The prevalence of work-related stress, and its association with self-perceived health and sick-leave, in a population of employed Swedish women

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

OBJECTIVE

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

DESIGN

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

SUBJECTS

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

METHODS

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

RESULTS

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

CONCLUSION

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

Work-related stress is associated with low work ability, but not with poor self-rated health: A cross-sectional study in primary healthcare

BACKGROUND

People seeking care at primary healthcare centres may be exposed to work-related stress, increasing the risk of future sick leave. Thus, it is important to identify work-related stress, and to explore how stress relates to work ability and health.

OBJECTIVE

To investigate the association between work-related stress and a) work ability, and b) self-rated health, among working women and men seeking care for physical or mental health complaints.

METHODS

This cross-sectional study analyzed baseline data (n = 232) from a randomized controlled trial investigating the effects of a brief intervention to prevent sick leave. Data regarding work-related stress, work ability and self-rated health were analyzed using binary logistic regression models.

RESULTS

In models adjusted for age, gender and education, high work-related stress measured by the Work Stress Questionnaire was significantly associated with low work ability. The highest odds ratio (OR 3.27, 95% CI 1.66-6.42) was found between the domain "interference between work and leisure time" and work ability, suggesting a more than three times higher odds for low work ability when perceiving that work interferes with leisure time. No significant association was found between work-related stress and self-rated health.

CONCLUSION

Health professionals should explore patients' work-related stress when they seek care for physical or mental complaints in primary healthcare. Patients' perceived balance between work and leisure time seems particularly important to address. Increased awareness might facilitate timely, relevant strategies to reduce stress and promote work ability.

A gender perspective on perceived causes of sick leave due to common mental disorders among young Swedish employees: A qualitative interview study

OBJECTIVE

Common mental disorder (CMD) is the most common reason for sick leave among young employees in Sweden, with young women having a higher prevalence. There is a lack of studies focusing on young employees' own perceptions of sick leave. The aim was twofold: to investigate 1) perceived causes of sick leave due to CMD among young employees, and 2) differences and similarities among women and men.

METHODS

Using a qualitative design with an applied gender perspective enabled us to capture young employees' gendered experiences and consider cultural and social aspects of their situations. We interviewed 13 women and 12 men (aged 20-29) with experience of being on sick leave and applied a conventional inductive content analysis.

RESULTS

Six categories were identified: a) Being new to the labour market and the workplace; b) Want to prove themselves; c) To be exposed to poor working conditions; d) Relations at work; e) Being vulnerable; and f) Additional private life burdens.

CONCLUSION

This study adds to the understanding of young employees' perceived causes of sick leave due to CMD, by letting them share their experiences of events prior to sick leave connected to work and private life. Similarities and differences in women's and men's experiences were revealed. Overall, both young men and women describe a more pressured work situation for young women compared to their male counterparts, that young women take more social responsibility in private life and at work whereas men on the other hand find it harder to disclose mental health problems.

Occupational health coaching for job stress management among technical college teachers: Implications for educational administrators

BACKGROUND

The need for stress management strategies has been empirically investigated and supported considering demands in workplaces. However, some people in public offices do not seem to have been exposed to occupational health strategies that could reduce the adverse impacts of stress on job productivity and quality of life. Consequently, they become susceptible to mental health disturbances requiring the attention of occupational therapists. Given this, we studied the impact of occupational health coaching for job stress management among technical college teachers.

METHODS

Using a randomized control design study, 90 technical college teachers were screened and ready to participate. The eligible teachers were included and assigned to intervention and control groups. An occupational stress index was given to the participants before, immediately after, and 2 months after the delivery of occupational coaching program by career counselors while the comparison group received no intervention. Data collected were analyzed using multivariate analysis of variance analysis.

RESULTS

The results showed a significant improvement in the management of job stress after receiving rational emotive occupational health coaching. According to the multivariate analysis of variance analysis, there were between-group differences immediately after the intervention and 3 months later. As a result, the study suggested that career counselors and school management systems should incorporate rational-emotive behavioral therapy into workforce and workplace programs.

Examining the quality of work-life of paramedics in northern Ontario, Canada: A cross-sectional study

BACKGROUND: Paramedics are exposed to multiple stressors in the workplace. They are more likely to develop occupational-related stress conditions compared to other occupations. This study focused on understanding the factors affecting QoWL of paramedics in northern Ontario, Canada; a particular focus was on understanding the personal and organizational factors, such as practicing community paramedicine (CP), which may be associated with Quality of Work Life (QoWL). METHODS: Paramedic QoWL was assessed using an online survey that was distributed to approximately 879 paramedics across northern Ontario. The survey included the 23-Item Work- Related Quality of Work Life Scale. Data analysis involved linear regressions with nine predictor variables deemed to be related to QoWL for paramedics with QoWL and its six subscales as dependent variables. Multiple linear regressions were used to assess the personal and organizational factors, such as practicing of CP, which predicted QoWL. RESULTS: One hundred and ninety-seven paramedics completed the questionnaire. Overall, the mean QoWL score of all paramedic participants was 73.99, and this average compared to relevant published norms for other occupations. Factors that were most associated with higher QoWL were, experience practicing CP (p < 0.05), number of sick days/year (p < 0.01), and higher self- rated mental health (p < 0.001). CONCLUSIONS: Higher paramedic QoWL appears to be associated with many factors such as number of sick days per year, self-rated mental health, and participation in CP. EMS organizations should consider establishing necessary workplace health promotion strategies that are targeted at improving QoWL for paramedics.

