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Rohrbacher M, Hasselhorn HM, Matilla-Santander N. Associations between precarious employment trajectories and mental health among older workers in Germany: Vertical and horizontal inequalities. Scand J Work Environ Health 2024; 50:290-299. [PMID: 38573826 DOI: 10.5271/sjweh.4160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE The aim of the study was to investigate the longitudinal association between multi-dimensionally measured precarious employment (PE) trajectories and mental health among older employees in Germany. METHODS Current data from the German lidA study was used, including panel cases, who participated in all four survey waves (2011, 2014, 2018, 2022). The study comprised 1636 subjects, aged 46 and 52 years at baseline. Group-based trajectory modelling was used to model PE trajectories based on a score combining multiple items from the dimensions employment insecurity and income inadequacy. The association between PE trajectories (2011-2022) and mental health (2022) was tested using weighted logistic regression. RESULTS We identified a PE trajectory with upward movement that best described 13.6% of the study sample. Representation in this group was socially unequally distributed with noticeably larger shares of female, lower-educated and lower-skilled workers in PE. Women following this trajectory had increased odds [odds ratio (OR) 1.68-1.82] of reporting poor mental health in 2022 compared to their counterparts in constant non-PE. This was not the case for men (OR 0.37-0.51). CONCLUSIONS Our findings highlight horizontal and vertical inequalities with respect to exposure to and consequences of PE. Future labor market reforms should improve protection of women, who will likely be disadvantaged by accumulating employment-related mental health risks over the course of their lives.
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Affiliation(s)
- Max Rohrbacher
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Gaussstrasse 20, 42119 Wuppertal, Germany.
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Schwedhelm C, Nimptsch K, Ahrens W, Hasselhorn HM, Jöckel KH, Katzke V, Kluttig A, Linkohr B, Mikolajczyk R, Nöthlings U, Perrar I, Peters A, Schmidt CO, Schmidt B, Schulze MB, Stang A, Zeeb H, Pischon T. Chronic disease outcome metadata from German observational studies - public availability and FAIR principles. Sci Data 2023; 10:868. [PMID: 38052810 PMCID: PMC10698176 DOI: 10.1038/s41597-023-02726-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Metadata from epidemiological studies, including chronic disease outcome metadata (CDOM), are important to be findable to allow interpretability and reusability. We propose a comprehensive metadata schema and used it to assess public availability and findability of CDOM from German population-based observational studies participating in the consortium National Research Data Infrastructure for Personal Health Data (NFDI4Health). Additionally, principal investigators from the included studies completed a checklist evaluating consistency with FAIR principles (Findability, Accessibility, Interoperability, Reusability) within their studies. Overall, six of sixteen studies had complete publicly available CDOM. The most frequent CDOM source was scientific publications and the most frequently missing metadata were availability of codes of the International Classification of Diseases, Tenth Revision (ICD-10). Principal investigators' main perceived barriers for consistency with FAIR principles were limited human and financial resources. Our results reveal that CDOM from German population-based studies have incomplete availability and limited findability. There is a need to make CDOM publicly available in searchable platforms or metadata catalogues to improve their FAIRness, which requires human and financial resources.
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Affiliation(s)
- Carolina Schwedhelm
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, 13125, Germany.
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, 13125, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, 28359, Germany
- Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, 28334, Germany
| | - Hans Martin Hasselhorn
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, 42119, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, 45122, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, 69120, Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), 06112, Germany
| | - Birgit Linkohr
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, 85764, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, Halle (Saale), 06112, Germany
- DZPG (German Center for Mental Health), partner site Halle-Jena-Magdeburg, 07743, Jena, Germany
| | - Ute Nöthlings
- Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, 53115, Germany
| | - Ines Perrar
- Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, 53115, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, 85764, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Department of Epidemiology, Medical Faculty of the Ludwig-Maximilians-Universität München, Munich, 81377, Germany
| | - Carsten O Schmidt
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, 17489, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, 45122, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam Rehbruecke, Nuthetal, 14558, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, 14558, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, 45122, Germany
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, 02118, USA
| | - Hajo Zeeb
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, 28359, Germany
- Faculty 11 - Human and Health Sciences, University of Bremen, Bremen, 28359, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, 13125, Germany
- Biobank Technology Platform, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, 13125, Germany
- Core Facility Biobank, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, 13125, Germany
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 10117, Germany
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Rohrbacher M, Hasselhorn HM. The contribution of work and health-related lifestyle to educational inequalities in physical health among older workers in Germany. A causal mediation analysis with data from the lidA cohort study. PLoS One 2023; 18:e0285319. [PMID: 37556415 PMCID: PMC10411755 DOI: 10.1371/journal.pone.0285319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 04/19/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The objective of the study was to investigate the contribution of work factors and health-related lifestyle to educational inequalities in physical health among older workers in Germany by applying causal mediation analysis with longitudinal data. METHODS Data from the German lidA study was used. 2653 persons (53% female, 47% male) aged 46 (born 1965) and 52 (born 1959) at baseline were followed up for seven years with exposure and outcome assessments in 2011 (t0), 2014 (t1) and 2018 (t2). The total effect of education on physical health was decomposed into a natural direct effect (NDE) and a natural indirect effect (NIE) by using a sex-stratified causal mediation analysis with an inverse odds weighting approach. Baseline health, partner status and working hours were entered as a first set of mediators preceding the putative mediators of interest. All analyses were adjusted for age and migrant status. RESULTS Independent of the first set of mediators, work factors explained 21% of educational inequalities in physical health between low and high educated women and 0% comparing moderate versus high educated women. The addition of health behaviors explained further 26% (low vs. high education) and 20% (moderate vs. high education), respectively. Among men, net of the first set of mediators, work factors explained 5% of educational inequalities in physical health between low and high educated and 6% comparing moderate versus high educated persons. Additional 24% (low vs. high education) and 27% (moderate vs. high education) were explained by adding health behaviors to the models. CONCLUSIONS To reduce educational inequalities in physical health among older workers in Germany, interventions to promote healthy behaviors are promising. Improving working conditions is likely an important prerequisite.
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Affiliation(s)
- Max Rohrbacher
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Wuppertal, Germany
| | - Hans Martin Hasselhorn
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Wuppertal, Germany
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Garthe N, Hasselhorn HM. [The Employment Perspective in the Health Care Sector - Until What Age do Older Employees Want to, Can and Plan to Work?]. Gesundheitswesen 2022. [PMID: 36195109 DOI: 10.1055/a-1915-4324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Abstract
OBJECTIVE The aim of the study was to compare the employment perspective of older employees in different occupations in the health care sector. A distinction is made between three aspects of the employment perspective: until what age older employees want to, can and plan to work. METHODS The data are based on the second (2014) and third (2018) wave of the representative lidA study, which surveyed employees born in 1959 and 1965, at intervals of 3 to 4 years since 2011. In descriptive cross-sectional and longitudinal analyses, five occupational groups of the health care sector were compared to further selected occupational groups (NSample=2.580). RESULTS The occupational groups examined differed significantly in terms of their employment perspective. Employees in care professions stood out as, on average, they wanted to leave working life early, but most importantly, they could not work for as long as they had planned to. Longitudinal analyses indicated that the employment perspective shifted to higher age as the individuals approached the legal retirement age. CONCLUSIONS Care professions are risk groups with regard to employment at higher working age and require special attention in health care organisations. The results also document substantial variability of employment perspective in individual employees over time. This finding has implications regarding opportunities for human resource management.
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Affiliation(s)
- Nina Garthe
- Lehrstuhl für Arbeitswissenschaft, Bergische Universitat Wuppertal, Wuppertal, Germany
| | - Hans Martin Hasselhorn
- Lehrstuhl für Arbeitswissenschaft, Bergische Universität Wuppertal Fakultät für Maschinenbau und Sicherheitstechnik, Wuppertal, Germany
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Rohrbacher M, Hasselhorn HM. Social inequalities in early exit from employment in Germany: a causal mediation analysis on the role of work, health, and work ability. Scand J Work Environ Health 2022; 48:569-578. [PMID: 35708627 PMCID: PMC10539108 DOI: 10.5271/sjweh.4043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the contribution of work factors, health, and work ability to social inequalities in early exit from employment among older employees in Germany. METHODS Longitudinal data from the representative German lidA Cohort study was linked with employment register data to obtain maximum information on exit routes out of paid employment. Information of N=2438 respondents, aged 46 and 52 at baseline, were obtained for a follow-up of six years (2011-2017). Causal mediation analysis with inverse odds weighting was conducted using discrete-time survival outcomes and baseline measurements of the socioeconomic status (SES: education), work factors, health, and work ability. RESULTS Older employees with low SES were at an increased risk of exiting employment early by receiving disability pension and through long-term unemployment but not through an unspecified labor market exit when compared to those with high and moderate SES. Low work ability accounted for up to 38% of the social inequalities in work exits into disability pension. Less-than-good physical health accounted for up to 59% of inequalities in work exits into long-term unemployment. Work factors contributed considerably to inequalities in exits through unemployment but not disability pension. CONCLUSIONS This study finds social inequalities in early exits through disability pension and long-term unemployment among older employees in Germany, predominantly attributable to differences in work ability (disability pension) and physical health (unemployment). Investments in work ability and promotion of physical health may constitute promising approaches to counteract an increase of these inequalities.
