Effects of a cognitive ergonomics workplace intervention (CogErg) on cognitive strain and well-being: a cluster-randomized controlled trial. A study protocol

Wellbeing and Problematic Smartphone Use: Serial Mediation of Mindfulness and Self-Compassion

The relationship between wellbeing and Problematic Smartphone Use (PSU) has been explored in the past, however, the role of the potential mediators of this association is a relatively neglected area of research. Therefore, the current study examined mindfulness and self-compassion as mediators of the relationship between wellbeing and PSU in 220 university students. WHO-5 Wellbeing Index, Mindful Attention Awareness Scale- State, Self-Compassion Scale- Short form and Smartphone Addiction Scale- Short version were used for assessing wellbeing, mindfulness, self-compassion, and PSU respectively. Wellbeing had a direct and indirect effect on PSU. In addition, results supported a serial mediation model where wellbeing was found to influence PSU via mindfulness and self-compassion in a sequential manner. The results expanded the Compensatory Internet Use Theory (CIUT) to understand PSU and have implications for the management of PSU.

Deciphering dynamic interactions among multidimensional psychological motivations, academic performance, and sociocultural adjustment: The critical influence of excessive WeChat use

As the preeminent mobile social media platform in Mainland China, WeChat's meteoric expansion has revolutionized the dynamics of interpersonal communication and the modalities of mutual interaction among individuals. Despite the escalating significance of mobile social media in the cross-cultural adaptation of international students, existing scholarly works have largely neglected the underlying relationship between psychological motivations, excessive WeChat use, academic performance, and sociocultural adaptation of these students. Anchored in uses and gratifications theory and cross-cultural adaptation paradigm, the primary objectives of this study are to devise a theoretical model and to scrutinize differential psychological motivations propelling international students' WeChat usage, its association with excessive WeChat use, and impacts on academic performance and sociocultural adjustment. The proposed model undergoes meticulous evaluation through data amassed online from 598 Chinese international students studying in Germany. Sequential analytical techniques, especially Confirmatory Factor Analysis and Structural Equation Modeling, were employed to elucidate the dynamic interplay among key variables. The final results validate the path effect suggesting that both hedonic and social motivations are positive predictors of excessive WeChat use. Moreover, excessive WeChat use is negatively correlated with academic performance and sociocultural adjustment. However, utilitarian motivation is not significantly related to excessive WeChat use. By demystifying the driving factors and consequences of excessive WeChat use, these findings not only accentuate the pivotal role of mobile social media in the cross-cultural adaptation of international students but also enrich the theoretical landscape and enhance the strategic approaches for educators and academic institutions.

Updating design guidelines for cognitive ergonomics in human-centred collaborative robotics applications: An expert survey

Within the framework of Industry 5.0, human factors are essential for enhancing the work conditions and well-being of operators interacting with even more advanced and smart manufacturing systems and machines and increasing production performances. Nevertheless, cognitive ergonomics is often underestimated when implementing advanced industrial human-robot interaction. Thus, this work aims to systematically update, develop, and validate guidelines to assist non-experts in the early stages of the design of anthropocentric and collaborative assembly applications by focusing on the main features that have positively influenced workers' cognitive responses. A methodology for structured development has been proposed. The draft guidelines have been created starting from the outcomes of a systematic and extended screening of the scientific literature. Preliminary validation has been carried out with the help of researchers working in the field. Inputs on comprehensibility and relevance have been gathered to enhance the guidelines. Lastly, a survey was used to examine in depth how international experts in different branches can interpret such guidelines. In total, 108 responders were asked to qualitatively and quantitatively evaluate the guideline's comprehensibility and provide general comments or suggestions for each guideline. Based on the survey's results, the guidelines have been validated and some have been reviewed and re-written in their final form. The present work highlights that integrating human factors into the design of collaborative applications can significantly bolster manufacturing operations' resilience through inclusivity and system adaptability by enhancing worker safety, ergonomics, and wellbeing.

Relationship between psychological capital and mental health at higher education: Role of perceived social support as a mediator

Research in Positive Psychology has indicated a correlation between Psychological Capital (PsyCap) and Mental health (MH). However, the specific contribution of Perceived Social Support (PSS) in the connection between PsyCap and MH, particularly within higher education, remains uninvestigated. This study investigated how PSS could mediate the effect of PsyCap on students' MH using a cross-sectional research design. The sample encompassed 443 undergraduate graduate students at Huazhong University of Science and Technology in Wuhan, China. Results from Partial Least Squares Structural Equation Modeling (PLS-SEM) showed that both PsyCap (β = 0.815, t = 31.074, p < 0.000) and PSS (β = 0.405, t = 28.051, p < 0.000) have a positive impact on students' MH. Additionally, PSS was identified as a significant mediator in relation to students' MH (b = 0.080, t = 2.319, p < 0.020). This study emphasizes the importance of developing these factors in educational and support programs to enhance students' well-being. Moreover, the results offer significant conceptual and practical insights for higher education faculty, psychologists, and curriculum designers.

Beyond HIV shame: the role of self-forgiveness and acceptance in living with HIV

Research is developing regarding the beneficial association of spirituality with numerous health outcomes in people living with HIV (PLWH); however, little attention has been paid to the association of these variables with forgiveness and acceptance of HIV status. This cross-sectional study used a sample of 648 PLWH from the United States aged 18-61 to test the mediating effects of forgiveness and acceptance of HIV status on the relationship of spirituality and life satisfaction. As expected, self-forgiveness and acceptance straightforwardly and serially explained the links between spirituality and life satisfaction, while forgiveness of others was not a significant mediator for this relationship. The data obtained suggest that spirituality and self-forgiveness are two important targets for future experimental research, and therapeutic interventions on these variables may have a synergistic effect of increasing acceptance and improving well-being in PLWH.

The Factor Structure and Measurement Invariance of the Coping Inventory for Stressful Situations in a Sexual Minority Population

Coping strategies have been studied as protective factors against stress for individuals. However, the psychometric properties of the most widely used coping self-report questionnaires, the Coping Inventory for Stressful Situations (CISS-21), have not been examined in a sexual minority population (men and women that identify as lesbian, gay, or bisexual or LGB). In this study, we conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) simultaneously to assess the factor structure of the CISS-21 questionnaire in LGBs. Also, we tested the measurement invariance of CISS across sex and sexual identity in the LGB sample (N = 2850, 52.00% woman, mean age = 32.46 years). The results show that a four-factor structure consisting of task-oriented coping (TOC), emotion-oriented coping (EOC), distraction-oriented coping (DOC), and social diversion-oriented coping (SOC) explained the data best. The results also show acceptable internal consistency reliability, convergent validity, and discriminant validity. Subsequently, multi-group analyses established measurement invariance across sex and sexual identity. These results indicate that the CISS-21 could be used as a simple, reliable, and valid scale for measuring coping strategies in LGBs, and that it allows valid score comparisons from different sex and sexual identity groups.

