Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling.

Mutsumi Teraoka,Makoto Kyougoku

doi:10.7717/peerj.1389

Abstract

Purpose. The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression) in healthcare workers.Method. Three cross sectional studies were conducted to assess the following relations: (1) occupational dysfunction on stress response (n = 468), (2) occupational dysfunction on burnout syndrome (n = 1,142), and (3) occupational dysfunction on depression (n = 687). Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships) as well as the Classification and Assessment of Occupational Dysfunction (CAOD). Furthermore, study 1 included the Stress Response Scale-18 (SRS-18), study 2 used the Japanese Burnout Scale (JBS), and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D). The Kolmogorov–Smirnov test, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and path analysis of structural equation modeling (SEM) analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1), burnout syndrome (Study 2), and depression (Study 3) were also analyzed.Results. In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure activities, and work relationships (p < 0.01). The hypothesis model results suggest that the classification of occupational dysfunction had good fit on the stress response (RMSEA = 0.061, CFI = 0.947, and TLI = 0.943), burnout syndrome (RMSEA = 0.076, CFI = 0.919, and TLI = 0.913), and depression (RMSEA = 0.060, CFI = 0.922, TLI = 0.917). Moreover, the detected covariates include opportunities for refreshment, time spent on leisure activities, and work relationships on occupational dysfunction.Conclusion. Our findings indicate that psychological problems are associated with occupational dysfunction in healthcare workers. Reduction of occupational dysfunction might be a strategy of better preventive occupational therapies for healthcare workers with psychological problems. However, longitudinal studies will be needed to determine a causal relationship.

Highlights

Practitioners, educators, and researchers acknowledge occupational dysfunction as a major health problem in preventive occupational therapy (Jackson et al, 1998; Mandel & Association AOT, 1999; Horowitz & Chang, 2004; Scaffa & Reitz, 2013)
We surmise that occupational dysfunction and psychological problems in healthcare workers is further influenced by personal factors, including age, gender, years of work experience, job category, opportunities for refreshment, time spent on leisure activities, and quality of work relationships
The covariates have structural relationships with occupational dysfunction

Summary

Introduction

Practitioners, educators, and researchers acknowledge occupational dysfunction as a major health problem in preventive occupational therapy (Jackson et al, 1998; Mandel & Association AOT, 1999; Horowitz & Chang, 2004; Scaffa & Reitz, 2013). Occupational dysfunction is defined as a negative experience emerging from an unsatisfactory lifestyle atmosphere; it includes occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization (Teraoka & Kyougoku, 2014; Teraoka & Kyougoku, 2015). Occupational marginalization is defined as impeding participation in daily activities (Townsend & Wilcock, 2004). Occupational deprivation is a lack of choices in daily activities that are beyond the individual’s control (Gail, 2000). Occupational alienation is the failure to fulfill the inner needs in everyday activities (Wendy, Christine & McKay, 2004). Occupational imbalance is a loss of balance in engagement during daily activities (Dana et al, 2010)

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