The Association of the Reporting of Somatic Symptoms with Job Stress and Active Coping among Japanese White‐collar Workers

Mediating effect of coping dispositions on the association between trauma and gastrointestinal symptoms

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are two gastrointestinal (GI) conditions known to be exacerbated by traumatic life experiences. One way in which these experiences might influence individuals' susceptibility to GI pathology, is by reducing their ability to deal with adversities effectively and predisposing them to passive coping styles that leave them vulnerable to the somatic effects of trauma. To validate this hypothesis, the present cross-sectional study assessed the mediating effect of coping dispositions on the association between trauma and GI disease activity in an adult sample of 189 bowel patients (94 IBD, 95 IBS) and 92 controls. Results confirmed that GI patients exhibit significantly more cumulative trauma, pervasive feelings of uncontrollability and passive coping strategies than controls. Moreover, the use of passive coping styles was positively associated with the accumulation of trauma and the expression of GI symptoms. Using hierarchical regression and mediation analyses, we found support for the sequential model postulating passive coping styles as (partial) mediators of trauma-induced (GI) disease manifestations. Specifically, out of all coping styles associated with cumulative trauma, behavioural disengagement most powerfully mediated the effect of trauma on GI symptom severity, accounting for 12% (IBD) to 14% (IBS) of its total effect. A somewhat smaller mediating role was observed for social support coping, the reduced reliance on which explained 7% (IBS) to 10% (IBD) of trauma's total effect. Finally, neuroticism acted as a channel through which past traumatization affected subjects' proneness to behavioural disengagement and, consequently, their GI disease activity.

Investigating the role of organizational stress in nurses' psychosomatic complaints: Evidence from a study in northeastern Italy

Background

Nursing is pivotal to healthcare delivery but is often associated with high levels of organizational stress. In this cross-sectional study, we aimed to investigate the associations between exposure to organizational stressors, measured using the Health and Safety Executive Management Standards Indicator Tool, and psychosomatic complaints among nurses in a medium-sized city hospital in northeastern Italy.

Methods

A total of 215 nurses participated in the study, completing self-report questionnaires assessing organizational stressors and the prevalence of psychosomatic complaints experienced over the preceding six months.

Results

Significant associations were observed between various organizational stressors and psychosomatic complaints among nurses. Specifically, the Relationships factor emerged as a significant predictor of palpitations, irritability, anxiety, physical and mental tiredness, and headache. Additionally, Demands and Managers' support were identified as significant predictors of specific psychosomatic complaints.

Conclusion

This study highlights the critical role of addressing organizational stressors, particularly those related to interpersonal relationships, in promoting nurse well-being and optimizing patient care delivery. Despite its strengths, including the use of a well-established measurement tool and a comprehensive assessment of psychosomatic complaints, limitations such as the cross-sectional design and self-report measures warrant consideration. By prioritizing supportive work environments and implementing targeted interventions, healthcare organizations can cultivate a culture of well-being among nurses, ultimately enhancing the quality and safety of healthcare delivery.

Validation of the work stress screener (WOSS-13) and resilience at work scale (ReWoS-24)

OBJECTIVE

Work stress is a global issue with countries such as the UK requiring organisations to protect employees. Work stress can be beneficial (challenging) or harmful (overwhelming), and characteristics such as resilience are thought to mitigate some of the negative effects. This paper describes the validation of two new scales. The WOSS-13 was designed to measure both benign and harmful experiences of work stress, while the ReWoS-24 captures information about individual and team resilience.

METHODS

For both scales the assessment of individual items, domains captured by scale items, reliability and validity were completed using data from a survey of 1980 individuals from the University of York, England. A sub-sample of respondents (N = 609) provided additional data for retest purposes. Analyses were performed using these two samples.

RESULTS

Responses to scale items were found to be normally distributed. Confirmatory factor analysis indicated the WOSS-13 was comprised of three subscales: positive work-related affect/stress, general positive affect and harmful stress. The ReWoS-24 is presented as four sub-scales: general well-being, well-being at work, satisfaction with job performance and team resilience. All subscales demonstrated good internal consistency (Cronbach's alpha ≥0.80). Both scales complement existing measures of stress and mental health.