Biomechanical analysis of wood processing work in tropical forest regions: A study in Midwest Brazil

In the wood processing industry, working with machines exposes workers to occupational risks. This study evaluates the biomechanics of work activities carried out in a wood processing operation in tropical forest regions to identify risks associated with the development of musculoskeletal injuries. Data were collected in a wood processing industry from a tropical forest region in Midwest Brazil. Forty forest workers were evaluated, equivalent to 100% of the population of the company participating in the study. Biomechanical movements were measured using the Three-Dimensional Biomechanical Model for Predicting Stances and Static Forces. There was a risk of injury to the joints of the upper limbs (wrists and shoulders), as well as to the torso. When splitting and manually stacking wood, a risk of spinal injury was identified. All workers had a high risk of developing injuries in all joints evaluated in addition to a risk of serious spinal injury. In this way, the development of these activities without any ergonomic interventions makes the risk of developing musculoskeletal injuries in the workers involved imminent, with consequent early professional incapacity.

Small and medium enterprises (SMEs) in a pandemic: A systematic review of pandemic risk impacts, coping strategies and resilience

Small and Medium Enterprises (SMEs) are particularly vulnerable to pandemics. Therefore, resilience and adaptation to shocks from pandemics such as COVID-19 are urgently needed. However, despite some coping strategies already in place among SMEs, research on their nature and effectiveness is limited. Thus, it remains unclear how effectively and sustainably documented coping strategies reduce SMEs' vulnerability and increase their resilience to pandemic risk. This article reviews academic literature for evidence of pandemic risk impacts on SMEs, coping strategies in response to these impacts, and the degree to which these strategies reduce SMEs' vulnerability and increase their resilience. According to the literature review, seven essential pandemic risk impacts were identified for SMEs - human movement restrictions, financial constraints, operational challenges, logistics difficulties, delayed business reopening, short-term policy focus and tacit knowledge workers. The study also outlined eleven critical coping strategies, notably structural or physical and behavioural changes. Study analysis reveals that resilience research among SMEs is predominantly conceptual with limited empirical evidence. To conclude, this study urges more adaptation research focused on developing new forms of pandemic risk education for SMEs addressing their complexities.

Strategies to meet marital intimacy needs in women infected with coronavirus 2019: A framework qualitative content analysis research

Background

Separating women with the coronavirus 2019 from family can affect marital life. Considering psychological vulnerability of women for anxiety and depression disorders, these women may experience more stress due to the loss of work at this time or special reproductive health conditions such as pregnancy, having a baby, or other medical conditions.

Objective

Considering a limited number of qualitative studies on the need for marital intimacy, this study was conducted to meet marital intimacy needs in women with coronavirus 2019.

Materials and Methods

Framework qualitative content analysis was conducted through participation of 13 key informants (sex therapist, couple therapist, psychologist, and midwifery counselor) and 18 infected women from Yazd, Iran in July 2020 who were selected purposefully and interviewed through the semi-structured in-depth interviews.

Results

3 main categories were: 1) mutual resilience (subcategories: 1. coping strategies; 2. value of marital life; 3. compassionate conflict resolving). 2) skillful relationship (subcategories: 1. assertiveness in sexual expression; 2. self-efficacy in the distance physical connectivity). 3) synergy (subcategories: 1. reframing spirituality closeness; 2. empowering aesthetic creativity; 3. management of family function, and 4. prioritizing).

Conclusion

Findings revealed sex and couple therapists, health providers, and policymakers should emphasize on using new forms of digital communication in these couples. Teaching skills that increase partners' creativity and empathy, enable women to fulfill their mental, sexual and reproductive health needs, and lead to more partners responsibility and loyalty, and maintenance of family function. In times of crisis, counseling should be considered in women treatment programs and care guidelines.

Providing an approach to analyze the risk of central oxygen tanks in hospitals during the COVID-19 pandemic

The central oxygen unit of hospitals is considered a high-risk unit, requiring high safety standards to maintain the integrity of the system during the COVID-19 pandemic. The linear reasoning assumption of conventional risk analysis methods cannot adequately describe these modern systems, which are characterized by tight connections and complex interactions between technical, human, and organizational aspects. Therefore, this study presents a new and comprehensive approach to oxygen tanks in hospitals during the COVID-19 pandemic. In this study, trapezoidal fuzzy numbers were used to calculate failure rates. After determining the probability of basic events (BEs), intermediate events (IE), and top event (TE) with fuzzy logic and transferring it into Bayesian Network (BN), deductive and inductive reasoning, and sensitivity analysis were performed using RoV in GeNIe software. The results of the case study showed that the IE of "Human Error" had the highest probability of fuzzy fault tree (FFT) and the probability of oxygen leakage was lower using FBN than FFT. According to the results, BE16 (failure to use standard and updated instructions) and BE12 (defects in the inspection and testing program of tank devices) had the highest posterior probability, while based on the FFT results, BE4 (defects in the external coating system of the tank) and, BE3 (Corrosive environment (acidity state)) had the least probability. According to the sensitivity analysis, basic events 10, 11, and 16 were the most important in the oxygen leakage event with a very small difference, which was almost in line with the results of posterior FBN (FBNPO). Updating the existing guidelines, fixing defects in the inspection of all types of tank gauges, and testing related equipment can greatly help the reliability of these tanks. Root cause analysis of these events provides opportunities for prevention and emergency response in critical situations, such as the COVID-19 pandemic.

Maternal COVID-19 infection and the fetus: Immunological and neurological perspectives

Immunoneuropsychiatry is an emerging field about the interaction between the immune and nervous systems. Infection and infection-related inflammation (in addition to genetics and environmental factors) can act as the etiopathogenesis of neuropsychiatric disorders (NPDs). Exposure to COVID-19 in utero may be a risk factor for developing NPDs in offspring in the future. Maternal immune activation (MIA) and subsequent inflammation can affect fetal brain development. Inflammatory mediators, cytokines, and autoantibodies can pass through the placenta and the compromised blood-brain barrier after MIA, leading to neuroinflammation. Neuroinflammation also affects multiple neurobiological pathways; for example, it decreases the production of the neurotransmitter serotonin. Fetal sex may affect the mother's immune response. Pregnant women with male fetuses have been reported to have decreased maternal and placental humoral responses. This suggests that in pregnancies with a male fetus, fewer antibodies may be transferred to the fetus and contribute to males' increased susceptibility/vulnerability to infectious diseases compared to female infants. Here, we want to discuss maternal COVID-19 infection and its consequences for the fetus, particularly the neurological outcomes and the interaction between fetal sex and possible changes in maternal immune responses.