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Affiliation(s)
- Max Rohrbacher
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Gaussstrasse 20, 42119 Wuppertal, Germany.
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Hasselhorn HM, Leinonen T, Bültmann U, Mehlum IS, du Prel JB, Kiran S, Majery N, Solovieva S, de Wind A. The differentiated roles of health in the transition from work to retirement - conceptual and methodological challenges and avenues for future research. Scand J Work Environ Health 2022; 48:312-321. [PMID: 35239972 PMCID: PMC9524164 DOI: 10.5271/sjweh.4017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The aim of this discussion paper is to (i) identify the differentiated roles of health in the work-retirement transition, and, with respect to these, (ii) highlight topics related to conceptual and methodological problems and challenges in research, and (iii) present avenues for future research. METHODS This discussion paper summarizes an OMEGA-NET working group discussion ongoing from November 2018 to September 2021 with face-to-face and online meetings as well as a written online discourse. RESULTS 'Health' and 'retirement' are ambiguous concepts. With respect to both, in retirement research, the choice of concept and indicator influences the findings. In addition, the impact of health on retirement is not necessarily a direct one, but can be influenced by further factors such as the ability, motivation and opportunity to work. The strong overall association of poor health with retiring early (path 1) bears the risk of masking distinct and deviating mechanisms in subgroups. In fact, there is evidence that also good health may lead to early retirement (path 2), while both poor health (path 3) and good health (path 4) may also make people retire later. CONCLUSIONS An increased awareness of the differentiated roles that health may have in the work-retirement transition as outlined in this discussion paper may support research to address questions relevant for policy and practice and increase the impact of research. Recommendations for occupational health and social research are given.
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Affiliation(s)
- Hans Martin Hasselhorn
- Department of Occupational Health Science, University of Wuppertal, Germany,
Correspondence to: Hans Martin Hasselhorn, Department of Occupational Health Science, University of Wuppertal, Gaussstrasse 20, D-42119 Wuppertal, Germany. [E-mail: ]
| | - Taina Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ingrid Sivesind Mehlum
- National Institute of Occupational Health (STAMI), Oslo; Institute of Health and Society, University of Oslo, Norway
| | | | - Sibel Kiran
- Institute of Public Health, Department of Occupational Health and Safety, Hacettepe University, Ankara, Turkey
| | - Nicole Majery
- Multisectoral Occupational Health Service, Luxembourg, Luxembourg
| | | | - Astrid de Wind
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Leinonen T, Boets I, Pletea E, Vandenbroeck S, Sivesind Mehlum I, Hasselhorn HM, de Wind A. A conceptual framework addressing the complex labour market dynamics of the work-to-retirement process. Eur J Ageing 2022; 19:1631-1637. [PMID: 36692752 PMCID: PMC9729618 DOI: 10.1007/s10433-022-00704-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 01/26/2023] Open
Abstract
The way in which retirement is conceptualized and measured is likely to influence the research findings. The previous literature has addressed a wide range of elements related to the complex work-to-retirement process, such as early, late and partial retirement, statutory retirement, work disability and unemployment paths to retirement, or different types of bridge employment. However, conceptual clarity in terms of connections between the different elements is called for. We introduce a conceptual framework of the work-to-retirement process to guide its future measurement. Together with information on the statutory retirement age, the main elements of the framework are based on employment and pension receipt, acknowledging that these may overlap. The framework is flexible to the user, providing the possibility to add various specifications-e.g. of types of employment, types of pension receipt, unemployment, and being outside the labour force-depending on the study context and aims. The framework highlights the complexity of the work-to-retirement process, bringing forth its multifaceted, multiphased and multidirectional features. Accounting for such complexity in later-life labour market dynamics helps to elaborate what is actually addressed when investigating "retirement". Our conceptual framework can be utilized to enhance well-defined, precise and comparable measurement of the work-to-retirement process in studies.
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Affiliation(s)
- Taina Leinonen
- grid.6975.d0000 0004 0410 5926Finnish Institute of Occupational Health, Helsinki, Finland
| | - Isabelle Boets
- grid.5596.f0000 0001 0668 7884Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ,Group IDEWE, Leuven, Belgium
| | | | - Sofie Vandenbroeck
- grid.5596.f0000 0001 0668 7884Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium ,Group IDEWE, Leuven, Belgium
| | - Ingrid Sivesind Mehlum
- grid.416876.a0000 0004 0630 3985National Institute of Occupational Health (STAMI), Oslo, Norway
| | - Hans Martin Hasselhorn
- grid.7787.f0000 0001 2364 5811Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Astrid de Wind
- grid.509540.d0000 0004 6880 3010Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
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Hasselhorn HM. Investigating and explaining the “early exit culture” in Germany. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Garthe N, Hasselhorn HM. Arbeitgeberwechsel bei älteren Erwerbstätigen – Wie verändern sich Gesundheit, Arbeitsfähigkeit und psychosoziale Arbeitsbedingungen? Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N Garthe
- Bergische Universität Wuppertal, Lehrstuhl für Arbeitwissenschaft
| | - HM Hasselhorn
- Bergische Universität Wuppertal, Lehrstuhl für Arbeitwissenschaft
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Breckenkamp J, Dyck M, Schröder CC, Schönfeld S, du Prel JB, Razum O, Hasselhorn HM. [Utilization of Medical Rehabilitation and Access Barriers for Persons with a Migrant Background - Results of the lidA Cohort Study]. REHABILITATION 2020; 60:11-20. [PMID: 33152776 DOI: 10.1055/a-1276-6811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Rehabilitation services are considerably less used by persons with a migration background of working age in Germany than by persons without migration background. One reason could be access barriers. They can arise both from the structures of the health/rehabilitation system as well as from influences of the personal environment, e. g. financial burdens incurred through the use of rehabilitation or cultural expectations. In addition to the migration status, other factors such as country of origin, reasons for immigration, length of stay as well as the religious affiliation and social status could influence the utilization of medical rehabilitation. It was examined to what extent differences in utilisation are due to the migration background and to migration-independent personal barriers to access. METHODS The lidA-study is a nationwide, representative prospective cohort study among employees with insurable employment born in 1959 and 1965 with a focus on work, age, health and employment. Data from the first (2011) and the second wave (2014) were combined for the analyses. In addition to bivariate analyses to describe the sample according to migration status, logistic regression analyses were carried out to estimate the odds ratios for the influence of migration background or nationality and other factors on the use of a medical rehabilitation measure. RESULTS The chance of receiving medical rehabilitation is increased for migrants of the 1st generation (odds ratio (OR) 1.56, 95% confidence interval (CI): 1.09-2.25). If predominantly or exclusively no German is spoken at home, this could be associated with a comparatively much lower chance of utilisation (OR: 0.56, 95% CI: 0.28-1.15). Because only nationality is often available in routine data to determine the status of migration, another model only considers migrants and 2nd generation nationals and examines the influence of nationality on utilisation. A foreign nationality was not associated with a higher utilisation (OR: 1.07, 95% CI: 0.55-2.08). DISCUSSION Results of previous studies on the use of medical rehabilitation for people with a migration background are inconsistent. This could be due to different examined population groups, different indications for rehabilitation, a temporal change in utilisation and the various study designs as well as data sources. We found a higher use of medical rehabilitation services by persons with a migrant background (1st generation) compared to non-migrant persons. One reason could be our more precise definition of the migration background compared to analyses of routine data. If predominantly or exclusively another language than German is spoken at home, the utilisation tends to be lower. The finding coincides with a lack of German language skills described as an access barrier in the literature.