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

Background

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

Methods

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

Results

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

Conclusions

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

Trial registration

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

Supplementary Information

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

The BELE program: The development of a holistic interdisciplinary health-promoting program enhancing work-life balance among female employees working in human service organizations in Sweden

BACKGROUND

Despite an increase in work-life balance literature, the development of successful support to help employees manage their work -life balance is slow. Moreover, there are few interventions with a comprehensive approach to workplace health promotion focusing on work-life balance.

OBJECTIVE

This paper aims to present the development and building blocks of a holistic interdisciplinary health-promoting program, the BELE program, to enhance female employees working in human service organizations health and well-being with a focus on work-life balance.

METHODS

The planning and development of the program was done through an intervention mapping and research circles methodology.

RESULTS

The planning- and development process of the program resulted in a theoretical framework, and a program structure with a program content. The intervention program was named "The Balance in Everyday Life Empowerment program" (BELE program).

CONCLUSIONS

The BELE program adds to the existing body of work-life balance knowledge, so far often based on a conflict approach. Interventions focusing on a comprehensive approach to health and work-life balance with a salutogenic approach are rare. Furthermore, the integration with occupational therapy and health promotion in a workplace health promotion framework is innovative. In a previous study, the BELE program has shown that it enhances women's well-being and balance in their everyday life.

Work situation and professional role for midwives at a labour ward pre and post implementation of a midwifery model of care - A mixed method study

Purpose: To explore and analyse the experience of work situation and professional role for midwives at a labour ward pre and post the implementation of a midwifery model of care (MiMo).

Methods: A simultaneous mixed method was used. The qualitative core component departed from three focus group interviews (n = 16 midwives). Secondary inductive and deductive content analysis was performed using an unconstrained matrix to make a corresponding comparison of the different time points. The supplemental component was a quantitative survey about the work situation (n = 58).

Results: The qualitative results pre the implementation showed three categories: Balance between Women and Organization, Midwives—Diverse as both Profession and Person, and Strained Work Situation. Post the intervention they transformed to Balance between Midwifery and Organization, Midwives—An Adaptable Profession, Strained Work Situation, and a new category Ability to concretize midwifery was found. There were no significant differences in the measures of work situation in the quantitative analyses.

Conclusions: The synthesized findings based on the qualitative part show that MiMo has a potential to strengthen the professional role and midwifery practice. As such, MiMo has the capability to offer benefits to the labour wards with additional considerations.

Study of the interrelationships between musculoskeletal disorders and psychosocial risk factors in occupational health and safety technicians

Objectives. The aim of this work is to examine the presence of musculoskeletal disorders (MSDs) and the exposure to psychosocial risk in a sample of 399 occupational health and safety technicians (OHSTs), deepening the associations between both aspects. Methods. The standardized Nordic questionnaire and the Decore questionnaire were used. Different descriptive and correlational analyses and a multivariate analysis model were carried out. Results. In total, 77.17% of the participants affirmed having suffered some muscle ailments. The most critical psychosocial risk factors are those related to the rewards that the worker obtains for their work, with 54.7% of the technicians in a situation of alert or emergency. It is highlighted that the fact of not feeling professionally valued, working outside working hours, having musculoskeletal discomfort and perceiving a state of poor or fair health increase the global risk index (GRI) score. Conclusions. The study highlights the high exposure of OHSTs to both physical and psychosocial risk factors as well as the significant relationship between these variables. Furthermore, the predictive model shows the variables that best predict the probability of MSDs: gender, training in emerging risks, perceived health and exposure to psychosocial risk.

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

OBJECTIVES

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

DESIGN

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

SETTING

Seven primary healthcare centres in western Sweden.

PARTICIPANTS

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

INTERVENTIONS

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

OUTCOME MEASURES

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

RESULTS

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

CONCLUSIONS

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

TRIAL REGISTRATION NUMBER

NCT02480855.

Self-rated exhaustion disorder and associated health-related factors among municipal employees in rural areas of northern Sweden

OBJECTIVE

The aims of this study among municipal employees in rural areas of northern Sweden were to assess the prevalence of self-rated exhaustion disorder (s-ED), describe plausible between-group differences in self-reported health-related factors among employees with or without s-ED, and identify health-related factors associated with s-ED.

METHODS

In a cross-sectional study, data were collected from 1093 municipal employees (76.1% women) in two rural areas using an instrument measuring s-ED and health variables drawn from the Modern Worklife Questionnaire (MWQ), the Perceived Stress Scale (PSS), and the National Board of Health and Welfare's questions about physical activity. Comparisons were made between an s-ED and a non-s-ED group. Health-related factors associated with s-ED were identified through a logistic regression.

RESULTS

Self-rated exhaustion disorder was reported by 21.5% of the participants. Health-related factors associated with s-ED were cognitive problems, sleep problems, depressive symptoms, high stress, poor self-rated health, and stomach problems. There was no statistically significant difference in the prevalence of participants who met the criteria of physical activity among s-ED and non-s-ED group.

CONCLUSION

Findings from this study suggest that s-ED is more common among municipal employees in rural areas than in other working populations in Sweden. Several health-related factors were associated with s-ED. Regular use of a self-rated instrument in evaluating the organizational and social work environment can identify people at risk of developing exhaustion disorder and requiring long-term sick leave.

