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Herold R, Lieb M, Borho A, Voss A, Unverzagt S, Morawa E, Erim Y. Relationship between working conditions and mental health of migrants and refugees/asylum seekers vs. natives in Europe: a systematic review. Int Arch Occup Environ Health 2023; 96:931-963. [PMID: 37439904 PMCID: PMC10361874 DOI: 10.1007/s00420-023-01981-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/15/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Migrants and refugees/asylum seekers make up a significant proportion of the European workforce. They often suffer from poor working conditions, which might impact mental health. The main objective of this systematic review was to summarize and analyze existing research on working conditions of migrants and refugees/asylum seekers in European host countries and compare them to those of natives. Furthermore, the relationship between working conditions and mental health of migrants/refugees/asylum seekers and natives will be compared. METHODS Three electronic databases (PubMed/MEDLINE, PsycInfo and CINAHL) were systematically searched for eligible articles using quantitative study designs written in English, German, French, Italian, Polish, Spanish or Turkish and published from January 1, 2016 to October 27, 2022. Primary health outcomes were diagnosed psychiatric and psychological disorders, suicide (attempts), psychiatric and psychological symptoms, and perceived distress. Secondary health outcomes were more general concepts of mental health such as well-being, life satisfaction and quality of life. Screening, data extraction and the methodological quality assessment of primary studies by using the Newcastle-Ottawa Scale were done independently by two reviewers. The results of the primary studies were summarized descriptively. Migrants and refugees/asylum seekers were compared with natives in terms of the association between working conditions and mental health. RESULTS Migrants and refugees often face disadvantages at work concerning organizational (low-skilled work, overqualification, fixed-term contracts, shift work, lower reward levels) and social conditions (discrimination experiences) in contrast to natives. Most unfavorable working conditions are associated with worse mental health for migrants as well as for natives. CONCLUSIONS Even if the results are to be taken with caution, it is necessary to control and improve the working conditions of migrants and refugees/asylum seekers and adapt them to those of the native population to maintain their mental health and thus their labor force.
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Affiliation(s)
- Regina Herold
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Andrea Borho
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Amanda Voss
- Institute and Outpatient Clinic of Occupational, Social, and Environmental Medicine, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Susanne Unverzagt
- Center of Health Sciences, Institute of General Practice and Family Medicine, Martin-Luther University of Halle-Wittenberg, Halle, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
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Felicia F, Sudibjo N, Harsanti HGR. Impact of psychosocial risk on intention to leave work during COVID-19 in Indonesia: The mediatory roles of burnout syndrome and job satisfaction. Heliyon 2023; 9:e17937. [PMID: 37456031 PMCID: PMC10344763 DOI: 10.1016/j.heliyon.2023.e17937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
The COVID-19 pandemic intensified the complexity of work in the health sector, leading to an increase in the intention to leave work (ITL) in Indonesia. Previous research has revealed a theoretical gap in investigating the roles of burnout syndrome (BS) and job satisfaction (JS) as mediators of the effect of psychosocial risk (PR) on ITL. This research study aimed to fill this gap by examining the effect of PR on ITL during the COVID-19 pandemic, with BS and JS as mediators. Data was collected from 306 health workers in public and private hospitals of Central Jakarta, Indonesia. This data was analyzed as part of a cross-sectional research study involving the partial least square-structural equation modeling (PLS-SEM) method and using SmartPLS software. The questionnaire was based on the Copenhagen Psychosocial Questionnaire (COPSOQ) III short version, the Burnout Assessment Tools (BAT), and a modified Turnover Intention. The findings revealed that, within the direct effect pathways, JS was the highest predictor of health workers' ITL, and workplace PR significantly impacted employees' JS and BS. Another notable finding was related to the research gap vis-a-vis the indirect effect pathways: it showed that JS and BS had partial mediatory power over the relationship between PR and ITL. BS and JS were found to have a high and significant impact on employees' ITL. Therefore, this research study has contributed to the model's novelty in measuring ITL mediated by JS and BS.
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Affiliation(s)
- Felicia Felicia
- Faculty of Economics and Business, Universitas Pelita Harapan, Indonesia
| | - Niko Sudibjo
- Faculty of Education, Universitas Pelita Harapan, Indonesia
| | - HG Retno Harsanti
- Faculty of Education and Language, Universitas Katolik Indonesia Atma Jaya, Indonesia
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Watanabe K, Imamura K, Eguchi H, Hidaka Y, Komase Y, Sakuraya A, Inoue A, Kobayashi Y, Sasaki N, Tsuno K, Ando E, Arima H, Asaoka H, Hino A, Iida M, Iwanaga M, Inoue R, Otsuka Y, Shimazu A, Kawakami N, Tsutsumi A. Usage of the Brief Job Stress Questionnaire: A Systematic Review of a Comprehensive Job Stress Questionnaire in Japan from 2003 to 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1814. [PMID: 36767182 PMCID: PMC9914747 DOI: 10.3390/ijerph20031814] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
The Brief Job Stress Questionnaire (BJSQ) is used widely in occupational health studies and practice. Summarizing scientific production based on measurement is crucial. This study aimed to systematically review observational studies that used the BJSQ and the New BJSQ to show their usability. A systematic search was conducted for studies investigating relationships between the BJSQ or the New BJSQ subscales and other validated measurements on 13 September 2021, in various literature databases. The BJSQ subscales, scoring methods, and other validated measurements in the studies were qualitatively summarized. In total, 145 published reports between 2003 and 2021 were included. Among the BJSQ subscales, job stressors (n = 95) such as quantitative job overload (n = 65) and job control (n = 64) were most often used. The subscales were utilized to investigate the relationships with several other measurements. Five reports used subscales from the New BJSQ. In the last two decades, the BJSQ and the New BJSQ help measure psychosocial factors (PF) at work and contribute to the publication of scientific papers in the occupational health field. This study would encourage the utilization of the questionnaires for future research and practice.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara 252-0374, Japan
| | - Kotaro Imamura
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hisashi Eguchi
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Yui Hidaka
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yu Komase
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Asuka Sakuraya
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akiomi Inoue
- Institutional Research Center, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Yuka Kobayashi
- Faculty of Social Policy & Administration, Hosei University, 4342 Aiharamachi, Machida, Tokyo 194-0298, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, 3-25-10 Tonomachi, Kawasaki-ku, Kawasaki 210-0821, Japan
| | - Emiko Ando
- Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Hideaki Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Hiroki Asaoka
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Mako Iida
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Mai Iwanaga
- Department of Community Mental Health & Law, National Center of Neurology and Psychiatry, National Institute of Mental Health, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-0031, Japan
