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Jung FU, Pabst A, Löbner M, Luppa M, Riedel-Heller SG. Behind the times? Associations of working-time autonomy with health-related and occupational outcomes in health care personnel- a latent profile analysis. BMC Public Health 2024; 24:825. [PMID: 38491458 PMCID: PMC10943857 DOI: 10.1186/s12889-024-18289-0] [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: 10/23/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND In the light of personnel shortage, the health care sector is facing the challenge to combine increasing employees' as well as patients' needs. The aim of this study was to investigate the association between working-time autonomy and health-related (fatigue, psychosomatic complaints and work ability), as well as occupational outcomes (job satisfaction and turnover intention) in a large sample of health care employees. METHOD Based on data of the BauA-Working Time survey, a sample of n = 1,093 employees working in the health care sector was analysed. Outcomes were assessed by the German Fatigue Scale, the Work Ability-Index and single-item measurements. Besides descriptive analyses, latent profile analysis (LPA) was used to determine clusters of employees based on working-time autonomy. Subsequently, regression analyses have been conducted to examine the association between autonomy clusters with health-related and occupational outcomes, controlling for sociodemographic characteristics and employment status. RESULTS LPA revealed that a three-cluster model was most suitable: high autonomy (cluster 1), medium autonomy (cluster 2) and low autonomy (cluster 3). The extracted profiles of working-time autonomy differed significantly in terms of sociodemographic and occupational characteristics, but not in terms of average working hours per week or monthly household income. The multivariate regression analysis revealed that being in the low-autonomy cluster was associated with more psychosomatic health complaints (IRR: 1.427, p = 0.008), lower work ability (OR 0.339, p < 0.001), as well as less job satisfaction (OR 0.216, p < 0.001). DISCUSSION Overall, the analyses indicate that it is crucial to prospectively consider working-time autonomy as an important factor of satisfaction, well-being and turnover intention in health care employees.
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Affiliation(s)
- Franziska U Jung
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Faculty of Medicine, Leipzig University, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
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Emmanuel T, Griffiths P, Lamas-Fernandez C, Ejebu OZ, Dall'Ora C. The important factors nurses consider when choosing shift patterns: A cross-sectional study. J Clin Nurs 2024; 33:998-1011. [PMID: 38151796 DOI: 10.1111/jocn.16974] [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: 09/21/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/29/2023]
Abstract
AIM To gain a deeper understanding of what is important to nurses when thinking about shift patterns and the organisation of working time. DESIGN A cross-sectional survey of nursing staff working across the UK and Ireland collected quantitative and qualitative responses. METHODS We recruited from two National Health Service Trusts and through an open call via trade union membership, online/print nursing profession magazines and social media. Worked versus preferred shift length/pattern, satisfaction and choice over shift patterns and nurses' views on aspects related to work and life (when working short, long, rotating shifts) were analysed with comparisons of proportions of agreement and crosstabulation. Qualitative responses on important factors related to shift preferences were analysed with inductive thematic analysis. RESULTS Eight hundred and seventy-three survey responses were collected. When nurses worked long shifts and rotating shifts, lower proportions reported being satisfied with their shifts and working their preferred shift length and pattern. Limited advantages were realised when comparing different shift types; however, respondents more frequently associated 'low travel costs' and 'better ability to do paid overtime' with long shifts and 'healthy diet/exercise' with short shifts; aspects related to rotating shifts often had the lowest proportions of agreement. In the qualitative analysis, three themes were developed: 'When I want to work', 'Impacts to my life outside work' and 'Improving my work environment'. Reasons for nurses' shift preferences were frequently related to nurses' priorities outside of work, highlighting the importance of organising schedules that support a good work-life balance. RELEVANCE TO CLINICAL PRACTICE General scheduling practices like adhering to existing shift work guidelines, using consistent and predictable shift patterns and facilitating flexibility over working time were identified by nurses as enablers for their preferences and priorities. These practices warrant meaningful consideration when establishing safe and efficient nurse rosters. PATIENT OR PUBLIC CONTRIBUTION This survey was developed and tested with a diverse group of stakeholders, including nursing staff, patients, union leads and ward managers. REPORTING METHOD The Strengthening the Reporting of Observational Studies (STROBE) checklist for cross-sectional studies was used to guide reporting.
