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Lee KFA, Lee EH, Roberts AC, Car J, Soh CK, Christopoulos G. Effects of fun-seeking and external locus of control on smoking behaviour: a cross-sectional analysis on a cohort of working men in Singapore. BMJ Open 2022; 12:e061318. [PMID: 36307163 PMCID: PMC9621162 DOI: 10.1136/bmjopen-2022-061318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES We examined the combined effects of behavioural inhibition and behavioural activation, on one hand, and locus of control, on the other hand, on different categories of smoking behaviour (non-smoking, ex-smoking, occasional smoking, daily smoking). DESIGN This study adopted a cross-sectional design. Participants completed questionnaires regarding demographics, smoking patterns, behavioural inhibition/behavioural activation systems and locus of control. SETTING The study was conducted across four companies from the transportation, cooling plant and education sectors in Singapore. PARTICIPANTS Three hundred sixty-nine male working adults were included in the final sample. RESULTS Corroborating previous research, a logistic regression model examining behavioural inhibition/behavioural activation systems revealed that the fun-seeking aspect of behavioural activation was a unique predictor in distinguishing non-smokers from daily smokers (OR=1.24, p=0.012). By contrast, in a separate model examining locus of control, external locus of control was found to be a unique predictor in distinguishing non-smokers from daily smokers (OR=1.13, p<0.001). In addition, a third model combining both behavioural inhibition/behavioural activation systems and locus of control found that only external locus of control remained a significant predictor (OR=1.12, p<0.001). Further analyses revealed a mediating effect of external locus of control on the relationship between fun-seeking and smoking behaviour. That is, the increase in the odds of daily smoking due to fun-seeking was explained by external locus of control (direct pathway OR=1.20, p=0.058; indirect pathway OR=1.04, p<0.050). CONCLUSIONS Overall, fun-seeking through its influence on external locus of control indirectly affects daily smoking behaviour, suggesting a more complex relationship than shown in previous research.
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Affiliation(s)
- Kar Fye Alvin Lee
- Nanyang Business School, Nanyang Technological University, Singapore
| | - Eun Hee Lee
- School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia
| | | | - Josip Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Chee Kiong Soh
- School of Civil and Environmental Engineering, Nanyang Technological University, Singapore
- School of Civil Engineering, Southeast University, Nanjing, China
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Nazeha N, Sathish T, Soljak M, Dunleavy G, Visvalingam N, Divakar U, Bajpai RC, Soh CK, Christopoulos G, Car J. A Comparative Study of International and Asian Criteria for Overweight or Obesity at Workplaces in Singapore. Asia Pac J Public Health 2021; 33:404-410. [PMID: 33715451 DOI: 10.1177/1010539521998855] [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: 01/29/2023]
Abstract
To compare the prevalence of and risk factors associated with overweight or obesity between the international (body mass index [BMI] ≥25 kg/m2) and Asian (BMI ≥23 kg/m2) criteria in a working population in Singapore. This was a cross-sectional analysis of a cohort study of 464 employees (aged ≥21 years) conducted at 4 workplaces in Singapore. The prevalence of overweight or obesity was 47.4% and 67.0% with the international and Asian criteria, respectively. With both the criteria, higher age, male sex, Malay ethnicity (vs Chinese), lower white rice intake, and consumption of sugar-sweetened beverages were positively associated with overweight or obesity. Participants with poorer mental health and higher levels of thermal comfort in the workplace were positively associated with overweight or obesity only with the Asian criteria. The use of international criteria alone in this population could have overlooked these risk factors that are highly relevant to the Singapore context.
