Effects of a worker participatory program for improving work environments on job stressors and mental health among workers: a controlled trial

Settings, populations, and time: a conceptual framework for public health interventions

This paper presents a conceptual framework displaying how combinations of settings and populations seen in a long-term perspective may guide public health and health promotion planning and research. The notion of settings constitutes a key element of health promotion as stipulated by the Ottawa Charter from 1986. The setting approach highlights the individual, social and structural dimensions of health promotion. Likewise, the notion of populations and how they are selected forms a center pillar of public health. By joining the two perspectives, four combinations of intervention strategies appear by addressing: (1) a single population segment within a single setting, (2) multiple population segments within a single setting, (3) a single population segment within multiple settings or (4) multiple population segments within multiple settings. Furthermore, the addition of a time dimension inspired by the life-course perspective illustrates how trajectories of individuals and projects change settings and population segments as time goes by. The conceptual framework displays how systematic awareness of long-term, multi-setting, multi-population trajectories allow health promotion planners and researchers to systematically develop, plan and analyze their projects.

The quantity and quality of scientific evidence about the health of working women in occupational health of Japan: A scoping review

OBJECTIVE

We aim to investigate the quantity and quality of scientific evidence dealing with comprehensive health issues of working women in occupational health.

METHODS

This scoping review of original articles that investigated comprehensive health issues of working women aged 19-64 years in Japan was published in PubMed (1967-2022) and Igaku Chuo Zasshi (or Ichu-shi, 1982-2022). Using identical broad search terms, we first identified 17 122 English and 6154 Japanese articles. We excluded those with clinically relevant topics, or ethnicity other than Japanese and included 853 English and 855 Japanese articles for review and classified them into nine research areas considered to be critical factors for women in the workforce and five study design groups to investigate the quality of the evidence accumulated.

RESULTS

Among 853 English-language articles in PubMed, "Mental health" was the most frequent area studied, followed by "Work-related disease" and "Lifestyle-related disease." Among 855 Japanese-language articles from Ichu-shi, "Mental health" was the most frequently studied area followed by "Work and balance," and "Work-related disease." "Infertility, pregnancy, and childbirth" and "Menstruation, menopause, and genital disease" were well studied in Ichu-shi but scarcely published in PubMed. "Harassment and discrimination" were sparsely reported in both databases. As for research designs, many articles in both PubMed and Ichu-shi employed descriptive or cross-sectional study designs. However, a few studies employed cohort/longitudinal or interventional studies.

CONCLUSION

The results underscored the need for higher-quality study designs with more scientific evidence on working women's health in the field of occupational health.

Participatory Action Research for Tackling Distress and Burnout in Young Medical Researchers: Normative Beliefs before and during the Greek Financial Crisis

(1) Background: We aimed to explore Young medical researchers (YMR) normative beliefs and perceived causes of distress and burnout, prior and during the financial crisis in Greece, and to assess their views on Participatory Action Research (PAR) interventions towards tackling these disorders. (2) Methods: A Participatory Learning and Action (PLA) methodology was performed in two time periods (prior crisis: December 2008; during crisis: February-March 2017). In both time periods, three different groups (Group 1: females, Group 2: males, Group 3: mixed) of 5-7 participants and two sessions (≈1 h/session) per group took place in each site. Overall, 204 sessions with 1036 YMR were include in the study. (3) Results: Several socio-demographic characteristics of YMR altered during the crisis (lower income, higher smoking/alcohol consumption, etc.). The majority of YMR conceived distress and burnout as serious syndromes requiring professional support. Feeling very susceptible and the necessity for establishing PAR interventions were frequently reported during the crisis. Numerous (a) barriers and (b) cues to action were mentioned: (a) lack of time, money and support from friends/family/colleagues (b) being extensively informed about the intervention, participation of their collaborators, and raising awareness events. (4) Conclusions: The changing pattern of Greek YMR's beliefs and needs during the crisis stresses the necessity of interventions to tackle distress and burnout. Effectiveness of these interventions could be enhanced by the suggested cues to action that emerged from this study.

Gender-Oriented Mental Health Prevention: A Reappraisal

Many studies have investigated the impact of gender on mental health, but only a few have addressed gender differences in mental health risk and prevention. We conducted a narrative review to assess the current state of knowledge on gender-specific mental health preventive interventions, along with an analysis of gender-based risk factors and available screening strategies. Out of 1598 articles screened using a comprehensive electronic search of the PubMed, Web-of-Science, Scopus, and Cochrane databases, 53 were included for review. Among risk factors for mental health problems, there are individual, familiar, social, and healthcare factors. Individual factors include childhood adversities, which show gender differences in distribution rates. However, current childhood abuse prevention programs are not gender-specific. Familiar factors for mental health problems include maternity issues and intimate partner violence, and for both, some gender-specific preventive interventions are available. Social risk factors for mental health problems are related to education, employment, discrimination, and relationships. They all display gender differences, but these differences are rarely taken into account in mental health prevention programs. Lastly, despite gender differences in mental health service use being widely known, mental health services appear to be slow in developing strategies that guarantee equal access to care for all individuals.

Workplace interventions that aim to improve employee health and well-being in male-dominated industries: a systematic review

The published evidence on whether workplace health and well-being interventions are as effective in male-dominated industries compared with mixed-gender environments has not been synthesised. We performed a systematic review of workplace interventions aimed at improving employee health and well-being in male-dominated industries. We searched Web of Knowledge, PubMed, Medline, Cochrane Database and Web of Science for articles describing workplace interventions in male-dominated industries that address employee health and well-being. The primary outcome was to determine the effectiveness of the intervention and the process evaluation (intervention delivery and adherence). To assess the quality of evidence, Cochrane Collaboration’s Risk of Bias Tool was used. Due to the heterogeneity of reported outcomes, meta-analysis was performed for only some outcomes and a narrative synthesis with albatross plots was presented. After full-text screening, 35 studies met the eligibility criteria. Thirty-two studies delivered the intervention face-to-face, while two were delivered via internet and one using postal mail. Intervention adherence ranged from 50% to 97%, dependent on mode of delivery and industry. 17 studies were considered low risk of bias. Albatross plots indicated some evidence of positive associations, particularly for interventions focusing on musculoskeletal disorders. There was little evidence of intervention effect on body mass index and systolic or diastolic blood pressure. Limited to moderate evidence of beneficial effects was found for workplace health and well-being interventions conducted within male-dominated industries. Such interventions in the workplace can be effective, despite a different culture in male-dominated compared with mixed industries, but are dependent on delivery, industry and outcome. CRD42019161283.

[The effects of writing and reading aloud the positive events that take place in the workplace on work engagement and the occupational stress of care workers in welfare facilities for long-term elderly care: A crossover trial]

OBJECTIVES

A number of earlier studies have pointed out that care workers in nursing homes for the elderly experience high levels of stress. In recent years, work engagement has been attracting attention as a concept that focuses on the positive psychological aspects of workers. In this study, we examined whether writing and reading aloud positive events that take place in the workplace would be useful as a measure to improve work engagement and to reduce occupational stress among care workers in such facilities.