Salaried Workers' Self-Perceived Health and Psychosocial Risk in Guayaquil, Ecuador

Self-perceived health is an important indicator of occupational health. This research explored the relationship between poor self-perceived health and exposure to psychosocial risk factors, taking into account potential socio-demographic, occupational, and employment determinants. Using data from the First Survey of Occupational Safety and Health Conditions, covering 1049 salaried workers in Guayaquil, Ecuador, descriptive and stratified binary logistic regression analyses (odds ratios with corresponding 95% confidence intervals) were carried out. A significant relationship was found between exposure to psychosocial risk factors and the probability of presenting poor self-perceived health by socio-demographic, occupational, and employment characteristics. Occupational exposure factors to psychosocial risks were predictors of self-perceived ill health and were related to the variables analyzed; the most frequently expressed factors among the respondents were cognitive demands (DCOG) and job insecurity (IL). The results have implications in terms of designing effective workplace interventions pursuant to ensuring the health and well-being of employees.

Positioning work related stress - GPs' reasoning about using the WSQ combined with feedback at consultation

BACKGROUND

General practitioners (GPs) regularly handle cases related to stress and work capacity, but often find this work difficult. However, using an assessment tool in a structured way can increase GPs' awareness of the risk for sick leave and need of referrals to preventive measures. Today there is no established methodical practice for this in primary health care. The aim of this study was to explore GPs' reasoning about using the Work Stress Questionnaire combined with feedback at consultation as an early intervention to reduce sick leave.

METHODS

A focus group study was performed with 23 GPs at six primary health care centres. The discussions were analysed based on a method by Krueger.

RESULTS

Three themes emerged. Positioning work-related stress describes the need to make fundamental standpoints on stress and how it should be handled, to make sense of their work concerning work-related stress. Making use of resources focuses on GPs performing to the best of their ability using assigned resources to treat patients with stress-related ill health, even if the resources were perceived as insufficient. Practising daily work focuses on the GPs' regular and preferred way of working set against the degree of intrusion and benefits. The two related themes making use of resources and practising daily work were mirrored through the third theme, positioning work-related stress, to form an understanding of how GPs should work with patients perceiving work-related stress.

CONCLUSIONS

The GPs own competence and tools, those of other professionals and the time allocated were seen as important when treating patients perceiving ill health due to work-related stress. When resources were insufficient though, the GPs questioned their responsibility for these patients. The results also indicate that the GPs viewed their ordinary consultative way of working as sufficient to identify these patients. The intervention was therefore not seen as useful for early treatment of patients at risk of sick leave due to work-related stress. However, prevention is an important part of the PHC's responsibility, and strategies concerning stress-related ill health therefore need to be more thoroughly formulated and incorporated.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02480855 . Registered 20 May 2015.

Effects of a work stress intervention on healthcare use and treatment compared to treatment as usual: a randomised controlled trial in Swedish primary healthcare

BACKGROUND

Work stress is an increasing burden in society. Identifying early symptoms of work stress in primary healthcare (PHC) could result in earlier and better-targeted care. The Work Stress Questionnaire (WSQ) was developed in PHC for this task. We aimed to evaluate whether the use of the WSQ, in combination with physicians' feedback, resulted in differences in healthcare visits and treatment compared to treatment as usual (TAU) in patients reporting high stress. Our hypothesis was that patients receiving the intervention would generate more visits to rehabilitation providers during follow-up compared to TAU.

METHODS

A two-armed randomised controlled trial was conducted at seven primary healthcare centres (PHCCs) in Region Västra Götaland, Sweden. One group received the WSQ intervention, and the controls received TAU. Employed, not sick-listed persons aged 18-64 years who sought care for mental or physical health complaints at the PHCCs participated. Register data on healthcare visits and treatments 12 months prior to inclusion and 12 months after were obtained and analysed with Fisher's exact test together with questionnaire data (WSQ and background features).

RESULTS

A total of 271 participants were included in the study, 132 intervention and 139 controls. Visits to psychologists/psychotherapists were higher among intervention participants with high stress (20%, n = 87) during follow-up compared to corresponding controls (7%, n = 97) (p < 0.05). Collaborative care measures were more common among the stressed intervention participants (23%) post-inclusion compared to the stressed controls (11%) (p < 0.05). The amount of received cognitive behavioural therapy (CBT) was higher among the stressed intervention group (16%) than among controls (10%) during follow-up.

CONCLUSIONS

The intervention group that used the WSQ with physicians' feedback had an increased number of rehabilitative measures and treatment more in line with established guidelines compared to treatment as usual. Findings of the study indicate that the WSQ can assist in identifying work stress in primary healthcare and contribute to physicians' recommendations of suitable rehabilitative measures at an earlier stage compared to treatment as usual.

TRIAL REGISTRATION

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

Effects of self-employment on hospitalizations: instrumental variables analysis of social security data

The importance of self-employment and small businesses raises questions about their health effects and public policy implications, which can only be addressed with suitable data. We explore the relationship between self-employment and health by drawing on comprehensive longitudinal administrative data to explore variation in individual work status and by applying novel instrumental variables. We focus on an objective outcome-hospital admissions-that is not subject to recall or other biases that may affect previous studies. Our main findings, based on a sample of about 6,500 individuals followed monthly from 2005 to 2011 and who switch between self-employment and wage work along that period, suggest that self-employment has a positive effect on health as it reduces the likelihood of hospital admission by at least half.