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Affiliation(s)
| | | | - Michael Soljak
- Nanyang Technological University, Singapore.,Imperial College London, London, UK
| | | | | | | | - Ram Chandra Bajpai
- Nanyang Technological University, Singapore.,Keele University, Staffordshire, UK
| | - Chee Kiong Soh
- Nanyang Technological University, Singapore.,Southeast University, Nanjing, China
| | | | - Josip Car
- Nanyang Technological University, Singapore.,Imperial College London, London, UK
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Thach TQ, Mahirah D, Sauter C, Roberts AC, Dunleavy G, Nazeha N, Rykov Y, Zhang Y, Christopoulos GI, Soh CK, Car J. Associations of perceived indoor environmental quality with stress in the workplace. INDOOR AIR 2020; 30:1166-1177. [PMID: 32453912 DOI: 10.1111/ina.12696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/16/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
Indoor environmental quality (IEQ) is a general indicator of the quality of conditions inside a building. We investigated associations of perceived IEQ including air quality, thermal comfort, noise, and light quality with stress at work and the extent to which workplace location modifies these associations. We recruited 464 full-time workers from four companies in Singapore. Data on socio-demographic characteristics, lifestyle/health-related factors, and workplace factors were collected through self-administered questionnaires. Perceived IEQ satisfaction scores of all four factors were collected using the validated OFFICAIR questionnaire. We fitted a logistic regression model to assess associations between each perceived IEQ score and stress at work, adjusting for potential confounders. The odds ratio for stress at work associated with a 1-unit increase in perceived air quality score was 0.88 (0.82-0.94), 0.89 (0.82-0.97) for thermal comfort, 0.93 (0.87-0.98) for noise, and 0.88 (0.82-0.94) for light quality. Significant associations were found in office and control rooms for all four perceived IEQ, except for thermal comfort in office rooms. Higher satisfaction levels of perceived air quality, thermal comfort, noise, and lighting, were significantly associated with a reduction in stress at work. Our findings could potentially provide a useful tool for environmental health impact assessment for buildings.
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Affiliation(s)
- Thuan-Quoc Thach
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Dhiya Mahirah
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Charlotte Sauter
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Adam Charles Roberts
- School of Mechanical and Aerospace Engineering, College of Engineering, Nanyang Technological University, Singapore, Singapore
| | - Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nuraini Nazeha
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yuri Rykov
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yichi Zhang
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - George I Christopoulos
- Division of Strategy, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University, Singapore, Singapore
| | - Chee-Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Venugopal V, Roberts AC, Kwok KW, Christopoulos GI, Soh CK. Employee experiences in underground workplaces: a qualitative investigation. ERGONOMICS 2020; 63:1337-1349. [PMID: 32515298 DOI: 10.1080/00140139.2020.1780306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
Underground workplaces (UWS) are increasingly being recognised as a sustainable solution to concerns regarding lack of space facing megacities. UWS can multiply available space by reducing urban sprawl thereby improving quality of life in cities. However, developing workplaces that respond to the needs and preferences of occupants will be a crucial factor in determining the success of this concept. We examine the experiences of existing full-time employees of a large underground facility in North America and analyse how these are related to company policies and other organisational factors. From in-depth interviews of 73 participants, three predominant themes emerged from the analyses: environmental effects (e.g. lack of sunlight), design (e.g. the unique working environment), and organisational factors and social dynamics (e.g. policies regarding breaks). We discuss these themes in relation with interventions that may improve employee comfort and retention and suggest that many factors are within organisational control. Practitioner Summary: Underground workplaces are a sustainable solution to lack of urban space. However, developing effective workplaces is crucial to their success. We examine the experiences of existing employees of an underground facility in North America. We suggest that most negative attitudes towards underground spaces can be mitigated through simple organisational interventions. Abbreviations: UWS: underground workplaces; IRB: institutional review board.