Exposure therapy acceptability among pregnant Latinas with anxiety: A qualitative content analysis

OBJECTIVE

Exposure therapy is the frontline treatment for anxiety among adults but is underutilized during pregnancy. We qualitatively assess the prospective acceptability of exposure therapy among pregnant Latinas with elevated anxiety, a group that experiences mental health disparities.

METHOD

Pregnant Latinas (N = 25) with elevated anxiety were interviewed regarding their acceptability of exposure therapy following the receipt of an informational clinical video vignette. Interviews were analyzed using deductive content analysis guided by the Theoretical Framework of Acceptability to understand pregnant Latinas' views about exposure therapy.

RESULTS

Nineteen themes were identified across seven theoretically driven subdomains of acceptability. Women expressed acceptability enhancing factors for exposure therapy including feeling hopeful about its effects, a belief that treatment could benefit their broader family, and a preference for treatment during pregnancy as opposed to the postpartum period. Women also expressed challenges to exposure therapy acceptability such as managing family reactions to prenatal psychotherapy, conflict with cultural conceptions of the maternal role, and perceived difficulty using exposure for avoidance related to prenatal health.

CONCLUSION

Identified themes provide insights about exposure acceptability among pregnant women and can be used to bettter engage Latinas in anxiety interventions, ultimately improving clinical outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Relationship among Maternal Perception of Childbirth Experience, Spiritual Health and Maternal-Infant Relationship in the Postpartum Women: A Cross-Sectional Study

Background

Birth represents an influential moment in women's lives that can be a powerful or traumatic experience. Therefore, the aim of this study was to assess the relationship among maternal perception of childbirth experience, spiritual health, and maternal-infant relationship in the postpartum women.

Materials and Methods

This descriptive-analytical study was conducted on 305 postpartum women referred to Health Centers in Karaj. The data were collected using the Perception of Birth Scale (POBS), maternal postnatal relationship scale, and spiritual health questionnaire.

Results

In this study, the mean (standard deviation (SD) age of the participants was 27.50 (5.56) years. The Spearman's correlation test results showed that there was a significant positive relationship among the maternal perception of childbirth experience, the general maternal-infant relationship (r = 0.34, p < 0.001), quality of relationship (r = 0.17, p = 0.002), pleasure with interaction (r = 0.32, p < 0.001), and absence of hostility (r = 0.28, p < 0.001). In addition, a positive relationship was observed among spiritual health and general maternal-infant relationship (r = 0.21, p < 0.001), pleasure in interaction (r = 0.08, p = 0.164), absence of hostility (r = 0.15, p = 0.008), and the maternal perception of childbirth experience (r = 0.11, p = 0.039).

Conclusions

It seems that to promote maternal-infant relationship, health care providers should not only try to promote physical intimacy between mother and infant but also create a positive emotional state for the mother during birth.

The mediating role of anxiety and depression between problematic social media use and bulimia nervosa among Lebanese university students

Background

Bulimia nervosa (BN) is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight. The aim of this study was to evaluate the mediating role of anxiety and depression between problematic social media use (PSMU) and BN among a sample of Lebanese university students.

Methods

This cross-sectional study was carried out between July and September 2021; a total of 363 university students was recruited through convenience sampling. The PROCESS SPSS Macro version 3.4, model four was used to test the indirect effect and calculate three pathways. Pathway A determined the regression coefficient for the effect of PSMU on mental health issues (depression/anxiety); Pathway B examined the association between mental health issues on BN, and Pathway C’ estimated the direct effect of PSMU on BN. Pathway AB was used to calculate the indirect effect of PSMU on BN via depression/anxiety.

Results

Results showed that depression and anxiety partially mediated the association between PSMU and BN. Higher levels of PSMU were associated with more depression and anxiety; higher depression and anxiety were associated with more BN. PSMU was directly and significantly associated with more BN. When entering anxiety (M1) then depression (M2) as consecutive mediators in a first model, the results showed that only depression mediated the association between PSMU and bulimia. When taking depression (M1) then anxiety (M2) as consecutive mediators in a second model, the results showed that the mediation PSMU → Depression → Anxiety → Bulimia was significant. Higher PSMU was significantly associated with more depression, which was significantly associated with more anxiety, which was significantly associated with more bulimia. Finally, higher PSMU was directly and significantly associated with more bulimia

Conclusion

The current paper highlights the relationship that social media use has on BN and other aspects of mental health such as anxiety and depression in Lebanon. Future studies should replicate the mediation analysis conducted in the current study while taking into account other eating disorders. Additional investigations of BN and its correlates must strive to improve the comprehension of these associations’ pathways through designs that allow to draw temporal frameworks, in order to efficiently treat this eating disorder and prevent its negative outcomes.

Bulimia nervosa, an eating disorder, is characterized by an impulsive consumption of food in a short period of time, followed by behaviors that compensate the eating such as vomiting or excessive exercise in order to avoid weight gain. Individuals with problematic social media use were found to have higher levels of bulimia symptoms. Symptoms of bulimia can also be associated with both depression and anxiety. The aim of the current study was to examine the mediating role of anxiety and depression between problematic social media use and bulimia nervosa. The results of our study found that problematic social media use was directly associated with more bulimia nervosa and also associated with higher depression and anxiety, both of which were associated with bulimia nervosa. Tackling associated disorders may help reduce symptoms of bulimia nervosa. Clinicians should carefully examine these associations while assessing and implementing treatment plans.

Work stressors and their controllability: Content analysis of employee perceptions of hindrances to the flow of work in the health care sector

High levels of work stress are prevalent today, and the underlying working conditions need to be tackled urgently. In this study, our aim was to identify the range of factors that employees themselves perceive as hindrances to the flow of work, that is, hindrance stressors. We analysed the open-ended questionnaire responses of 4766 employees working in the health care sector using semi-automated content analysis. We then used more detailed conventional content analysis to compare the responses of the groups that reported high (n = 1388) and low (n = 833) levels of subjective stress. Finally, we interpreted and categorised the stressors raised by the respondents from the viewpoint of controllability, to shed light on where to target interventions. The main hindrance stressors reflected inadequate staffing, work overload, time pressure, and management-related issues, of which the responses revealed concrete examples. Interruptions and problems related to cooperation and instructions were also commonly mentioned. The respondents in the high stress group emphasised work overload and issues related to management and clients. Our results suggest that the major hindrances to daily work are beyond employees' control and require decisions and resources at the level of supervisors, managers, directors, and policymakers. Future studies on work stress should explore the controllability of common stressors in more detail and include the appraisal of controllability in explanatory models. Avoiding overemphasis of psychological coping and instead targeting harmful working conditions and the organisational actors who can influence these could make workplace stress management interventions more effective.