A scale to measure organizational stress among women workers in the garment industry

Purpose

Stress has been a common phenomenon among the working professionals. The stress has been known to affect the job satisfaction level, health outcomes, affect burnout through the physiological, emotional, behavioral and cognitive processes resulting in to low performance. This study aims to identify the factors determining organizational stress among women workers in the garment industry in India and to develop and validate a contextual scale for organizational stress among women workers in the garment industry in India.

Design/methodology/approach

This study consisted of women workers who were employed in garment manufacturing companies. The data has been collected through a structured questionnaire, which identifies the factors leading to stress. The respondents of the study included women workers employed in the garment manufacturing units in and around Bangalore. An exploratory factor analysis was conducted and the model fit was tested using confirmatory factor analysis.

Findings

The measurement scale for the organization stress of women workers in the garment industry was found to be highly reliable and valid for conducting the study in any Indian garment industry. The analysis identified the factors as follows: job-related factor, organization-related factor, social factor and personal factor.

Research limitations/implications

Due to limited access to the population, which is the women workers, the authors have not been able to collect a large sample data. The sample size is the limitation of the study.

Practical implications

Organizational stress have has been shown to have a detrimental effect on the health and well-being of employees. Organizations need to step up their effort to integrate emotional well-being, conducive work environment, workloads and job responsibilities, social connectedness and job satisfaction with their efforts to support the physical health and mental health of the workers.

Originality/value

The study is one of its kind with a focus on women workers in the garment industry in India. The study highlights the factors that result in stress among women workers who have not been studied in past research studies. The strategies to cope with organizational stress in such a work requirement is different and very challenging, making it unique for practitioners.

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

Background

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

Methods

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

Results

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

Conclusion

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

Trial registration

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

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

Stress-related mental health and growth among first-time grandparents: The moderating role of family support

Grandparents play a significant role in modern society, often while struggling to juggle the expectations, demands, and commitments of career and family. The current study examined the unique and combined contribution of stress-related variables associated with multiple roles, such as work stress over commitment, economic stress, and grandchild care burden, to mental health and personal growth of first-time grandparents. The study also examined the role of family support as a moderator of these associations. One hundred ninety-seven first-time Israeli grandparents were asked to complete a series of self-report questionnaires. Higher levels of work-related stress were associated with lower mental health, whereas grandchild care burden was associated with higher personal growth. Self-mastery and family support contributed to the prediction of mental health. When family support was high, work commitment was positively related to mental health, and economic stress was positively related to personal growth. The findings point to the crucial role of family support in balancing and preserving resources that are important to the mental health of first-time grandparents, while enabling grandparents to be challenged and thrive through their stressors. Therapists who meet with first-time grandparents in the community should take these factors into account when assisting them in adjusting to their new role.

Impact of rational emotive occupational health coaching on work-related stress management among staff of Nigeria police force

BACKGROUND

Empirical studies indicated that job-related stress is threatening the well-being of Nigerian public workers. The objective of this investigation was to examine the impact of REOHC for improving work-stress management among Staff of Nigeria Police Force in southeast Nigeria.

METHOD

This is a pretest-posttest control group design study with follow-up. A total of 63 Nigerian police officers (randomized into one of 2 groups: n = 32 for treatment group, n = 31 for waitlist control group) completed the study. Two self-report questionnaire measuring organizational and operational stressors associated with police general well-being were used as outcome measures. The intervention group received a 12-week REBC manual intervention. The intervention and waitlisted groups were evaluated at 3-time points: Time1, Time2, and Time3. Statistical analyses were achieved using repeated-measures ANOVA.

RESULTS

Results showed that there was no significant difference between the REOHC group and waiting-list control group in initial work-related stress management among staff of Nigerian Police Force. REOHC program had a significant effect on work-related stress management among staff of Nigerian Police Force when compared to their counterparts in the waiting-list control group.

CONCLUSION

Therefore, REOHC program is a time-effective treatment approach for improving work-stress management among Staff of Nigeria Police Force in southeast Nigeria.

"The importance of awareness, support and inner strength to balance everyday life" - a qualitative study about women's experiences of a workplace health promotion program in human service organizations in Sweden

BACKGROUND

In many European countries, women have a higher sickness absence rate than men. Women also report higher levels of work-life conflict, which has a negative impact on women's self-perceived health. Interventions studies on work-life balance literature are scarce. This research adds knowledge about work-life balance by examining female employees' experiences of a newly developed intervention program, the BELE program (Balance in Everyday Life Empowerment program), aiming to enhance the work-life balance and wellbeing of female employees.

METHODS

All participants in the BELE program were included in the sample (n = 55) of the study. The methods used for gathering data were focus group interviews (n = 8) and semi-structured individual interviews (n = 8). A qualitative content analysis was used for the analyses.

RESULTS

The results showed that a majority of the participants experienced a process of change for enhancement of wellbeing and balance in their everyday life when taking part in the BELE program. In the analyses, three main themes emerged. Reflecting and strengthening inner resource, Trying to change everyday patterns and habits and Experiencing more balance and well-being.

CONCLUSIONS

The results point out the importance of awareness and reflection on everyday life to promote work-life balance and wellbeing. The BELE program was described as a wakeup call to one's own life and as an enhancer of empowerment processes and equality in the homes. Moreover, the results showed the need for health education in the workplace focusing on both work and private life to enhance balance and wellbeing among female employees'. The findings indicate that it is important to work at individual and group levels in work-life balance interventions and not merely at the organizational level or in the workplace setting.