CONCLUSION

The findings suggest that the WOSS-13 is a valid and reliable measure which enables the assessment of both benign and harmful forms of work stress. The ReWoS-24 is a valid and reliable measure of individual and team resilience. These scales could be used in workplaces to assess for and mitigate against, harmful work stress.

Multiple Physical Symptoms Are Useful to Identify High Risk Individuals for Burnout: A Study on Faculties and Hospital Workers in Japan

Healthcare workers have a high risk of burnout. This study aimed to investigate if the numbers of physical symptoms are associated with burnout among healthcare workers. We conducted a cross-sectional survey at a large university in Tokyo, Japan, in 2016. Participants were 1080: 525 faculties and 555 hospital workers. We investigated 16 physical symptoms perceived more than once per week and examined the association between the number of physical symptoms and Copenhagen Burnout Inventory (CBI); work-related (WBO), personal (PBO), and client-related (CBO) burnout. All CBI scores were higher among hospital workers than among faculties: WBO (43 vs. 29), PBO (50 vs. 33), CBO (33 vs. 29). Moreover, the higher the number of physical symptoms perceived, the higher the degree of burnout scores became (trend p-values < 0.001), except for CBO among faculties. Job strain (all except for CBO among hospital workers) and work–family conflict were associated with an increased risk of burnout. Being married (WBO and CBO among faculties), having a child (except for PBO and CBO among faculties), and job support (faculty and hospital workers with WBO and faculties with PBO) were associated with a decreased risk of burnout. Multiple physical symptoms might be useful for identifying high risk individuals for burnout.

Sleep quality of nurses in the emergency department of public hospitals in China and its influencing factors: a cross-sectional study

Background

Studies have shown that poor sleep could result in many unpleasant consequences and is prevalent in nurses. Considering the fact of high stress, overwhelming workload and many night shifts in the emergency department in China, this study aimed to evaluate the current status of emergency nurses’ sleep quality in public hospitals in Shandong, China and explored its influencing factors.

Methods

A self-administered questionnaire incorporating the Job Content Questionnaire and Pittsburgh Sleep Quality Index (PSQI) was conducted among 4856 emergency nurses in five randomly selected city emergency command systems in Shandong, China. The association of potential influencing factors, including occupational, psychosocial and individual factors, with poor sleep (PSQI> 5) was quantified by multivariate logistic regression analysis.

Results

The average PSQI score of 4730 emergency nurses in public hospitals was 8.2 ± 3.9, including 3114 (65.8%) subjects with PSQI > 5 and 2905 (61.4%) > 8; these figures were found highest for 337 emergency nurses in 14 tertiary hospitals with 11.8 ± 4.3, 257 (76.3%) and 232 (68.8%), followed by 1044 emergency nurses in 43 secondary hospitals with 9.5 ± 3.9, 725 (69.4%) and 675 (64.7%) and 3349 emergency nurses in 167 primary hospitals with 7.4 ± 3.5, 2132 (63.7%) and 1998 (59.7%). The following factors were associated with poor sleep: hospital level (tertiary vs. primary, secondary vs. primary), female sex, less of exercise, long work hours per week, many patients in the charge of at night, high monthly night shift frequency (4–6 vs. never, ≥7 vs. never) and high occupational stress.

Conclusions

The sleep quality of emergency nurses in public hospitals in China was poor, especially in tertiary hospitals. Many factors as listed above, especially occupational stress, night shift taking and workload at night, should be considered when improving emergency nurses’ sleep quality.