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Affiliation(s)
- Jürgen Breckenkamp
- AG3 Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld.,Lehrstuhl für Arbeitswissenschaft, Fakultät für Maschinenbau und Sicherheitstechnik, Bergische Universität Wuppertal
| | - Maria Dyck
- AG3 Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld
| | - Chloé Charlotte Schröder
- Lehrstuhl für Arbeitswissenschaft, Fakultät für Maschinenbau und Sicherheitstechnik, Bergische Universität Wuppertal
| | - Simone Schönfeld
- AG3 Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld
| | - Jean-Baptist du Prel
- Lehrstuhl für Arbeitswissenschaft, Fakultät für Maschinenbau und Sicherheitstechnik, Bergische Universität Wuppertal
| | - Oliver Razum
- AG3 Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld
| | - Hans Martin Hasselhorn
- Lehrstuhl für Arbeitswissenschaft, Fakultät für Maschinenbau und Sicherheitstechnik, Bergische Universität Wuppertal
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Hasselhorn HM, Stiller M, du Prel JB, Ebener M. Work profiles of older employees in Germany-results from the lidA-cohort study. BMC Public Health 2020; 20:1452. [PMID: 32977775 PMCID: PMC7519553 DOI: 10.1186/s12889-020-09542-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigates whether a typology of work exposure can be established among older workers in Germany. Work exposure comprises physical work, working time quality, work intensity, skills & discretion, social environment, leadership, continued education, earnings and work prospects. METHODS Latent profile analysis was conducted on a representative sample of the socially insured workforce in Germany born in 1959 or 1965 (N = 6277). Seven year-prospective associations between the typology and work-related outcomes (physical and mental health, work ability and work-privacy-conflict) were investigated to establish the distinctness of the profiles. RESULTS Five profiles were identified: "Poor Quality" (19%), "Relaxed Manuals" (30%), "Strained non-Manuals" (16%), "Smooth Running" (33%) and "High Flying" (3%). These profiles exhibited diverging patterns of association with the selected outcomes, thus representing qualitatively distinct subgroups of older workers in Germany. CONCLUSIONS We conclude that a typological approach may broaden the understanding of the ageing work force and the complex interplay of the overall work situation with outcomes of high individual and social relevance such as health, work ability and employment. The five work profiles identified in this study may constitute crucial clusters needed to reliably mirror today's over-all work exposure patterns in the older work force in Germany. They may allow for the comprehensible monitoring of quality of work and personal life among the older work force during their last working years and their transition to retirement in current times of extending working lives.
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Affiliation(s)
- Hans Martin Hasselhorn
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, 42119, Wuppertal, Germany.
| | - Michael Stiller
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, 42119, Wuppertal, Germany
| | - Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, 42119, Wuppertal, Germany
| | - Melanie Ebener
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, 42119, Wuppertal, Germany
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Schröder CC, Hasselhorn HM, du Prel JB, Breckenkamp J. Subjective employment perspective among older workers with and without migrant background in Germany-Results of the lidA cohort study. J Occup Health 2020; 62:e12166. [PMID: 32906224 PMCID: PMC7507058 DOI: 10.1002/1348-9585.12166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/10/2020] [Accepted: 08/22/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the subjective employment perspective in higher working age for different employee groups with migrant background (EMB) and without (non-EMB), meaning willing, being able, and planning to work until the individual state pension age (iSPA). METHODS A representative sample of socially insured employees born in 1959 or 1965 was surveyed in 2011, 2014, and 2018 with computer-assisted personal interviews. The current cross-sectional analysis is based on data from the third study wave (n = 3286) of the lidA cohort study. EMB were differentiated via generation (first generation, G1, vs second generation, G2) or nationality (German vs foreign). Applying bivariate statistics with the tests of independence and block-wise logistic regressions, group differences were investigated. Sex, age, educational level, net household income, health, and work factors were considered as covariates. RESULTS When comparing subgroups of EMB, significant differences appeared in bivariate analyses for willing and planning to work. G1 were to a higher degree planning to work longer than G2 and those with foreign nationality were more willing and planning than those with German nationality. Multivariate analyses revealed significant differences of G1 and non-EMB for planning, being significant in the fully adjusted model, but not for willing. CONCLUSION The findings underline the need for differentiation of migrant groups in social research and policy. When it comes to extended working lives, the first-generation migrant group, as well as foreigners may constitute risk groups and require increased attention from a work, health, and economic point of view.
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Affiliation(s)
| | | | - Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Jürgen Breckenkamp
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
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Garthe N, Hasselhorn HM. Leaving and staying with the employer-Changes in work, health, and work ability among older workers. Int Arch Occup Environ Health 2020; 94:85-93. [PMID: 32893311 PMCID: PMC7826300 DOI: 10.1007/s00420-020-01563-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 08/25/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this prospective study was to examine employer changes among older workers and to relate them to psychosocial work factors, health, and work ability. Four groups of employees as elaborated by Hom et al. (2012) were distinguished: Enthusiastic leavers (EL), reluctant leavers (RL), enthusiastic stayers (ES), and reluctant stayers (RS). METHODS Repeated Measures ANOVA analyses were based on data from the second and third waves (2014, 2018) of the German lidA Cohort Study, a representative study of employees born in 1959 or 1965. RESULTS The largest proportion of participants was ES (73.3%), 13.2% stayed with their employer although they would have preferred to leave (RS). 7.1% changed employer between 2014 and 2018 voluntarily (EL), 6.4% involuntarily (RL). Analyses confirmed that the four groups already differed in 2014 in terms of health, work ability, and psychosocial work factors and that these outcomes change in different characteristic patterns over time. Most outcomes improved substantially following the change among EL. RS already reported poor outcomes in 2014 and exhibited a further deterioration while staying at the undesired workplace. CONCLUSION Our findings indicate that an employer change is followed by improvements of work, health, and work ability. We conclude that an inclusive labor market policy for older workers allowing for high job mobility may have the potential to contribute to considerable improvements of workers' individual working conditions, health, and work ability, thereby increasing the work participation. Also, the considerable group of RL requires increased political and scientific attention.
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Affiliation(s)
- Nina Garthe
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Gaußstraße 20, 42119, Wuppertal, Germany.
| | - Hans Martin Hasselhorn
- Department of Occupational Health Science, School of Mechanical Engineering and Safety Engineering, University of Wuppertal, Gaußstraße 20, 42119, Wuppertal, Germany
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Schröder CC, Breckenkamp J, du Prel JB, Hasselhorn HM. Subjective employment perspective among older workers with and without migrant background in Germany. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the coming years, large groups of workers with migrant background will reach pensionable age in Germany. However, this group has been virtually ignored by worldwide retirement research so far. The aim of this study was to investigate the subjective employment perspective in higher working age for employees with migrant background (EMB) and without (non-EMB). By subjective employment perspective, we mean willing, being able to and planning to work until the individual state pension age (iSPA).
Methods
A representative sample of socially insured employees, born in 1959 or 1965, was surveyed in 2011, 2014 and 2018 with computer assisted personal interviews for the lidA-study. The current cross-sectional analysis is based on data from the third study wave (n = 3286) of the lidA cohort study. EMB were differentiated via generation (first-generation, G1, vs. second-generation, G2), or nationality (German vs. foreign). Applying bivariate statistics with tests of independence and block-wise logistic regressions, group differences were investigated. Sex, age, educational level, net household income, health and work factors were considered as covariates.
Results
When comparing subgroups of EMB, significant differences appeared in bivariate analyses for willing and planning to work. G1 were to a higher degree planning to work longer than G2 and those EMB with foreign nationality were more willing and planning than those EMB with German nationality. Multivariate analyses revealed significant differences of G1 and non-EMB for planning, being significant in the fully adjusted model, but not for willing.
Conclusions
Our study has found persistent differences between first-generation migrants and non-migrant workers in the subjective employment perspective with regard to planning. These findings underline the need for further retirement research in migrant groups as well as the need for differentiation of migrant groups in social and public health research.
Key messages
Socio-epidemiological research identifies employees born abroad or with foreign nationality as risk-groups in times of extending working lives. Public health and social policy shall focus on them. Public health research should differentiate migrant subgroups, as people with migrant background are not homogenous and very diverse in various aspects.