METHODS

Participants included 57 care workers (across 13 groups) working at seven welfare facilities in Wakayama Prefecture, Japan. A crossover trial with two groups the intervention and control groups was used. The intervention group wrote about positive events, and read them aloud for each group at the morning assemblies and other gatherings. The control group continued work as usual. The survey spanned eight weeks. The questionnaire items were sourced from the Japanese version of the Utrecht Work Engagement Scale (UWES), the Brief Job Stress Questionnaire (BJSQ), and included items concerning participants' biographical attributes. The number of positive events that the participants individually wrote about and the frequency of listening to reading about them was asked for at the end of the intervention period. Multiple linear regression analysis was used to examine the relationship between the number of written accounts or the frequency of listening to readings and the amount of change in the scores of the subscales.

RESULTS

The median number of positive events that the participants individually wrote about was three (interquartile range 1-5). The number of those who answered that the frequency of listening to readings was rare was 22 (38.6%). Significant differences in the changes in the scores between the two groups were recognized in terms of "absorption," a subscale of the UWES, and the "work control," "work worth," and "family support," subscales of the BJSQ. Multiple linear regression analyses showed that the number of written accounts was associated with the amount of change in absorption and the amount of change in work worth. The frequency of how often the participants listened to the readings was not related to the amount of change across any of the four subscales.

CONCLUSION

Writing about positive events during work could enhance "absorption" of UWES and improve "work worth" of BJSQ. It is suggested that writing and reading aloud positive events that take place in the workplace is one of the measures to improve "absorption" and "work worth" among care workers in welfare facilities.

Effects of participatory workplace improvement program on stress-related biomarkers and self-reported stress among university hospital nurses: a preliminary study

Although participatory workplace improvement programs are known to provide favorable effects on high stress occupations like nursing, no studies have confirmed its effect using biomarkers. The aim of this study was to determine whether a participatory workplace improvement program would decrease stress-related symptoms as evaluated by biomarkers and self-reported stress among hospital nurses. Three actions to alleviate job stress, which were determined through focus group interviews and voting, were undertaken for two months. A total of 31 female Japanese nurses underwent measurement of inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points; before the program (T1), within a week after the completion of the program (T2), and three months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin (IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15 significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our participatory program exerted beneficial effects in reducing inflammatory responses, but not for ANA and PJS. Further investigations with a better study design, i.e., a randomized controlled trial, and a larger sample size are warranted to determine what exerted beneficial effects on inflammatory markers and why other outcomes remained unchanged.

Organizational and Individual Outcomes of Health Promotion Strategies-A Review of Empirical Research

The main purpose of the paper is to identify the outcomes for employers and employees indicated in research related to workplace health promotion interventions (WHPIs). We investigated what methods are used and what types of organization this type of research is most often carried out in. In addition, the authors attempted to assess to what extent the methods used in the previous research prove the effectiveness of the implemented WHPIs. A systematic review of English-language papers (2000–2020) focused on types of health-promoting interventions in the workplace, and outcomes for employers and employees were conducted using the SCOPUS database (n = 260). As a result, 29 texts qualified for a final qualitative synthesis of the results. The analyses were most frequently conducted in small and medium-sized enterprises (SMEs) based on both quantitative and qualitative methods. In order to draw conclusions, analyses were made by classifying the research presented in the texts according to the type of intervention implemented, classifying the outcomes identified, and indicating the type of evaluation made by the researcher. The analysis showed that most of the outcomes presented refer to changes in the strategy and organizational culture, as well as the behavior of employees. In 18 studies, the indication of outcomes resulted directly from the evaluation outcomes. In other cases, the outcomes were identified by an evaluation of the process or structure of WHPI. The conducted analysis showed significant diversity in terms of the outcomes measured and the research methods used. The quasi-experimental methods, randomly controlled cluster trials, or cross-sectorial studies used in the study to confirm the effectiveness of WHPI were used only in every third study. In these studies, measurements were usually performed twice: at baseline and after intervention. The majority of studies confirmed that WHPIs led to a positive change in the healthy behavior of employees and effected an organizational change, and more rarely led to savings or a reduction in costs resulting from sickness absenteeism, presentism, turnover, etc., and return on investment (ROI). The article shows the need to conduct further research towards the development of guidelines for the evaluation of the effectiveness of implemented programs.

Implementation and effectiveness of the Stress Check Program, a national program to monitor and control workplace psychosocial factors in Japan: a systematic review. Translated secondary publication

Purpose

The purpose of this paper is to conduct a comprehensive review on the implementation and the effect of Japan's Stress Check Program, a national program to monitor and control workplace psychosocial factors that was initiated in December 2015.

Design/methodology/approach

We comprehensively reviewed articles published in Japanese and English, assessed the performance of the Stress Check Program and summarized future challenges. We also discussed the implications for practice.

Findings

The available literature presented a scientific basis for the efficiency and validity of predictions using the Brief Job Stress Questionnaire, which is the instrument recommended to screen workers with high stress in the program. No study has verified the effect of the program on workers' mental health by using group analysis of stress check results. There is room for improvement in tools that contribute to identifying workers with high stress and in measures for improving the work environment. The Stress Check Program contrasts with risk management of psychosocial factors at work, widely adopted in European countries as a strategy for improving workers' mental health by focussing on the psychosocial work environment.

Practical implications

Although the effectiveness of the Japanese program needs further evaluation, future developments of the program would provide insight for national policies on psychosocial risks/psychosocial stress at work.

Originality/value

This paper is the first systematic review on the implementation and effects of Japan's Stress Check Program.

Interventions for common mental disorders in the occupational health service: a systematic review with a narrative synthesis

Introduction

Common mental disorders (CMD) are leading causes of decreased workability in Sweden and worldwide. Effective interventions to prevent or treat such disorders are important for public health.

Objective

To synthesize the research literature regarding occupational health service (OHS) interventions targeting prevention or reduction of CMD among employees. The effect on workability (sickness absence, return-to-work and self-reported workability) and on CMD symptoms was evaluated in a narrative analysis.

Data sources

The literature search was performed in four electronic databases in two searches, in 2014 and in 2017.

Eligibility criteria (using PICO)

Population: studies investigating employees at risk or diagnosed with CMD, as well as preventive workplace intervention targeting mental health. Intervention: studies where the recruitment or the intervention was delivered by the OHS or OHS personnel were included. Control: individuals or groups who did not receive the target intervention. Outcome: all types of outcomes concerning sickness absence and psychological health were included.

Study quality was assessed using a Swedish AMSTAR-based checklist, and results from studies with low or medium risk of bias were narratively synthesized based on effect or absence thereof.