Fatigue trajectories during pediatric ALL therapy are associated with fatigue after treatment: a national longitudinal cohort study

OBJECTIVE

Fatigue is one of the most prevalent and distressing symptoms reported by survivors of childhood cancer. There is currently a lack of longitudinal studies on cancer-related fatigue, and especially on the relationship between the course of fatigue during treatment and fatigue at follow-up. The purpose of the current study was therefore to investigate if the course of fatigue during treatment, treatment intensity, serious adverse events, sex, or age at diagnosis are associated with cancer-related fatigue after treatment.

METHODS

Participants were 92 children and adolescents diagnosed with acute lymphoblastic leukemia (mean age at diagnosis was 6.26 years). Fatigue was measured with PedsQL multidimensional fatigue scale proxy reports 5 months after diagnosis, 12 months after diagnosis, 24 months after diagnosis, and at follow-up 12 months after end of treatment. The effect of patient and treatment characteristics on fatigue reported at follow-up was tested through logistic regression analyses.

RESULTS

The course of fatigue during treatment significantly predicted fatigue reported at follow-up for general fatigue (p = .038, OR = 9.20), sleep/rest fatigue (p = .011, OR = 15.48), and cognitive fatigue (p < .001, OR = 10.78). None of the other variables were associated with fatigue at follow-up for any of the subscales.

CONCLUSIONS

The findings demonstrate that fatigue reported during treatment can predict fatigue at follow-up. These results stress the need for longitudinal assessments. Healthcare professionals need to be aware that pediatric patients who are fatigued during treatment need to receive additional attention and timely interventions since cancer-related fatigue will not resolve by itself in the first year after end of treatment.

Development and Reliability of a Questionnaire Assessing Stress, Coping, and Empathy (SCOPE) in Occupational Settings: Preliminary Evidence from Veterinarians

Workplaces can be associated with occupational stress, detrimental consequences in terms of loss of health and reduced psychosocial well-being. Importantly, employees may be particularly at risk of poorer well-being during times of adversity at work, when not able to apply adaptive coping strategies and adopt a more empathetic approach. This study aimed to develop a scale to estimate occupational stress both in terms of situational and individual components, by performing item selection, internal reliability assessment, and investigation of the ceiling/floor effect. The target population consisted of veterinarians (n = 116), based on evidence of high risk of occupational stress and related mental distress. Out of twenty initial candidate entries, exploratory factor analysis retained fifteen items consisting of three domains related to occupational stress, copying strategies, and empathy (SCOPE). The SCOPE scale demonstrated good internal consistency as a whole (Cronbach’s alpha = 0.79) and when considering the three subscales (stress, 0.85; coping, 0.77; and empathy, 0.71). On a possible range from 15 (worst adjustment) to 75 (best adjustment), the sample mean performance was 51.68 (SD, 8.50). Preliminary evidence indicated that the SCOPE questionnaire may reveal differential effects of type of work on levels of occupational stress and related coping and empathy skills.

Expectations of Mental Illness Disclosure Outcomes in the Work Context: A Cross-Sectional Study Among Dutch Workers

Purpose The decision whether to disclose mental illness at work can have important positive and negative consequences for sustainable employment and well-being. The aim of the study is (1) to examine workers' expectations of outcomes of mental illness disclosure in the workplace and to evaluate their expectations regarding which factors are of influence on these outcomes, (2) to identify distinct subgroups of workers, and (3) to characterize these subgroups in terms of personal, sociodemographic, and work-related characteristics. Methods In this cross-sectional survey study, a sample of 1224 Dutch workers was used. Latent Class Analysis (LCA) was used to identify classes of workers based on expected workplace mental illness outcomes. A three-step approach LCA was chosen to investigate whether the classes differed in characteristics. Results The majority of workers expected predominantly positive outcomes of workplace mental illness disclosure (e.g., being able to be one's authentic self; 82.4%), even though they simultaneously expected disclosure to lead to advancement-related discrimination (e.g., lower chances of contract renewal; or getting a promotion; 68.4% and 57%, respectively). Six distinct subgroups of workers were identified based on expected workplace mental illness disclosure outcomes: two positive classes (50.1%), two negative classes (33.3%), and two classes who indicated not to know what the outcomes would be (16.7%). Significant differences between the classes were found on personal experience, work-related association with mental illness, gender, educational level, and workplace atmosphere. Conclusion The disclosure process is complex, as most workers were optimistic (i.e., expected generally positive outcomes) whilst simultaneously expecting workplace discrimination. Subgroup differences in expectations regarding workplace mental illness disclosure outcomes were found.

Explaining the Psychological Distress of Women with High-Risk Pregnancies in Iran: A Qualitative Study

Background

Psychological Distress (PD) is one of the most common mental disorders during pregnancy and involves stress, anxiety, and depression. According to the literature, High-Risk Pregnancy' (HRP) is a major physiological risk factor associated with PD during pregnancy. The main purpose of this study was to explore the perception and experience of women with HRP who, based on standard questionnaires, had moderate-to-severe stress and anxiety scores.

Materials and Methods

This qualitative study was conducted using conventional content analysis from December 2020 to June 2021. To this aim, 16 women with HRP were purposefully selected from Imam Khomeini Hospital in Ahvaz, Iran, with maximum diversity. In-depth, semi-structured, individual interviews were conducted to collect the data. The MAXQDA software was used for data analysis.

Results

Data analysis led to the extraction of two main categories and nine subcategories. "Disrupted peace" and "inefficient adaptation to the situation" were the two extracted categories. The former included the five subcategories of concerns about pregnancy complications, concerns about the parenting process, concerns about the couple's relationship, fear of Covid-19, and occupation-related stress. The latter included the three subcategories of unpleasant feelings, current pregnancy experiences, and previous pregnancy experiences.

Conclusions

This study highlighted a wide range of psychosocial factors involved in the PD of women with HRP. These findings can be used to design appropriate prevention strategies to manage the mental health problems of these women in order to turn their pregnancy into a pleasurable experience.