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Affiliation(s)
- Vinita Venugopal
- Civil and Environmental Engineering, Nanyang Technological University, Singapore, Singapore
| | - Adam Charles Roberts
- Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - Kian-Woon Kwok
- School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | | | - Chee-Kiong Soh
- Civil and Environmental Engineering, Nanyang Technological University, Singapore, Singapore
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Mahirah D, Sauter C, Thach TQ, Dunleavy G, Nazeha N, Christopoulos GI, Soh CK, Car J. Factors associated with health-related quality of life in a working population in Singapore. Epidemiol Health 2020; 42:e2020048. [PMID: 32660219 PMCID: PMC7871151 DOI: 10.4178/epih.e2020048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the determinants of health-related quality of life (HRQoL) among workers in Singapore. METHODS We analysed data from a cross-sectional study of 464 participants from 4 companies in Singapore. Physical and mental components of HRQoL were assessed using the Short-Form 36 version 2.0 survey. A generalized linear model was used to determine factors associated with the physical component summary (PCS) and mental component summary (MCS) scores of HRQoL. RESULTS The overall mean PCS and MCS scores were mean±standard deviation 51.6±6.7 and 50.2±7.7, respectively. The scores for subscales ranged from 62.7±14.7 for vitality to 83.5±20.0 for role limitation due to emotional problems. Ethnicity, overweight/obesity, and years working at the company were significantly associated with physical HRQoL, and age and stress at work were significantly associated with mental HRQoL. Moreover, sleep quality was significantly associated with both physical and mental HRQoL. CONCLUSIONS These findings could help workplaces in planning strategies and initiatives for employees to maintain a worklife balance that encompasses their physical, emotional, and social well-being.
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Affiliation(s)
- Dhiya Mahirah
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Charlotte Sauter
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Thuan-Quoc Thach
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Nuraini Nazeha
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - George I. Christopoulos
- Division of Strategy, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University, Singapore
| | - Chee Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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Thach TQ, Mahirah D, Dunleavy G, Zhang Y, Nazeha N, Rykov Y, Nah A, Roberts AC, Christopoulos GI, Soh CK, Car J. Association between shift work and poor sleep quality in an Asian multi-ethnic working population: A cross-sectional study. PLoS One 2020; 15:e0229693. [PMID: 32130268 PMCID: PMC7055880 DOI: 10.1371/journal.pone.0229693] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/11/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND We aimed to examine the association between shift work and sleep quality in a diverse occupational type. METHODS This was a cross-sectional study of self-reported sleep quality in 424 workers aged ≥21 using the Pittsburgh Sleep Quality Index (PSQI). We divided workers into two categories based on their PSQI score: (a) ≤5 (good sleep quality) and (b) >5 (poor sleep quality). We used multiple logistic regressions to assess the association between shift work and sleep quality adjusted for potential confounders. RESULTS The mean age was 39.2 (SD = 11.3) years, with shift workers being older than their counterparts. Most workers were of Chinese ethnicity (63.9%). Males were significantly more likely to undertake shift work than females (89% v 11%, p-value<0.001), but it should be noted that the majority of workers was male (78.8%) in this sample of workers. Shift workers had a 198% increased odds of poor sleep quality compared to non-shift workers (OR = 2.98; 95% CI:1.53-5.81). CONCLUSION Shift work was significantly and independently associated with increased odds of poor sleep quality in this sample of workers. The present findings may inform employment guidelines and help develop workplace health promotion interventions aimed at improving sleep quality among workers and ultimately lead to a healthier workforce.