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Affiliation(s)
- C C Schröder
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - J Breckenkamp
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
- Office Department 3, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - J-B du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - H M Hasselhorn
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
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Schröder CC, Dyck M, Breckenkamp J, Hasselhorn HM, du Prel JB. Utilisation of rehabilitation services for non-migrant and migrant groups of higher working age in Germany - results of the lidA cohort study. BMC Health Serv Res 2020; 20:31. [PMID: 31924217 PMCID: PMC6954536 DOI: 10.1186/s12913-019-4845-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 12/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background An ageing and a shrinking labour force implies that the prevention of a premature exit from work due to poor health will become more relevant in the future. Medical rehabilitation is a health service that aims at active participation in working life. The provision of this service will be relevant for an increasing part of the ageing labour force, namely, employees with a migrant background and their different subgroups. Thus, this study examines whether first- and second-generation employees with migrant background differ from non-migrants in their utilisation of rehabilitation services and whether within the subsample of migrant employees, those persons with foreign nationality differ from those with German nationality. Methods Socially insured employees born in 1959 or 1965 were surveyed nationwide in 2011 as part of the lidA cohort study (n=6303). Survey data of the first study wave were used to identify the dependent variable of the utilisation of rehabilitation (in- and outpatient), the independent variable of migrant status and the covariates of sociodemographic, work- and non-work-related factors. Applying bivariate statistics with tests of independence and block-wise logistic regressions, differences between the groups were investigated. Additionally, average marginal effects were computed to directly compare the adjusted models. Results The study showed that first-generation migrants had a significantly lower likelihood of utilising outpatient rehabilitation than non-migrants (fully adj. OR 0.42, 95% CI 0.22-0.82) and that average marginal effects indicated higher differences in the full model than in the null model. No significant differences were found between the first- or second-generation migrants and non-migrants when comparing the utilisation of inpatient rehabilitation or any rehabilitation or when analysing German and foreign employees with migrant background (n=1148). Conclusions Significant differences in the utilisation of outpatient rehabilitation between first-generation migrants and non-migrants were found, which could not be explained by sociodemographic, work- and non-work-related factors. Thus, further factors might play a role. The second-generation migrants resemble the non-migrants rather than their parent generation (first-generation migrants). This detailed investigation shows the heterogeneity in the utilisation of health services such as medical rehabilitation, which is why service sensitive to diversity should be considered.
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Affiliation(s)
- Chloé Charlotte Schröder
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, D-42097, Wuppertal, Germany.
| | - Maria Dyck
- Office Dep. 3 - Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstraße 25, D-33615, Bielefeld, Germany.,Health Services Research Unit, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, D-58448, Witten, Germany
| | - Jürgen Breckenkamp
- Office Dep. 3 - Epidemiology & International Public Health, School of Public Health, Bielefeld University, Universitätsstraße 25, D-33615, Bielefeld, Germany
| | - Hans Martin Hasselhorn
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, D-42097, Wuppertal, Germany
| | - Jean-Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Gaußstraße 20, D-42097, Wuppertal, Germany
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Hasselhorn HM, Ebener M, Vratzias A. Household income and retirement perspective among older workers in Germany-Findings from the lidA Cohort Study. J Occup Health 2020; 62:e12130. [PMID: 32515884 PMCID: PMC7221420 DOI: 10.1002/1348-9585.12130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/24/2020] [Accepted: 04/19/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION In times of extending working lives, it is relevant to understand why, today, most workers leave employment long before regular retirement age. Financial factors have been central for explaining retirement timing, yet their impact seems rather complicated. This study explores the motivation to keep working, in relation to the economic household conditions among older workers and it investigates the impact of socio-demographic, individual and work factors on the motivation to keep working (MTW), again differentiated by economic household condition. METHODS Based on data from wave three (2018) of the lidA Cohort Study, a representative interview study of socially insured employees born in 1959 or 1965 in Germany, descriptives and linear regression analyses were performed among 2835 employed participants. For all analyses, the sample was divided into five household equivalized net income groups. RESULTS The groups with low and second lowest income were most motivated to work longer, followed by those with the highest income. The lowest income group exhibited most adverse scores for work indicators and health. Furthermore, in this group, MTW was unrelated to physical and mental health indicating that the comparably high motivation may be driven by financial imperatives. DISCUSSION AND CONCLUSIONS The findings indicate that many workers with low income may find themselves forced to extend their working life, irrespective of their health. This requires increased attention by research as well as policy. Policy might have to acknowledge group specific negative side effects of regulations effectively extending working lives.
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Affiliation(s)
| | - Melanie Ebener
- Department of Occupational Health ScienceUniversity of WuppertalWuppertalGermany
| | - Athanasios Vratzias
- Department of Occupational Health ScienceUniversity of WuppertalWuppertalGermany
- Department of PsychologyAristotle University of ThessalonikiThessalonikiGreece
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Ebener M, Hasselhorn HM. Validation of Short Measures of Work Ability for Research and Employee Surveys. Int J Environ Res Public Health 2019; 16:E3386. [PMID: 31547466 PMCID: PMC6765804 DOI: 10.3390/ijerph16183386] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/04/2019] [Accepted: 09/10/2019] [Indexed: 11/16/2022]
Abstract
Work ability (WA) is an important concept in occupational health research and for over 30 years assessed worldwide with the Work Ability Index (WAI). In recent years, criticism of the WAI is increasing and alternative instruments are presented. The authors postulate that theoretical and methodological issues need to be considered when developing alternative measures for WA and conclude that a short uni-dimensional measure is needed that avoids conceptual blurring. The aim of this contribution is to validate the short and uni-dimensional WAI components WAI 1 (one item measuring "current WA compared with the lifetime best") and WAI 2 (two items assessing "WA in relation to the [mental/physical] demands of the job"). Cross-sectional and 12-month follow-up data of two large samples was used to determine construct validity of WAI 1 and WAI 2 and to relate this to respective results with the WAI. Data sources comprise nurses in Europe investigated in the European NEXT-Study (Sample A; Ncross-sectional = 28,948 and NLongitudinal = 9462, respectively) and nursing home employees of the German 3Q-Study (Sample B) where nurses (N = 786; 339, respectively) and non-nursing workers (N = 443; 196, respectively) were included. Concurrent and predictive validity of WAI 1 and WAI 2 were assessed with self-rated general health, burnout and considerations leaving the profession. Spearman rank correlation (ρ) with bootstrapping was applied. In all instances, WAI 1 and WAI 2 correlated moderately, and to a similar degree, with the related constructs. Further, WAI 1 and 2 correlated with WAI moderately to strongly with ρ ranging from 0.72-0.76 (WAI 1) and 0.70-0.78 (WAI 2). Based on the findings and supported by theoretical and methodological considerations, the authors confirm the feasibility of the short measures WAI 1 and WAI 2 for replacing WAI at least in occupational health research and employee surveys.
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Affiliation(s)
- Melanie Ebener
- Department of Occupational Health Science, University of Wuppertal, 42119 Wuppertal, Germany.
| | - Hans Martin Hasselhorn
- Department of Occupational Health Science, University of Wuppertal, 42119 Wuppertal, Germany.
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Borchart D, Hasselhorn HM, du Prel JB. Wer macht mit und hält sich fit? Inanspruchnahme von gesundheitsfördernden und präventiven Maßnahmen bei älteren Beschäftigten. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Borchart
- Bergische Universität Wuppertal, Fakultät für Maschinenbau und Sicherheitstechnik, Fachgebiet Arbeitswissenschaft, Wuppertal, Deutschland
| | - HM Hasselhorn
- Bergische Universität Wuppertal, Fakultät für Maschinenbau und Sicherheitstechnik, Fachgebiet Arbeitswissenschaft, Wuppertal, Deutschland
| | - JB du Prel
- Bergische Universität Wuppertal, Fakultät für Maschinenbau und Sicherheitstechnik, Fachgebiet Arbeitswissenschaft, Wuppertal, Deutschland
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du Prel JB, Hasselhorn HM, Borchart D. Depressivität als Mediator zwischen Work-Family-Konflikt und Gedanken an vorzeitige Erwerbsaufgabe. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- JB du Prel
- Universität Wuppertal, Lehrstuhl für Arbeitswissenschaft, Wuppertal
| | - HM Hasselhorn
- Universität Wuppertal, Lehrstuhl für Arbeitswissenschaft, Wuppertal
| | - D Borchart
- Universität Wuppertal, Lehrstuhl für Arbeitswissenschaft, Wuppertal
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Burr H, Hasselhorn HM, Kersten N, Pohrt A, Rugulies R. Does age modify the association between psychosocial factors at work and deterioration of self-rated
health? Scand J Work Environ Health 2017; 43:465-474. [DOI: 10.5271/sjweh.3648] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Wind AD, Burr H, Pohrt A, Hasselhorn HM, Van der Beek AJ, Rugulies R. The association of health and voluntary early retirement pension and the modifying effect of quality of supervision: Results from a Danish register-based follow-up study. Scand J Public Health 2017; 45:468-475. [PMID: 28381121 PMCID: PMC5495428 DOI: 10.1177/1403494817699998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP. Methods: Employees aged 49–64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization (N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP. Results: Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02–1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90–1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=−0.33; 95% CI −1.79 to 1.14). Conclusions:This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors’ opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP.