Results

Thirty-three studies were included and assessed for risk of bias. Twenty-one studies had low or medium risk of bias. In 18 studies, rehabilitation interventions were evaluated, 11 studies concerned interventions targeting employees at risk for developing CMD and four studies investigated preventive interventions. Work-focused cognitive behavioral therapy and problem-solving skill interventions decreased time to first return-to-work among employees on sick leave for CMD in comparison with treatment-as-usual. However, effect on return to full-time work was not consistent, and these interventions did not consistently improve CMD symptoms. Selective interventions targeting employees at risk of CMD and preventive interventions for employees were heterogeneous, so replication of these studies is necessary to evaluate effect.

Limitations

Other workplace interventions outside the OHS may have been missed by our search. There was considerable heterogeneity in the included studies, and most studies were investigating measures targeting the individual worker. Interventions at the workplace/organizational level were less common.

Conclusions and implication of key findings

Return-to-work and improvement of CMD symptoms are poorly correlated and should be addressed simultaneously in future interventions. Further, interventions for CMD administered through the occupational health service require further study. Rehabilitative and preventive strategies should be evaluated with scientifically robust methods, to examine the effectiveness of such interventions.

Outcomes for facilitators of workplace environment improvement applying a participatory approach

Objectives

The purpose of this study was to determine changes in awareness, behavior, and relationships among facilitators who were involved in facilitating the conduct of the participatory workplace improvement program and to examine the facilitators' outcomes as a result of their active involvement in the program. The outcome components were also examined in relationship to their associations with various factors.

Methods

An anonymous self‐administered questionnaire survey was conducted for 83 facilitators. Exploratory factor analysis was applied to determine the facilitators' outcomes. The relationship between those elements which influenced the outcomes was taken into account by means of hierarchal multiple regression analysis.

Results

The outcomes for facilitators consisted of four sub‐concepts: “knowing practical ways and strategies to ensure full participation,” “building confidence and self‐development,” “improving safety and health‐risk sensitivity,” and “gaining better‐than‐expected results based on developing relationships with workers.” According to the results of hierarchal multiple regression analysis, facilitators' outcomes were significantly associated with the realization of creativity, sense of solution for safety and health issues, and facilitators' involvement.

Conclusions

It is suggested that the role of a facilitator dynamically changes through a participatory workplace improvement program as a key person in the workplace. Supporting acting facilitators' initiatives in the process of workplace improvement programs, as well as promoting the active involvement of workers and managers were considered useful for effective implementation of workplace improvement programs.

[Readiness factors to improve the work environment using an employee participatory approach: Development and validation of readiness state checklist]

OBJECTIVES

The employee participatory approach is an effective method for improving work environments. However, there are some challenges in executing this method in each workplace because of such factors as a lack of employee interest or motivation to commit to the activity. Research was conducted to clarify readiness factors to improve the workplace environment using an employee participatory approach. Additionally, we developed a checklist to efficiently measure the readiness factors.

METHODS

A pool of readiness items for the employee participatory approach was created from expert consensus and interviews with practitioners. A total of 300 Japanese workers (150 men; 150 women) responded to a survey after being recruited by an internet research company. After exploratory factor analysis (EFA), path analysis with categorical variables was conducted by the robust maximum likelihood method with defined readiness as an endogenous variable and resource for readiness as an external variable, then threshold (θ) and path coefficients (γ) were estimated. We set the level of the item according to the threshold per item, and the highest pass coefficients for each level with 0.60 or more items were adopted in the checklist. Finally, the relationship between each level and the readiness and related items (psychosocial factors, work engagement, and psychological stress responses in the workplace) was confirmed in the ANOVA.

RESULTS

As a result of the EFA, a three-factor structure with 71 items was developed. The path analysis extracted the first factor (workplace acceptability) with three items and the second factor (supervisor's leadership) with two items. The third factor, preferences for the workplace, was judged insufficient because the relevant item was not adequately related to the readiness state. Finally, the checklist was created to determine four levels judged by the five items. Significant differences were observed in each level and readiness state by ANOVA.

CONCLUSIONS

To facilitate the participatory approach method, it was suggested that the status of workplace acceptance, supervisor's leadership, and preferences for the workplace might be important. In addition, using the checklist developed in this study, it is possible to assess the readiness state for improving the work environment using an employee participative approach, as well as to set promotion targets in each workplace.

We cannot be "forever young," but our children are: A multilevel intervention to sustain nursery school teachers' resources and well-being during their long work life cycle

INTRODUCTION

The aging of workers generally implies an increased number of workers with health problems or psychological diseases because of the growing distance between personal resources and job demands; the first may decrease, while the second are stable. In the preschool setting, the demands remain constant because children are always aged 0-3 years, while the preschool teacher's personal resources decrease with age. It is, therefore, necessary to propose multilevel interventions aimed at supporting work sustainability and workers' resources.

METHOD

This study involved twenty-seven preschools (324 teachers with an average age of 48.7 years): the control group included seventeen schools (190 teachers with an average age of 48.5 years), five schools were assigned to experimental group one (69 teachers with an average age of 48.8), and five schools were assigned to experimental group two (65 teachers with an average age of 49.1). In this context, we proposed two protocols of multilevel intervention comprising three solutions; two of these were common to both experimental groups: psychological counseling and psychosocial intervention. The third solution differed between groups: environmental redefinition (for group one); gymnastic and vocal hygiene (for group two). We hypothesized that the interventions improve teachers' work abilities, increase well-being, and decrease stress and burnout. Furthermore we hypothesized that there would be an improvement in the organizational climate of trust and in social job resources.

RESULTS

Data analysis showed that the interventions were effective. In particular, the experimental groups reported significant decreases in psychological exhaustion (EG2: ß = -1.48; p = .00), indolence (EG1: ß = -1.36; p = .00), and stress (EG2: ß = -0.94; p = .00). Furthermore, the experimental groups significantly increased their enthusiasm towards work (EG2: ß = 1.21; p = .01), vertical trust (EG1: ß = 0.54; p = .01), and the perception of coworker social support (EG2: ß = 0.54; p = .01). The protocol that involved the GC2 was particularly effective.

CONCLUSIONS

These results demonstrate the effectiveness of the intervention in a particular job setting (preschool classroom), emphasizing the need for implementing solutions aimed at supporting workers' well-being, especially in light of an aging workforce.

The Introduction of an Active Rest Program by Workplace Units Improved the Workplace Vigor and Presenteeism Among Workers: A Randomized Controlled Trial

OBJECTIVE

The present study was designed to examine the effects of active rest by workplace units on not only workers' individual vigor but also workplace vigor and presenteeism.

METHODS

A total of 130 workers performed our active rest (short-time exercise) program for 10 minutes per day during their lunch breaks, three to four times per week for 8 weeks. Subjects from a workplace unit were randomly allocated to the intervention (n = 66) or control (n = 64) groups. The participants' work engagement and Work Functioning Impairment Scale (WFun) were examined at the baseline and after the 8-week intervention period.

RESULTS

After 8 weeks, the intervention group showed improved "vigor" values in work engagement and WFun (P < 0.05).

CONCLUSION

These results suggest that the introduction of active rest program by workplace units provides a viable means for improving workplace vigor and presenteeism.