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Affiliation(s)
- Thuan-Quoc Thach
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Dhiya Mahirah
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yichi Zhang
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nuraini Nazeha
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Yuri Rykov
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Audrey Nah
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Adam Charles Roberts
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore
| | - George I. Christopoulos
- Division of Strategy, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University, Singapore, Singapore
| | - Chee-Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Rykov Y, Thach TQ, Dunleavy G, Roberts AC, Christopoulos G, Soh CK, Car J. Activity Tracker-Based Metrics as Digital Markers of Cardiometabolic Health in Working Adults: Cross-Sectional Study. JMIR Mhealth Uhealth 2020; 8:e16409. [PMID: 32012098 PMCID: PMC7055791 DOI: 10.2196/16409] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/26/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
Background Greater adoption of wearable devices with multiple sensors may enhance personalized health monitoring, facilitate early detection of some diseases, and further scale up population health screening. However, few studies have explored the utility of data from wearable fitness trackers in cardiovascular and metabolic disease risk prediction. Objective This study aimed to investigate the associations between a range of activity metrics derived from a wearable consumer-grade fitness tracker and major modifiable biomarkers of cardiometabolic disease in a working-age population. Methods This was a cross-sectional study of 83 working adults. Participants wore Fitbit Charge 2 for 21 consecutive days and went through a health assessment, including fasting blood tests. The following clinical biomarkers were collected: BMI, waist circumference, waist-to-hip ratio, blood pressure, triglycerides (TGs), high-density lipoprotein (HDL) and low-density lipoprotein cholesterol, and blood glucose. We used a range of wearable-derived metrics based on steps, heart rate (HR), and energy expenditure, including measures of stability of circadian activity rhythms, sedentary time, and time spent at various intensities of physical activity. Spearman rank correlation was used for preliminary analysis. Multiple linear regression adjusted for potential confounders was used to determine the extent to which each metric of activity was associated with continuous clinical biomarkers. In addition, pairwise multiple regression was used to investigate the significance and mutual dependence of activity metrics when two or more of them had significant association with the same outcome from the previous step of the analysis. Results The participants were predominantly middle aged (mean age 44.3 years, SD 12), Chinese (62/83, 75%), and male (64/83, 77%). Blood biomarkers of cardiometabolic disease (HDL cholesterol and TGs) were significantly associated with steps-based activity metrics independent of age, gender, ethnicity, education, and shift work, whereas body composition biomarkers (BMI, waist circumference, and waist-to-hip ratio) were significantly associated with energy expenditure–based and HR-based metrics when adjusted for the same confounders. Steps-based interdaily stability of circadian activity rhythm was strongly associated with HDL (beta=5.4 per 10% change; 95% CI 1.8 to 9.0; P=.005) and TG (beta=−27.7 per 10% change; 95% CI −48.4 to −7.0; P=.01). Average daily steps were negatively associated with TG (beta=−6.8 per 1000 steps; 95% CI −13.0 to −0.6; P=.04). The difference between average HR and resting HR was significantly associated with BMI (beta=−.5; 95% CI −1.0 to −0.1; P=.01) and waist circumference (beta=−1.3; 95% CI −2.4 to −0.2; P=.03). Conclusions Wearable consumer-grade fitness trackers can provide acceptably accurate and meaningful information, which might be used in the risk prediction of cardiometabolic disease. Our results showed the beneficial effects of stable daily patterns of locomotor activity for cardiometabolic health. Study findings should be further replicated with larger population studies.
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Affiliation(s)
- Yuri Rykov
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Thuan-Quoc Thach
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Adam Charles Roberts
- School of Mechanical and Aerospace Engineering, College of Engineering, Nanyang Technological University, Singapore, Singapore
| | - George Christopoulos
- Division of Leadership, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University, Singapore, Singapore
| | - Chee-Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University, Singapore, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Prevalence of Vitamin D Deficiency and Its Associated Work-Related Factors among Indoor Workers in a Multi-Ethnic Southeast Asian Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010164. [PMID: 31881679 PMCID: PMC6981433 DOI: 10.3390/ijerph17010164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/09/2019] [Accepted: 12/13/2019] [Indexed: 01/21/2023]
Abstract
Little is known about the effect of working conditions on vitamin D status in Southeast Asia, where vitamin D deficiency is common despite the presence of sunlight all year round in most places. We examined the prevalence of vitamin D deficiency and its associated work-related factors among indoor workers using the data of 213 participants (aged ≥21 years) from a workplace cohort study in Singapore. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/L. Data on work-related factors, socio-demographic characteristics, and lifestyle habits were collected using standardized questionnaires. Clinical and biochemical measurements were performed using standard tools and protocols. Multivariate Poisson regression was used to examine the independent association of work-related factors with vitamin D deficiency. Mean serum 25(OH)D concentration was 59.6 nmol/L. The prevalence of vitamin D deficiency was 32.9% (95% confidence interval (CI): 26.6-39.6%). In the multivariate analysis, office workers (prevalence ratio (PR): 2.16, 95% CI: 1.12-4.16 versus control room workers), workshop workers (PR: 2.25, 95% CI: 1.05-4.81 versus control room workers), and night shift workers (PR: 1.31, 95% CI: 1.03-1.67) were at a greater risk for vitamin D deficiency. Workplace policies and wellness programs should encourage workers to take regular breaks to go outdoors for sunlight exposure and to consume adequate amounts of vitamin D-rich foods to maintain optimal vitamin D levels.