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Affiliation(s)
- Astrid de Wind
- 1 Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,2 Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands.,3 Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Hermann Burr
- 4 Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Anne Pohrt
- 4 Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | | | - Allard Johan Van der Beek
- 1 Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,3 Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Reiner Rugulies
- 6 National Research Centre for the Working Environment, Copenhagen, Denmark.,7 Department of Public Health, University of Copenhagen, Denmark.,8 Department of Psychology, University of Copenhagen, Denmark
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Burr H, Pohrt A, Rugulies R, Holtermann A, Hasselhorn HM. Does age modify the association between physical work demands and deterioration of self-rated
general health? Scand J Work Environ Health 2017; 43:241-249. [DOI: 10.5271/sjweh.3625] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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23
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Hasselhorn HM, Ebener M, Müller BH. Determinanten der Erwerbsteilhabe im höheren Erwerbsalter – das „lidA-Denkmodell zu Arbeit, Alter und Erwerbsteilhabe“. ACTA ACUST UNITED AC 2016. [DOI: 10.1515/zsr-2015-0404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Im Beitrag wird das „lidA-Denkmodell zu Arbeit, Alter und Erwerbsteilhabe“ dargestellt und im Kontext vergleichbarer Modelle diskutiert. Ziel des Denkmodells ist, die Erwerbsteilhabe älterer Beschäftigter genauer zu verstehen und zur interdisziplinären Betrachtung und Bearbeitung der Thematik anzuregen. Es stellt Determinanten der Erwerbsteilhabe Älterer in elf Domänen (z. B. Gesundheit) zusammen, zeigt wichtige Interdependenzen zwischen diesen und ermöglicht die Darstellung vier zentraler Charakteristika der Erwerbsteilhabe im höheren Erwerbsalter bzw. des Erwerbsausstiegs: die Komplexität, die Prozesshaftigkeit, die Individualität und die Strukturabhängigkeit der Erwerbsteilhabe. Abschließend wird anhand von Kriterien sowie praktischen Erfahrungen diskutiert, inwieweit das Denkmodell geeignet ist, die wissenschaftliche Auseinandersetzung mit der Thematik weiter voranzubringen.
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Affiliation(s)
| | - Melanie Ebener
- Bergische Universität Wuppertal Fakultät für Maschinenbau und Sicherheitstechnik Lehrstuhl für Arbeitssicherheit/Ergonomie 42097 Wuppertal
| | - Bernd H. Müller
- Bergische Universität Wuppertal Fakultät für Maschinenbau und Sicherheitstechnik Lehrstuhl für Arbeitssicherheit/Ergonomie 42097 Wuppertal
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Burr H, Pohrt A, Hasselhorn HM. Der theoretische Hintergrund: Arbeit, Alter, Gesundheit und Erwerbsteilhabe – Welche Bedeutung hat der sozioökonomische Status? Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1386872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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25
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Hasselhorn HM, Peter R, Rauch A, Schröder H, Swart E, Bender S, du Prel JB, Ebener M, March S, Trappmann M, Steinwede J, Müller BH. Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation. Int J Epidemiol 2014; 43:1736-49. [PMID: 24618186 PMCID: PMC4276057 DOI: 10.1093/ije/dyu021] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx).
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Affiliation(s)
- Hans Martin Hasselhorn
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Richard Peter
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Angela Rauch
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Helmut Schröder
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Enno Swart
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Stefan Bender
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jean-Baptist du Prel
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Melanie Ebener
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Stefanie March
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Mark Trappmann
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jacob Steinwede
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bernd Hans Müller
- Federal Institute for Occupational Safety and Health, BAuA, Berlin, Germany, Institute for Safety Engineering, University of Wuppertal, Wuppertal, Germany, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany, Institute for Employment Research, IAB, Nuremberg, Germany, Institute for Applied Social Sciences, infas, Bonn, Germany, Institute of Social Medicine and Health Economics, Otto-von-Guericke-University of Magdeburg, Magdeburg, Germany and Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
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Schmidt SG, Dichter MN, Schwab CGG, Bartholomeyczik S, Hasselhorn HM. [Satisfaction with the quality of care in nursing homes--the nurses' perspective]. Pflege Z 2014; 67:170-174. [PMID: 24783344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND In Germany, the number of residents in Nursing Homes (NH) has increased in recent years, residents become older, increasingly multimorbid and suffer more from dementia. In parallel demands concerning the quality of care in NH have increased. The vivid poltical and public debate about quality of care, however, widely disregards the perception of nurses. The aim of this study is to investigate the nurses' satisfaction with the quality of care in their NH and potential psychological consequences. METHODS Secondary questionnaire data from 1489 nurses in 88 NH of the German 3Q-study (www.3q-studie.de) were used from the 2011 investigation. Questions regarding satisfaction enquire satsifaction in five nursing work domains. Descriptive analyses as well Chi2-tests were performed. RESULTS The majority of nurses were satisfied in the subdomain "overall quality of care" and "physical care" (80% each). 67% were satisfied with "the quality of care for residents with dementia" and 64% with "end-of-life care". Only 56% of the nurses were satisfied with "mental care". If nurses were unsatisfied with the quality of care, this was mostly perceived as a psychological stressor. Subgroup analysis showed a pattern for four of the five domains: dissatisfied nurses were older, better qualified, worked more than 25 hours per week and worked in larger NH. No such pattern was found for "quality of care for residents with dementia". CONCLUSIONS Nurses' satisfaction with the quality of care has shown to be a relevant work factor and potential stressor deserving more scientific and clinical attention. For NH it could constitute a core indicator for internal quality management as well as for human resource management. Research in work, health and economy in NH should also consider this factor.
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Hasselhorn HM, Rauch A. [Perspectives of work, age, health, and labor market participation in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:339-48. [PMID: 23455551 DOI: 10.1007/s00103-012-1614-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The German population is aging and shrinking. This will have a significant impact on the labor market, because labor supply will start to shrink. Consequently, there is a need to develop additional labor market resources. In this setting, a crucial issue is the health and employment of the older working population. This article discusses--on the basis of nine articles in this special issue--the health of the working population in the context of work, age, and labor participation. It shows the diversity of morbidity in the work force in general and particularly in older age, and it identifies older labor force groups with good health and those with bad health. The latter shows that "working while having a bad state of health" is today's reality. Labor market participation is less dependent on health than on the "work ability" and/or the "motivation to work" of older workers. The employment dynamics of an aging population will be a key issue in future political debate. A reliable knowledge base is needed for proper discussion, judgment, and action in the economic, political, and social fields. Current research is often focused on subtopics or on subgroups; however, a network of all the related scientific disciplines and the establishment of new comprehensive research approaches are needed in this area.
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Affiliation(s)
- H M Hasselhorn
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, BAuA, Nöldnerstrasse 40-42, Berlin, Germany.
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Peter R, Hasselhorn HM. [Work, age, health, and work participation. A theoretical model]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:415-21. [PMID: 23455559 DOI: 10.1007/s00103-012-1615-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Research into the associations between work, age, and health and the impact of these associations on employment status has focused on health as a crucial determinant of staying on the job. In our paper, we ask whether concentrating on health is still feasible, particularly when considering the change in demographics and the increasing proportion of older people in the workplace. We introduce a theoretical model describing health as a variable that indirectly influences leaving employment. According to our model, the immediate decision to leave employment is due to work motivation and work ability. These two factors may require intervention activities different from those needed to improve health. Our model explains employment participation as a result of complex associations between work, socioeconomic status, lifestyle, and health especially with work ability and work motivation. The complexity of these processes should be considered in studies by conducting longitudinal investigations like the German lidA study (http://www.lida-studie.de). If the model is verified in scientific studies like lidA, it can be used as a basis for preventive and intervening activities in practice, i.e., in politics, enterprises, and science.
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Affiliation(s)
- R Peter
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Helmholtzstrasse 22, Ulm, Germany.
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Galatsch M, Li J, Derycke H, Müller BH, Hasselhorn HM. Effects of requested, forced and denied shift schedule change on work ability and health of nurses in Europe -results from the European NEXT-Study. BMC Public Health 2013; 13:1137. [PMID: 24308567 PMCID: PMC3878997 DOI: 10.1186/1471-2458-13-1137] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 12/02/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule. METHODS Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed. RESULTS The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p <0.001), lowest general health (t1: 63.9, t2: 59.2, p <0.001) and showed the highest decrease in both outcomes. Shift pattern change in line with the nurses' wishes was associated with improved work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health. CONCLUSIONS The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and - to somewhat lesser extent - health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable preventive tool to promote nurses' work ability and - to lesser extent - their perceived health, not least in aging nursing work forces.