Eating Disorders in the Workplace: A Qualitative Investigation of Women’s Experiences

Though employment is typically associated with positive mental health outcomes for individuals with disabilities, the ubiquity of stress and stigma at work may complicate the relation between work and well-being for women with eating disorders (EDs). To date, however, the experiences of women with EDs in the workplace have not been examined. By utilizing a qualitative methodology to form an initial framework for the examination of EDs in the workplace, we address this gap in the literature. Seventy adult women with anorexia, bulimia, and binge eating disorder discussed the relation between work and their condition. The data analysis led to the delineation of a theoretical model, which we propose explains the interconnections between key study constructs, including individual characteristics; workplace stressors; identity, stigma, and stress management techniques; and related personal and organizational outcomes. Our research suggests that, depending on how stress is managed, the workplace can serve as a bridge or a barrier to ED recovery. This study lays the groundwork for understanding the ways in which workplace life interacts and interferes with ED management, opening up a new line of investigation for researchers working to enhance the lives of individuals with EDs across life domains.

Work related stress and associated factors among Huajian shoe manufacturing employees in Dukem town, central Ethiopia

OBJECTIVE

The objective of this study was to assess the prevalence of work-related stress (WRS) and its determinants among Huajian shoe manufacturing company employees in Dukem town, central Ethiopia. An institutional-based cross-sectional study was conducted from February to March 2016. Data were collected using pretested structured interviewer-administered questionnaires.

RESULTS

The mean age of the participants, 56.2% of whom were male was 25 (SD ± 5) years. The overall prevalence of work-related stress was 40.4% (95% CI 35.7, 45.3). Poor organizational support (adjusted odds ratio (AOR) 2.40, 95% CI 1.39, 4.77), inadequate work experience (AOR 3.77, 95% CI 1.68, 8.45), poor salary (AOR 7.04, 95% CI 3.39, 14.59), long working hours (AOR 3.40, 95% CI 2.00, 5.79), overtime work (AOR 2.24, 95% CI 1.10, 4.61), and poor physical environment (AOR 2.44, 95% CI 1.42, 4.19) were factors significantly associated with the stress. The prevalence of the stress was higher than what can be expected of many such employees. Poor organizational support, inadequate work experience, poor salary offers, long working hours, overtime work, and poor physical environment were significantly and independently associated with WRS. Establishing a functional collective agreement between employer and an employee trade union are needed to improve the problem.

Factors associated with low patient satisfaction in out-of-hours primary care in Denmark - a population-based cross-sectional study

BACKGROUND

Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telephone triage. This study aimed to identify patient-related, GP-related and organizational factors associated with low patient satisfaction.

METHODS

The study was based on data from a 1-year population-based survey of OOH-PC (LV-KOS) in the Central Denmark Region in 2010-2011. GPs on OOH duty completed an electronic questionnaire in the OOH computer system, and the registered patients received a subsequent postal questionnaire focusing on contact evaluation, waiting time, demographic characteristics and general self-perceived health. Associations were analysed using multivariable logistic regression with dissatisfaction as the dependent variable.

RESULTS

The patient response rate was 50.6%. For all contact types, 82.5% of the patients were satisfied with the OOH-PC service. More patients were dissatisfied with telephone consultations than with clinic consultations or home visits (8.5% vs. 6.0% and 4.3%, respectively). Contacts assessed by the GP as 'not severe' were associated with dissatisfaction for telephone consultations and home visits. Poor general self-perceived health was associated with dissatisfaction for all contact types. Living in urban areas was associated with dissatisfaction for telephone consultations, while unacceptable waiting time was associated with dissatisfaction for all contact types.

CONCLUSIONS

We found a high level of patient satisfaction with the OOH-PC service. The only factors affecting patient satisfaction across all contact types were unacceptable waiting time and poor general self-perceived health. For the other investigated factors, patient satisfaction depended on the type of contact. Generally, patients contacting for GP-assessed non-severe health problem and patients living in urban areas were more dissatisfied.

Early identification in primary health care of people at risk for sick leave due to work-related stress - study protocol of a randomized controlled trial (RCT)

BACKGROUND

Early identification of persons at risk of sickness absence due to work-related stress is a crucial problem for society in general, and primary health care in particular. Tho date, no established method to do this exists. This project's aim is to evaluate whether systematic early identification of work-related stress can prevent sickness absence. This paper presents the study design, procedure and outcome measurements, as well as allocation and baseline characteristics of the study population.

METHOD/DESIGN

The study is a two-armed randomized controlled trial with follow-up at 3, 6 and 12 months. Non-sick-listed employed women and men, aged 18 to 64 years, who had mental and physical health complaints and sought care at primary health care centers (PHCC) were eligible to participate. At baseline work-related stress was measured by the Work Stress Questionnaire (WSQ), combined with feedback at consultation, at PHCC. The preventive intervention included early identification of work-related stress by the WSQ, GP training in the use of WSQ, GP feedback at consultation and finding suitable preventive measures. A process evaluation was used to explore how to facilitate future implementation and structural use of the WSQ at the PHCC. The primary outcome to compare the preventive sick leave intervention by the general practitioner (GP) versus treatment as usual is sick leave data obtained from the Swedish Social Insurance Agency register.