Successful return to work after burnout: an evaluation of job, person- and private-related burnout determinants as determinants of return-to-work quality after sick leave for burnout

PURPOSE

Burnout literature has primarily studied determinants and rehabilitation. Remarkably, ways to enable qualitative return to work after burnout are considered considerably less and were studied here. Specifically, building on the Job Demands-Resources model and Effort-Recovery model, this study investigated determinants of the quality of return to work.

MATERIAL AND METHODS

Hierarchical regression analyses were conducted to evaluate the quality of reintegration among 786 workers who were surveyed about their return to work after a burnout episode.

RESULTS

Restarting work at a new employer and especially getting supervisor support appeared beneficial, whereas remaining burnout symptoms, stressors in one's private environment and - mostly - neuroticism hampered the quality of return to work.

CONCLUSION

Given the high prevalence and important costs burnout entails, primary prevention alone proves insufficient. Current study findings inform on how to optimize the quality of reintegration in the workplace after a burnout episode, demonstrating that supportive managers and inclusive workplaces (i.e., open to hire applicants with a burnout history) are important levers for qualitative return to work, next to ensuring workers are not (so much) impaired by their burnout rest symptoms.Implications for RehabilitationReintegration trajectories after burnout should not only be evaluated by sick leave duration but also by the clients' subjective experience of quality of return to work.Rehabilitation professionals should ensure clients prepare return to work early so they return timely and are not (so much) impaired by their burnout rest symptoms.Rehabilitation professionals should propose reorientation towards a new employer in case of irreversible work ability problems at the current workplace.The clients' current work situation should allow for sufficient supervisor social support.Also stressors in private life (like divorce) and personality characteristics (like neuroticism) should be considered as they may hamper quality of return to work.

The self-efficacy in distress tolerance scale (SE-DT): a psychometric evaluation

BACKGROUND

Skills training is believed to be essential in dialectical behavior therapy (DBT) and is also offered as a standalone intervention. There is a need to better understand each skills module's separate contribution to treatment outcomes. Several assessment instruments are available, but none of them provides specific information about patients' perceived ability to use skills promoting distress tolerance. The aim of the present study was to develop and evaluate the psychometric properties of a Swedish adaptation of the General Self-Efficacy scale (GSE) for skills use in distress tolerance - the Self-Efficacy in Distress Tolerance scale (SE-DT).

METHODS

Cross-sectional and longitudinal data were gathered in a non-clinical (NC) community sample (n = 407) and a clinical psychiatric (CP) sample (n = 46). Participants in the NC sample were asked to complete a set of 19 self-report instruments, including the SE-DT, and 45 participants repeated the assessment after 2 weeks. The patients in the CP sample filled out a subset of eight instruments; twenty patients repeated the assessment after completing a treatment intervention including mindfulness skills and distress tolerance skills or emotion regulation skills.

RESULTS

The analyses showed that the SE-DT is unidimensional with high internal consistency (Cronbach's alpha = .92) and good test-retest reliability (intraclass correlation = .74). The SE-DT also showed good convergent and divergent validity, demonstrating positive correlations with general self-efficacy and self-compassion, and negative correlations with difficulties in emotion regulation, psychiatric symptoms, and borderline symptoms. The SE-DT showed sensitivity to change, when pre- and post-treatment assessments were compared (Cohen's d = 0.82).

DISCUSSION

This is preliminary evidence that the SE-DT has adequate to good psychometric properties, supporting the use of a total sum score. The results indicate that the SE-DT can adequately measure the construct of self-efficacy with regard to dealing with distress and emotional crises. The instrument enables continued investigation of standalone skills training and the specific contribution of distress tolerance skills to treatment outcomes in DBT. Further studies are needed to investigate whether these results are valid in other populations. In addition, the field would benefit from a common definition of distress tolerance.

Development and evaluation of design guidelines for cognitive ergonomics in human-robot collaborative assembly systems

Industry 4.0 is the concept used to summarize the ongoing fourth industrial revolution, which is profoundly changing the manufacturing systems and business models all over the world. Collaborative robotics is one of the most promising technologies of Industry 4.0. Human-robot interaction and human-robot collaboration will be crucial for enhancing the operator's work conditions and production performance. In this regard, this enabling technology opens new possibilities but also new challenges. There is no doubt that safety is of primary importance when humans and robots interact in industrial settings. Nevertheless, human factors and cognitive ergonomics (i.e. cognitive workload, usability, trust, acceptance, stress, frustration, perceived enjoyment) are crucial, even if they are often underestimated or ignored. Therefore, this work refers to cognitive ergonomics in the design of human-robot collaborative assembly systems. A set of design guidelines has been developed according to the analysis of the scientific literature. Their effectiveness has been evaluated through multiple experiments based on a laboratory case study where different participants interacted with a low-payload collaborative robotic system for the joint assembly of a manufacturing product. The main assumption to be tested is that it is possible to improve the operator's experience and efficiency by manipulating the system features and interaction patterns according to the proposed design guidelines. Results confirmed that participants improved their cognitive response to human-robot interaction as well as the assembly performance with the enhancement of workstation features and interaction conditions by implementing an increasing number of guidelines.

The causal relationship between social support and psychological well-being among undergraduate students in North China

BACKGROUND

Psychological well-being is an important part that undergraduate students and universities cannot neglect as it helps students lead a better study life at the university. Various studies revealed that social support can affect students' psychological well-being. However, the causal relationship between social support and psychological well-being has received little attention in North China. Therefore, the aim of the current study was to analyze the causal relationship between social support and psychological well-being among undergraduate students in North China.

MATERIALS AND METHODS

The survey approach was adopted and conducted with a total of 689 undergraduate students in North China. Data were collected using a reliable questionnaire. Data analysis was performed with descriptive statistics, Pearson's correlation, and structural equation modeling at P < 0.01 significance level using Statistical Package for Social Sciences (SPSS) and Linear Structural Relations (LISREL).

RESULTS

The overall levels of social support and psychological well-being among undergraduate students in North China were high. All observed variables in this study were significantly correlated. The findings also confirmed that the causal relationship between social support and undergraduate students' psychological well-being in North China fitted to the empirical data well (χ² [22, N = 689] = 27.69, χ²/degree of freedom [df] = 1.26, P = 0.19, goodness of fit index [GFI] = 0.99, adjusted goodness of fit index [AGFI] = 0.98, comparative fit index [CFI] = 1.00, standardized root mean square residual [SRMR] = 0.02, root mean square error of approximation [RMSEA] = 0.02).

CONCLUSIONS

Undergraduate students' psychological well-being had been significantly affected by social support in North China. The findings from the current study will be useful for university administrators to develop strategies for the enhancement of undergraduate students' psychological well-being.