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Affiliation(s)
- Talia Emmanuel
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Peter Griffiths
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration, Wessex, UK
| | - Carlos Lamas-Fernandez
- National Institute for Health Research (NIHR) Applied Research Collaboration, Wessex, UK
- Southampton Business School, University of Southampton, Southampton, UK
| | - Ourega-Zoé Ejebu
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration, Wessex, UK
| | - Chiara Dall'Ora
- School of Health Sciences, University of Southampton, Southampton, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration, Wessex, UK
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Raman S, Hyland P, Coogan AN. Stability of social jetlag and sleep timing into the second year of the Covid-19 pandemic: Results from a longitudinal study of a nationally representative adult sample in Ireland. Chronobiol Int 2024; 41:29-37. [PMID: 38093635 DOI: 10.1080/07420528.2023.2292098] [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] [Received: 09/06/2023] [Accepted: 12/02/2023] [Indexed: 01/16/2024]
Abstract
The early phase of the COVID-19 pandemic has previously been associated with marked changes in sleep/wake timing arising from the imposition of society-wide infection mitigation measures. Such observations are considered of broader significance as they reveal the social pressures that sleep timing normally operates under. In order to assess how persistent such changes were as the COVID-19 pandemic developed, we assessed sleep timing and quality in a longitudinal study of a nationally-representative sample of Irish adults with data collected at two time-points (December 2021 and March 2021). Data on social jetlag and chronotype was derived from the micro Munich Chronotype Questionnaire from 830 and 843 participants who provided data in December 2020 and March 2021 respectively, of which 338 contributed data to both timepoints. Demographics and measures of insomnia symptoms, anxiety, depression and loneliness were also collected, and data was analysed both within-subjects and cross-sectionally within data waves. Social jetlag (the mismatch between sleep timing on "work" and "free" days) and other measures of sleep timing were stable across the two time-points, although insomnia symptoms improved slightly from December 2020 to March 2021. The mean social jetlag at both timepoints was ~ 30 minutes, considerably lesser than reported pre-pandemic levels in similar populations. Multiple regression analysis of cross-sectional data reveals that the timing of midsleep on "free" days was only a weak-to-moderate predictor of social jetlag, whilst hours worked per week was the strongest predictor of social jetlag. Requirement for "face-to-face" contact with the public at work and urban location of residence also emerged as predictors of social jetlag, although insomnia, anxiety and depression symptoms and loneliness rating did not. We conclude that sleep timing changes that occurred during the initial phase of the COVID-19 pandemic persisted into the second year of the pandemic, and these results further illustrate the key roles working practices and other social factors have in shaping social jetlag.
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Affiliation(s)
- Sudha Raman
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, Kildare, Ireland
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Zotcheva E, Bratsberg B, Strand BH, Jugessur A, Engdahl BL, Bowen C, Selbæk G, Kohler HP, Harris JR, Weiss J, Tom SE, Krokstad S, Mekonnen T, Edwin TH, Stern Y, Håberg AK, Skirbekk V. Trajectories of occupational physical activity and risk of later-life mild cognitive impairment and dementia: the HUNT4 70+ study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 34:100721. [PMID: 37927437 PMCID: PMC10625024 DOI: 10.1016/j.lanepe.2023.100721] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 11/07/2023]
Abstract
Background High levels of occupational physical activity (PA) have been linked to an increased risk of dementia. We assessed the association of trajectories of occupational PA at ages 33-65 with risk of dementia and mild cognitive impairment (MCI) at ages 70+. Methods We included 7005 participants (49.8% were women, 3488/7005) from the HUNT4 70+ Study. Group-based trajectory modelling was used to identify four trajectories of occupational PA based on national registry data from 1960 to 2014: stable low (30.9%, 2162/7005), increasing then decreasing (8.9%, 625/7005), stable intermediate (25.1%, 1755/7005), and stable high (35.2%, 2463/7005). Dementia and MCI were clinically assessed in 2017-2019. We performed adjusted multinomial regression to estimate relative risk ratios (RRR) with 95% confidence intervals (CI) for dementia and MCI. Findings 902 participants were diagnosed with dementia and 2407 were diagnosed with MCI. Absolute unadjusted risks for dementia and MCI were 8.8% (95% CI: 7.6-10.0) and 27.4% (25.5-29.3), respectively, for those with a stable low PA trajectory, 8.2% (6.0-10.4) and 33.3% (29.6-37.0) for those with increasing, then decreasing PA; while they were 16.0% (14.3-17.7) and 35% (32.8-37.2) for those with stable intermediate, and 15.4% (14.0-16.8) and 40.2% (38.3-42.1) for those with stable high PA trajectories. In the adjusted model, participants with a stable high trajectory had a higher risk of dementia (RRR 1.34, 1.04-1.73) and MCI (1.80, 1.54-2.11), whereas participants with a stable intermediate trajectory had a higher risk of MCI (1.36, 1.15-1.61) compared to the stable low trajectory. While not statistically significant, participants with increasing then decreasing occupational PA had a 24% lower risk of dementia and 18% higher risk of MCI than the stable low PA group. Interpretation Consistently working in an occupation with intermediate or high occupational PA was linked to an increased risk of cognitive impairment, indicating the importance of developing strategies for individuals in physically demanding occupations to prevent cognitive impairment. Funding This work was supported by the National Institutes of Health (R01AG069109-01) and the Research Council of Norway (296297, 262700, 288083).
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Affiliation(s)
- Ekaterina Zotcheva
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre of Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Bernt Bratsberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Ragnar Frisch Center for Economic Research, Oslo, Norway
| | - Bjørn Heine Strand
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre of Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Astanand Jugessur
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bo Lars Engdahl
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Geir Selbæk
- Norwegian National Centre of Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Hans-Peter Kohler
- Population Aging Research Center and Department of Sociology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer R. Harris
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jordan Weiss
- Stanford Center on Longevity, Stanford University, Stanford, CA, USA
| | - Sarah E. Tom
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, USA
- Department of Epidemiology, Columbia University, Mailman School of Public Health, USA
| | - Steinar Krokstad
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Norway
| | - Teferi Mekonnen
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
| | - Trine Holt Edwin
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Yaakov Stern
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, USA
| | - Asta Kristine Håberg
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Vegard Skirbekk
- Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre of Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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