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Teoh KRH, Dunning A, Taylor AK, Gopfert A, Chew-Graham CA, Spiers J, Appleby L, Van Hove M, Buszewicz M, Riley R. Working conditions, psychological distress and suicidal ideation: cross-sectional survey study of UK junior doctors. BJPsych Open 2023; 10:e14. [PMID: 38099399 PMCID: PMC10755551 DOI: 10.1192/bjo.2023.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/01/2023] [Accepted: 11/01/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Evidence attests a link between junior doctors' working conditions and psychological distress. Despite increasing concerns around suicidality among junior doctors, little is known about its relationship to their working conditions. AIMS To (a) establish the prevalence of suicidal ideation among junior doctors in the National Health Service; (b) examine the relationships between perceived working conditions and suicidal ideation; and (c) explore whether psychological distress (e.g. symptoms of depression and anxiety) mediates these relationships. METHOD Junior doctors were recruited between March 2020 and January 2021, for a cross-sectional online survey. We used the Health and Safety Executive's Management Standards Tool; Depression, Anxiety and Stress Scale 21; and Paykel Suicidality Scale to assess working conditions, psychological distress and suicidality, respectively. RESULTS Of the 424 participants, 50.2% reported suicidal ideation, including 6.1% who had made an attempt on their own life. Participants who identified as LGBTQ+ (odds ratio 2.18, 95% CI 1.15-4.12) or reported depression symptoms (odds ratio 1.10, 95% CI 1.07-1.14) were more likely to report suicidal ideation. No direct relationships were reported between working conditions (i.e. control, support, role clarity, strained relationships, demand and change) and suicidal ideation. However, depression symptoms mediated all six relationships. CONCLUSIONS This sample of junior doctors reported alarming levels of suicidal ideation. There may be an indirect relationship between working conditions and suicidal ideation via depressive symptoms. Clearer research exploring the experience of suicidality in junior doctors is needed, including those who identify as LGBTQ+. Systematic interventions addressing working environment are needed to support junior doctors' mental health.
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Affiliation(s)
- Kevin Rui-Han Teoh
- Department of Organizational Psychology, Birkbeck, University of London, UK
| | - Alice Dunning
- School of Health and Related Research, University of Sheffield, UK
| | - Anna Kathryn Taylor
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, UK
| | - Anya Gopfert
- Department of Sports Sciences and Public Health, University of Exeter, UK
| | | | | | - Louis Appleby
- Division of Psychology and Mental Health, School of Medicine, University of Manchester, UK
| | - Maria Van Hove
- Department of Health and Community Sciences, University of Exeter, UK
| | - Marta Buszewicz
- UCL Great Ormand Street Institute of Child Health, University College London, UK
| | - Ruth Riley
- School of Health Sciences, University of Surrey, UK
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Attoe C, Matei R, Thompson L, Teoh K, Cross S, Cox T. Returning to clinical work and doctors' personal, social and organisational needs: a systematic review. BMJ Open 2022; 12:e053798. [PMID: 35641015 PMCID: PMC9157349 DOI: 10.1136/bmjopen-2021-053798] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This systematic review aims to synthesise existing evidence on doctors' personal, social and organisational needs when returning to clinical work after an absence. DESIGN Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES AMED, BNI, CINAHL, EMBASE, EMCARE, HMIC, Medline, PsycINFO and PubMed were searched up to 4 June 2020. Non-database searches included references and citations of identified articles and pages 1-10 of Google and Google Scholar. ELIGIBILITY CRITERIA Included studies presented quantitative or qualitative data collected from doctors returning to work, with findings relating to personal, social or organisational needs. DATA EXTRACTION AND SYNTHESIS Data were extracted using a piloted template. Risk of bias assessment used the Medical Education Research Study Quality Instrument or Critical Appraisal Skills Programme Qualitative Checklist. Data were not suitable for meta-analyses and underwent narrative synthesis due to varied study designs and mixed methods. RESULTS Twenty-four included studies (14 quantitative, 10 qualitative) presented data from 92 692 doctors in the UK (n=13), US (n=4), Norway (n=3), Japan (n=2), Spain (n=1), Canada (n=1). All studies identified personal needs, categorised as work-life balance, emotional regulation, self-perception and identity, and engagement with return process. Seventeen studies highlighted social needs relating to professional culture, personal and professional relationships, and illness stigma. Organisational needs found in 22 studies were flexibility and job control, work design, Occupational Health services and organisational culture. Emerging resources and recommendations were highlighted. Variable quality and high risk of biases in data collection and analysis suggest cautious interpretation. CONCLUSIONS This review posits a foundational framework of returning doctors' needs, requiring further developed through methodologically robust studies that assess the impact of length and reason for absence, before developing and evaluating tailored interventions. Organisations, training programmes and professional bodies should refine support for returning doctors based on evidence.