The Effectiveness of Transactional Analysis Treatments and Their Predictors: A Systematic Literature Review and Explorative Meta-Analysis

Objectives:

Despite many studies on transactional analysis (TA) psychotherapy, there are no comprehensive reviews or meta-analyses on its effectiveness. We conducted a systematic literature review and meta-analysis on TA psychotherapeutic treatments to examine the extent of psychological and psychosocial change in pre-post studies, the effects compared with other treatments in randomized clinical trials, and factors explaining these effects and differences.

Method:

We conducted a systematic literature review and meta-analysis according to Meta-Analysis of Observational Studies in Epidemiolog (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in Pubmed, Medline, PsycInfo, Web-of-Knowledge, and scholar.google.com .

Results:

Overall, 41 clinical trials of TA treatments had moderate to large effects on psychopathology (Hedges’s g = .66), social functioning ( g = .62), self-efficacy ( g = .80), ego-state functioning ( g = .69), well-being ( g = .33), and behavior ( g = .56). Compared with control conditions, TA had moderate to large effects on psychopathology ( g = .61), social functioning ( g = .69), self-efficacy ( g = .88), ego-states ( g = .70), well-being ( g = .85), and behavior ( g = .46). TA was more effective on most outcomes in individuals, groups, and families than in schools or prisons. Psychopathology changes were significantly predicted by improvements in ego-states, self-efficacy, social functioning, and client–practitioner relationship ( r² range = .27–.43). Treatments were more effective if they included systematic assessment, treatment stages, psycho-education, TA-unique techniques, and an experiential focus ( r² range = .03–.31).

Conclusions:

TA may be considered an effective treatment for many clients.

Psychological and other Correlates of Academic Performance in Medical Students at a Tertiary Care Hospital: A Cross-Sectional Study

BACKGROUND

High percentage of medical students showed multiple psychological factors that may interfere with their academic performance and identifying the problems in early stage and providing them advice is very important for their mental health.

METHODOLOGY

The study targeted undergraduate medical students studying at All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India. Selected students completed the self-administered questionnaire comprising the psychological correlates such as perceived stress scale, Pittsburgh sleep quality index, ten-item personality inventory, and other correlates such as sociodemographic and scholastic characteristics. The association of these psychological and other correlates with academic performance was analyzed using the Chi-square test at P >0.05.

RESULTS

Students with poor sleep quality 60.2% and 57.1% of students had high-stress levels perform well in academics. 70.2% of girls and 64.5% of general category students performed well in academics. Student's family head having a professional degree was associated with good performance in academics 64.3%. Moreover, students belonging to the upper class (69.2%) performed better. No significant association was observed between psychological correlates with academic performance but observed between sociodemographic and scholastic variables with academic performance.

CONCLUSION

Among undergraduate medical students, there was no significant association of psychological correlates such as stress level, sleep quality, and anxiety trait with academic performance.

Coronavirus Disease 2019 (COVID-19) Infection-Related Stigma, Depression, Anxiety, and Stress in Iranian Healthcare Workers

Background

Psychological conditions aggravate during outbreaks. Here, we have discussed the existing COVID-19 depression, anxiety, and stress and the resulting stigma and its different aspects in Iranian health care workers and their 1^st-degree relatives.

Methods

In this cross-sectional study, information of our study groups (237 participants including health care workers and their nuclear family members) was collected via two online stigma and depression, anxiety, and stress scale (DASS) questionnaires.

Results

The DASS questionnaire's mean depression, anxiety, and stress scores were 13.59 ± 5.76, 11.07 ± 4.38, and 15.05 ± 5.86, respectively, in our study population. Marriage status was effective on depression and stress scores. Married participants were having less depression (P = 0.008) but more stressful (P = 0.029) than single ones. Education was found to be effective on anxiety and stress scores. Those with an associate, master, Ph.D., and higher college degrees were significantly less anxious and stressed than those with a diploma or bachelor's degrees (P = 0.032 and 0.016, respectively, for anxiety and stress). Participants with a history of psychiatric conditions showed significantly higher depression, anxiety, and stress rates than those without a past psychiatric condition (P = 0.001). Healthcare workers and their nuclear family members suffer from severe stigma (mean stigma scores were 33.57 and 33.17, respectively).

Conclusions

Healthcare workers and their nuclear family members in Iran suffer from severe COVID-19 related stigma. We also showed that depression, anxiety, and stress are common among Iranian Healthcare workers and their nuclear family members during this pandemic. This study showed that people with preexisting psychiatric conditions need extra mental care during the pandemic.

Attention Classification Based on Biosignals during Standard Cognitive Tasks for Occupational Domains

Occupational disorders considerably impact workers’ quality of life and organizational productivity, and even affect mortality worldwide. Such health issues are related to mental health and ergonomics risk factors. In particular, mental health may be affected by cognitive strain caused by unexpected interruptions and other attention compromising factors. Risk factors assessment associated with cognitive strain in office environments, namely related to attention states, still suffers from the lack of scientifically validated tools. In this work, we aim to develop a series of classification models that can classify attention during pre-defined cognitive tasks based on the acquisition of biosignals to create a ground truth of attention. Biosignals, such as electrocardiography, electroencephalography, and functional near-infrared spectroscopy, were acquired from eight subjects during standard cognitive tasks inducing attention. Individually tuned machine learning models trained with those biosignals allowed us to successfully detect attention on the individual level, with results in the range of 70–80%. The electroencephalogram and electrocardiogram were revealed to be the most appropriate sensors in this context, and the combination of multiple sensors demonstrated the importance of using multiple sources. These models prove to be relevant for the development of attention identification tools by providing ground truth to determine which human–computer interaction variables have strong associations with attention.

Stress and Turnover Intentions Within Healthcare Teams: The Mediating Role of Psychological Safety, and the Moderating Effect of COVID-19 Worry and Supervisor Support

Employees at healthcare organizations are experiencing more stress than ever given the current COVID-19 pandemic. Different types of stress are affecting diverse organizational outcomes, including the employees' voluntary turnover. This is the case of cognitive stress, a type of stress that affects how individuals process information, which can influence employees' turnover intentions. In this study, we look at the mechanisms that can reduce the adverse effects of cognitive stress on turnover intentions, particularly the role of employees' perceived psychological safety (i.e., how safe they perceive the interactions with their colleagues are). We hypothesize that psychological safety mediates the relationship between cognitive stress and turnover intentions, and COVID-19 worry and supervisor support moderate the relationship between cognitive stress and psychological safety. To test our hypothesis, we invited two public health care organizations in Chile to join this study. In total, we obtained a sample of 146 employees in 21 different teams. Using a multilevel model, we found that psychological safety prevents the harmful effects of cognitive stress on employees' turnover intentions. In addition, while COVID-19 worry can worsen the relationship between cognitive stress and psychological safety, supervisor support only directly affects psychological safety. This study contributes to expanding the stress and psychological safety literature and informs practitioners in healthcare organizations about how to deal with cognitive stress in the "new normality" that the pandemic has brought.