The Impact of a Mindfulness Intervention for Nurse Managers

Purpose: To examine the impact of a mindfulness intervention on nurse managers in an acute care hospital. Design: A pre/post intervention design with three data collection points: prior to, at the conclusion of, and at 3 months following the intervention. Method: A survey to measure the impact of a mindfulness workshops on nurse managers’ perception of professional quality of life, burnout, and perceived wellness. Findings: There were significant changes in the scores on the compassion satisfaction (T-1 mean 3.9, T-2 mean 4.5, p = .002) and burnout subscales (T-1 mean 3.4, T-2 mean 2.8, p = .016) of the Professional Quality of Life scale, and on personal burnout (T-1 mean 4.2, T-2 mean 3.8, p = .023) and work-related burnout (T-1 mean 4.0, T-2 mean 3.5, p = .029) on the Copenhagen Burnout Inventory scale, following the mindfulness intervention. The 3-month follow-up scores on compassion satisfaction were higher but not statistically significant ( p = .810). Scores on the burnout scales, while lower than the preintervention levels, were higher at the 3-month follow-up than immediately following the intervention. Conclusions: These findings suggest that mindfulness practices need to be reinforced. Without continuous reinforcement, it may become a self-care practice moved to the bottom of the list of things to be done among the activities of a busy day.

Relationships of Musculoskeletal Symptoms, Sociodemographics, and Body Mass Index With Leisure-Time Physical Activity Among Nurses

Nurses have a high prevalence of musculoskeletal symptoms from patient handling tasks such as lifting, transferring, and repositioning. Comorbidities such as musculoskeletal symptoms may negatively affect engagement in leisure-time physical activity (LTPA). However, limited data are available on the relationship between musculoskeletal symptoms and LTPA among nurses. The purpose of this study was to describe musculoskeletal symptoms and LTPA, and to examine the relationships of musculoskeletal symptoms, sociodemographics, and body mass index with LTPA among nurses. Cross-sectional data on sociodemographics, employment characteristics, musculoskeletal symptoms, body mass index, and LTPA were collected from a statewide random sample of 454 California nurses from January to July 2013. Descriptive statistics, bivariate and multiple logistic regressions were performed. We observed that non-White nurses were less likely to engage in regular aerobic physical activity than White nurses (odds ratio [OR] = 0.61; 95% confidence interval [CI] = [0.40, 0.94]). Currently working nurses were less likely to engage in regular aerobic physical activity than their counterparts (OR = 0.48; 95% CI = [0.25, 0.91]). Nurses with higher body mass index were less likely to perform regular aerobic physical activity (OR = 0.93; 95% CI = [0.89, 0.97]) or muscle-strengthening physical activity (OR = 0.92; 95% CI = [0.88, 0.96]). This study found no evidence that musculoskeletal symptoms may interfere with regular engagement in LTPA. Physical activity promotion interventions should address employment-related barriers, and particularly target racial minority nurses and those who have a high body mass index.

Effect of the National Stress Check Program on mental health among workers in Japan: A 1-year retrospective cohort study

Objectives:

This retrospective cohort study evaluated the impact of the Stress Check Program, a recently introduced national policy and program aimed at reducing psychological distress among Japanese workers.

Methods:

A baseline survey was conducted from November 2015 to February 2016, the period when Japan began enforcing the Stress Check Program. A one-year follow-up survey was conducted in December 2016. In the follow-up survey, two exposure variables were collected: having taken the annual stress survey, and experiencing an improvement in the psychosocial work environment. Psychological distress was assessed using the Brief Job Stress Questionnaire (BJSQ) at baseline and 1-year follow-up. The two exposure variables were used to define four groups: "Neither", "Stress survey (SS) only", "Psychosocial work environment improvement (WI) only", and "Both". BJSQ results were analyzed using repeated measures general linear modeling (GLM).

Results:

The study included 2,492 participants: 1,342 in the "Neither" group, 1,009 in the "SS only" group, 76 in the "WI only" group, and 65 in the "Both" group. Overall time-group interaction effects were not significant. The "Both" group showed significantly greater improvements in psychological distress than the "Neither" group (p = 0.02) at the 1-year follow-up, although the effect size was small (d = -0.14).

Conclusions:

Combination of the annual stress survey and improvement in psychosocial work environment may have been effective in reducing psychological distress in workers, although the effect size was small.

Linking work-family interference, workplace incivility, gender and psychological distress

Purpose

Drawing on COR theory, the purpose of this paper is to contribute to the scarce literature of work-family interference, workplace incivility, gender and psychological distress at the practical and academic juncture.

Design/methodology/approach

The linear (structural equation modeling (SEM)) and non-linear (artificial neural network (ANN)) techniques were applied to the survey data from a sample of Nigerian health workers (n=447) to investigate the relationships between the aforementioned variables.

Findings

The results from SEM and ANN revealed that work-family conflict (WFC), family-work conflict, supervisor incivility and coworker incivility have positive impacts on psychological distress. A multi-group moderation analysis suggests that women were more likely to experience psychological distress.

Originality/value

The work-family interference and incivility are pervasive and gendered problems in the workplace. This paper strives to enhance the understanding of the nature of the relationship in an African work setting. The implications for making the workplace better and safer are discussed.

Medical Surveillance, Continuous Health Promotion and a Participatory Intervention in a Small Company

The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers' wellbeing using a holistic approach during medical surveillance enables us to promptly identify problems in work organisation and the company climate. Problems of this kind can be adequately managed by using a participatory approach. The aim of this paper is twofold: to signal this way of proceeding with medical surveillance, and to describe an organisational development intervention. Participatory groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the Effort/Reward Imbalance questionnaire, and an improvement in psychological wellbeing assessed by means of the Goldberg Anxiety/Depression scale. Although the limited size of the sample and the lack of a control group call for a cautious evaluation of this study, the participatory strategy proved to be a useful tool due to its cost-effectiveness.

The effect of long-term sickness absence on coworkers in the same work unit

After workers take long-term sickness absence due to mental disorders (LTSA-MD), the occupational stress of the coworkers in the same work unit might be affected. The aims of this study were to evaluate the effect of the incident of LTSA-MD on the coworkers' occupational stress. A retrospective cohort study of 16,032 public servants was conducted. The Brief Job Stress Questionnaire (BJSQ) was used, which was administered in 2011 and 2012. To analyze the amount of change in occupational stress, the difference between the scores of the BJSQ scales in 2011 and 2012 was calculated. After adjusting for the baseline BJSQ scales, sex, age, total number of workers, and social support, analysis of covariance of the difference between the BJSQ scales' scores showed that job stressors and stress responses worsened among the coworkers after the incident of LTSA-MD. Social support did not change among the coworkers. This study indicates that an incident of LTSA-MD in the same work unit adversely affects the coworkers' occupational stress. Focusing on the coworkers' mental state after an incident of LTSA-MD in the same work unit and an early intervention strategy are needed to prevent secondary mental illness and sickness absence in the coworkers.