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Affiliation(s)
- Chris Attoe
- Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
- Centre for Sustainable Working Life, Birkbeck University of London, London, UK
- Psychiatry Psychology and Neuroscience, King's College London Institute, London, UK
| | - Raluca Matei
- Centre for Sustainable Working Life, Birkbeck University of London, London, UK
| | - Laura Thompson
- Centre for Sustainable Working Life, Birkbeck University of London, London, UK
| | - Kevin Teoh
- Department of Organizational Psychology, Birkbeck University of London, London, UK
| | - Sean Cross
- Maudsley Learning, South London and Maudsley NHS Foundation Trust, London, UK
- Psychiatry Psychology and Neuroscience, King's College London Institute, London, UK
| | - Tom Cox
- Centre for Sustainable Working Life, Birkbeck University of London, London, UK
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Ropponen A, Koskinen A, Puttonen S, Ervasti J, Kivimäki M, Oksanen T, Härmä M, Karhula K. Working hours, on-call shifts, and risk of occupational injuries among hospital physicians: A case-crossover study. J Occup Health 2022; 64:e12322. [PMID: 35297542 PMCID: PMC9176712 DOI: 10.1002/1348-9585.12322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To investigate the association of hospital physicians' working hours and on-call shifts with the risk of occupational injuries. METHODS In this nested cohort study of 556 Finnish hospital physicians, we linked electronic records from working-hour and on-call duty payroll data to occupational injury data obtained from the Finnish Workers' Compensation Center for the period 2005-2019. We used a case-crossover design with matched intervals for a 7-day 'case window' immediately prior to occupational injury and a 'control window' 7 days prior to the beginning of the case window, and analyzed their associations using conditional logistic regression models. RESULTS We noted 556 occupational injuries, 281 at the workplace and 275 while commuting. Having three to four long (>12 h) work shifts on the preceding 7 days was associated with a higher probability of an occupational injury (odds ratio [OR] 2.14, 95% confidence interval [CI] 1.11, 4.09), and the OR for three to four on-call shifts was 3.54 (95%CI 2.11, 5.92) in comparison to having none of these work shift types. A higher number of several consecutive working days was associated with a higher probability of injury in a dose-response manner. Moreover, increasing weekly working hours was associated with an increased likelihood of injury (OR 1.03, 95%CI 1.01, 1.04), whereas the number of normal (≤12 h) work shifts reduced this likelihood (OR 0.79, 95%CI 0.64, 0.98). CONCLUSIONS Our findings suggest that accumulated working-hour load, as opposed to single, very long (>24 h) work shifts, may increase the risk of occupational injury among hospital physicians.
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Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational HealthHelsinkiFinland
- Division of Insurance MedicineDepartment of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Aki Koskinen
- Finnish Institute of Occupational HealthHelsinkiFinland
| | | | - Jenni Ervasti
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Mika Kivimäki
- Finnish Institute of Occupational HealthHelsinkiFinland
- ClinicumFaculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
| | - Tuula Oksanen
- School of MedicineInstitute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
| | - Mikko Härmä
- Finnish Institute of Occupational HealthHelsinkiFinland
| | - Kati Karhula
- Finnish Institute of Occupational HealthHelsinkiFinland
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Ropponen A, Koskinen A, Puttonen S, Ervasti J, Kivimäki M, Oksanen T, Härmä M, Karhula K. Association of working hour characteristics and on-call work with risk of short sickness absence among hospital physicians: A longitudinal cohort study. Chronobiol Int 2021; 39:233-240. [PMID: 34724854 DOI: 10.1080/07420528.2021.1993238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians' risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1-3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68-3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61-4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44-3.21) and a higher number of short (<11 h) shift intervals (OR for ≥5 versus none: 12.61, 95% CI 8.88-17.90) were all associated with the increased risk of short sickness absence. These associations did not differ between male and female physicians or between age groups. To conclude, the findings from objective working hour records show that long work shifts, on-call shifts and short shift intervals are related to the risk of short (1-3 days) sickness absence among hospital physicians.