DISCUSSION

Early screening for sick leave due to work-related stress makes it possible not only to identify those at risk for sick leave, but also to put focus on the patient's specific work-related stress problems, which can be helpful in finding suitable preventive measures. This study investigates if use of the WSQ by GPs at PHCCs, combined with feedback at consultation, prevents future sickness absence.

TRIAL REGISTRATION

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

Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home

PURPOSE

The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave.

METHODS

A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work.

RESULTS

Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities.

CONCLUSIONS

This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.

[Workplace stress and its impact on the 16-year risk of myocardial infarction and stroke in an open female population aged 25-64 years in Russia/Siberia (WHO MONICA-psychosocial program)]

AIM

To determine the impact of workplace stress on the hazard ratio (HR) of myocardial infarction (M) and stroke in an open female population aged 25-64 years in Russia/Siberia (Novosibirsk) for 16 years.

SUBJECTS AND METHODS

A random representative sample of 25-64-year-old women (n=870) residing in a Novosibirsk district was surveyed within the framework of the WHO <<MONICA-psychological>> program. Workplace stress was investigated using the Karasek scale; an attitude towards work and health prophylactic examinations was studied applying the Health Awareness and Attitude questionnaire of the WHO <<MONICA-psychological>> program. For 16 years (1994 to 2010), a cohort of all new cases of MI and stroke was examined employing the WHO <<Acute MI Registry>> program and all possible medical records. The Cox regression model was used to determine HR for MI and stroke in the open female population aged 25-64 years for 16 years.

RESULTS

The prevalence of high-level stress in the open female population aged 25-64 years was 31.6%. The high level of job stress was associated with a high responsibility, impossibility to have a rest at the end of a working day, frequent professional dissatisfaction, and a reduced work capacity. During 16 years, the women having high-level job stress showed a 3.22- and 1.96-fold increases in the HR of MI (p<0.05) and stroke (p<0.05), respectively. The incidence of MI and stroke was higher in married women expressing job stress as managers or manual laborers and having high and low educational attainment.

CONCLUSION

The prevalence of high-level workplace stress was substantial in the open population of 25-64-year-old women in Russia/Siberia (Novosibirsk). The stress-related HR of Ml and stroke was 3-2 times higher than in those without high-level stress. The HR of MI and stroke is affected by a social gradient.

High job demands and lack of time: a future challenge in occupational therapy

OBJECTIVE

The aim of this study was to identify work-related stress factors that contributed to work-related stress among Swedish occupational therapists and to investigate the association between work-related stress, demographic factors, and perceived overall stress.

METHODS

A postal questionnaire and a letter of invitation were sent to 807 Swedish occupational therapists, selected at random and representing 10% of occupational therapists working in Sweden. The response rate was 59%. A stress index presenting 49 stress factors graded on a scale from 1 (indicating no source of stress) to 6 (definitely a source of stress) was included. In addition, the level of perceived overall stress during the last two weeks was scored on a rating scale with the end points 0 (no stress) and 10 (extreme stress).

RESULTS

The main findings indicated that lack of resources and lack of time were the main stressors. "Working at a superficial level due to lack of time" was the only variable associated with high overall stress when both work-related and personal factors were included. Professional identity and clarity concerning the role were graded low with regard to stress.

CONCLUSIONS

Work-related stress is just one aspect of the overall stress experienced but knowledge about its consequences highlights the importance of further studies.

The well-being of women at work: the importance of resources across the life course

Purpose

– The purpose of this paper is to explore the factors that impact on the well-being of women workers, as assessed through depression, anxiety and stress, across the life course, i.e. age, marital status and parental status.

Design/methodology/approach

– The quantitative study was cross-sectional in nature and used an online self-report questionnaire to generate information on job/work characteristics, belief systems and demographic variables. A snowball sample was used to recruit the respondents.

Findings

– The results showed that the availability of resources was the influencing factor in women workers maintaining their well-being. Those respondents with resources, such as job autonomy and support from colleagues, were less likely to be depressed, anxious or stressed. The life course was not an influencing factor in the models tested suggesting that regardless of women's stage in life, they require appropriate resources to address the demands of the work environment, to maintain their well-being.

Practical implications

– The implications of this study are that when considering diversity in the work environment, it is important to assess if all workers have the resources they require to cope with the demands of the workplace.

Originality/value

– This present study outlines the importance of the life course in the context of the workplace, but highlights also that it is only one perspective and that others should be considered; such as those factors that are inherent in improving well-being and relationships within organisations.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Development of burnout in middle-aged working women: a longitudinal study

OBJECTIVE

The present study had two aims: first, to identify developmental patterns of burnout in middle-aged women from the working population and, second, to evaluate whether work-related and individual factors are associated with concurrent changes in burnout.

METHODS

The study design was longitudinal and used a random, population-based sample of urban middle-aged women. One baseline and two follow-up assessments were carried out during a 9-year period. At baseline, 142 women participated. Complete data were available for 116 women, who constituted the sample of the present study. Burnout was assessed using the Shirom-Melamed Burnout Questionnaire (SMBQ). In order to identify typical developmental patterns (trajectories) hierarchical cluster analysis was used. Within-group changes in burnout levels over time were analyzed using repeated-measures analysis of variance (ANOVA).

RESULTS

When using a variable-based approach, the results showed no significant changes in burnout over time. However, underlying these levels, six trajectories were identified. These clusters represented four different developmental patterns: high levels followed by recovery, increasing levels, increasing and diminishing levels, and stable levels.