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Prevalence of and factors associated with poor sleep quality and short sleep in a working population in Singapore. Sleep Health 2019; 6:277-287. [PMID: 31836498 DOI: 10.1016/j.sleh.2019.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/29/2019] [Accepted: 10/21/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVES We aimed to examine the prevalence of poor sleep quality and short sleep and their associated factors in a working population in Singapore. DESIGN This is a cross-sectional analysis. SETTING Four companies in Singapore were included in this study. PARTICIPANTS Participants included 464 full-time employees (aged ≥21 years). MEASUREMENTS Self-reported sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Self-administered questionnaires were used to collect data on sociodemographic characteristics, health behaviours, medical history, chronotype, psychosocial factors, health-related quality of life (HRQoL) and occupational factors. Clinical measurements were performed using standard tools and protocols. Multivariate logistic regression was used to examine the factors associated with poor sleep quality (PSQI global score >5) and short sleep (<7 hours/night). RESULTS The mean age was 39.0 (SD: 11.4) years, and 79.5% were men. The prevalence of poor sleep quality was 42.5%, and 66.2% were short sleepers. Nearly three-fourths (71.3%) had at least one of these two conditions. Age, Malay ethnicity (vs. Chinese), chronic conditions, poorer mental health, stress at home or work and shift work were positively associated, and mental component summary of the HRQoL scale and work years in the current company were negatively associated with poor sleep quality. Age, Malay and Indian ethnicities (vs. Chinese), longer dinner-to-bed time, snacking between dinner and bed time, and poorer mental health were positively associated with short sleep. CONCLUSIONS Poor sleep quality and short sleep were highly common in this working population in Singapore. Workplace policies should include education and intervention programmes to promote better sleep hygiene.
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Dunleavy G, Bajpai R, Comiran Tonon A, Chua AP, Cheung KL, Soh CK, Christopoulos G, de Vries H, Car J. Examining the Factor Structure of the Pittsburgh Sleep Quality Index in a Multi-Ethnic Working Population in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4590. [PMID: 31756941 PMCID: PMC6926964 DOI: 10.3390/ijerph16234590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/11/2019] [Accepted: 11/13/2019] [Indexed: 11/21/2022]
Abstract
The Pittsburgh Sleep Quality Index (PSQI) is a widely used measure for assessing sleep impairment. Although it was developed as a unidimensional instrument, there is much debate that it contains multidimensional latent constructs. This study aims to investigate the dimensionality of the underlying factor structure of the PSQI in a multi-ethnic working population in Singapore. The PSQI was administered on three occasions (baseline, 3 months and 12 months) to full-time employees participating in a workplace cohort study. Exploratory factor analysis (EFA) investigated the latent factor structure of the scale at each timepoint. Confirmatory factor analysis (CFA) evaluated the model identified by EFA, and additionally evaluated it against a single factor and a three-factor model. The EFA identified a two-factor model with similar internal consistency and goodness-of-fit across each timepoint. In the CFA, the two- and three-factor models were both superior to the unidimensional model. The two- and three-factor models of the PSQI were reliable, consistent and provided similar goodness-of-fit over time, and both models were superior to the unidimensional measure. We recommend using the two-factor model to assess sleep characteristics in working populations in Singapore, given that it performs as well as the three-factor model and is simpler compared to the latter.
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Affiliation(s)
- Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232, Singapore; (R.B.); (J.C.)
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6022 MD Maastricht, The Netherlands;
| | - Ram Bajpai
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232, Singapore; (R.B.); (J.C.)