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Affiliation(s)
- Annina Ropponen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
| | - Tuula Oksanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kati Karhula
- Finnish Institute of Occupational Health, Helsinki, Finland
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Alba-Jurado ML, Aguado-Benedí MJ, Moreno-Morales N, Labajos-Manzanares MT, Martín-Valero R. Occupation and Sickness Absence in the Different Autonomous Communities of Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11453. [PMID: 34769969 PMCID: PMC8583026 DOI: 10.3390/ijerph182111453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 12/02/2022]
Abstract
The occupation of a worker is a determining factor of sickness absence (SA) and can influence both the beginning and continuation of the latter. This study describes SA in Spain, separately in the different Autonomous Communities (AC) in relation to the occupation of workers, with the aim of determining the possible differences in its frequency and duration, relating it also to the diagnosis. A total of 6,543,307 workers, aged 16 years and older, who had at least one episode of SA in the year 2019, constituted the study sample. The obtained results indicate that SA is more frequent and shorter in more elemental occupations. The average duration increases with age and is longer in women, except in technical and administrative occupations, where there is no gender divide. Sickness absences caused by musculoskeletal and mental disorders are more frequent in the lower occupational classes, although their average duration is shorter than in other, more qualified groups. The ACs with shorter duration in almost all the occupational groups are Madrid, Navarre and the Basque Country. In conclusion, SA is more frequent and shorter in lower occupational classes.
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Affiliation(s)
| | | | - Noelia Moreno-Morales
- Department of Physiotherapy, Faculty of Health Science, Ampliacion de Campus de Teatinos, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Malaga, Spain; (N.M.-M.); (M.T.L.-M.)
| | - Maria Teresa Labajos-Manzanares
- Department of Physiotherapy, Faculty of Health Science, Ampliacion de Campus de Teatinos, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Malaga, Spain; (N.M.-M.); (M.T.L.-M.)
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, Ampliacion de Campus de Teatinos, University of Malaga, C/Arquitecto Francisco Peñalosa 3, 29071 Malaga, Spain; (N.M.-M.); (M.T.L.-M.)
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Willeke K, Janson P, Zink K, Stupp C, Kittel-Schneider S, Berghöfer A, Ewert T, King R, Heuschmann PU, Zapf A, Wildner M, Keil T. Occurrence of Mental Illness and Mental Health Risks among the Self-Employed: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8617. [PMID: 34444369 PMCID: PMC8393630 DOI: 10.3390/ijerph18168617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed.
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Affiliation(s)
- Kristina Willeke
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany;
| | - Patrick Janson
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany;
| | - Katharina Zink
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
| | - Carolin Stupp
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany;
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Würzburg, 97080 Würzburg, Germany;
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.B.); (R.K.)
| | - Thomas Ewert
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
| | - Ryan King
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.B.); (R.K.)
| | - Peter U. Heuschmann
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany;
- Clinical Trial Center Würzburg, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Andreas Zapf
- Bavarian State Ministry of the Environment and Consumer Protection, 81925 Munich, Germany;
- Pettenkofer School of Public Health, University of Munich, 81377 Munich, Germany
| | - Manfred Wildner
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
- Pettenkofer School of Public Health, University of Munich, 81377 Munich, Germany
| | - Thomas Keil
- State Institute of Health, Bavarian Health and Food Safety Authority, 91058 Erlangen, Germany; (P.J.); (K.Z.); (C.S.); (T.E.); (M.W.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, 97070 Würzburg, Germany;
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.B.); (R.K.)
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Alba-Jurado ML, Aguado-Benedí MJ, Moreno-Morales N, Labajos-Manzanares MT, Martín-Valero R. Descriptive study of sickness absence in Spanish regions in 2018: database study. BMJ Open 2020; 10:e038239. [PMID: 33127632 PMCID: PMC7604840 DOI: 10.1136/bmjopen-2020-038239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To provide a wide and thorough description of sickness absence (SA) in Spain, focussing on the different regions of the country and the main characteristics of SA. METHODS A study of the SA spells in Spain, managed by the medical units of the National Institute of Social Security in 2018. The geographical scope of this observational study is the regions (Autonomous Community). Incidence, prevalence, and average duration SA in employees and self-employed are described. The study also describes the differences between non-work-related SA and work-related SA. In age and sex variables, the incidence and the average duration are described. The average duration by Diagnostic Chapters (International Classification of Diseases, 10th Revision (ICD-10)) and the highest number of SA spells by occupational activity and diagnosis are analysed. RESULTS A total of 540 045 SA spells are analysed by non-work-related SA and 63 441 by work-related SA. The national average prevalence in non-work-related SA spells is 32.98/1000 among employed and 30.48/1000 among self-employed; in work-related SA spells, the prevalence is 3.99/1000. The national incidence in non-work-related SA spells is 24.8/1000 for employees and 9.51/1000 for self-employed workers; in work-related SA spells the incidence is 3.55/1000. The average duration is 58.67 days, with the longest duration being neoplasms and the shortest corresponding to infectious disease. The Community of Madrid shows the lowest prevalence, incidence and average duration in work-related SA. Influenza is the diagnosis that generates the largest number of SA spells. Activities of call centres and temporary employment agency activities are the occupations that have the highest number of SA spells. CONCLUSIONS The biggest differences are found in the incidence and average duration, between the non-work-related SA spells and work-related SA. If those characteristics of the SA in which a region is more in deficit are known, it will be possible to do better management of the SA.