| | - Reiko Inoue
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara 252-0374, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, 5322 Endo, Fujisawa 252-0882, Japan
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara 252-0374, Japan
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Ramana AB, Singh S, Rupani MP, Mukherjee R, Mohapatra A. Plight of migrant construction-site workers during the COVID-19 lockdown in 2020: A qualitative exploration in Bhavnagar, Western India. Work 2023; 76:33-45. [PMID: 36872825 DOI: 10.3233/wor-220127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND During the unexpected lockdown implemented in early 2020 in reaction to the coronavirus 2019 (COVID-19) pandemic, a considerable section of India's population of migrant construction-site workers were stuck. OBJECTIVE Our objective was to explore the lived experiences and consequent perceptions of migrant workers related to the COVID-19 lockdown and the consequences on their lives. METHODS We conducted structured in-depth interviews (IDIs) with twelve migrant construction-site workers in Bhavnagar, Western India, from November to December 2020, using qualitative research methods. All IDIs were conducted with participant's consent, audio-recorded, transcribed in English, inductively coded, and thematically analyzed. RESULTS The primary financial challenges mentioned by the migrant workers in the interviews were unemployment, monetary issues, and a difficult sustenance. The social concerns were described as anxious migrant exodus, discrimination, mistreatment, lack of social assistance, inability to fulfil their family's expectations, lack of safe transportation arrangements by the authorities during the exodus, inadequacies in the public distribution system, law and order, and apathy of their employers. The psychological repercussions were described using terms like "fear," "worry," "loneliness," "boredom," "helplessness," and "trapped." Monetary compensation, job opportunities at the native place, and a well-managed migrant exodus were reportedly their key expectations from the government. Healthcare issues mentioned during the lockdown included a lack of facilities to treat common ailments, substandard care, and repeated COVID-19 testing prior to departure. CONCLUSION The study highlights the need to have rehabilitation mechanisms such as targeted cash transfers, ration kits, and safe transportation services for migrant workers through inter-sectoral coordination for mitigating hardship.
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Affiliation(s)
- Ashvinkumar B Ramana
- Department of Community Medicine, Government Medical College Bhavnagar, Maharaja Krishnakumarsinhji Bhavnagar University, Gujarat, India
| | - Sweta Singh
- Department of Community Medicine, Government Medical College Bhavnagar, Maharaja Krishnakumarsinhji Bhavnagar University, Gujarat, India
| | - Mihir P Rupani
- Department of Community Medicine, Government Medical College Bhavnagar, Maharaja Krishnakumarsinhji Bhavnagar University, Gujarat, India
- Clinical Epidemiology, Division of Health Sciences, ICMR - National Institute of Occupational Health (NIOH), Indian Council of Medical Research, Gujarat, India
| | - Ritika Mukherjee
- Executive Office, Generating Research Insights for Development (GRID) Council, Uttar Pradesh, India
| | - Archisman Mohapatra
- Executive Office, Generating Research Insights for Development (GRID) Council, Uttar Pradesh, India
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Cano-Gutiérrez JC, Olguín-Tiznado JE, Camargo-Wilson C, López Barreras JA, García-Rivera BR, García-Alcaráz JL. Psychosocial risk factors identification in Mexican workers and RGIII validation. Work 2023; 76:189-203. [PMID: 36847055 DOI: 10.3233/wor-220316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Since 2018, NOM-035-STPS-2018 has been applied in Mexico, focused on measuring psychosocial risk factors (PRFs) in workers and the Reference Guide III (RGIII) has been presented, however, research focused on its validation has been scarce, in very specific sectors and with small samples. OBJECTIVE Determine the levels of PRFs of five work centers and reliability and validity aspects of RGIII. METHOD The RGIII was applied to 1458 workers (806 women and 652 men) from five workplace in the industrial sector of Ensenada (Mexico), and the level of risk of the PRFs was analyzed, as well as their reliability and validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). RESULTS The PRFs with medium, high and very high-risk levels are Workload, Lack of control over work and Workday. The RGIII presents adequate reliability with Cronbach's α, Alpha ordinal RHO and Omega of 0.93, 0.95 and 0.95, respectively. The EFA shows all five subscales maintain factor loadings greater than 0.43, although Leadership and relationships at work has better saturation values, and Work environment ended with only three items. The CFA indicates Leadership and work relationships with a Root Mean Square Error of Approximation (RMSEA) goodness of fit index of 0.072. CONCLUSION The RGIII allows the identification and evaluation of the level of risk of PRFs. It complies with sufficient internal consistency. It does not have a clear factorial structure, because it does not meet the minimum values of goodness-of-fit indexes that would allow confirming the structure proposed in RGIII.
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Affiliation(s)
- Julio César Cano-Gutiérrez
- Faculty of Engineering, Architecture and Design, Universidad Autónoma de Baja California, Ensenada, Mexico
| | | | - Claudia Camargo-Wilson
- Faculty of Engineering, Architecture and Design, Universidad Autónoma de Baja California, Ensenada, Mexico
| | | | - Blanca Rosa García-Rivera
- Faculty of Administrative and Social Sciences, Universidad Autónoma de Baja California, Ensenada, Mexico
| | - Jorge Luis García-Alcaráz
- Departament of Industrial Engineering and Manufacturing, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Mexico
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Asplund S, Åhlin J, Åström S, Lindgren BM. Experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. Int J Qual Stud Health Well-being 2022; 17:2056957. [PMID: 35350958 PMCID: PMC8973353 DOI: 10.1080/17482631.2022.2056957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Affiliation(s)
- Sofia Asplund
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Johan Åhlin
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Sture Åström
- Department of Nursing, Umeå University, Umeå, Sweden
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7
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Mopkins D. Workplace Psychological Distress: A Concept Analysis. Workplace Health Saf 2022; 70:436-444. [PMID: 35620890 DOI: 10.1177/21650799221090641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Workplace psychological distress (WPD) significantly impacts employees' mental and physical well-being. However, WPD has not been well-defined in the literature as a concept. This concept analysis aims to clarify the concept of WPD and promote the use of the term in occupational health nursing research. METHODS Strategies introduced by Walker and Avant's conceptual analysis method will be utilized to conceptualize WPD and its impact on employees. A literature search was conducted using Cumulative Index of Nursing and Allied Health Literature (CINAHL), Business Source Complete, and APA PsycArticles. The keyword search included the terms "workplace" AND "employee" AND "psychological distress." RESULTS Antecedents of WPD are an increase in job demands, lack of control, low support, and workplace bullying. Defining attributes for WPD are extreme fatigue, role conflict, and time pressures. Consequences of WPD were identified as mental disorders, physical disorders, and loss in productivity. This concept was further illustrated using a model, borderline, and contrary case. DISCUSSION/CONCLUSION Identifying signs of WPD is of great importance in caring for employees in the workplace. Occupational health nurses can use information obtained from a workplace assessment to develop policies, implement well-being programs, and provide employee referrals.