- Research Institute for Primary Care and Health Sciences, Keele University, David Weatherall Building, Staffordshire ST5 5BG, UK
| | - André Comiran Tonon
- Laboratório de Cronobiologia e Sono, Porto Alegre Clínicas Hospital (HCPA), R. Ramiro Barcelos, 2350—Santa Cecilia, Porto Alegre 90035-007, RS, Brazil;
- Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande Do Sul (UFRGS), Av. Paulo Gama, 110—Farroupilha, Porto Alegre 90040-060, RS, Brazil
| | - Ai Ping Chua
- Department of Medicine, Jurong Health Campus, National University Health System, 1 Jurong East Street 21, Singapore 609606, Singapore;
| | - Kei Long Cheung
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex, London UB8 3PH, UK;
| | - Chee-Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University Singapore, 50 Nanyang Avenue, Singapore 639798, Singapore;
| | - Georgios Christopoulos
- Division of Leadership, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University Singapore, 50 Nanyang Avenue, Singapore 639798, Singapore;
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6022 MD Maastricht, The Netherlands;
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore 308232, Singapore; (R.B.); (J.C.)
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London SW7 2AZ, UK
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Risk Factors for Non-Communicable Diseases at Baseline and Their Short-Term Changes in a Workplace Cohort in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224551. [PMID: 31752089 PMCID: PMC6888317 DOI: 10.3390/ijerph16224551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 10/31/2019] [Accepted: 11/12/2019] [Indexed: 12/14/2022]
Abstract
We aimed to examine the behavioural and clinical risk factors for non-communicable diseases (NCDs) at baseline and their changes over 12 months in a workplace cohort in Singapore. A total of 464 full-time employees (age ≥ 21 years) were recruited from a variety of occupational settings, including offices, control rooms, and workshops. Of these, 424 (91.4%) were followed-up at three months and 334 (72.0%) were followed up at 12 months. Standardized questionnaires were used to collect data on health behaviours and clinical measurements were performed by trained staff using standard instruments and protocols. Age-adjusted changes in risk factors over time were examined using generalized estimating equations or linear mixed-effects models where appropriate. The mean age of the participants at baseline was 39.0 (SD: 11.4) years and 79.5% were men. Nearly a quarter (24.4%) were current smokers, slightly more than half (53.5%) were alcohol drinkers, two-thirds (66%) were consuming <5 servings of fruit and vegetables per day, and 23.1% were physically inactive. More than two-thirds (67%) were overweight or obese and 34.5% had central obesity. The mean follow-up was 8.6 months. After adjusting for age, over 12 months, there was a significant increase in the proportion consuming <5 servings of fruit and vegetables per day by 33% (p = 0.030), who were physically inactive by 64% (p < 0.001), and of overweight or obese people by 15% (p = 0.018). The burden of several key NCD risk factors at baseline was high and some worsened within a short period of time in this working population. There is a need for more targeted strategies for behaviour change towards a healthy lifestyle as part of the ongoing health and wellness programs at workplaces in Singapore.
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A Multifactorial Approach to Sleep and Its Association with Health-Related Quality of Life in a Multiethnic Asian Working Population: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214147. [PMID: 31661849 PMCID: PMC6862149 DOI: 10.3390/ijerph16214147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022]
Abstract
This study aims to explore if objectively and subjectively measured sleep parameters are associated with physical and mental health-related quality of life in a multiethnic working population in Singapore. We performed a cross-sectional analysis with data from 329 full-time employees enrolled in a workplace cohort study in Singapore. The Short-Form 36v2 (SF-36v2) survey was used to assess health-related quality of life, in terms of physical and mental health. Subjective and objective sleep parameters were measured using the Pittsburgh Sleep Quality Index and wrist actigraphy, respectively. Generalized linear modeling was performed to examine the association between sleep parameters and health-related quality of life. After adjusting for confounders, subjectively measured sleep disturbances were associated with a lower physical health-related quality of life, whereas higher, objectively measured sleep efficiency was associated with greater physical health-related quality of life. Subjectively measured daytime dysfunction was associated with impaired mental health-related quality of life. Using both objective and subjective measurements of sleep, the current study suggests that there is an association between sleep and health-related quality of life. Workplace health-promotion planners in Singapore should consider programmes that educate workers on better sleep hygiene practices in an effort to improve sleep and health-related quality of life.
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