland
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Fox KE, Johnson ST, Berkman LF, Sianoja M, Soh Y, Kubzansky LD, Kelly EL. Organisational- and group-level workplace interventions and their effect on multiple domains of worker well-being: A systematic review. WORK AND STRESS 2021. [DOI: 10.1080/02678373.2021.1969476] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Kimberly E. Fox
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
- Department of Sociology, Bridgewater State University, Bridgewater, MA, USA
| | - Sydney T. Johnson
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - Lisa F. Berkman
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marjaana Sianoja
- MIT Sloan School of Management, Cambridge, MA, USA
- Faculty of Social Sciences/Psychology, University of Tampere, Tampere, Finland
| | - Yenee Soh
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Do Multicomponent Workplace Health and Wellbeing Programs Predict Changes in Health and Wellbeing? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178964. [PMID: 34501554 PMCID: PMC8430978 DOI: 10.3390/ijerph18178964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 11/17/2022]
Abstract
Organizations typically deploy multiple health and wellbeing practices in an overall program. We explore whether practices in workplace health and wellbeing programs cohere around a small number of archetypal categories or whether differences between organizations are better explained by a continuum. We also examine whether adopting multiple practices predicts subsequent changes in health and wellbeing. Using survey data from 146 organizations, we found differences between organizations were best characterized by a continuum ranging from less to more extensive adoption of practices. Using two-wave multilevel survey data at both individual and organizational levels (N = 6968 individuals, N = 58 organizations), we found that, in organizations that adopt a wider range of health and wellbeing practices, workers with poor baseline psychological wellbeing were more likely to report subsequent improvements in wellbeing and workers who reported good physical health at baseline were less likely to report experiencing poor health at follow-up. We found no evidence that adopting multiple health and wellbeing practices buffered the impact of individuals’ workplace psychosocial hazards on physical health or psychological wellbeing.
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Denuwara B, Gunawardena N, Dayabandara M, Samaranayake D. A systematic review and meta-analysis of the effectiveness of individual-level interventions to reduce occupational stress perceptions among teachers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:530-544. [PMID: 34338619 DOI: 10.1080/19338244.2021.1958738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Teachers are largely affected by OS, during their most productive years, leading to catastrophic physical, psychological, and economic burden on themselves, families and society by large. Teachers are responsible for producing the workforce of any nation, and thus have a major impact indirectly on the economy and health of a nation. There are several individual-level interventions conducted to reduce occupational stress (OS) among teachers. This study was conducted to systematically review and conduct a meta-analysis of the effectiveness of individual-level interventions to reduce occupational stress among teachers. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration ID: CRD42020149277) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Cochrane, PsycInfo, and Web of Science databases were searched using predefined search strategies covering the eligibility criteria. Studies were selected in four rounds. Risk of bias assessments were conducted with GRADE recommendations and ROBINS-I criteria for randomized and non-randomized interventions, respectively. Study selection, data extraction and bias assessments were performed independ ently by two reviewers with a third reviewer to resolve conflicts. Narrative synthesis of the findings were also performed. Clinical, methodological, and statistical heterogeneity assessments were conduct ed. Meta-analyses were performed with Review Manager 5.3 software using the "generic inverse variance method" with mean difference as the pooled estimate. Sensitivity analyses of the findings was also performed. At the initial search, 293 articles were identified and 29 subsequently selected for synthesis of findings. The findings of the meta-analysis indicated that Cognitive Behavioral Therapy (CBT) and relaxation interventions significantly reduced OS among teachers with an effect size of 6.2 (p < 0.001). Effect size was highest for combined CBT and relaxation interventions which was 6.57 (p < 0.001). Relaxation interventions only and CBT interventions only had effect sizes of 3.35 (p < 0.001) and 3.12 (p = 0.002) respectively. In sensitivity analysis, after removing low-quality studies, CBT interventions only, combined CBT and relaxation interventions and overall effect size were 6.31 (p < 0.00001), 17.36 (p < 0.00001), and 14.55 (p < 0.00001), respectively, ie, substantially greater than with low-quality studies included. Inconclusion, CBT and relaxation interventions reduce OS among teachers and it's most effective when those individual-level interventions are conducted together.
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Affiliation(s)
- Buddhini Denuwara
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nalika Gunawardena
- Health Systems Analysis and Evidence, WHO Country Office for Sri Lanka, Colombo, Sri Lanka
| | | | - Dulani Samaranayake
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Bokaba M, Modjadji P, Mokwena KE. Undiagnosed Hypertension in a Workplace: The Case of a Logistics Company in Gauteng, South Africa. Healthcare (Basel) 2021; 9:healthcare9080964. [PMID: 34442101 PMCID: PMC8394589 DOI: 10.3390/healthcare9080964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022] Open
Abstract
A large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular diseases in South Africa. A workplace may either mitigate or accentuate the risk factors for hypertension. A cross sectional study was conducted to determine the prevalence of undiagnosed hypertension and associated factors among 312 employees in a Logistics Company, South Africa. A modified, validated, self-administered WHO STEPwise questionnaire was used to collect data on demography, lifestyle factors, anthropometry and blood pressure (BP). Hypertension was defined at BP ≥ 140/90 mmHg. Data was analysed using STATA 14. Mean age of employees was 40 ± 10 years, with a 50% prevalence of undiagnosed hypertension. No significant association was observed between occupation and undiagnosed hypertension, except for high prevalence of undiagnosed hypertension among truck drivers and van assistants (43%), and general workers (27%), having higher odds of increased waist-to-height ratio. Hypertension was associated with age (OR = 2.3, 95%CI; 1.21–4.27), alcohol use (AOR = 1.8, 95%CI; 1.05–2.93), waist circumference (AOR = 2.3, 95%CI; 1.29–4.07) and waist-to-height-ratio (AOR = 3.7, 95%CI; 1.85–7.30). Improved and effective workplace health programs and policies are necessary for management of undiagnosed hypertension among employees. Longitudinal studies on mediation of occupation in association of demographic and lifestyle factors with hypertension in workplaces are needed.
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