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Lucero-Perez MR, Sabastizagal I, Astete-Cornejo J, Burgos MA, Villarreal-Zegarra D, Moncada S. Validation of the medium and short version of CENSOPAS-COPSOQ: a psychometric study in the Peruvian population. BMC Public Health 2022; 22:910. [PMID: 35524201 PMCID: PMC9077908 DOI: 10.1186/s12889-022-13328-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background The presence of psychosocial risks at work are associated with mental and physical health issues in workers. The study aim was to adapt the COPSOQ-ISTAS21 (Spanish version of the Copenhagen Psychosocial Questionnaire and Union Institute of Work, Environment and Health) Medium-Version to the Peruvian context and to develop a Short-Version of the instrument. Method Cross-sectional design study. The COPSOQ-ISTAS21 Medium Version was used. A confirmatory factor analysis was performed to determine the internal structure of each subdimension (first-order) and dimension (second-order) using the Robust Maximum Likelihood estimation method, and classic fit indices in the literature (CFI, SRMR, RMSEA). Internal consistency was evaluated using the alpha and omega coefficients. A short version was developed based on the items with the highest factorial load and that reduce the factorial complexity. Results A total of 1707 participants were evaluated. In the confirmatory factor analysis, the goodness-of-fit indices for seventeen of the 20 one-dimensional models (subdimensions) were identified; two subdimensions could not be evaluated because they presented only two items. When conducting a multidimensional analysis, we identified that all second-order models presented optimal goodness-of-fit indices, except “psychological demands at work”. Finally, a short version of only 31 items was designed from the items with optimal fit indices. Conclusions The new adapted versions of COPSOQ-ISTAS21 were renamed CENSOPAS-COPSOQ (National center of occupational health and environment protection for health -in Spanish- and Copenhagen Psychosocial Questionnaire). The CENSOPAS-COPSOQ is an instrument with sufficient evidence of validity and reliability in its medium and short version, which is why its use is recommended in Peruvian work centers to identify the evaluation and prevention of psychosocial risks at work in Peru. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13328-0.
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Affiliation(s)
- Martha R Lucero-Perez
- Instituto Nacional de Salud, Lima, Peru.,Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Iselle Sabastizagal
- Instituto Nacional de Salud, Lima, Peru.,Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jonh Astete-Cornejo
- Instituto Nacional de Salud, Lima, Peru.,Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Salvador Moncada
- Instituto Sindical de Trabajo Ambiente y Salud, Barcelona, Spain
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Healthcare Services and Formal Caregiver's Psychosocial Risk Factors: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095009. [PMID: 35564402 PMCID: PMC9105897 DOI: 10.3390/ijerph19095009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
The prevention and management of chronic disease primarily requires risk reduction measures, through strategic coordination across various government areas. Recognizing that health workers and the public health workforce are integral to building strong and resilient health, the present study analyses the relation between Psychosocial Risk Factors (PRFs, to which formal caregivers are exposed in the healthcare settings), and the work system related elements of the Systems Engineering Initiative for Patient Safety (SEIPS 3.0) framework. An empirical study was carried out, involving 333 formal caregivers of healthcare services. A total of 31 PRFs were assessed (using the COPSOQ III), making it possible to find a relationship between the PRFs analyzed with three elements of the work system, namely Task (5 PRFs), Organizational factors (17 PRFs), and Individual (9 PRFs). The present work contributes not only in terms of outcomes that allow the development of mental illness prevention and mental health promotion actions for healthcare formal caregivers, but also in terms of the relevance that these factors can have on the quality of health services, as well as their users (patients), in line with SEIPS 3.0 model.
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Which Personal and Organizational Factors Influence the Organizational Commitment and Job Satisfaction of Shipyard Blue-Collar Workers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084849. [PMID: 35457719 PMCID: PMC9031882 DOI: 10.3390/ijerph19084849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/06/2023]
Abstract
Background: The purpose of this research was to analyze which personal and organizational factors are related to organizational commitment and job satisfaction of shipyard workers who work in different auxiliary shipyard military companies in the north of Spain. Methods: In total, 567 shipyard workers participated in this cross-sectional survey study. The ages were between 19 and 64 (M = 39.36, SD = 10.01), males 82.52%, females 17.48%. We used a survey that included questions about personal and organizational factors such as physical environment, occupational risks, and psychosocial risks, in addition to the job commitment and job satisfaction scales. Results: The results of this study show that job commitment is significantly related to a higher age, lower education, and environmental risk (low vs. high). Furthermore, job satisfaction (high vs. low) and organizational commitment (high vs. low) is related with environmental risk (low vs. high). Job commitment is also higher in workers with a low educational level and older workers. Job satisfaction is lower in workers with a high educational level. Conclusions: This study shows that different personal and environmental factors influence the shipyard workers’ organizational commitment and job satisfaction.
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Besoain-Saldaña Á, Flores GA, Muñoz TA, Sanhueza JR. Conditions of employment, work and quality of life of men and women in informal jobs. Rev Saude Publica 2022; 56:17. [PMID: 35416843 PMCID: PMC8973026 DOI: 10.11606/s1518-8787.2022056003505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Identify gender gaps in the employment conditions, work and quality of life of informal sellers in Vega Central of Chile. METHODS We conducted a cross-sectional study with eighty workers, who answered modules of the Encuesta Nacional de Condiciones de Empleo, Trabajo y Salud (ENETS – National Survey of Employment, Work and Health Conditions) and the SF-36 Health Questionnaire for data collection. We performed a descriptive analysis to determine the characteristics of the population and the Chi-square test to study correlations between each of the variables with gender. RESULTS Of the sample, fifty (62.5%) are male and thirty (37.5%) are female. Both groups have similar conditions of employment, work and quality of life. However, women express greater fear than men do with respect to demanding better working conditions, as well as more discouragement and sadness during the workday and a worse perception of their state of health. CONCLUSIONS Strategies for the promotion and prevention of occupational health and social security should consider a gender perspective on working conditions and health indicators, allowing women to develop tools to demand fair conditions and promote employer obligations to care for the well-being of male and female workers.