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Affiliation(s)
- Michael Galatsch
- Chair of Family Nursing and Community Care, Department of Nursing Science, Witten/Herdecke University, Stockumer Str, 12, D-58285 Witten, Germany.
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Li J, Shang L, Galatsch M, Siegrist J, Miüller BH, Hasselhorn HM. Psychosocial work environment and intention to leave the nursing profession: a cross-national prospective study of eight countries. Int J Health Serv 2013; 43:519-36. [PMID: 24066419 DOI: 10.2190/hs.43.3.i] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many countries throughout the world are facing a serious nursing shortage, and retention of nurses also is a challenge. The aim of this study was to compare the predictive contribution of a broad spectrum of psychosocial work factors, including job strain, effort-reward imbalance, and alternative employment opportunity, to the probability of intention to leave the nursing profession. A total of 7,990 registered female nurses working in hospitals in eight countries (Germany, Italy, France, The Netherlands, Belgium, Poland, Slovakia, and China) were included in the one-year prospective study. A standardized questionnaire on job strain, effort-reward imbalance, employment opportunity, and intention to leave the nursing profession was used in the survey. Multilevel logistic regression modeling was used to analyze the data. Results showed that an imbalance between high effort and low reward (in particular, poor promotion prospects) and good employment opportunity at baseline were independently associated with a new intention to leave the nursing profession at follow-up. However, job strain appeared to have relatively less explanatory power. Findings suggest that interventions to improve the psychosocial work environment, especially the reciprocity experienced between effort and reward, may be effective in improving retention of nurses and tackling the international nursing shortage.
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Affiliation(s)
- Jian Li
- Institute of Occupational and Social Medicine, University of Düsseldorf, Germany.
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Galatsch M, Iskenius M, Schlarmann JG, Schmidt SG, Müller BH, Hasselhorn HM. [Exposure to aggressive patient behaviour and its' association with the nurses' "work ability" in Germany]. Pflege Z 2013; 66:676-680. [PMID: 24319899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Aggressive behavior and violence in patients, residents or clients are growing challenges in nursing. Aggressive behavior can have both, physical and psychological consequences for nurses and can lead to a reduced performance at work, demotivation, sickness absence and the premature exit from the nursing profession. To develop purposive strategies and to deal with aggressive behavior and health promotion programs, it is crucial to know more about the prevalence of aggressive behavior from patients and the effect on the work ability of nurses in different types of institutions. METHOD Data of 1735 German nurses was derived from the European NEXT-Study. Description and analysis of variance for each working area (hospital ward, Intensive Care Unit, psychiatric ward, nursing home and home care) were conducted. The work ability was measured with the Work Ability Index (WAI). The aggressive behavior was measured by one item developed by the NEXT Study Group. Linear regression models were applied to analyze the effect of aggressive behavior on the work ability of nurses in a comparison of the five different working areas. RESULTS A total of 84.9 percent of the nurses were "sometimes" or "often/always" confronted with aggressive behavior from patients. In the comparison of the five working areas, nurses were exposed to different levels of aggressive behavior, while differences in the work ability of nurses were also observed. It was found that aggressive behavior from patients was associated with reduced work ability in nurses working in hospital wards, nursing homes and home care, but not nurses working in ICUs and psychiatric wards. CONCLUSIONS The findings indicate that many nurses in Germany are exposed to aggressive behavior from patients, which has negative effect on the nurses' work ability. However, it is assumed that strategies to deal with aggressive behavior could play a buffer role between aggressive behavior and work ability of nurses, highlighting one possibility of intervention in future.
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Affiliation(s)
- Michael Galatsch
- Universität Witten/Herdecke, Department für Pflegewissenschaft, Institut für Sicherheitstechnik.
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Peter R, Hasselhorn HM. Work, age, health and work participation - a model. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1354241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Rongen A, Robroek SJW, van der Heijden BIJM, Schouteten R, Hasselhorn HM, Burdorf A. Influence of work-related characteristics and work ability on changing employer or leaving the profession among nursing staff. J Nurs Manag 2013; 22:1065-75. [PMID: 23941401 DOI: 10.1111/jonm.12066] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2013] [Indexed: 11/28/2022]
Abstract
AIM To investigate how work-related characteristics and work ability influence nursing staff decisions to change employer or leave the profession. BACKGROUND Previous cross-sectional studies have indicated that decreased work ability and unfavourable work-related characteristics are important determinants for the intention to leave the profession among nursing staff. METHODS A 1-year longitudinal study, using data from the European Nurses' Early Exit Study. The study population consisted of 9927 (66%) members of the eligible nursing staff of which 345 left their current employer. Work-related characteristics, work ability and employment status were assessed by questionnaires. RESULTS Nursing staff with a low work ability were more likely to either change employer or leave the profession. Among nursing staff with a low work ability the risk of changing employer increased significantly with unfavourable work-related characteristics. However, among nursing staff with a good work ability the risk of changing employer barely changed with unfavourable work-related characteristics. CONCLUSION The negative effects of decreased work ability on changing employer and leaving the profession are partly counterbalanced by favourable psychological and physical work-related characteristics. IMPLICATIONS FOR NURSING MANAGEMENT Managers should implement strategies that focus on promoting the work ability of nursing staff in combination with improving work-related characteristics in order to prevent unnecessary changes of employment.
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Affiliation(s)
- Anne Rongen
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands
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Schmidt SG, Dichter MN, Palm R, Hasselhorn HM. Distress experienced by nurses in response to the challenging behaviour of residents - evidence from German nursing homes. J Clin Nurs 2013; 21:3134-42. [PMID: 23083388 DOI: 10.1111/jocn.12066] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this research is to investigate the degree of distress experienced by nurses in response to the challenging behaviour of nursing home residents (residents' challenging behaviour) and their impact on nurses individual resources (general health, burnout and work ability). BACKGROUND Because of the increasing and ageing population of nursing home residents, professional nursing care faces several challenges. One highly prevalent issue among nursing home residents is the so-called 'challenging behaviour'. However, to date, 'challenging behaviour' has not yet been recognised as an occupational stressor, and the extent of the impact of 'challenging behaviour' on nurses' well-being and functioning is not well understood. DESIGN Cross-sectional study. METHOD Self-report questionnaire data collected from 731 registered nurses and nursing aides in 56 German nursing homes were used in a secondary data analysis. The level of residents' challenging behaviour-related distress that nurses experienced was assessed using a scale consisting of nine questions. Validated instruments were used for the assessment of individual resources. RESULTS The mean score for residents' challenging behaviour-related distress was 41·3 (SD 21·2). Twenty-seven per cent of all nurses reported over 50 residents' challenging behaviour. Residents' challenging behaviour had a significant impact on all three measures of individual resources. Specifically, nurses exposed to frequent residents' challenging behaviour reported a significantly lower quality of general health, reduced workability and high burnout levels. CONCLUSION Our findings indicate that residents' challenging behaviour-related distress is a significant work place stressor for nurses in nursing homes with a clear impact on general health, the risk of burnout and work ability. RELEVANCE TO CLINICAL PRACTICE Our findings suggest that residents' challenging behaviour is a stressor for nurses in nursing homes. Further scientific and practical attention is necessary from the point of view of working conditions for nurses. The development of preventive concepts for nursing staff and residents is recommended.
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Affiliation(s)
- Sascha G Schmidt
- Nursing Research Section, Institute for Safety Technology, University of Wuppertal, Wuppertal, Germany.
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Cheng Y, Chen IS, Chen CJ, Burr H, Hasselhorn HM. The influence of age on the distribution of self-rated health, burnout and their associations with psychosocial work conditions. J Psychosom Res 2013; 74:213-20. [PMID: 23438711 DOI: 10.1016/j.jpsychores.2012.12.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/11/2012] [Accepted: 12/13/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Self-rated health (SRH) and burnout are commonly used health indicators. This study was designed to examine the age-specific patterns of SRH and burnout and their correlations with self-reported disease symptoms, and to investigate the moderating effects of age on the associations of psychosocial work conditions with these two health measures. METHODS Study subjects were 20,454 male and 16,875 female employees from 2 representative surveys conducted in 2007 and 2010 in Taiwan. SRH was assessed by a single item and burnout was assessed by the general burnout subscale of the Copenhagen Burnout Inventory (CBI). Psychosocial work conditions including working hours, psychological and physical job demands, job control, job insecurity and workplace justice were assessed by a validated questionnaire. RESULTS Older workers were at higher risk for poor SRH which was correlated with the presence of multiple disease symptoms. In contrast, employees aged 30-40 years had higher burnout which was strongly correlated with emotional disturbance. Among all the examined work factors, low workplace justice was found to be the most predominant predictor for poor SRH and high burnout, and the associations were more profound in younger workers than in older workers. CONCLUSION SRH and burnout were differentially related to age, and there were evidences of moderating effects of age on the associations between psychosocial work conditions and health. Researchers and health practitioners should pay attention to the influence of age when using the measures of SRH and burnout as indicators to detect health risk in association with adverse psychosocial work conditions.