The FACAM study: protocol for a randomized controlled study of an early interdisciplinary intervention to support women in vulnerable positions through pregnancy and the first 5 years of motherhood

BACKGROUND

Inequality in health can have profound short- and long-term effects on a child's life. Infants develop in a responsive environment, and the relationship between mother and infant begins to develop during pregnancy. The mother's ability to bond with the fetus and newborn child may be challenged by mental health issues which can cause impaired functioning and poorer health outcomes. Families with complex problems need interdisciplinary interventions starting in early pregnancy to be prepared for motherhood and to ensure healthy child development. This study aims to examine the effects of an early and coordinated intervention (the Family Clinic and Municipality (FACAM) intervention) offered to vulnerable pregnant women during pregnancy and the child's first year of life on the mother-child relationship, maternal social functioning, mental health, reflective functioning, well-being, parental stress, and the development and well-being of the child.

METHODS

The study is a prospective randomized controlled trial where we will randomize 320 pregnant women enrolled to receive antenatal care at the family clinic at Odense University Hospital, to either FACAM intervention or usual care. The FACAM intervention consists of extra support by a health nurse or family therapist during pregnancy and until the child starts school. The intervention is most intensive in the first 12 months and also includes attachment-based support provided either individually or in groups. The participants are assessed at baseline, and when the infant is 3 and 12 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior (CIB) instrument. Secondary outcomes include prenatal parental reflective functioning, mental well-being, depressive symptoms, breastfeeding duration, maternal satisfaction, child development, parent competence, parental stress, and activities with the child.

DISCUSSION

The trial is expected to contribute knowledge about the effect of early coordinated support in antenatal and postnatal care for vulnerable pregnant women and their families.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03659721 . Registered on September 6, 2018.

Electronic Health Record Implementations and Insufficient Training Endanger Nurses' Well-being: Cross-sectional Survey Study

Background

High expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after implementations of HIS. In particular, poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive workload. Moreover, the need to learn new systems may require considerable effort from nurses. Thus, EHR implementations may have an effect on the well-being of nurses.

Objective

This study aimed to examine the associations of EHR-to-EHR implementations and the sufficiency of related training with perceived stress related to information systems (SRIS), time pressure, and cognitive failures among registered nurses. Moreover, we examined the moderating effect of the employment sector (hospital, primary care, social services, and others) on these associations.

Methods

This study was a cross-sectional survey study of 3610 registered Finnish nurses in 2020. EHR implementation was measured by assessing whether the work unit of each respondent had implemented or will implement a new EHR (1) within the last 6 months, (2) within the last 12 months, (3) in the next 12 months, and (4) at no point within the last 12 months or in the forthcoming 12 months. The associations were examined using analyses of covariance adjusted for age, gender, and employment sector.

Results

The highest levels of SRIS (adjusted mean 4.07, SE 0.05) and time pressure (adjusted mean 4.55, SE 0.06) were observed among those who had experienced an EHR implementation within the last 6 months. The lowest levels of SRIS (adjusted mean 3.26, SE 0.04), time pressure (adjusted mean 4.41, SE 0.05), and cognitive failures (adjusted mean 1.84, SE 0.02) were observed among those who did not experience any completed or forthcoming implementations within 12 months. Nurses who perceived that they had received sufficient implementation-related training experienced less SRIS (F₁=153.40, P<.001), time pressure (F₁=80.95, P<.001), and cognitive failures (F₁=34.96, P<.001) than those who had received insufficient training. Recent implementations and insufficient training were especially strongly associated with high levels of SRIS in hospitals.

Conclusions

EHR implementations and insufficient training related to these implementations may endanger the well-being of nurses and even lead to errors. Thus, it is extremely important for organizations to offer comprehensive training before, during, and after implementations. Moreover, easy-to-use systems that allow transition periods, a re-engineering approach, and user involvement may be beneficial to nurses in the implementation process. Training and other improvements would be especially important in hospitals.

Low self-esteem is related to depression and anxiety during recovery from an ectopic pregnancy

BACKGROUND

Considering the increasing incidence of ectopic pregnancy and the negative effects of pregnancy loss on mental health, this study aimed to determine the status of mental health in women with ectopic pregnancy and examine its relationship with their self-esteem.

METHODS

This was a cross-sectional study on 150 women (with a 100% response rate) hospitalized for ectopic pregnancy et al.-Zahra hospital in Tabriz, Iran, during 2018-2019, and recruited via convenience sampling. Data were collected using the General Health Questionnaire-28, which has four subscales (overall score range: 0 to 84; subscale score range: 0 to 21 with a lower score indicating a better mental state), and Rosenberg Self-Esteem Scale (score range: - 10 to + 10 with a higher score indicating higher self-esteem). To determine the association between self-esteem and mental health, independent t-tests, and multivariable logistic regression were used.

RESULTS

The response rate was 100%. The mean score (SD) of participants' mental health was 31.4 (8.5), and that of self-esteem was 4.5 (3.80). The percentage of participants who were considered as having mental distress (i.e., overall GHQ-28 score ≥ 24) was 76%. Among the subscales of mental health, social dysfunction was the most prevalent (observed in 100% of the participants), followed by somatic symptoms (79.3%). Lower self-esteem was significantly associated with overall mental distress (odds ratio (OR): 0.74; 95% confidence interval (95% CI): 0.64-0.87; P < 0.001), depression (OR: 0.70; 95% CI: 0.60-0.80; P < 0.001) and anxiety/insomnia (OR: 0.76; 95% CI: 0.66-0.87; P < 0.001).

DISCUSSION

Mental distress was common among women with ectopic pregnancy. This study is the first to examine the relationship between self-esteem and mental health among women with ectopic pregnancy and highlights the important role of self-esteem in mental wellbeing among those women.