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Affiliation(s)
- Álvaro Besoain-Saldaña
- Universidad de Chile. Facultad de Medicina. Departamento de Kinesiología. Santiago, Chile.,Universidad de Chile. Facultad de Medicina. Núcleo Desarrollo Inclusivo. Santiago, Chile
| | - Gustavo Agurto Flores
- Universidad de Chile. Facultad de Medicina. Escuela de Kinesiología. Santiago, Chile.,Universidad de Chile. Facultad de Medicina. Núcleo Desarrollo Inclusivo. Santiago, Chile
| | - Tiare Alarcón Muñoz
- Universidad de Chile. Facultad de Medicina. Escuela de Kinesiología. Santiago, Chile
| | - Jame Rebolledo Sanhueza
- Universidad de Chile. Facultad de Medicina. Departamento de Kinesiología. Santiago, Chile.,Universidad de Chile. Facultad de Medicina. Núcleo Desarrollo Inclusivo. Santiago, Chile
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Cotrim TP, Bem-Haja P, Pereira A, Fernandes C, Azevedo R, Antunes S, Pinto JS, Kanazawa F, Souto I, Brito E, Silva CF. The Portuguese Third Version of the Copenhagen Psychosocial Questionnaire: Preliminary Validation Studies of the Middle Version among Municipal and Healthcare Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031167. [PMID: 35162192 PMCID: PMC8834667 DOI: 10.3390/ijerph19031167] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 12/10/2022]
Abstract
A third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was developed internationally aiming to respond to new trends in working conditions, theoretical concepts, and international experience. This article aims to present the preliminary validation studies for the Portuguese middle version of COPSOQ III. This is an exploratory cross-sectional study viewing the cross-cultural adaption of COPSOQ III to Portugal, ensuring the contents and face validity and performing field-testing in order to reduce the number of items and to obtain insight into the data structure, through classic test theory and item response theory approaches. The qualitative study encompassed 29 participants and the quantitative one 659 participants from municipalities and healthcare settings. Content analysis suggested that minor re-wording could improve the face validity of items, while a reduced version, with 85 items, shows psychometric stability, achieving good internal consistency in all subscales. The COPSOQ III Portuguese middle version proved to be a valid preliminary version for future validation studies with various populations, able to be used in correlational studies with other dimensions.
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Affiliation(s)
- Teresa P. Cotrim
- Ergonomics Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal;
- CIAUD, Faculdade de Arquitetura, Universidade de Lisboa, 1349-063 Alto da Ajuda, Portugal
- Correspondence:
| | - Pedro Bem-Haja
- CINTESIS, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Anabela Pereira
- CIDTFF, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal; (A.P.); (I.S.)
| | | | - Rui Azevedo
- Research Unit in Management Sciences and Sustainability (UNICES), University of Maia (UMAIA), 4475-690 Maia, Portugal;
- Center ALGORITMI, University of Minho, 4800-058 Guimarães, Portugal
| | - Samuel Antunes
- APPsyCI—Applied Psychology Research Center Capabilities & Inclusion, ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal;
| | - Joaquim S. Pinto
- IETA, Departamento de Eletrónica, Telecomunicações e Informática, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Flávio Kanazawa
- Ergonomics Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal;
| | - Isabel Souto
- CIDTFF, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal; (A.P.); (I.S.)
| | - Elisabeth Brito
- GOVCOPP, School of Technology and Management of Águeda, University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Carlos F. Silva
- WJCR, Department of Education and Psychology, University of Aveiro, 3810-193 Aveiro, Portugal;
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Matamala Pizarro J, Aguayo Fuenzalida F. Mental health in mine workers: a literature review. INDUSTRIAL HEALTH 2021; 59:343-370. [PMID: 34588377 PMCID: PMC8655752 DOI: 10.2486/indhealth.2020-0178] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 05/12/2021] [Indexed: 06/13/2023]
Abstract
The mining environment is hazardous for worker's health. It can affect the mental health, triggering symptoms and diseases, such as anxiety, job stress, depression, sleep disorders, mental fatigue and other. The aim of this study was to describe and analyze the scientific literature about the mental health in mine workers and to summarize the findings. The method used was scoping review. The principal outcomes were the following: evidence in the last 12 years in the topic was focused in four themes 1) Psychological problems & personal factors (38.2%); 2) Psychosocial problems & health related factor (23.6%); 3) Well-being (21.1%) and 4) Physical problems & organization factors (17.1%). Several affections, symptoms, characteristics or disorders were inquired about mine worker's mental health, such as job strain, unsafety experiences, poor quality of sleep, non-subjective well-being, job unsatisfaction, social-relations conflict, risk of accidents and injuries, musculoskeletal disorders (MSDs), substance abuse, dangerous working conditions and demanding job organization, and so on. For those factors, Mining could expose to serious mental health problems to a part of their workers. It's necessary to deepen the elaboration of international policies and carry out more scientific research and suggestions to make programs on the topic.
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Donato TAA, Silva RMA, Andrade ACDS, Kochergin CN, Medeiros DSD, Soares DA, Louzado JA, Silva KO, Cortes ML, Mistro S, Amorim WWCC, Oliveira MGGD, Bezerra VM. [Periodic occupational examination: an opportunity for diagnosis and monitoring of chronic noncommunicable diseases in men]. CAD SAUDE PUBLICA 2021; 37:e00298320. [PMID: 34816961 DOI: 10.1590/0102-311x00298320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/15/2021] [Indexed: 11/22/2022] Open
Abstract
The study aimed to estimate the prevalence of arterial hypertension as the principal marker of chronic noncommunicable diseases (NCDs) and to identify associated modifiable factors in male workers. Baseline data were used from a longitudinal study with a sample of 1,024 male workers 18 years or older in a municipality in Northeast Brazil. The marker for NCDs was arterial hypertension, defined as systolic pressure ≥ 140mmHg and/or diastolic pressure ≥ 90mmHg and/or prior diagnosis of arterial hypertension and/or use of antihypertensive medication. Poisson regression with robust variance was used, adopting hierarchical entry of variables. Population attributable fractions (PAFs) were calculated for the lifestyle variables to measure the impact of modifiable factors on workers' health. Prevalence of hypertension was 28.6% (95%CI: 25.9-31.5). Distal factors associated with hypertension were age > 40 years, black skin color, and family income ≥ 3 times the monthly minimum wage. Intermediate factors were alcohol abuse, smoking, high self-rated salt intake, and physical inactivity. Proximal factors were overweight and obesity. Calculation of PAFs showed that a reduction or elimination of unhealthy lifestyle habits and behaviors in this population group would reduce the prevalence of the target NCD, hypertension, by 56.1%. The identification of modifiable factors and the ways they can negatively impact male workers' health allows planning interventions in the workplace itself to reach the largest number of individuals, aimed at reducing the harmful effects of NCDs.