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Affiliation(s)
- Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
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Galatsch M, Iskenius M, Müller BH, Hasselhorn HM. [A comparison of general health and potential predictors of general health among nurses in different age groups in Germany]. Pflege 2012; 25:23-32. [PMID: 22290512 DOI: 10.1024/1012-5302/a000167] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The increasing need for certified nursing staff moves healthy ageing in the nursing profession into the focus of scientific consideration. The purpose of this investigation consisted a) in an age-differentiated, longitudinal consideration of the general state of health and b) in an age differentiated identification of variables which forecast the general state of health of the nursing forces after 12 months. The identification of suitable predictors should give indications in which areas interventions could begin. The investigation based on data of the NEXT study. The analysis of the general health situation by means of ANOVA proved that older persons showed a worse state of health than younger. Besides, the general state of health changed stronger in older nursing forces after one year. The identification of the health predictors was carried out by means of linear regression. Results exhibited that work family-conflict was a significant predictor in every age group. While leadership quality for younger persons was another important factor, quantitative demands and social support from colleagues forecasted the health situation after one year for medium old employees. For older nursing forces, a good relationship with the superiors seemed to be an important component for preservation of a good health status. The different results in the examined age groups indicate that intervention measures, which have the purpose to hold up the general state of health as long as possible, should be implemented age-differentiatedly.
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Affiliation(s)
- Michael Galatsch
- Bergische Universität Wuppertal, Institut für Sicherheitstechnik, Fachgruppe Pflegeforschung, Wuppertal.
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Derycke H, Clays E, Vlerick P, D'Hoore W, Hasselhorn HM, Braeckman L. Perceived work ability and turnover intentions: a prospective study among Belgian healthcare workers. J Adv Nurs 2012; 68:1556-66. [PMID: 22348810 DOI: 10.1111/j.1365-2648.2012.05961.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To report a study exploring prospective relations between nurses' perceived work ability and three forms of turnover intentions, respectively, intent to leave the ward, organization and profession. BACKGROUND Turnover of nursing staff is a major challenge for healthcare settings and for healthcare in general, urging the need to improve retention. DESIGN Survey. METHODS Based on the longitudinal data of the Belgian sample from the European Nurses' Early Exit study, a total of 1531 healthcare workers who remained in their job, completed in 2003 and 1 year later a self-administered questionnaire including the Work Ability Index to assess work ability. Multiple logistic regression analysis was performed adjusting for possible confounding variables. RESULTS In a population with low intent to leave at baseline prospective analyses showed that a poor work ability at baseline increased the risk of high intent to leave the ward and high intent to leave the organization, 1 year later. A substantial deterioration in work ability was a risk factor for developing high turnover intentions 1 year later. Social support had no effect on the relation between work ability and all three types of intent to leave but the relation between work ability and intent to leave the ward was borderline significantly moderated by good interpersonal relations. CONCLUSIONS Poor work ability was a risk factor for developing turnover intentions. Maintaining good work ability and improving poor work ability becomes increasingly important to retain nurses.
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Li J, Galatsch M, Siegrist J, Müller BH, Hasselhorn HM. Reward frustration at work and intention to leave the nursing profession—Prospective results from the European longitudinal NEXT study. Int J Nurs Stud 2011; 48:628-35. [DOI: 10.1016/j.ijnurstu.2010.09.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 07/23/2010] [Accepted: 09/10/2010] [Indexed: 10/18/2022]
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Schmidt SG, Palm R, Dichter M, Hasselhorn HM. Arbeitsbedingte Prädiktoren für Zufriedenheit in der Demenzversorgung bei Pflegenden in stationären Altenpflegeeinrichtungen. Pflege 2011; 24:85-95. [DOI: 10.1024/1012-5302/a000104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In stationären Altenpflegeeinrichtungen nimmt die Pflege von Bewohnern mit Demenz einen immer größeren Stellenwert ein. Gleichzeitig stellt die Pflege von Bewohnern mit Demenz einen Risikofaktor für eine Arbeitsbelastung bei Pflegenden selbst dar. In diesem Zusammenhang wurde die Assoziation von potenziellen arbeitbedingten Prädiktoren mit der «Zufriedenheit von Pflegenden mit der Pflege von Bewohnern mit Demenz» mittels Sekundärdatenanalyse von Daten aus der 3Q-Studie untersucht. Eingeschlossen wurden 813 Pflegende (Fachkräfte und Hilfskräfte) aus 53 stationären Altenpflegeeinrichtungen. 42% der Pflegenden waren unzufrieden, wobei größere Unterschiede zwischen den Einrichtungen zu finden waren. Fachkräfte und Pflegende in Leitungsfunktionen waren unzufriedener. Im multivariaten Regressionsmodell waren «quantitative Anforderungen», die «Führungsqualität» und «soziale Interaktion mit anderen Berufsgruppen» am stärksten mit Zufriedenheit mit der Pflege von Bewohnern mit Demenz assoziiert. Keine Assoziation wurde dagegen bei «emotionale Anforderungen» und «Entwicklungsmöglichkeiten» gefunden. Die Ergebnisse geben Hinweise darauf, dass die «Zufriedenheit von Pflegenden mit der Pflege von Bewohnern mit Demenz» ein wichtiger Aspekt bei der Arbeit von Pflegenden ist, welcher sowohl in der Praxis als auch in der Forschung größere Beachtung finden müsste. Die große prädiktive Stärke verschiedener Faktoren der Arbeitsorganisation weist darauf hin, dass präventive Ansätze zur Steigerung der Zufriedenheit speziell in diesem Bereich ansetzen sollten.
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Affiliation(s)
- Sascha G. Schmidt
- Bergische Universität Wuppertal, FB D, Institut für Sicherheitstechnik - Fachgruppe Pflegeforschung
| | - Rebecca Palm
- Bergische Universität Wuppertal, FB D, Institut für Sicherheitstechnik - Fachgruppe Pflegeforschung und Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Standort Witten
| | - Martin Dichter
- Bergische Universität Wuppertal, FB D, Institut für Sicherheitstechnik - Fachgruppe Pflegeforschung
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Nuebling M, Hasselhorn HM. The Copenhagen Psychosocial Questionnaire in Germany: from the validation of the instrument to the formation of a job-specific database of psychosocial factors at work. Scand J Public Health 2011; 38:120-4. [PMID: 21172777 DOI: 10.1177/1403494809353652] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was established and tested in a sample of 2561 employees in order to: (a) assess the questionnaires' psychometric properties; and (b) develop an appropriate instrument to use in the assessment of psychosocial risk factors. A shortened version of the instrument was developed, reducing the number of items from 141 to 87. With this, a database has been established since 2005. In a cooperation model between science (Freiburg Research Centre of Occupational and Social Medicine) and companies or organizations, new COPSOQ data are added to the dynamically growing database with profession-specific profiles of psychosocial factors at work. In return, companies can compare their results with job-related data in the database, facilitating the interpretation of their results and the implementation of improvement measures. The COPSOQ database has reached > 25,000 respondents. Ongoing projects will expand the German COPSOQ database and include representative samples. Furthermore, a job exposure matrix for psychosocial factors at work will be constructed in 2009. Finally, in several projects, a first assessment has been followed by efforts to improve the problematic areas of psychosocial working conditions.
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Affiliation(s)
- Matthias Nuebling
- FFAS-Freiburg Research Centre of Occupational and Social Medicine (Freiburger Forschungsstelle Arbeits- und Sozialmedizin), Freiburg, Germany.
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Li J, Fu H, Hu Y, Shang L, Wu Y, Kristensen TS, Mueller BH, Hasselhorn HM. Psychosocial work environment and intention to leave the nursing profession: Results from the longitudinal Chinese NEXT study. Scand J Public Health 2009; 38:69-80. [PMID: 21172773 DOI: 10.1177/1403494809354361] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: A shortage of nurses happens not only in developed countries, but also in developing countries, such as in China, but the nurse turnover here makes the situation worse. Why do Chinese nurses want to leave the nursing profession? Our hypothesis is that unfavourable psychosocial work environment could predict nurses’ intention to leave (ITL). Methods: Collaborating with the EU NEXT study (Nurses’ Early eXit sTudy), the longitudinal study was conducted in China, and the psychosocial work environment was measured with the Copenhagen Psychosocial Questionnaire (COPSOQ). A total of 3,088 registered female nurses working in hospitals were eligible for the baseline analyses by multivariate logistic regression, and 1,521 for the one-year follow-up analyses by multivariate Poisson regression. Results: A wide range of psychosocial factors at work — in particular, increased emotional demands, decreased meaning of work, decreased commitment to the workplace, and decreased job satisfaction — were associated with ITL in both baseline analyses and prospective analyses after adjusting for numerous confounders. Conclusions: The findings suggest that unfavourable psychosocial work environment predicts ITL in Chinese nurses. Improvements in the psychosocial work environment may be helpful in retention of the nursing workforce.