Men's Mental Health Promotion Interventions: A Scoping Review

There is an increasing need for mental health promotion strategies that effectively engage men. Although researchers have examined the effectiveness of diverse mental wellness interventions in male-dominated industries, and reviewed suicide prevention, early intervention, and health promotion interventions for boys and men, few have focused on sex-specific program effects. The purpose of this review was to (a) extend the previous reviews to examine the effectiveness of mental health promotion programs in males, and (b) evaluate the integration of gender-specific influences in the content and delivery of men's mental health promotion programs. A search of MEDLINE, CINAHL, PsycINFO, and EMBASE databases for articles published between January 2006 and December 2016 was conducted. Findings from the 25 included studies indicated that a variety of strategies offered within (9 studies) and outside (16 studies) the workplace show promise for promoting men's mental health. Although stress was a common area of focus (14 studies), the majority of studies targeted multiple outcomes, including some indicators of positive well-being such as self-efficacy, resilience, self-esteem, work performance, and happiness/quality of life. The majority of programs were offered to both men and women, and six studies explicitly integrated gender-related influences in male-specific programs in ways that recognized men's interests and preferences.

Job design, employment practices and well-being: a systematic review of intervention studies

There is inconsistent evidence that deliberate attempts to improve job design realise improvements in well-being. We investigated the role of other employment practices, either as instruments for job redesign or as instruments that augment job redesign. Our primary outcome was well-being. Where studies also assessed performance, we considered performance as an outcome. We reviewed 33 intervention studies. We found that well-being and performance may be improved by: training workers to improve their own jobs; training coupled with job redesign; and system wide approaches that simultaneously enhance job design and a range of other employment practices. We found insufficient evidence to make any firm conclusions concerning the effects of training managers in job redesign and that participatory approaches to improving job design have mixed effects. Successful implementation of interventions was associated with worker involvement and engagement with interventions, managerial commitment to interventions and integration of interventions with other organisational systems. Practitioner Summary: Improvements in well-being and performance may be associated with system-wide approaches that simultaneously enhance job design, introduce a range of other employment practices and focus on worker welfare. Training may have a role in initiating job redesign or augmenting the effects of job design on well-being.

Effectiveness of participatory training for the promotion of work-related health and safety among Korean farmers

This study was conducted to explore the effectiveness of participatory training for promoting farmer's health and reducing agricultural work-related injuries. Candidates for this study included 595 farmers in 8 rural villages of South Korea. The one-day course participatory training was administered to 217 (36.5%) farmers and included an action-checklist, a good example presentation, and group discussion. The follow-up visit to participants' houses and farms was performed after 1 to 3 months. A direct interview survey was administered pre- and post-trainings. The total number of proposed action plans for the improvement of working condition was 620. It was observed that 61.5% of action plans (72.2% of short term and 41.3% of long term plans) were completely implemented. In regards to health and safety indices, the proportion of current smokers was reduced from 29.8% to 25.3% in the group that underwent training. The pesticide intoxication was reduced from 16.1% to 4.8% in participants that underwent training. However, the agricultural injury rate was unchanged in both groups. This study reports significant beneficial effects of participatory training in the agriculture sector in Korea.

Job stress and behavioral characteristics in relation to coronary heart disease risk among Japanese police officers

This study examined the association between job-related behavioral characteristics and the risk of coronary heart diseases (CHD) in Japanese male police officers. Compared to office clerks, police officers exhibited greater age-related increases of the prevalence of CHD risk factors, and a clustering number of CHD risk factors was significantly higher in the group of those over 45 yr of age. Among the police officers, coronary-prone behavior was more frequent than that seen in office clerks. The police officers with coronary-prone behavior tended to engage in shift work and to work overtime more; yet they were less likely to perceive job stress and to express the relevant physical and psychological symptoms than those without coronary-prone behavior. The subjects with such behavioral characteristics had a significantly greater number of CHD risk factors. In a multiple regression analysis, coronary-prone behavior together with age, social support, walking hours per day, and amount of alcohol consumption were selected as significant determinants of a cluster of CHD risk factors. These results suggest that coronary-prone behavior may contribute to the higher prevalence of CHD risk factors in police officers via leading the long working hours and the work-related unfavorable lifestyles, such as alcohol drinking and physical inactivity.

A randomized controlled trial of the effect of participatory ergonomic low back pain training on workplace improvement

Objectives:

This study aimed to determine the effects of participatory workplace improvement (PWI) -based provision of ergonomic training and ergonomic action checklists (ACLs) to on-site managers on workplace improvement activities for low back pain (LBP).

Methods:

A randomized controlled trial (RCT) was conducted at a manufacturing company in Japan. Teams entered in the study were randomly assigned to a control and an intervention group. A total of three interventional training sessions on methods of ergonomics were provided to on-site managers in the intervention group, with 1-month intervals between sessions. Ergonomic ACLs were provided at the same time. After completion of the training sessions, each team then provided a report of improvements each month for the next 10 months. Two people in charge of safety and health chose two major objectives of the implemented activities from the five categories. The reported number of improvements was analyzed using a Poisson regression model.

Results:

In the intervention group, although the incident rate ratio (IRR) of PWIs in countermeasures for the LBP category was significantly elevated after the training sessions, the IRR of improvements decreased over time during the 10-month follow-up period. No significant difference was observed in the IRR of total PWIs in either the control or intervention group.

Conclusions:

PWI-based provision of ergonomic training sessions and ergonomics ACLs to on-site managers was shown to be effective for workplace improvement activities targeted at LBP. However, because the effects decrease over time, efforts should be made to maintain the effects through regular interventions.

Improvement of the Work Environment and Work-Related Stress: A Cross-Sectional Multilevel Study of a Nationally Representative Sample of Japanese Workers

OBJECTIVE

This cross-sectional multilevel study aimed to investigate the relationship between improvement of the work environment and work-related stress in a nationally representative sample in Japan.

METHODS

The study was based on a national survey that randomly sampled 1745 worksites and 17,500 nested employees. The survey asked the worksites whether improvements of the work environment were conducted; and it asked the employees to report the number of work-related stresses they experienced. Multilevel multinominal logistic and linear regression analyses were conducted.

RESULTS

Improvement of the work environment was not significantly associated with any level of work-related stress. Among men, it was significantly and negatively associated with the severe level of work-related stress. The association was not significant among women.

CONCLUSIONS

Improvements to work environments may be associated with reduced work-related stress among men nationwide in Japan.

The practice of active rest by workplace units improves personal relationships, mental health, and physical activity among workers

Aim:

This study was designed to clarify the effects of active rest, with a focus on the practice of short-time group exercise by workplace units, on personal relationships, mental health, physical activity, and work ability among workers.