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Affiliation(s)
| | | | | | | | | | - Daniela Arruda Soares
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - José Andrade Louzado
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - Kelle Oliveira Silva
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - Matheus Lopes Cortes
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | - Sóstenes Mistro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
| | | | | | - Vanessa Moraes Bezerra
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil
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Singh GP. Psychosocial and Mental Health Issues of the Migrants Amidst COVID-19 Pandemic in India: A Narrative Review. Indian J Psychol Med 2021; 43:473-478. [PMID: 35210674 PMCID: PMC8826203 DOI: 10.1177/02537176211044802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The objective of this review was to identify and synthesize the findings of the existing literature that highlighted the psychosocial and mental health issues of the migrants during the COVID-19 pandemic in India. MATERIALS AND METHODS An exploration of the PubMed, Google Scholar, Web of Science, ScienceDirect, Google search, and some other manual searches was undertaken so that no relevant study was missed. A search on Indian scientific literature and cross-references retrieved was also conducted to get further information. The period of the search has been one year from March 1, 2020, to March 31, 2021. The database was searched with the terms "migrants," "migrant workers," "COVID-19 pandemic," "lockdown," "migrant population," "mental health issues," "psychosocial issues" to retrieve the published literature. RESULTS Initially, 48 research articles were retrieved and 10 of them were excluded as they had no sufficient information about mental and psychosocial challenges faced by the migrants. In the remaining 38 articles, 9 articles were original research work (n = 9) published from India related to the impact of COVID-19 on migrants. The second category consisted of editorials or commentary or letters to the editor or policy paper on psychosocial and mental health aspects of migrants during the COVID-19 pandemic (n = 17). The third category was 11 articles on perspectives or opinions or viewpoints (n = 11) related to various psychosocial and mental health issues among migrants in India during the COVID-19 pandemic. Predominantly psychosocial issues found among migrants were living conditions, basic needs, family concerns, and joblessness. The mental health issues found among migrants during the COVID-19 pandemic included psychological distress, depressive disorders, anxiety disorders, substance use disorders. CONCLUSION Existing literature from India has shown that the COVID-19 pandemic severely impacted the psychosocial and mental health status of the migrants in India. This review suggests the need for more research work from the affected states of India and the development of psychosocial and mental health intervention strategies to minimize the impact of the COVID-19 pandemic on migrants.
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Affiliation(s)
- Gurvinder Pal Singh
- Dept. of Psychiatry, Government Medical College and Hospital, Chandigarh, India
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Argus M, Pääsuke M. Musculoskeletal disorders and associated factors among office workers in an activity-based work environment. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2419-2425. [PMID: 34714221 DOI: 10.1080/10803548.2021.1999616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the prevalence of musculoskeletal disorders (MSD) and associated factors among office workers working in the activity-based workplace (ABW). METHODS 42 office workers with ABW and 68 office workers as control participated. Nordic Musculoskeletal Questionnaire, Baecke Physical Activity Questionnaire, Copenhagen Psychosocial Questionnaire III, and Fear Avoidance Beliefs Questionnaire were used and Pain pressure threshold (PPT) was measured. RESULTS There were no significant differences in the prevalence of MSDs in most body areas between the ABW and control group. ABW group experienced significantly (p < 0.05) more right wrist, hand, and finger pain in the past 6 months when compared with the control group. ABW group demonstrated significantly (p < 0.05) more work-related physical activity and daily time spent standing. There were no significant differences in other pain-related factors measured. CONCLUSIONS Office workers with ABW had a similar prevalence of MSDs to office workers with a designated workplace and no differences in associated factors.
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Affiliation(s)
- Martin Argus
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Estonia.
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17
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Lancman S, Barroso BIDL. Mental health: Professional rehabilitation and the return to work - A systematic review. Work 2021; 69:439-448. [PMID: 34092692 DOI: 10.3233/wor-213489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The problem of illnesses, sick leave and the necessary return to work and permanence at work has been determining the development of different protocols and professional rehabilitation programs in different countries. OBJECTIVE We sought to identify articles that address programs for professional rehabilitation and the return to work of people laid off due to mental health problems, and to verify the results of professional rehabilitation programs and the follow-up processes for such return. METHOD A systematic review was performed according to the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The serial search of the articles was carried out in the electronic databases: Web of Science, MEDLINE/PubMed and Scopus. The variations in the descriptors served to find a greater range of significant results for the research. RESULTS In total, 2,306 articles were found. Another two articles that met the inclusion criteria were located through manual searches, adding up to a total of 2,308. Applying the exclusion criteria resulted in a final data set of 47 peer-reviewed articles. CONCLUSIONS The issues involving return to work and permanence in work were complex and multifaceted in the research articles studied. Recovery from Common Mental Disorders (CMDs) is a major cause of long-term sick leave and the granting of disability benefits. Many people with these diagnoses remain employed; however, further studies are needed with women, workers with fragile relationships, and immigrants.
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Affiliation(s)
- Selma Lancman
- Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
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Roy P, Grandi A, Pira E. On demonetization short term effects: Psychosocial risks in tea garden workers. Work 2021; 69:265-274. [PMID: 34024806 DOI: 10.3233/wor-213475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In November 2016, the government of India declared 86%of the total money in circulation as demonetized. This policy was brought into effect overnight, and it had great macro socioeconomic impact not only on the economy of the country but on the common people, especially the socioeconomically challenged. While several researchers have focused on, and continue to investigate, the effects of demonetization on the economy, its impact on the psychosocial health of workers has not yet been studied. OBJECTIVE To provide an exploratory investigation of the psychosocial consequences of demonetization on the workers in Indian tea gardens. METHODS A qualitative research approach was employed. Face-to-face interviews were conducted with seven key informants (clinicians and executives/managers), and 36 tea garden workers were involved in six focus groups. Collected data were analyzed using the Template Analysis technique. RESULTS From the data analysis, five main themes emerged concerning the psychosocial factors involved in demonetization effects: socioeconomic changes, organizational consequences, workplace interpersonal relationships, work-family interface, and psychophysical symptoms. CONCLUSIONS This preliminary study highlighted the significant impact that demonetization had on tea gardens at both the organizational and individual levels.