Stress and psychosomatic symptoms in Chinese adults with sleep complaints: mediation effect of self-compassion

Although stress has been widely acknowledged to link to psychosomatic dysfunctioning, the underlying mechanism that transmits the impact is not adequately investigated. This study examined self-compassion as a potential mediator that may explain the pathway from stress to depressive and somatic symptoms. Data in the present study were drawn from a baseline survey of 998 Chinese participants who enrolled in an intervention study on sleep disturbance in Hong Kong. Participants completed measures of perceived stress, self-compassion, depressive symptoms, and somatic symptoms. The results showed that stress was associated with depressive symptoms (r = .79, p < .01) and somatic symptoms (r = .47, p < .01). The path analyses showed that low levels of self-compassion mediated the association between stress and psychosomatic symptoms. Our findings provide insight into the pathway how stress affects psychosomatic symptoms. The intervention programs for stress management to improve psychological and physical functioning are recommended to consider self-compassion as a promising component in practice.

[Association between Job Stress and Number of Physical Symptoms among Female Nurses of Medical-university-affiliated Hospitals]

OBJECTIVES

To clarify the association between job stress and the number of physical symptoms among newly certified female nurses.

METHODS

In this cross-sectional self-administered survey, we investigated 313 female nurses working at three medical-university-affiliated hospitals in February 2016. We investigated working conditions including numbers of working and on-call hours, work-life balance, Job Content Questionnaire (JCQ) scores, and 16 physical symptoms perceived more often than once a week.

RESULTS

Among the 313 participants (mean age, 31.9), 57% were aged 21-29 years and 70% were single. Of the 16 physical symptoms investigated, fatigability was the most frequent complaint (66.1%), followed by lower back pain (44.7%). Univariate analysis showed that significant factors related to physical symptoms are job demands (p<0.001) and social support (p<0.001) in JCQ, binary index of supports (p<0.001), and total working hours per day (p =0.025). Multivariable-adjusted logistic regression analyses demonstrated that the likelihood of reporting a greater number (n≥3) of physical symptoms increased by 7% [95% confidence interval (CI), 2-13%] with a one-unit increase in job demand degree, and decreased by 16% (95% CI, 10-22%) in social support degree. When binary JCQ indexes were assessed, the high-support group [odds ratio (OR) 0.36; 95% CI, 0.23-0.59] was protectively associated with a greater number of physical symptoms while long working hours was significantly associated with a higher risk (OR 18%, 95% CI, 1-38%).

CONCLUSIONS

Reporting a greater number of physical symptoms may be a good indicator of job stress perceived by a nurse in a university hospital setting.

Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients

OBJECTIVE

Despite an extensive body of research on somatic symptom presentation among people of East- and Southeast-Asian descent, results are still inconclusive. Examining and comparing symptom presentation in clinically and ethnically well-characterized populations may constitute a step towards understanding symptom presentation between patients with a different cultural background. This study aims to compare Vietnamese and German patients regarding cultural dynamics of symptom presentation upon first admission to a psychiatric outpatient service.

METHODS

110 Vietnamese and 109 German patients seeking psychiatric treatment at two outpatient clinics completed the Patient Health Questionnaire (PHQ). The somatic symptom subscale (PHQ-15), the depression subscale (PHQ-9) and PHQ-subscales examining anxiety and psychosocial stress levels were analyzed and compared for both groups using multivariate analysis of covariance. Regression analysis was utilized to examine the influences of sociodemographic and migration specific factors.

RESULTS

Vietnamese and German patients showed comparable Cronbach's alpha for all subscales. Vietnamese patients endorsed significantly higher levels of somatic symptoms overall and on certain items (as pain-related items, dizziness, and fainting spells) despite similar levels of depression severity in comparison with German patients. Vietnamese patients with poor German language skills showed a significantly higher focus on somatic symptoms.

CONCLUSION

Raising awareness for cultural dynamics of symptom presentation in patients with depression is indispensable. Cross-cultural symptom assessment using the PHQ seems feasible and expands our understanding of depressive and psychosomatic symptoms when assessed by clinicians.

Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors

BACKGROUND

This study aimed to determine the prevalence of sleep disturbances among clinical nurses in general hospitals in Mainland China, and identify its associate factors.