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Affiliation(s)
- Jian Li
- Department of Safety Engineering, University of Wuppertal,
Wuppertal, Germany, , School of Public Health, Fudan University, Shanghai,
China, School of Public Health, Kunming Medical University,
Kunming, China
| | - Hua Fu
- School of Public Health, Fudan University, Shanghai,
China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China
| | - Li Shang
- School of Public Health, Kunming Medical University,
Kunming, China
| | - Yinghui Wu
- School of Nursing, Kunming Medical University, Kunming,
China
| | | | - Bernd Hans Mueller
- Department of Safety Engineering, University of Wuppertal,
Wuppertal, Germany
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van der Heijden BIJM, Kümmerling A, van Dam K, van der Schoot E, Estryn-Béhar M, Hasselhorn HM. The impact of social support upon intention to leave among female nurses in Europe: secondary analysis of data from the NEXT survey. Int J Nurs Stud 2009; 47:434-45. [PMID: 19909953 DOI: 10.1016/j.ijnurstu.2009.10.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2008] [Revised: 10/07/2009] [Accepted: 10/10/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study examined the importance of one's social work environment in the light of prevention of premature leave from the nursing profession. A research model with social support (from direct supervisor and close colleagues) as predictor and intention to leave as the dependent variable has been tested, while controlling for job satisfaction and age. Moreover, we have studied the impact of nurses' age upon the prevalence of social support from both parties. PARTICIPANTS Data were obtained from 17,524 registered female nurses working in hospitals throughout Europe (Belgium, Germany, Finland, France, Italy, The Netherlands, Poland, and Slovakia). RESULTS Our findings indicated that a lack of job satisfaction is an important risk factor in the light of nurses' turnover as for most countries the intention to leave cannot be buffered by social support from one's close colleagues. However, in general, social support from one's direct superior appeared to contribute negatively to the intention to leave the profession, over and above job satisfaction and age. As regards age effects, in line with our expectation, we have found a significant negative relationship between age and social support from close colleagues, while the hypothesis regarding the relationship between age and supervisory support could not be confirmed. CONCLUSIONS Given its importance in the light of preventing premature leave, we advocate not to neglect the possible positive effects of social support from important key figures like nurses' direct supervisor and close colleagues. It is necessary for health care institutions to carefully pay attention to finding opportunities to obtain more social support for all staff members. In Section 5, limitations and practical implications of this study are dealt with.
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Hasselhorn HM, Tackenberg P, Kuemmerling A, Wittenberg J, Simon M, Conway PM, Bertazzi PA, Beermann B, Büscher A, Camerino D, Caillard JF, D'Hoore W, Estryn-Behar M, Fontenla M, Gould D, van der Heijden B, Josephson M, Kiss P, Kovarova M, Kuhn K, Laine M, Le Nezet O, Lindberg P, Oginska H, Pokorski J, Pokorska J, Radkiewicz P, Rimarcik M, van der Schoot E, Stelzig S, Stordeur S, Wickstroem G, Widerszal-Bazyl M, Mueller BH. Nurses' health, age and the wish to leave the profession--findings from the European NEXT-Study. Med Lav 2006; 97:207-14. [PMID: 17017351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND OBJECTIVES In many industrialised countries the number of workers with low health is expected to increase in the nursing profession. This will have implications for occupational health work in health care. The European NEXT-Study (www. next-study. net, funded by EU) investigates working conditions of nurses in ten European countries and provides the opportunity to evaluate the role of health with respect to age and the consideration of leaving nursing. METHODS 26,263 female registered nurses from Belgium, Germany, Finland, France, England, Italy, Netherlands, Poland and Slovakia were eligible for analysis. RESULTS In most countries, older nurses considered leaving the profession more frequently than younger nurses. 'Health' was--next to 'professional opportunities' and 'work organisational factors'--strongly associated with the consideration of leaving nursing. However, more than half of all nurses with low health wanted to remain in the profession. This group reported rather positive psychosocial working conditions--but also the highest fear for unemployment. CONCLUSIONS The findings indicate that 'the nurse with low health' is reality in many health care settings. Both positive supporting working conditions but also lack of occupational alternatives and fear of unemployment may contribute to this. Current economic, political and demographic trends implicate that the number of active nurses with low health will increase. Occupational health surveillance will be challenged by this. But NEXT findings implicate that prevention also will have to regard work organisational factors if the aim is to sustain nurses' health and to enable nurses to remain healthy in their profession until retirement age.
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Affiliation(s)
- H M Hasselhorn
- University of Wuppertal, FB D, Dept. of Occupational Health, Gauss Strasse 20, D-42097 Wuppertal
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Nübling M, Stößel U, Hasselhorn HM, Michaelis M, Hofmann F. COPSOQ: Ein Instrument zur Messung psychischer Belastungen am Arbeitsplatz. Gesundheitswesen 2005. [DOI: 10.1055/s-2005-920554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Theorell T, Hasselhorn HM. On cross-sectional questionnaire studies of relationships between psychosocial conditions at work and health—are they reliable? Int Arch Occup Environ Health 2005; 78:517-22. [PMID: 15995878 DOI: 10.1007/s00420-005-0618-6] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Accepted: 02/17/2005] [Indexed: 10/25/2022]
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Simon M, Tackenberg P, Büscher A, Hasselhorn HM, Müller BH. [Creating the future of nursing]. Krankenpfl J 2005; 43:5-7. [PMID: 15912807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Michael Simon
- Ergebnisse der NEXT-Konferenz an der Universität Witten/Herdecke.
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Hasselhorn HM, Hofmann F, Nübling M. Effect of a Diphtheria Booster Vaccination in Adults with a Documented History of an Incomplete Primary Series Vaccination. Infection 2004; 32:282-6. [PMID: 15624892 DOI: 10.1007/s15010-004-3149-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND An incomplete series of diphtheria vaccination is frequently found in the vaccination documents of adult patients. This paper investigates the effect of a booster vaccination in adults with an incomplete series of primary vaccination. MATERIALS AND METHODS The effect of one diphtheria booster vaccination in adults with a documented history of only two childhood vaccinations has been investigated in 21 adults. Before the vaccination and 4 to 8 weeks thereafter, blood samples were taken and analyzed with an in vitro neutralization assay. RESULTS None of the participants had prevaccinal full protective diphtheria antitoxin levels (AT) > or = 0.1 IU/ml and four (19%) had limited serological protection (AT 0.01 to 0.1 IU/ml). After the vaccination, 14 individuals (67%) had protective LeveLs and six (29%) had limited protective levels. The risk for post-booster non-protection (AT < 0.1 IU/ml) was 7.7 times higher in comparison with a group of 170 adults with a history of at least one booster vaccination. CONCLUSION A specific immunologic memory exists in adults with a history of only two previous diphtheria vaccinations. However, our results also indicate the need for a second booster vaccination in this group if long-term protection is to be achieved.
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Affiliation(s)
- H M Hasselhorn
- Dept. of Occupational Medicine, University of Wuppertal, Wuppertal, Germany.
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Abstract
The year 2000 was the first without the registration of any cases of diphtheria in Germany. However, serologic protection against diphtheria amongst the population is very low, especially among young and middle-aged adults, where over 50 % are not or only minimally protected. In a review of the diphtheria cases of the last 7 years (n = 18), three factors were associated with the disease: adult age (14 cases between 18 and 50 years of age), travelling (in 14 of 18 cases travelling to or from endemic areas played a role) and occupational exposure (suspected in 6 of 18 cases). In Germany, the official guidelines which suggest a booster vaccination every ten years are followed very insufficiently. Should vaccination habits fail to improve, population immunity will further decrease and a resurgence of diphtheria will become more likely. Measures for future preventive activities are being discussed.
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Affiliation(s)
- H M Hasselhorn
- Lehrstuhl für Arbeitsmedizin, Arbeitsphysiologie und Infektionsschutz, Bergische Universität/Gesamthochschule Wuppertal, Germany.
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