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Affiliation(s)
- Priyanka Roy
- Department of Labour, Government of West Bengal, Kolkata, India
| | - Annalisa Grandi
- Department of Labour, Government of West Bengal, Kolkata, India
| | - Enrico Pira
- Department of Labour, Government of West Bengal, Kolkata, India
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Aldasoro JC, Cantonnet ML. The management of the new and emerging musculoskeletal and psychosocial risks by EU-28 enterprises. JOURNAL OF SAFETY RESEARCH 2021; 77:277-287. [PMID: 34092319 DOI: 10.1016/j.jsr.2021.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/13/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Although the strategic framework of the European Union in the field of Health and Safety at Work 2014-2020 considers as one of its main challenges to improve the prevention of diseases related to NERs (New and Emerging Risks) (European Commission, 2014) there are still not many studies in the literature related to them. METHOD An exploratory study was carried out in order to get a picture of the NERs management in the UE-28 countries. The sample was extracted from the ESENER-2 datasets. ESENER-1 was carried out in 2009 and ESENER- 2 in 2014. This survey explores managers' and workers representatives' opinions on health and safety management. It surveyed over 49,000 enterprises in 36 countries. RESULTS The results obtained confirm that there are significant differences between the EU-28 countries in terms of the identification and the management of NERs. Conclusions NERs are becoming an increasingly studied phenomenon due to the changes that are taking place in the labour market: the percentage of temporary workers is increasing, the demands to the workers due to the globalization of the market are more complex and all this with an aging working force. Pratical A pplications It would be necessary to rethink the management of OHS, so that managers are aware that the combination of musculoskeletal and psychosocial risks should have a global approach in order to reduce accident and disability rates.
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Affiliation(s)
- Juan Carlos Aldasoro
- Faculty of Engineering of Gipuzkoa, Plaza de Europa 1, 2018 San Sebastián, Spain.
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20
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Frisone F, Sicari F, Settineri S, Merlo EM. Clinical Psychological Assessment of Stress: A Narrative Review of the Last 5 Years. CLINICAL NEUROPSYCHIATRY 2021; 18:91-100. [PMID: 34909024 PMCID: PMC8629067 DOI: 10.36131/cnfioritieditore20210203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Work-related stress typically occurs due to particularly challenging dynamics, risks and pressure. Prolonged exposure to stress may cause serious consequences on psychophysical well-being. The current study was conducted to reexamine the clinical instruments useful for evaluating the risk factors and to examine two closely linked dimensions, which may constitute protective factors such as coping strategies and satisfaction. METHOD Through a narrative review of the scientific literature of the last 5 years, carried out through the PubMed, Web of Science and Scopus databases, the most relevant clinical instruments used in the evaluation of stress, job satisfaction and coping strategies were examined. RESULTS Based on the considered inclusion criteria, 142 articles were selected, and 10 of the most used psycho-diagnostic instruments were identified for the evaluation of the three dimensions. The selected assessment instruments were deeply discussed in order to highlight strengths and limitations. CONCLUSIONS A variety of studies used a range of psycho-diagnostic tools in order to measure stress, coping strategies and job satisfaction. However, their integration is necessary to guarantee a complete evaluation protocol.
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Affiliation(s)
- Fabio Frisone
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Italy,CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences), University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), Italy
| | - Federica Sicari
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Italy
| | - Salvatore Settineri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy
| | - Emanuele Maria Merlo
- CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences), University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), Italy,Department of Adult and Childhood Human Pathology “Gaetano Barresi”, University of Messina, Italy,Corresponding author Emanuele Maria Merlo E-mail:
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21
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Persistent inequality: evolution of psychosocial exposures at work among the salaried population in Spain between 2005 and 2016. Int Arch Occup Environ Health 2020; 94:621-629. [PMID: 33237481 DOI: 10.1007/s00420-020-01609-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/09/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To assess the prevalence of poor mental health and of exposure to psychosocial risks among the working population in Spain in 2005, 2010 and 2016; to analyse the associations between workplace psychosocial exposures and mental health problems according to gender and occupation. METHODS Three representative samples of the Spanish working population were analysed, in 2005 (n = 7,023), 2010 (n = 4,979), and 2016 (n = 1,807). Prevalence ratios between mental health and the five dimensions - job demands, job control, social support, employment insecurity and insecurity over working conditions-were estimated using multilevel mixed-effects Poisson regressions. All the analyses were separated by gender and occupation. RESULTS In 2016, there were improvements in job control, job demands and social support, and deteriorations in employment insecurity and insecurity over working conditions. The risk of poor mental health among manual workers rose if they were exposed to high demands, low social support and high employment insecurity; among non-manual workers, the risk increased if they were exposed to high demands, low control, low social support and high insecurity over working conditions. There were no differences according to gender. CONCLUSION The new findings shed light on the evolution of the working conditions and health of the wage-earning population in Spain over the last 11 years. The stratification by gender and occupational group is relevant, since it allows a detailed analysis of the social disparities in the associations between psychosocial risks and mental health. The most vulnerable groups can be identified and preventive measures developed at source.
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Frutiger M, Borotkanics R. Systematic Review and Meta-Analysis Suggest Strength Training and Workplace Modifications May Reduce Neck Pain in Office Workers. Pain Pract 2020; 21:100-131. [PMID: 32657531 DOI: 10.1111/papr.12940] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Neck pain is a burdensome musculoskeletal disorder in office workers. Workplace interventions aim to prevent and minimize the effect of neck pain and improve work quality. However, the summed effect of workplace interventions on neck pain in office workers remains unclear. This systematic review with meta-analysis and meta-regression evaluated the summed effect of workplace interventions on neck pain in office workers. METHODS We searched 7 electronic databases to January 2020 for randomized clinical trials. We selected studies, independently extracted data, and assessed risk of bias. Meta-analyses were carried out along with normalized trend plots. RESULTS Twenty-nine trials, including 8 of high quality, met our inclusion criteria. Normalized trend plots indicate that neck strengthening demonstrated the sharpest decrease in pain scores. The results of pre- and post-outcome measurement of the effect of activity performance and workplace modification showed significant improvements in self-reported neck pain (P ≤ 0.001). Meta-regression was used to evaluate the effect of time, but it was not significant. CONCLUSIONS There is low-quality evidence that neck strengthening and tailored workstation modifications are effective at reducing neck pain in office workers. Further high-quality research methodology, including clinicians, is important to evaluate this summed effect.