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Affiliation(s)
| | - María José Aguado-Benedí
- Director of Coordination of Medical Units, National Institute of Social Security, Madrid, Chief Medical Inspector, Spain
| | | | | | - Rocío Martín-Valero
- Physiotherapy, University of Malaga Faculty of Health Sciences, Malaga, Spain
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Rosta J, Bååthe F, Aasland OG, Isaksson Rø K. Changes in work stress among doctors in Norway from 2010 to 2019: a study based on repeated surveys. BMJ Open 2020; 10:e037474. [PMID: 33082185 PMCID: PMC7577039 DOI: 10.1136/bmjopen-2020-037474] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To explore and discuss the changes in the levels of work stress for Norwegian doctors in different job positions (hospital doctors, general practitioners (GPs), private practice specialists, doctors in academia) from 2010 to 2019. DESIGN Repeated questionnaire surveys in 2010, 2016 and 2019, where samples were partly overlapping. SETTING Norway. PARTICIPANTS A representative sample of 1500-2200 doctors in different job positions. Response rates were 66.7% (1014/1520) in 2010, 73.1% (1604/2195) in 2016 and 72.5% (1511/2084) in 2019. MAIN OUTCOME MEASURE Validated 9-item short form of the 'Effort-Reward Imbalance' questionnaire. A risky level of work stress was defined as an effort/reward ratio above 1.0. ANALYSES Linear mixed models with estimated marginal means of job positions controlled for gender and age. Proportions with 95% CIs. RESULTS From 2010 to 2016 and further to 2019, GPs reported a significant increase in levels on the effort scale (ES: 2.96, 3.25, 3.51) and significant decrease in levels on the reward scale (RS: 4.27, 4.05, 3.67). No significant changes were reported by hospital doctors (ES: 3.13, 3.10, 3.14; RS: 4.09, 3.98, 4.04), private practice specialists (ES: 2.58, 2.61, 2.59; RS: 4.32, 4.32, 4.30) and doctors in academia (ES: 2.63, 2.51, 2.52; RS: 4.09, 4.11, 4.14). The proportion of doctors with risky levels of work stress increased significantly for GPs (10.3%, 27.7%, 40.1%), but did not significantly change for hospital doctors (23.0%, 27.3%, 26.9%), private practice specialists (8.2%, 12.7%, 9.4%) and doctors in academia (11.9%, 19.0%, 16.4%). CONCLUSION During a 9-year period, the proportion of risky levels of work stress increased significantly for GPs but did not significantly change for other job positions. This may be partly due to changes in expectations of younger GPs and several healthcare reforms and regulations.
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Affiliation(s)
- Judith Rosta
- Institute for Studies of the Medical Profession, Oslo, Norway
| | - Fredrik Bååthe
- Institute for Studies of the Medical Profession, Oslo, Norway
- Institute of Stress Medicine, Gothenburg, Sweden
| | - Olaf G Aasland
- Institute for Studies of the Medical Profession, Oslo, Norway
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Occupational exposures and genetic susceptibility to occupational exposures are related to sickness absence in the Lifelines cohort study. Sci Rep 2020; 10:12963. [PMID: 32737337 DOI: 10.1038/s41598-020-69372-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/17/2020] [Indexed: 11/09/2022] Open
Abstract
In this cross-sectional study, we investigated the association between occupational exposures and sickness absence (SA), the mediating role of respiratory symptoms, and whether genetic susceptibility to SA upon occupational exposures exists. Logistic regression was used to examine associations and structural equation modelling was used for mediation analyses. Genetic susceptibility was investigated by including interactions between occupational exposures and 11 candidate single nucleotide polymorphisms (SNPs). Biological dust, mineral dust, and pesticides exposure were associated with a lower prevalence of any SA (OR (95% CI) = 0.72 (0.58-0.89), 0.88 (0.78-0.99), and 0.70 (0.55-0.89), respectively) while gases/fumes exposure was associated with a higher prevalence of long-term SA (1.46 (1.11-1.91)). Subjects exposed to solvents and metals had a higher prevalence of any (1.14 (1.03-1.26) and 1.68 (1.26-2.24)) and long-term SA (1.26 (1.08-1.46) and 1.75 (1.15-2.67)). Chronic cough and chronic phlegm mediated the association between high gases/fumes exposure and long-term SA. Two of 11 SNPs investigated had a positive interaction with exposure on SA and one SNP negatively interacted with exposure on SA. Exposure to metals and gases/fumes showed a clear dose-response relationship with a higher prevalence of long-term SA; contrary, exposure to pesticides and biological/mineral dust showed a protective effect on any SA. Respiratory symptoms mediated the association between occupational exposures and SA. Moreover, gene-by-exposure interactions exist.