CONCLUSIONS

In contrast to previous research suggesting that burnout is a stable construct over time, the present study identified distinct subgroups of women showing different developmental patterns of burnout during a 9-year period. Furthermore, our findings showed that the development of burnout was accompanied by concurrent changes in life stress as well as work-related and individual factors.

Occupational stress and self-rated health among nurses

OBJECTIVE: To analyze the association between job stress and self-rated health among nurses in public hospital emergency units. METHODS: This is a cross-sectional study undertaken through the administration of a self-administered questionnaire in a sample of 134 health professionals, using the brief version of the Job Stress Scale. Descriptive analyses of the socio-demographic, health and work variables were undertaken, as was multivariate analysis through unconditional logistic regression for adjustment of the association between job stress and poor self-rated health, in accordance with potential confounding variables, with a level of significance of 5%. RESULTS: 70% of the interviewees were classified as passive workers or as with high strain. Poor self-rated health was significantly greater among health professionals with high demand and low control, compared to those with low strain, after adjusting for co-variables. CONCLUSIONS: Low control, allied with low demand, can serve as a demotivating factor, contributing to the increase in professional dissatisfaction. It is recommended that institutions should adopt a policy of planning and managing human resources so as to encourage the participation of health professionals in decision-making, with a view to reducing job stress among nurses.

Gender difference in sickness absence from work: a multiple mediation analysis of psychosocial factors

BACKGROUND

Previous research has shown that job characteristics, private life and psychosocial factors partially account for gender difference in work absences because of sickness. Most studies have analysed these factors separately. The aim of the present study was to evaluate whether these explanatory factors act as mediators when they are considered simultaneously.

METHODS

The evaluated data set comprises the merger of two Belgian longitudinal studies, BELSTRESS III and SOMSTRESS. It includes 3821 workers (1541 men) aged 21-66 years, employed in eight organizations. A multiple mediation analysis was performed to explain the higher prevalence among women. Estimated factors were occupational grade, total number of paid working hours per week, job strain, overcommitment, home-work interference and social support at and outside work. Prospective data concerning duration and frequency of medically justified sickness absence (registered by the organizations) were used as outcomes.

RESULTS

Overall, the mediating factors partially account for gender difference in sickness absence. The strongest mediator for both outcomes is job strain. In addition, difference in absence duration is mediated by social support at work, whereas difference in frequency is mediated by professional grade and home-work interference.

CONCLUSIONS

Our results call attention to the necessity to elaborate actual preventive actions aiming at favouring a better positioning of women on the labour market in term of hierarchical level as well as in terms of quality of work for reducing sickness absence in this group.

Making the invisible visible: are health social workers addressing the social determinants of health?

This study explored the ways in which health social workers (HSW) address the social determinants of health (SDH) within their social work practice. Social workers (n = 54) employed at major hospitals across Toronto had many years of practice in health care (M = 11 years; SD = 10.32) and indicated that SDH were a top priority in their daily work; with 98% intentionally intervening with at least one and 91% attending to three or more. Health care services were most often addressed (92%), followed by housing (72%), disability (79%), income (72%), and employment security (70%). Few HSW were tackling racism, Aboriginal status, gender, or social exclusion in their daily practice.

Implementation of a low-budget, lifestyle-improvement method in an ordinary primary healthcare setting: a stepwise intervention study

OBJECTIVE

To evaluate, in an ordinary primary healthcare setting, the effects of a screening questionnaire and a self-administered health profile dealing with special reference to the involvement of motivated individuals in need of lifestyle changes.

DESIGN

Intervention study in a naturalistic context, using a screening questionnaire offered to consecutive patients, followed by a self-administered health profile and a health dialogue.

SETTING

Hisingen primary healthcare area (130 033 inhabitants), Gothenburg, Sweden.

PARTICIPANTS

Men and women aged between 18 and 79, visiting any of the eight public primary healthcare centres (PCC) during an 8-month period, were presented with a screening questionnaire and, were offered, a health profile, a plasma glucose (p-glucose), blood pressure check and a health dialogue.

MAIN OUTCOME MEASURES

Motivation level, negative lifestyle factors in screening questionnaire and intraindividual changes in blood pressure, p-glucose, body mass index (BMI) and lifestyle factors between baseline and 1-year follow-up.

RESULTS

Subjects with less favourable lifestyle and higher motivation chose to participate. A higher percentage of presumptive participants reported a less favourable lifestyle. The presumptive participants also indicated higher motivation. Participants showed more readiness to initiate lifestyle changes compared to non-participants (p<0.001). At 1-year follow-up significant reductions in BMI, waist circumference, waist-hip ratio (WHR), blood pressure and p-glucose were observed.

CONCLUSIONS

The results indicate that the method is on target and applicable to motivated individuals with a 'risk profile'. A pedagogical model including a self-administered health-profile and a health dialogue, combined with emphasising the individual's own resources, seems to be a feasible method for effective preventive work in primary healthcare.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Stressful working conditions and poor self-rated health among financial services employees

OBJECTIVE

To assess the association between exposure to adverse psychosocial working conditions and poor self-rated health among bank employees.

METHODS

A cross-sectional study including a sample of 2,054 employees of a government bank was conducted in 2008. Self-rated health was assessed by a single question: "In general, would you say your health is (...)." Exposure to adverse psychosocial working conditions was evaluated by the effort-reward imbalance model and the demand-control model. Information on other independent variables was obtained through a self-administered semi-structured questionnaire. A multiple logistic regression analysis was performed and odds ratio calculated to assess independent associations between adverse psychosocial working conditions and poor self-rated health.