METHODS

Using a cross-sectional design, a total of 5012 clinical nurses selected by random cluster sampling completed the survey on the Pittsburgh Sleep Quality Index (PSQI), measures of quality of life indexed by the Medical Outcomes Study 12-item Short-Form Health Survey, occupational stress evaluated by the Job Content Questionnaire, lifestyle and sociodemographic details.

RESULTS

The average PSQI score of 4951 subjects was 7.32 ± 3.24, including 3163 subjects with PSQI ≥5, accounting for 63.9%. Multivariate Logistic regression analysis showed that the risk factors for sleep disturbances in nurses were female gender, the Emergency department and ICU, many years of service, high night shift frequency, professional status: primary and intermediate, employment status: temporary, poor quality of life: poor mental health, low perceived health, high occupational stress (high psychological demand, low job control and low workplace social support).

CONCLUSIONS

Sleep disturbances are highly prevalent among clinical nurses in general hospitals in Mainland China. Many of the factors listed above were associated with the prevalence of sleep disturbances in nurses, and occupational stress plays an important role in the development of sleep disturbances in Chinese clinical nurses.

Effects and mediators of psychosocial work characteristics on somatic symptoms six years later: Prospective findings from the Mannheim Industrial Cohort Studies (MICS)

OBJECTIVE

Ample evidence documented the adverse health effects of work stressors, and recent research has increasingly focused on somatic symptoms which are very common and costly. Prospective evidence is however sparse and yielded mixed findings. Furthermore, there is reason to assume that depression and anxiety might mediate the effects of adverse psychosocial work conditions on somatic symptoms. This study aimed to investigate longitudinal effects of work stressors on somatic symptoms and the potential mediation by anxiety and/or depression.

METHODS

Six year follow-up data from 352 individuals - free of potentially stress-related chronic disease - were utilized. Somatic symptoms were assessed by 19 items of an established list of complaints at baseline and follow-up. The effort-reward-imbalance (ERI) model measured adverse psychosocial work conditions and over-commitment (OC). Linear regressions adjusted for socio-demographics, social status, lifestyle, and baseline symptoms estimated the effects of the ERI ratio, effort, reward, OC, and the ERI ratio×OC interaction on somatic symptoms six years later. Furthermore, single and multiple mediation by anxiety and/or depression was investigated.

RESULTS

There was a strong longitudinal effect of the ERI ratio, as well as of its subcomponents, and OC on somatic symptoms (all Bs≥|0.49|; p-values ≤0.004). Moreover, the ERI ratio×OC interaction was significant (p-value=0.047). Multiple mediation analyses revealed especially anxiety to mediate the effect of work stressors on somatic symptoms (Sobel test=0.007).

CONCLUSION

Adverse psychosocial work conditions seem to longitudinally affect somatic symptoms, potentially moderated by OC, and mediated by anxiety.

The association of work stress with somatic symptoms in Chinese working women: a large cross-sectional survey

OBJECTIVE

It has been suggested that the relationship between work stress and somatic symptoms (e.g., cardiopulmonary, gastrointestinal complaints, general pain, and fatigue) is particularly pronounced in women. As evidence from China is sparse, we used a large sample of Chinese working women to test those potential associations.

METHODS

Data were obtained from a cross-sectional study of 6826 working women in five urban areas in China who were free from major clinical disease. The sample was drawn from five occupations (physicians, nurses, school teachers, bank employees, and industrial workers). The Effort-Reward Imbalance Questionnaire and Patient Health Questionnaire-15 were used to measure work stress and somatic symptoms, respectively. Multivariate ordinal logistic regression was performed to analyze the associations.

RESULTS

52.6% participants reported high work stress in terms of concurrent high effort and low reward. The distribution of severity of somatic symptoms covered the full range from minimal (37.3%) and low (30.6%), to medium (19.7%) and high (12.4%). The adjusted odds ratio of somatic symptoms by high work stress was 2.45 (95% confidence interval=2.24-2.68), and all single psychosocial work factors (effort, reward, and over-commitment) exerted substantial effects on somatic symptoms (odds ratios>2.00).