The evolution of the concept of stress and the framework of the stress system

Stress is a central concept in biology and has now been widely used in psychological, physiological, social, and even environmental fields. However, the concept of stress was cross-utilized to refer to different elements of the stress system including stressful stimulus, stressor, stress response, and stress effect. Here, we summarized the evolution of the concept of stress and the framework of the stress system. We find although the concept of stress is developed from Selye's "general adaptation syndrome", it has now expanded and evolved significantly. Stress is now defined as a state of homeostasis being challenged, including both system stress and local stress. A specific stressor may potentially bring about specific local stress, while the intensity of stress beyond a threshold may commonly activate the hypothalamic-pituitary-adrenal axis and result in a systematic stress response. The framework of the stress system indicates that stress includes three types: sustress (inadequate stress), eustress (good stress), and distress (bad stress). Both sustress and distress might impair normal physiological functions and even lead to pathological conditions, while eustress might benefit health through hormesis-induced optimization of homeostasis. Therefore, an optimal stress level is essential for building biological shields to guarantee normal life processes.

Intensified Job Demands and Cognitive Stress Symptoms: The Moderator Role of Individual Characteristics

Intensified job demands (IJDs) originate in the general accelerated pace of society and ever-changing working conditions, which subject workers to increasing workloads and deadlines, constant planning and decision-making about one’s job and career, and the continual learning of new professional knowledge and skills. This study investigated how individual characteristics, namely negative and positive affectivity related to competence demands, and multitasking preference moderate the association between IJDs and cognitive stress symptoms among media workers (n = 833; 69% female, mean age 48 years). The results show that although IJDs were associated with higher cognitive stress symptoms at work, that is, difficulties in concentration, thinking clearly, decision-making, and memory, competence demands-related negative affectivity explained the most variance in cognitive stress symptoms. In addition, IJDs were more strongly associated with cognitive stress symptoms at work in individuals with high competence demand-related negative affectivity, and low multitasking preference (moderation effects). Altogether, the present findings suggest that HR practices or workplace interventions to ease employees’ negative affectivity from increasing competence demands at work could usefully support employees’ effective cognitive functioning when confronted with IJDs.

Does breaking up prolonged sitting improve cognitive functions in sedentary adults? A mapping review and hypothesis formulation on the potential physiological mechanisms

Background

Prolonged (excessive) sitting is detrimentally associated with cardiovascular, metabolic and mental health. Moreover, prolonged sitting has been associated with poor executive function, memory, attention and visuospatial skills, which are important cognitive aspects of work performance. Breaking up prolonged sitting with standing or light-intensity exercises at the workplace is recognized as a potential measure in improving cognition. However, preliminary evidence, primarily from acute laboratory experiments, has enabled formulating hypothesis on the possible mechanistic pathways. Hence, the aim of this mapping review is to gather preliminary evidence and substantiate possible physiological mechanisms underpinning the putative effects of breaking prolonged sitting on improving cognitive function among sedentary office workers.

Mapping method

We searched four databases to identify relevant studies that explored the effects of uninterrupted sitting on cognitive function. First, we introduce how prolonged sitting increases the risks of hyperglycemia, autonomic stability, inflammation, adverse hormonal changes and restrictions in cerebral blood flow (CBF) and alters cognitive function. Second, we elucidate the direct and indirect effects of breaking up prolonged sitting time that may prevent a decline in cognitive performance by influencing glycaemic variability, autonomic stability, hormones (brain derived neurotrophic factor, dopamine, serotonin), vascular functions, and CBF. We highlight the importance of breaking up prolonged sitting on metabolic, vascular and endocrine functions, which in turn may improve cognitive functions and eventually foster work productivity. Improved synaptic transmission or neuroplasticity due to increased brain glucose and mitochondrial metabolism, increased endothelial shear and CBF, increased brain neurotrophic factors (dopamine) and accelerated anti-inflammatory functions are some of the hypothetical mechanisms underpinning improved cognitive functions.

Conclusion

We postulate that improving cognitive function by breaking up prolonged sitting periods is biologically plausible with the myriad of (suggested) physiological mechanisms. Future experimental studies to ascertain the aforementioned hypothetical mechanisms and clinical trials to break sedentary behavior and improve cognitive functions in sedentary office workers are warranted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04136-5.

The effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers in the traditional metal casting industry

This research aimed to evaluate the effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers of the traditional metal casting industry that manually pour molten metal into molds. The workers' physical complaints are typically in the form of musculoskeletal complaints, which include (1) an activity aspect, (2) a physical aspect, and (3) a motivational aspect. The method used in this research was stratified random sampling. The subjects (n = 127) were divided into three groups, namely, the process cement department (PCD) group, the loam department (LD) group, and the black sand department (BSD) group. The evaluation was carried out using questionnaires based on musculoskeletal complaints and fatigue. Meanwhile, an assessment of musculoskeletal complaints and fatigue was conducted one month before the ergonomic intervention, and then during follow-ups at one and eight months after the ergonomic intervention. The results showed that the average reduction in musculoskeletal complaints and fatigue experienced by the workers in the LD group was lower than that of the workers in the PCD and BSD groups at one and eight months after the ergonomic intervention. The positive effects of the ergonomic intervention on musculoskeletal complaints were evident in terms of the back, waist, left and right thighs, right knee, right ankle, and left foot (p < 0.05). The positive effects of the ergonomic intervention on the level of activity-based fatigue were felt in the body and legs, and the feeling of wanting to lie down decreased. The motivational fatigue experienced by the workers manifested as difficulty in thinking, concentrating, and controlling behavior, while the physical fatigue experienced by the workers was in the form of headaches, back pain, excessive thirst, and feeling unwell (p < 0.05). It can be concluded that ergonomic intervention can reduce both musculoskeletal complaints and fatigue, especially by conducting a morning briefing, using ergonomic ladles when pouring molten metal into molds, and consuming nutritious food during break times.

The Associations of Electronic Health Record Usability and User Age With Stress and Cognitive Failures Among Finnish Registered Nurses: Cross-Sectional Study

BACKGROUND

Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood.

OBJECTIVE

The objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses.

METHODS

A cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient's care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector.

RESULTS

Poor EHR usability was associated with higher levels of stress related to information systems (β=.38; P<.001). The strength of the association did not depend on user age. Poor EHR usability was also associated with higher levels of cognitive failures (β=.28; P<.001). There was a significant interaction effect between age and EHR usability for cognitive failures (β=.04; P<.001). Young nurses who found the EHR difficult to use reported the most cognitive failures.

CONCLUSIONS

Information system stress due to poor EHR usability afflicts younger and older nurses alike. However, younger nurses starting their careers may be more cognitively burdened if they find EHR systems difficult to use compared to older nurses. Adequate support in using the EHRs may be particularly important to young registered nurses, who have a lot to learn and adopt in their early years of practice.