Methods:

Fifty-nine white-collar workers (40 males and 19 females) performed our active rest (short-time exercise) program, which consists of warm-up, cognitive functional training, aerobic exercise, resistance training and cool-down for 10 minutes per day, 3 times per week during their lunch breaks for 10 weeks. Participants from a workplace unit were randomly allocated to the intervention (five workplaces, n=29) or control groups (six workplaces, n=30). The participants' anthropometric measurements, and their Profile of Mood States (POMS) 2, Brief Job Stress Questionnaire (BJSQ), physical activity levels and Work Ability Index were examined at the baseline and after the 10-week intervention.

Results:

After 10 weeks, physical activity levels, especially the time spent in moderate and vigorous intensity, increased in the intervention group (p<0.05). The items of "vigor-activity" and "friendliness" improved in POMS 2, while "vigor," "interpersonal stress," "support from superiors, colleagues, and family/friends," and "job satisfaction" improved in BJSQ in the intervention group (p<0.05). In the intervention group, the number of exercise participation was positively correlated with the change in "vigor-activity" in POMS 2 (r=0.467, p=0.011).

Conclusions:

These results suggest that the practice of active rest by workplace units is important for improving personal relationships, mental health, and physical activity among workers.

Feasibility of a Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel

BACKGROUND

Surgical intensive care unit personnel are exposed to catastrophic situations as they care for seriously injured or ill patients. Few interventions have been developed to reduce the negative effects of work stress in this environment.

OBJECTIVE

This pilot study evaluated the feasibility of a workplace intervention for increasing resilience to stress. The intervention was implemented within the unique constraints characteristic of surgical intensive care units.

METHODS

Participants were randomly assigned to an intervention or control group. The mindfulness-based intervention included meditation, mild yoga movement, and music and was conducted in a group format 1 hour a week for 8 weeks in a surgical intensive care unit during work hours. Assessments were performed 1 week before and 1 week after the intervention.

RESULTS

The intervention was well received, with a 97% overall retention rate and 100% retention in the intervention group. Work satisfaction, measured with the Utrecht Work Engagement Scale, increased significantly in the intervention group with no change in the control group. Negative correlations were found between the vigor subscale scores of the Utrecht Work Engagement Scale and scores for emotional exhaustion on the Maslach Burnout Inventory and scores for burnout on the Professional Quality of Life scale. Participants rated recognizing their stress response as a main benefit of the intervention.

CONCLUSION

Workplace group interventions aimed at decreasing the negative effects of stress can be applied within hospital intensive care units. Despite many constraints, attendance at weekly sessions was high. Institutional support was critical for implementation of this program.

Associations between psychological distress and the most concerning present personal problems among working-age men in Japan

Background

Personal problems are known to influence mental health among workers. The current study investigated the most concerning present personal problems which have the greatest impact on psychological distress among working-age Japanese men, rather than issues relating to work tasks or duties.

Methods

We obtained data from the 2010 Comprehensive Survey of Living Conditions conducted by the Ministry of Health, Labour and Welfare. The original survey interviewed 289,363 households in 5,150 randomly selected municipalities of Japan, from which 228,664 households agreed to participate. We analyzed the data pertaining to men who were 20 to 59 years of age and the head of a family. The questionnaire included occupation, employment status, the most concerning present personal problems, and a measure of psychological distress (the Kessler 6 scale). Multiple logistic regression analysis was conducted to delineate the association between present personal problems and psychological distress.

Results

A total of 76,950 males were included in the analysis, 27.7% of whom reported some type of psychological distress. Statistical analysis revealed that psychological distress was associated with bullying and harassment (Odds Ratio (OR): 2.05, 95% Confidence Interval (95% CI): 1.50-2.56), divorce (OR: 1.90, 95% CI: 1.53-2.26), concerns about one’s purpose in life (OR: 1.73, 95% CI: 1.59-1.88), personal relationships with family members (OR: 1.49, 95% CI: 1.37-1.60), personal relationships with others (OR: 1.38, 95% CI: 1.29-1.48), own diseases (OR: 1.24, 95% CI: 1.15-1.33), and financial difficulties (OR: 1.16, 95% CI: 1.12-1.20); when compared with problems related to work tasks or duties.

Conclusions

Several personal factors appear to have a greater impact on the mental health of Japanese men of working age, when compared to the influence of work tasks or duties. Asking workers directly about the problems that most concern them in life might help better identify those in need psychological support. Multidisciplinary interventions to address their life concerns will likely be necessary for solving these problems and reducing psychological distress.

Workplace interventions to reduce HIV and TB stigma among health care workers - Where do we go from here?

Fear of stigma and discrimination among health care workers (HCWs) in South African hospitals is thought to be a major factor in the high rates of HIV and tuberculosis infection experienced in the health care workforce. The aim of the current study is to inform the development of a stigma reduction intervention in the context of a large multicomponent trial. We analysed relevant results of four feasibility studies conducted in the lead up to the trial. Our findings suggest that a stigma reduction campaign must address community and structural level drivers of stigma, in addition to individual level concerns, through a participatory and iterative approach. Importantly, stigma reduction must not only be embedded in the institutional management of HCWs but also be attentive to the localised needs of HCWs themselves.

Utility of action checklists as a consensus building tool

The present study's objective was to determine the mechanisms for enhancing the utility of action checklists applied in participatory approach programs for workplace improvements, to identify the benefits of building consensus and to compare their applicability in Asian countries to find the most appropriate configuration for action checklists. Data were collected from eight trainees and 43 trainers with experience in Participatory Action-Oriented Training. Statistical analysis was performed in SPSS using the package PASW, version 19.0. The difference in the mean score for the degree of the utility of action checklists between countries was analyzed using ANOVA methods. Factor analysis was performed to validate the action checklists' utility. Pearson Correlation Coefficients were then calculated to determine the direction and strength of the relationship between these factors. Using responses obtained from trainees' in-depth interviews, we identified 33 key statements that were then classified into 11 thematic clusters. Five factors were extracted, namely "ease of application", "practical solutions", "group interaction", "multifaceted perspective" and "active involvement". The action checklist was useful for facilitating a participatory process among trainees and trainers for improving working conditions. Action checklists showed similar patterns of utility in various Asian countries; particularly when adjusted to local conditions.

Effectiveness of a comprehensive stress management program to reduce work-related stress in a medium-sized enterprise

Objectives

To assess the effectiveness of a comprehensive workplace stress management program consisting of participatory action-oriented training (PAOT) and individual management.

Methods

A comprehensive workplace stress management program was conducted in a medium-sized enterprise. The baseline survey was conducted in September 2011, using the Korean Occupational Stress Scale (KOSS) and Worker’s Stress Response Inventory (WSRI). After implementing both organizational and individual level interventions, the follow up evaluation was conducted in November 2011.

Results

Most of the workers participated in the organizational level PAOT and made Team-based improvement plans. Based on the stress survey, 24 workers were interviewed by a researcher. After the organizational and individual level interventions, there was a reduction of several adverse psychosocial factors and stress responses. In the case of blue-collar workers, psychosocial factors such as the physical environment, job demands, organizational system, lack of rewards, and occupational climate were significantly improved; in the case of white-collar workers, the occupational climate was improved.