CONCLUSIONS

Work stress is strongly associated with somatic symptoms in Chinese working women. Future longitudinal studies and intervention studies are needed to understand and improve women's psychosocial work environment and their psychosomatic health in China and elsewhere.

The Association Between Effort-Reward Imbalance and Depressive Symptoms Is Modified by Selection, Optimization, and Compensation Strategy

OBJECTIVE

To examine the main and interactive effects of effort-reward imbalance (ERI) and selection, optimization, and compensation (SOC) strategy on depressive symptoms among the working population in the City of Kumning, China.

METHODS

We assessed the separate and combined effects of low versus high ERI and good versus poor SOC strategy on depressive symptoms using multivariable logistic regression analyses in a population-based sample (N = 2457).

RESULTS

High ERI and poor SOC were significantly associated with depressive symptoms, respectively. In employees with both high ERI and poor SOC, the odds ratio was highly elevated as compared with the reference group (low ERI and good SOC).

CONCLUSIONS

If our findings are confirmed by prospective studies, health promotion programs in work settings might consider SOC as an integral part to mitigate the adverse mental health effects of ERI.

Psychosocial Risk Factors and Musculoskeletal Symptoms among White and Blue-collar Workers at Private and Public Sectors

OBJECTIVES

The aim of this study was to evaluate musculoskeletal and psychosocial perception and compare these conditions regarding the type of job (white or blue-collar) and the type of management model (private or public).

METHODS

Forty-seven public white-collar (PuWC), 84 private white-collar (PrWC) and 83 blue-collar workers (PrBC) were evaluated. Job Content Questionnaire (JCQ) and Utrecht Work Engagement Scale (UWES) were applied to evaluate psychosocial factors. Nordic Musculoskeletal Questionnaire (NMQ) was used to assess musculoskeletal symptoms. Pressure Pain Threshold (PPT) was measured to evaluate sensory responses.

RESULTS

According to JCQ, all groups were classified as active profile. There was a significant association between work engagement and workers' categories (p < 0.05). PrWC workers had the highest scores for all the UWES domains, while PrBC had the lowest ones. PPT showed that PrBC workers had an increased sensitivity for left deltoid (p < 0.01), and for both epicondyles (p < 0.01), when compared to the other groups. PrWC workers had an increased sensitivity for both epicondyles than PuWC (right p < 0.01; left, p = 0.05). There was no significant association in the report of symptoms across the groups (p > 0.05).

CONCLUSION

This study showed differences in psychosocial risk factors and musculoskeletal symptoms in workers engaged in different types of jobs and work organization. Personal and work-related characteristics, psychosocial factors and PPT responses were different across workers' group. Despite all, there was no significant difference in reported symptoms across the groups, possibly indicating that the physical load is similar among the sectors.

Coping and self-image in patients with symptoms attributed to indoor environment

This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure.

Job stress strengthens the link between metabolic risk factors and renal dysfunction in adult men

Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease. The metabolic risk factors obesity, hypertension, diabetes, and dyslipidemia are closely associated with renal dysfunction. As psychosocial stress affects these risk factors, here, we examined relationships between metabolic risk factors and renal function, and their association with job stress. The participants were 1,231 Japanese male office workers attending annual health examinations. The estimated glomerular filtration rate (eGFR) was determined using the equation recommended by the Japanese Society for Nephrology: eGFR (mL/min/1.73 m(2)) = 194 × age(-0.287) × Cr(-1.094). Job stress was measured using the Job Content Questionnaire based on the job demand-control model. The job strain index equaled the job demand scores divided by the job control scores. The participants were classified into four ordinal groups of job strain index, based on previous studies (i.e., ≤ 0.4 the lowest, 0.4-0.5 lower, 0.5-0.6 higher, or ≥ 0.6 the highest). A significant correlation was found between lowered eGFR and each of the metabolic risk factors waist circumference, systolic and diastolic blood pressure, and total cholesterol (p < 0.001). Furthermore, job stress had an interactive effect on the relationships between eGFR and systolic and diastolic blood pressure, and triglycerides, depending on the job strain index (highest vs. lowest) (p < 0.05). The highly stressed workers exhibited a close association of eGFR with metabolic risk factors like hypertension and dyslipidemia. Therefore, intensive management may be important for preventing the progression of renal dysfunction and cardiovascular complications in those experiencing stress.