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Rosta J, Aasland OG. Perceived bullying among Norwegian doctors in 1993, 2004 and 2014-2015: a study based on cross-sectional and repeated surveys. BMJ Open 2018; 8:e018161. [PMID: 29431127 PMCID: PMC5829781 DOI: 10.1136/bmjopen-2017-018161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine 12-month prevalence of perceived bullying at work for doctors in different job categories and medical disciplines in 1993, 2004 and 2014-2015, and personality traits, work-related and health-related factors associated with perceived workplace bullying. DESIGN Cross-sectional questionnaire surveys in 1993, 2004 and 2014-2015 where the 2004 and the 2012-2015 samples are partly overlapping. SETTING Norway. PARTICIPANTS Response rates were 72.8% (2628/3608) in 1993, 67% (1004/1499) in 2004 and 78.2% (1261/1612) in 2014-2015. 485 doctors responded both in 2004 and 2014-2015. OUTCOME MEASURE Perceived bullying at work from colleagues or superiors at least a few times a month during the last year. RESULTS Between the samples from 1993, 2004 and 2014-2015, there were no significant differences in the prevalence of perceived bullying at work. More senior hospital doctors and surgeons reported being bullied. Doctors with higher scores on the personality trait neuroticism were more likely to perceive bullying, as were female doctors, doctors with poor job satisfaction and poor self-rated health. CONCLUSIONS The fraction of doctors who experienced bullying at work was stable over a 20-year period. Psychological, psychosocial and cultural factors are predictors of perceived bullying.
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Affiliation(s)
- Judith Rosta
- Institute for Studies of the Medical Profession, Oslo, Norway
| | - Olaf G Aasland
- Institute for Studies of the Medical Profession, Oslo, Norway
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Braquehais MD, Arrizabalaga P, Lusilla P, Valero S, Bel MJ, Bruguera E, Sher L, Casas M. Gender Differences in Demographic and Clinical Features of Physicians Admitted to a Program for Medical Professionals with Mental Disorders. Front Psychiatry 2016; 7:181. [PMID: 27933002 PMCID: PMC5122574 DOI: 10.3389/fpsyt.2016.00181] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 10/24/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the demographic and clinical differences between men and women admitted to a Physicians' Health Programme (PHP). METHOD Retrospective chart review of 778 medical records of physicians admitted to the Barcelona PHP from February 1, 1998 until December 31, 2015. RESULTS Women admitted to the Barcelona PHP were younger than men, were more likely to be self-referred and to be admitted for a non-addictive mental disorder. Prevalence of unipolar affective disorders (60.1 vs. 37.6%), adjustment disorders (62.4 vs. 37.6%), and obsessive-compulsive disorder (61.1 vs. 38.9%) was significantly higher among women, whereas prevalence of alcohol use disorders was lower (32.7 vs. 67.3%). Nevertheless, both groups were similar with regard to medical specialty, working status, length of their first treatment episode, and presence of hospitalization during that episode. After multivariate analysis, age, type of referral, and main diagnosis (addictive disorders vs. other mental disorders) discriminated the differences between groups. CONCLUSION Women physicians seem to be more prone to voluntarily ask for help from PHPs and are more likely to suffer from mood and anxiety disorders compared to men. However, mental disorders' severity may be similar in both groups. More studies are needed to clarify the gender factors related to this behavior.
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Affiliation(s)
- María Dolores Braquehais
- Integral Care Program for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Collegi Oficial de Metges de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Pilar Lusilla
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Sergi Valero
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Miquel Jordi Bel
- Integral Care Program for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Collegi Oficial de Metges de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eugeni Bruguera
- Integral Care Program for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Collegi Oficial de Metges de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Leo Sher
- James J. Peters Veterans Affairs Medical Center, Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Miquel Casas
- Integral Care Program for Sick Health Professionals, Galatea Clinic, Galatea Foundation, Collegi Oficial de Metges de Barcelona, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
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Aasland OG. Sykenærvær. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:586. [DOI: 10.4045/tidsskr.15.0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Losvik OK. Privatpraktiserende spesialister har lavest sykefravær. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2014. [DOI: 10.4045/tidsskr.14.0874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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