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Affiliation(s)
- Martin Frutiger
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, North Ryde, NSW, Australia
| | - Robert Borotkanics
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Sundstrup E, Andersen LL. Joint association of physical and psychosocial working conditions with risk of long-term sickness absence: Prospective cohort study with register follow-up. Scand J Public Health 2020; 49:132-140. [PMID: 32597327 DOI: 10.1177/1403494820936423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: The interplay between physical and psychosocial working conditions for the risk of developing poor health is not well understood. This study aimed to determine the joint association of physical and psychosocial working conditions with risk of long-term sickness absence (LTSA) in the general working population. Methods: Based on questionnaire responses about physical working conditions and psychosocial working conditions (influence at work, emotional demands, support from colleagues and support from managers) and two-year prospective follow-up in a national register on social transfer payments, we estimated the risk of incident LTSA of >30 days among 9544 employees without previous LTSA from the Danish Work Environment Cohort Study. The analyses were censored for all events of permanent labour market drop-out (retirement, disability pension, immigration or death) and controlled for potential confounders. Results: In the total cohort, more demanding physical working conditions were associated with risk of LTSA in a dose-response fashion (trend test, p<0.0001). The combination of poor overall psychosocial working conditions (index measure of influence at work, emotional demands, support from managers and support from colleagues) and hard physical working conditions showed the highest risk of LTSA. However, poor overall psychosocial working conditions did not interact with physical working conditions in the risk of LTSA (p=0.9677). Conclusions: The results of this study suggest that workplaces should strive to improve both psychosocial and physical work factors in order to ensure the health of workers.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Denmark.,Department of Health Science and Technology, Aalborg University, Denmark
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Protano C, De Sio S, Cammalleri V, Pocino RN, Murano S, Perri R, Buomprisco G, De Giusti M, Vitali M. A Cross-Sectional Study on Prevalence and Predictors of Burnout among a Sample of Pharmacists Employed in Pharmacies in Central Italy. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8590430. [PMID: 31950056 PMCID: PMC6944955 DOI: 10.1155/2019/8590430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/21/2019] [Accepted: 12/04/2019] [Indexed: 12/22/2022]
Abstract
Burnout is defined as an occupational phenomenon linked to chronic workplace stress that has not been successfully managed and included among the factors influencing health status or contact with health services. Although several studies were performed for assessing this phenomenon, there is a lack of data on the prevalence of burnout and associated predictors, due to different definitions of the syndrome and heterogeneity of assessment methods. One of the well-known evidences on burnout is related to the highest risk professions, which include policemen, firemen, teachers, psychologists, medical students, nurses, physicians, and other health professionals, such as pharmacists. Objective. The aims of the present study were to (1) assess the occurrence of burnout syndrome among a sample of pharmacists employed in public and private pharmacies located in Rome province (Latium Region; central Italy); (2) evaluate the role of some potential predictors for the development of the syndrome. Materials and Methods. A questionnaire elaborated ad hoc was administered online to 2,000 members of the Association of Professional Pharmacists of Rome and its province and employed in public or private pharmacies. The questionnaire included the 14-item Shirom-Melamed Burnout Measure (SMBM) tool and questions on demographic characteristics and working conditions. Results. Physical exhaustion was the burnout dimension with the highest score; besides, approximately 11% of the studied pharmacists were categorized as having clinically relevant burnout levels (≥4.40). Several of the investigated variables significantly influenced the single burnout dimensions at the univariate analyses; multivariate analyses demonstrated that alcohol consumption and workplace location have a significant independent role on the overall SMBM index, while working time significantly influences clinically relevant burnout level. Conclusions. The results revealed that pharmacists are at risk of burnout, and thus, it is necessary to perform specific preventive intervention for managing this occupational threat.
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Affiliation(s)
- Carmela Protano
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Simone De Sio
- Specialty School of Occupational Medicine—Research Unit of Occupational Medicine, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Vittoria Cammalleri
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Roberta Noemi Pocino
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Stefano Murano
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Roberto Perri
- Specialty School of Occupational Medicine—Research Unit of Occupational Medicine, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Giuseppe Buomprisco
- Specialty School of Occupational Medicine—Research Unit of Occupational Medicine, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Maria De Giusti
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, University of Rome “La Sapienza”, P.le Aldo Moro 5, 00185 Rome, Italy
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Abstract
Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.
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Maia EG, Claro RM, Assunção AÁ. Multiple exposures to the risk of work absenteeism among Brazilian schoolteachers. CAD SAUDE PUBLICA 2019; 35Suppl 1:e00166517. [PMID: 30994817 DOI: 10.1590/0102-311x00166517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 08/16/2018] [Indexed: 11/22/2022] Open
Abstract
The study aimed to identify multiple exposures to the risk of work absenteeism among Brazilian schoolteachers, independently of the reasons reported by teachers (n = 6,510). The data came from a telephone survey on health, working conditions, and absenteeism among schoolteachers in Brazil (Educatel Study, 2015/2016). Exposures were identified and studied by principal components analysis and Poisson regression, with a focus on working conditions and quality of school administration. Three components of risk factors for work absenteeism were identified. Component 1 featured lack of opportunities for new learning experiences, insufficient time for performing tasks, constraints on teachers' autonomy, and little or no social support in the school environment; component 2 was characterized by the perception of heavy demand from tasks and an agitated classroom environment due to students' lack of discipline and intense noise; and component 3 by the experience of verbal or physical violence from students. All three components were specially associaed with stress-related work absenteeism in relation to reported stress at school (aPR = 3.87; 95%CI: 2.93-5.10; p < 0.05/aPR = 3.18; 95%CI: 2.47-4.09; p < 0.05/aPR = 3.31; 95%CI: 2.58-4.25; p < 0.05; respectively) and emotional problems (aPR = 2.28; 95%CI: 1.93-2.70; p < 0.05/aPR = 2.43; 95%CI: 2.05-2.87; p < 0.05/aPR = 2.09; 95%CI: 1.78-2.45; p < 0.05; respectively). The identification of these risk components highlighted the need for systemic changes in Brazilian Basic Education schools.
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Affiliation(s)
- Emanuella Gomes Maia
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Rafael Moreira Claro
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Ada Ávila Assunção
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Common mental disorders through the eyes of German employees: attributed relevance of work-related causes and prevention measures assessed by a standardised survey. Int Arch Occup Environ Health 2019; 92:795-811. [PMID: 30729316 PMCID: PMC6609828 DOI: 10.1007/s00420-019-01414-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/30/2019] [Indexed: 10/31/2022]
Abstract
PURPOSE Common mental disorders (CMDs) are becoming increasingly relevant in the working world. Numbers of risk factors have been confirmed by mostly correlative cross-sectional studies. Comprehensive and effective prevention is urgently needed. There is little knowledge about employees' own perceptions on causes of CMDs and prevention measures. Therefore, a survey was conducted in 2016. METHODS A standardised instrument was developed for an online survey in a commercial access panel, targeted employees in different job types. We assessed two outcomes: perceived relevance of (1) work-related demands to the development of CMDs, and (2) prevention approaches in the workplace and on individual and societal levels. Possible predictive aspects were analysed exploratively by multivariate linear regression analysis. RESULTS The response rate was 75% (n = 610). Job types were categorised as "blue", "grey" and "white-collar" workers (n = 193, 169, 248). The majority of respondents rated both outcomes consistently as "quite" or "very relevant"; societal prevention strategies were more relevant for non-white-collar workers. Perceived relevance of individual predisposition to develop a CMD was the strongest predictor for both outcomes, indicating the perception that people with higher personal vulnerability might suffer a higher strain from work-related risk factors than others. CONCLUSION We assume that participants in our survey judged the relevance of work-related causes of CMDs independently of their own workload. The perceived relevance of prevention measures in different areas is consistent with official guidelines. A possible selection bias due to characteristics of access panel collectives and own direct or indirect experiences with CMD should be critically questioned.