Psychobiological correlates of allostatic overload in a healthy population

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

Environmental discomfort and musculoskeletal disorders

BACKGROUND

Musculoskeletal disorders (MSDs) are the most common occupational disease in Europe, with high prevalence among hospital workers. Both environmental and psychosocial work factors may impact significantly on the development and exacerbation of MSDs.

AIMS

To evaluate whether environmental factors at work are associated with MSDs in hospital workers and to investigate potential interactions between environmental and psychosocial risk factors in the workplace that are associated with MSDs.

METHODS

A cross-sectional investigation was performed using the Nordic questionnaire to assess MSDs, the IAQ/MM-040 indoor air questionnaire for environmental factors, the demand-control model for job strain and the Goldberg questionnaire for anxiety and depression. The association between environmental factors and MSDs was studied using logistic regression analysis. In addition, the interactions of environmental factors with strain, anxiety and depression for MSDs were examined.

RESULTS

Environmental complaints were associated with MSDs. The strongest associations were found between temperature complaints (OR 2.73), noise and light complaints (OR 2.22), other environmental complaints (OR 3.12) and upper limb disorders. A significant interaction between temperature complaints and strain for upper limb disorders (F = 9.52, P < 0.05) was found.

CONCLUSIONS

To prevent MSDs, a multi-level approach is needed, including environmental measures and interventions directed to both psychosocial and organizational factors.

Are skin disorders related to work strain in hospital workers? A cross-sectional study

Background

To evaluate whether occupational stress factors (high demands, low control, low social support, strain, and iso-strain) are associated with skin disorders in hospital workers and whether psychological problems, such as anxiety and depression, act as potential mechanisms through which occupational stress factors are associated with skin disorders.

Methods

1,744 hospital workers were invited to answer a questionnaire concerning the occurrence of skin disorders and psychosocial factors at work. The abbreviated Italian version of the Demand/Control model (Karasek) was used to assess perceived work strain, while the Goldberg scales were used to assess anxiety and depression. Analyses were adjusted for age, gender, occupation, latex glove use and history of atopy.

Results

Of the participants, 25% reported hand dermatitis in the previous 12 months and 35% had been affected by skin disorders in other parts of the body. High job demands (OR = 1.09 CI95% 1.05-1.14), low social support (OR = 0.90, CI95% 0.87-0.93), high strain (OR = 1.54 CI95% 1.20-1.98) and high iso-strain (1.66 CI95% 1.27-2.19) were all associated with a higher prevalence of reported hand skin disorders. Both depression (OR = 2.50 CI95% 1.99-3.14) and anxiety (OR = 2.29 CI95% 1.81-2.89) were associated with higher risk of hand skin disorders. The same pattern was observed for dermatological complaints in other parts of the body. Only a slight reduction in the association between occupational stress variables and skin disorders was observed after including depression and anxiety in the model.

Conclusions

Job stress plays a significant role in triggering skin disorders among hospital workers and psychological problems do not appear to be the mechanism behind this association. Occupational health education and training should focus on reducing job demands and occupational stress in order to prevent skin problems among hospital workers.

[An analysis of the relation between stress coping profile and job stress using structural equation modeling (SEM)]

OBJECTIVES

This study aimed to clarify what type of coping profile can reduce the stress reaction caused by job stress.

METHODS

Using the Brief Job Stress Questionnaire and the Brief Scales for Coping Profile Questionnaire, 1,319 male workers in Japanese manufacturing companies were surveyed. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Structural Equation Modeling (SEM) were used for the statistical analysis.