Conclusions

In light of these results, we concluded that the comprehensive stress management program was effective in reducing work-related stress in a short-term period. A persistent long-term follow up is necessary to determine whether the observed effects are maintained over time. Both team-based improvement activities and individual interviews have to be sustainable and complementary to each other under the long-term plan.

Development of a short questionnaire to measure an extended set of job demands, job resources, and positive health outcomes: the new brief job stress questionnaire

This study aimed to investigate the reliability and construct validity of a new version of the Brief Job Stress Questionnaire (New BJSQ), which measures an extended set of psychosocial factors at work by adding new scales/items to the current version of the BJSQ. Additional scales/items were extensively collected from theoretical job stress models and similar questionnaires in several countries. Scales/items were field-tested and refined through a pilot internet survey. Finally, an 84-item questionnaire (141 items in total when combined with the current BJSQ) was developed. A nationally representative survey was administered to employees in Japan (n=1,633) to examine the reliability and construct validity. Most scales showed acceptable levels of internal consistency and test-retest reliability. Principal component analyses showed that the first factor explained 50% or greater proportion of the variance in most scales. A scale factor analysis and a correlation analysis showed that these scales fit the theoretical expectations. These findings provided a piece of evidence that the New BJSQ scales are reliable and valid. Although more detailed content and construct validity should be examined in future study, the New BJSQ is a useful instrument to evaluate psychosocial work environment and positive mental health outcomes in the current workplace.

The effects of improving hospital physicians working conditions on patient care: a prospective, controlled intervention study

BACKGROUND

Physicians, particularly in hospitals, suffer from adverse working conditions. There is a close link between physicians' psychosocial work environment and the quality of the work they deliver. Our study aimed to explore whether a participatory work-design intervention involving hospital physicians is effective in improving working conditions and quality of patient care.

METHODS

A prospective, controlled intervention study was conducted in two surgical and two internal departments. Participants were 57 hospital physicians and 1581 inpatients. The intervention was a structured, participatory intervention based on continuous group meetings. Physicians actively analyzed problematic working conditions, developed solutions, and initiated their implementation. Physicians' working conditions and patients' perceived quality of care were outcome criteria. These variables were assessed by standardized questionnaires. Additional data on implementation status were gathered through interviews.

RESULTS

Over the course of ten months, several work-related problems were identified, categorized, and ten solutions were implemented. Post-intervention, physicians in the intervention departments reported substantially less conflicting demands and enhanced quality of cooperation with patients' relatives, compared to control group physicians. Moreover, positive changes in enhanced colleague support could be attributed to the intervention. Regarding patient reports of care quality of care, patient ratings of physicians organization of care improved for physicians in the intervention group. Five interviews with involved physicians confirm the plausibility of obtained results, provide information on implementation status and sustainability of the solutions, and highlight process-related factors for re-design interventions to improve hospital physicians work.

CONCLUSIONS

This study demonstrates that participatory work design for hospital physicians is a promising intervention for improving working conditions and promoting patient quality of care.

A prospective study of psychosocial work characteristics and long sick leave of Japanese male employees in multiple workplaces

The aim of this study was to identify psychosocial work characteristics associated with long sick leave in a large population of male Japanese employees in multiple workplaces. We examined various psychosocial work characteristics (job overload, job control, supervisor support, coworker support, support by family and friends, role ambiguity, role conflict, intragroup conflict and intergroup conflict) of employees in six factories at the base line. We then conducted a follow-up survey on the recorded long sick leaves of ≥ 30 continuous days taken by the employees due to any medical condition. We found 574 cases of long sick leave out of 15,531 subjects during an average 5.07-yr follow-up. The results showed that high supervisor support was significantly associated with a decrease in the hazard ratio (HR) of long sick leave after adjustment for several confounding factors (95%CI; 0.69-0.97). High role ambiguity also tended to increase HR, but without reaching significance (95%CI; 0.99-1.41). The results suggest that supervisor support in the workplace may be important to reduce long sick leave in Japanese male employees.

Effect on mental health of a participatory intervention to improve psychosocial work environment: a cluster randomized controlled trial among nurses

OBJECTIVES

Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment.

METHODS

A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire.

RESULTS

No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10).

CONCLUSIONS

It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.

[Concept analysis of a participatory approach to occupational safety and health]

PURPOSE

The purpose of this study was to analyze a participatory approach to occupational safety and health, and to examine the possibility of applying the concept to the practice and research of occupational safety and health.

METHODS

According to Rodger's method, descriptive data concerning antecedents, attributes and consequences were qualitatively analyzed. A total of 39 articles were selected for analysis.

RESULTS

Attributes with a participatory approach were: "active involvement of both workers and employers", "focusing on action-oriented low-cost and multiple area improvements based on good practices", "the process of emphasis on consensus building", and "utilization of a local network". Antecedents of the participatory approach were classified as: "existing risks at the workplace", "difficulty of occupational safety and health activities", "characteristics of the workplace and workers", and "needs for the workplace". The derived consequences were: "promoting occupational safety and health activities", "emphasis of self-management", "creation of safety and healthy workplace", and "contributing to promotion of quality of life and productivity".

CONCLUSIONS

A participatory approach in occupational safety and health is defined as, the process of emphasis on consensus building to promote occupational safety and health activities with emphasis on self-management, which focuses on action-oriented low-cost and multiple area improvements based on good practices with active involvement of both workers and employers through utilization of local networks. We recommend that the role of the occupational health professional be clarified and an evaluation framework be established for the participatory approach to promote occupational safety and health activities by involving both workers and employers.

Relationship between the onset of depression and stress response measured by the Brief Job Stress Questionnaire among Japanese employees: a cohort study

Background

The proportion of Japanese workers experiencing intense worry or stress during working life is in excess of 60%, and the incidence of psychiatric disorders and suicide due to psychological burden from work duties is increasing. To confirm whether the stress response measured by the Brief Job Stress Questionnaire (BJSQ) can identify risk for depression, a cohort study was conducted to evaluate whether the stress response measured by BJSQ was associated with the onset of depression.

Methods

A total of 1,810 participants aged 20–70 years in 2005 completed the stress response of the BJSQ and were followed-up until August, 2007 by examining sick pay records. Depression was defined by a description in sick pay records that included “depression” or “depressive symptoms” as a reason for sick leave according to a physician's medical certificate. The participants were divided into quartiles (Ql, Q2, Q3, and Q4) according to the total stress response score of BJSQ at baseline. Furthermore, the participants were divided into a higher score category (Q4) and a lower score category (Q1–Q3). Risk ratios of the stress response of the BJSQ for onset of depression were calculated using a multivariable Cox proportional hazard model.

Results

Among 1,810 participants, 14 developed depression during a mean of 1.8 years of follow-up. The risk ratio was 2.96 (95% confidence interval [CI], 1.04–8.42, p for trend = 0.002) when the higher stress response score category of BJSQ was compared with the low stress response score category for sick leave due to depression. After adjusting for gender, age, marital status, and having children, the risk ratios were similar to no adjustment.