RESULTS

The overall prevalence of poor self-rated health was 9%, with no significant gender difference. Exposure to high demand and low control environment at work was associated with poor self-rated health. Employees with high effort-reward imbalance and overcommitment also reported poor self-rated health, with a dose-response relationship. Social support at work was inversely related to poor self-rated health, with a dose-response relationship.

CONCLUSIONS

Exposure to adverse psychosocial work factors assessed based on the effort-reward imbalance model and the demand-control model is independently associated with poor self-rated health among the workers studied.

Psychobiological correlates of allostatic overload in a healthy population

The concept of allostatic load (AL) represents the cost of the continual adjustment of the internal milieu required by an organism to adapt to different challenges. The majority of studies concerning AL have focused mainly on identifying its biological components. Recently, new criteria for a clinimetric evaluation of AL have been introduced, adding a new definition of allostatic overload (AO). This study aims to identify psychological and biological correlates of AO in a population of blood donors, according to this new definition of AO. Participants included 240 blood donors recruited from May 2007 to December 2009 in 4 different blood Centers. Blood samples from each participant were collected for laboratory analysis and self-rating instruments were administered on the same day. Biological parameters included those usually assessed during blood donation. Individuals were selected based on the criteria for the clinimetric evaluation of AO. Differences in biomarkers between subjects with and without allostatic overload were performed using the GLM with biological measures as dependent variables, AO groups as the fixed factor and specific confounders as covariates. Based on the selection criteria for allostatic overload, 98 subjects have been identified as presenting with AO. Results showed that individuals with allostatic overload presented lower levels of serum proteins, erythrocytes and immune differential count than donors without allostatic overload. Further, greater mean corpuscular volume has been found in persons included in the AO group. The evaluation of the AO correlates, along with a biomarker profile, may help to identify those conditions that, by exceeding individual resources, may constitute a danger to health.

[Use of medication among hospital workers]

Although medication is acknowledged as a key element in treating health problems, there is little information available on the use of medication by hospital workers. To estimate the prevalence and describe the patterns of medication consumption by hospital workers and to identify the factors associated with such consumption in this population, data from the "PROSEC" baseline cohort were analyzed (n=417). The prevalence of overall medication consumption was 72.4%, most of which was for nervous complaints (25.4%), especially analgesics (17.8%). Use of any amount of medication was independently associated with gender, number of medically diagnosed conditions and health problem in the two weeks prior to the interview. Use of a drug was significantly associated with income whereas self-diagnosed health problems were independently related with the use of two or more pharmaceutical products. The high prevalence of medication usage in this population, with analgesics being the most consumed medication, should be seen as a cause for concern, since many consumers are unaware that these products are not exempt from risk. Women and individuals in poor health are the main candidates for intervention programs in order to promote adequate and proper use of these pharmaceutical products.

Occupational pressure-targeting organisational factors to ameliorate occupational dysfunction

INTRODUCTION

Chronic pressure at work has debilitating impact on healthcare employers (e.g. reduced productivity, high costs, poor patient care) and on female healthcare employees (e.g. sickness, dysfunction). This paper highlights relationship at work as the key occupational source of work-stress which is organisational in nature.

METHODS

A cross-sectional study (n = 230) was conducted using the Pressure Management Inventory on several female dominated health professions within a large public hospital. Analysis of variance was used to show relationship between sources and outcome of pressure. Linear regressions were used to predict which sources of pressure (IV) was linked to the outcomes of occupational pressure (DV).

RESULTS

The number one source of occupational pressure is relationships at work (i.e. with supervisors), and not workload. 'Relationship' is also the key predictor of several negative outcomes of pressure at work. Analysis of variance showed significant differences in two sources of pressures, i.e. Workload (P = 0.04) and Home-work balance (P = 0.03).

CONCLUSION

This paper provides insights into the occupational pressure of women health professionals by highlighting the organisational sources of pressure and the implications for preventing occupational dysfunction secondary to stress at work.

Health, sleep, and professional career in female white-collar workers back to work after long-term sick-listing due to minor mental disorders

Aims: This study is a 3-year follow up of female white-collar workers, who were on long-term sick leave in 2004 due to stress-related and minor mental disorders. The aim is to show what promotes return-to-work (RTW) and the impact of a long period of sickness absence on professional career. Methods: The study includes a cohort of 233 women who were currently on medically certified sick leave lasting ≥90 days in 2004. A postal questionnaire was sent out after 34 months, regarding self-rated health, quality of sleep, sick-listing status, occupational status, etc. Results: After 34 months, 69% of the women had fully returned to working life. One of the most salient findings is that almost half of those had changed jobs and more than a third were in a new profession. Those who were back in working life rated less negative consequences of the long-term sick-listing on their professional career and their quality of sleep was better (OR 2.90, 95% CI 1.50–5.60 “sleeping all night”). Self-rated health did not show significant association with RTW (OR 2.83, 95% CI 0.91–8.77). Those who had returned to working life reported more control over their lives (OR 1.98, 95% CI 1.01–3.88). Conclusions: The findings imply that, in work health promotion and rehabilitation and efforts to prevent sickness absence due to stress-related disorders, important factors to be considered are job mobility, changes in present work, improved sleep, and control over one's own life.