RESULTS

Six factors for coping profile and job stress were extracted by EFA. Three factors of job stress were thought to correspond to job overload, good human relations and stress reaction, and three factors of coping profile were thought to correspond to problem-focused coping, emotion-focused active coping and escape-avoidance coping. These factors showed good agreement (GFI=0.947, AGFI=0.915, RMSEA=0.070) in CFA. A path diagram showing that coping profile influenced human relations and job overload, and that these conscious stress factors caused the stress reaction was constructed. The validity of this path model was shown (GFI=0.937, AGFI=0.904, RMSEA=0.074) using SEM. In the path analysis, the emotion-focused active coping profile created good human relations and reduced job overload, and either or both of these stress factors worked in the direction in which the stress reaction was reduced. The emotion-focused active coping profile acted finally to reduced the stress reaction (standardized total effect: -0.205). On the other hand, the escape-avoidance coping profile influences human relations harmfully and increased job overload. The escape-avoidance coping profile remarkably deteriorated the stress reaction (standardized total effect: +0.160). The problem-focused coping profile created good human relations though it increased job overload. Through both stress factors the problem-focused coping profile only increased slightly the stress reaction (standardized total effect: +0.019). However, a correlation existed among the three coping profiles. The problem-focused coping profile positively correlated with the emotion-focused active coping profile, that decreases the stress reaction, but negatively correlated with the escape-avoidance coping profile, that increases the stress reaction. Because it was thought that a worker who tends to use a problem-focused coping profile also often adopted other coping profiles that simultaneously reduced the stress reaction, the many workers who tend to use a problem-focused coping profile finally have reduced stress reactions.

CONCLUSIONS

The emotion-focused active coping profile reduced the stress reaction caused by job stress, but the escape-avoidance coping profile intensified the stress reaction. The problem-focused coping profile, that has often been reported to reduce the stress reaction, finally increased the stress reaction slightly because job overload increased as a cost.

Job stress factors, stress response, and social support in association with insomnia of Japanese male workers

The aim of the present study was to examine the relation of insomnia with job stress factors, stress response, and social support. A self-completed questionnaire survey was conducted in 212 male Japanese workers at a synthetic fiber plant. With regard to insomnia, subjects were asked the first 5 of the 8 questions on the Athens Insomnia Scale (AIS). Job stress factors, stress response and social support were assessed using the Job Stress Questionnaire. Multiple regression analyses showed that psychological job stress factors of poor appropriateness of work and high qualitative workload were associated with insomnia. The psychological stress response of depression and physical stress responses were also related with insomnia. Depression was also related to appropriateness of work. The present results showed that insomnia was closely related with the psychological job stress factor of appropriateness of work and the psychological response of depression. These mutual relationships between insomnia and poor mental health need be investigated further.

Mental health issues in Chinese offshore oil workers

BACKGROUND

Offshore oil platform work is regarded as a stressful occupation, and occupational stress has been shown to be an important risk factor for mental illness. Little, however, is known about the main and interactive effects of occupational stress and coping styles on the mental health of Chinese offshore oil platform workers.

AIMS

To explore the association of mental health with occupational stress, coping styles and their interaction among Chinese offshore oil platform workers.

METHODS

A cross-sectional survey was conducted among 561 Chinese offshore oil platform workers. They were sent a self-administered questionnaire exploring their socio-demographic characteristics, occupational stress, coping styles and mental health. Hierarchical multiple regression was used to assess the main and interactive effects of occupational stress and coping styles on mental health.

RESULTS

After controlling for age, educational level, marital status and years of offshore working, poor mental health was significantly positively associated with occupational stress, 'internal behaviour' coping methods and the interaction between occupational stress and internal behaviour coping.

CONCLUSIONS

The results of this study suggest that the mental health of Chinese offshore oil platform workers is associated with occupational stress, some coping styles and interactions of occupational stress and some coping styles.