Conclusions

These findings suggest that the stress response measured by the BJSQ can demonstrate risk for the onset of depression.

The effects of workplace occupational mental health and related activities on psychological distress among workers: a multilevel cross-sectional analysis

OBJECTIVE

To investigate the association of workplace occupational mental health (OMH) and related activities with psychological distress of workers in Japan.

METHODS

A total of 121 workplaces and their 3540 workers were surveyed using questionnaires assessing selected workplace OMH activities, demographic characteristics, psychological distress, and psychosocial work environment of the workers. A multilevel analysis was conducted.

RESULTS

Promotion of communication correlated significantly and negatively with psychological distress among workers after adjusting for the covariates (P < 0.01). Occupational mental health activities correlated marginally significantly and negatively with psychological distress (P = 0.06). Their moderating effect for the worker-level association between psychosocial work environment and psychological distress was not significant.

CONCLUSIONS

The findings suggest that promotion of communication in the workplace is associated with reduced psychological distress among workers. In addition, OMH activities may also be useful in reducing psychological distress.

A cross-sectional study of workplace social capital and blood pressure: a multilevel analysis at Japanese manufacturing companies

OBJECTIVES

We examined the contextual effect of workplace social capital on systolic blood pressure (SBP).

DESIGN

Cross-sectional.

SETTING

A conglomerate from 58 workplaces in Japan.

PARTICIPANTS

Of the 5844 workers at a Japanese conglomerate from 58 workplaces, 5368 were recruited. Individuals who received drugs for hypertension (n=531) and who lacked information on any variable (n=167) were excluded from the analyses, leaving 4735 individuals (3281 men and 1454 women) for inclusion.

PRIMARY AND SECONDARY OUTCOME MEASURES

Systolic blood pressure.

RESULTS

The contextual effect of workplace social capital on SBP was examined using a multilevel regression analysis with a random intercept. Coworker support had a contextual effect at the workplace level (coefficient=-1.97, p=0.043), while a lack of trust for coworkers (coefficient=0.27, p=0.039) and lack of helpfulness from coworkers were associated with SBP (coefficient=0.28, p=0.002).

CONCLUSIONS

The present study suggested that social capital at the workplace level has beneficial effects on SBP.

Interventions to facilitate return to work in adults with adjustment disorders

BACKGROUND

Adjustment disorders are a frequent cause of sick leave and various interventions have been developed to expedite the return to work (RTW) of individuals on sick leave due to adjustment disorders.

OBJECTIVES

To assess the effects of interventions facilitating RTW for workers with acute or chronic adjustment disorders.

SEARCH METHODS

We searched the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) to October 2011; the Cochrane Central Register of Controlled Trials (CENTRAL) to Issue 4, 2011; MEDLINE, EMBASE, PsycINFO and ISI Web of Science, all years to February 2011; the WHO trials portal (ICTRP) and ClinicalTrials.gov in March 2011. We also screened reference lists of included studies and relevant reviews.

SELECTION CRITERIA

We selected randomised controlled trials (RCTs) evaluating the effectiveness of interventions to facilitate RTW of workers with adjustment disorders compared to no or other treatment. Eligible interventions were pharmacological interventions, psychological interventions (such as cognitive behavioural therapy (CBT) and problem solving therapy), relaxation techniques, exercise programmes, employee assistance programmes or combinations of these interventions. The primary outcomes were time to partial and time to full RTW, and secondary outcomes were severity of symptoms of adjustment disorder, work functioning, generic functional status (i.e. the overall functional capabilities of an individual, such as physical functioning, social function, general mental health) and quality of life.

DATA COLLECTION AND ANALYSIS

Two authors independently selected studies, assessed risk of bias and extracted data. We pooled studies that we deemed sufficiently clinically homogeneous in different comparison groups, and assessed the overall quality of the evidence using the GRADE approach.

MAIN RESULTS

We included nine studies reporting on 10 psychological interventions and one combined intervention. The studies included 1546 participants. No RCTs were found of pharmacological interventions, exercise programmes or employee assistance programmes. We assessed seven studies as having low risk of bias and the studies that were pooled together were comparable. For those who received no treatment, compared with CBT, the assumed time to partial and full RTW was 88 and 252 days respectively. Based on two studies with a total of 159 participants, moderate-quality evidence showed that CBT had similar results for time (measured in days) until partial RTW compared to no treatment at one-year follow-up (mean difference (MD) -8.78, 95% confidence interval (CI) -23.26 to 5.71). We found low-quality evidence of similar results for CBT and no treatment on the reduction of days until full RTW at one-year follow-up (MD -35.73, 95% CI -113.15 to 41.69) (one study with 105 participants included in the analysis). Based on moderate-quality evidence, problem solving therapy (PST) significantly reduced time until partial RTW at one-year follow-up compared to non-guideline based care (MD -17.00, 95% CI -26.48 to -7.52) (one study with 192 participants clustered among 33 treatment providers included in the analysis), but we found moderate-quality evidence of no significant effect on reducing days until full RTW at one-year follow-up (MD -17.73, 95% CI -37.35 to 1.90) (two studies with 342 participants included in the analysis).

AUTHORS' CONCLUSIONS

We found moderate-quality evidence that CBT did not significantly reduce time until partial RTW and low-quality evidence that it did not significantly reduce time to full RTW compared with no treatment. Moderate-quality evidence showed that PST significantly enhanced partial RTW at one-year follow-up compared to non-guideline based care but did not significantly enhance time to full RTW at one-year follow-up. An important limitation was the small number of studies included in the meta-analyses and the small number of participants, which lowered the power of the analyses.

Relationship of social factors including trust, control over life decisions, problems with transport and safety, to psychological distress in the community

PURPOSE

Psychological distress encompasses anxiety and depression with the previous studies showing that psychological distress is unequally distributed across population groups. This paper explores the mechanisms and processes which may affect the distribution of psychological distress, including a range of individual and community level socioeconomic determinants.

METHODS

Representative cross-sectional data was collected for respondents aged 16+ from July 2008 to June 2009, as a part of the South Australian Monitoring and Surveillance System (SAMSS) using Computer Assisted Telephone Interviews (CATI). Univariate and multivariate analyses (n = 5,763) were conducted to investigate the variables that were associated with psychological distress.

RESULTS

The overall prevalence of psychological distress was 8.9%. In the multivariate model, females, those aged 16-49, respondents single with children, unable to work or unemployed, with a poorer family financial situation, earning $20,000 or less, feeling safe in their home some or none of the time, feeling as though they have less then total control over life decisions and sometimes experiencing problems with transport, were significantly more likely to experience psychological distress.

CONCLUSIONS

This paper has demonstrated the relationship between low-income, financial pressure, less than optimal safety and control, and high-psychological distress. It is important that the groups highlighted as vulnerable be targeted in policy, planning, and health promotion and prevention campaigns.