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Coutinho H, Queirós C, Henriques A, Norton P, Alves E. Work-related determinants of psychosocial risk factors among employees in the hospital setting. Work 2019; 61:551-560. [DOI: 10.3233/wor-182825] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Hugo Coutinho
- Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Porto, Portugal
| | - Cristina Queirós
- Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, Porto, Portugal
| | - Ana Henriques
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
| | - Pedro Norton
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
- Department of Occupational Health, São João Hospital Center, Porto, Portugal
| | - Elisabete Alves
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
- Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Talavera-Velasco B, Luceño-Moreno L, Martín-García J, García-Albuerne Y. Psychosocial Risk Factors, Burnout and Hardy Personality as Variables Associated With Mental Health in Police Officers. Front Psychol 2018; 9:1478. [PMID: 30279667 PMCID: PMC6153341 DOI: 10.3389/fpsyg.2018.01478] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/26/2018] [Indexed: 11/17/2022] Open
Abstract
Among the variables associated with occupational stress, two of the most studied are the adverse perceptions of psychosocial risk factors in the workplace and burnout. With the rise of positive psychology, other variables of the individual type, such as hardy personality have also been the subject of study. No studies have been found that jointly examine these variables related to mental health in police officers. The aim of this research was to analyze which variables were associated with mental health in police officers. A total of 223 policemen (202 men and 21 women) participated in a cross-sectional study. Of all the variables, emotional exhaustion and perception of problems as challenges were the only factors introduced in the regression model. These factors must be considered to improve both human resource interventions and occupational health practices in this professional group.
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Affiliation(s)
- Beatriz Talavera-Velasco
- Department of Social, Organizational and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Lourdes Luceño-Moreno
- Department of Social, Organizational and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Jesús Martín-García
- Department of Social, Organizational and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Yolanda García-Albuerne
- Department of Social, Organizational and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
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Sundstrup E, Hansen ÅM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Møller A, Andersen LL. Retrospectively assessed psychosocial working conditions as predictors of prospectively assessed sickness absence and disability pension among older workers. BMC Public Health 2018; 18:149. [PMID: 29343243 PMCID: PMC5773165 DOI: 10.1186/s12889-018-5047-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 01/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim was to explore the association between retrospectively assessed psychosocial working conditions during working life and prospectively assessed risk of sickness absence and disability pension among older workers. METHODS The prospective risk of register-based long-term sickness absence (LTSA) and disability pension was estimated from exposure to 12 different psychosocial work characteristics during working life among 5076 older workers from the CAMB cohort (Copenhagen Aging and Midlife Biobank). Analyses were censored for competing events and adjusted for age, gender, physical work environment, lifestyle, education, and prior LTSA. RESULTS LTSA was predicted by high levels of cognitive demands (HR 1.31 (95% CI 1.10-1.56)), high levels of emotional demands (HR 1.26 (95% CI 1.07-1.48)), low levels of influence at work (HR 1.30 (95% CI 1.03-1.64)), and high levels of role conflicts (HR 1.34 (95% CI 1.09-1.65)). Disability pension was predicted by low levels of influence at work (HR 2.73 (95% CI 1.49-5.00)) and low levels of recognition from management (HR 2.04 (95% CI 1.14-3.67)). CONCLUSIONS This exploratory study found that retrospectively assessed high cognitive demands, high and medium emotional demands, low influence at work, low recognition from management, medium role clarity, and high role conflicts predicted LTSA and/or disability pension.
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Affiliation(s)
- Emil Sundstrup
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Otto Melchior Poulsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Thomas Clausen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Department of Occupational Medicine, Copenhagen University Hospital Holbæk, Copenhagen, Denmark.,The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Aalborg, Denmark
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Crocce Carlotto PA, Moraes Cruz R, Guilland R, Ruppel da Rocha RE, Dalagasperina P, Ornellas Ariño D. Riscos Psicossociais Relacionados ao Trabalho: perspectivas teóricas e conceituais. REVISTA INTERAMERICANA DE PSICOLOGÍA OCUPACIONAL 2018. [DOI: 10.21772/ripo.v37n1a04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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32
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Silva MAD, Wendt GW, Argimon IIDL. Propriedades psicométricas das medidas do Questionário Psicossocial de Copenhague I (COPSOQ I), versão curta. REGE - REVISTA DE GESTÃO 2017. [DOI: 10.1016/j.rege.2017.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Fernandez CA, Moore K, McClure LA, Caban-Martinez AJ, LeBlanc WG, Fleming LE, Cifuentes M, Lee DJ. Occupational Psychosocial Hazards Among the Emerging US Green Collar Workforce. J Occup Environ Med 2017; 59:1-5. [PMID: 28045790 PMCID: PMC5214345 DOI: 10.1097/jom.0000000000000903] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare occupational psychosocial hazards in green collar versus non-green collar workers. METHODS Standard Occupational Classification codes were used to link the 2010 National Health Interview Survey to the 2010 Occupational Information Network Database. Multivariable logistic regressions were used to predict job insecurity, work life imbalance, and workplace harassment in green versus non-green collar workers. RESULTS Most participants were white, non-Hispanic, 25 to 64 years of age, and obtained greater than a high school education. The majority of workers reported no job insecurity, work life imbalance, or workplace harassment. Relative to non-green collar workers (n = 12,217), green collar workers (n = 2,588) were more likely to report job insecurity (Odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.02 to 1.26) and work life imbalance (1.19; 1.05 to 1.35), but less likely to experience workplace harassment (0.77; 0.62 to 0.95). CONCLUSIONS Continuous surveillance of occupational psychosocial hazards is recommended in this rapidly emerging workforce.
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Affiliation(s)
| | - Kevin Moore
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Laura A. McClure
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine
- Department of Environmental Health, Harvard School of Public Health
| | - William G. LeBlanc
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Lora E. Fleming
- Department of Public Health Sciences, University of Miami Miller School of Medicine
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital
| | - Manuel Cifuentes
- Center for Health Policy and Research, University of Massachusetts Medical School
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine
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