High Sickness Absence Research Articles

Understanding sickness absence in nurses and personal support workers: Insights from frontline staff and key informants in Northeastern Ontario.

Nurses and personal support workers (PSWs) have high sickness absence rates in Canada. Whilst the evidence-based literature helped to identify the variables related to sickness absenteeism, understanding "why" remains unknown. This information could benefit the healthcare sector in northeastern Ontario and in locations where healthcare is one of the largest employment sectors and where nursing staff have high absence and turnover rates. To identify and understand the factors associated with sickness absence among nurses and PSWs through several experiences while investigating if there are northern-related reasons to explain the high rates of sickness absence. In this descriptive qualitative study, focus group sessions took place with registered nurses (n = 6), registered practical nurses (n = 4), PSWs (n = 8), and key informants who specialize in occupational health and nursing unions (n = 5). Focus group sessions were transcribed verbatim followed by inductive thematic analysis. Four main themes emerged, which were occupational/organizational challenges, physical health, emotional toll on mental well-being, and northern-related challenges. Descriptions of why such factors lead to sickness absence were addressed with staff shortage serving as an underlying factor. Despite the complexity of the manifestations of sickness absence, work support and timely debriefing could reduce sickness absence and by extension, staff shortage.

Effects of exposure to workplace terrorism on subsequent doctor certified sickness absence, and the modifying role of psychological and social work factors: a combined survey and register study

BackgroundStudies have shown that terrorist attacks affect the mental and physical health of persons exposed to terrorism. When terror strikes at the workplace where people spend much time, and should feel safe, the health consequences for those affected might be severe. The aim of the study was to determine whether psychological and social work factors moderates effects of exposure to a workplace terrorist attack on subsequent doctor-certified sickness absence.MethodsThe study design combined survey data with register data on sickness absence. Data on exposure to the attack, and psychosocial working conditions were collected by a web-based questionnaire 10 months after the attack. Survey data was linked to registry data on doctor-certified sickness absence over the one-year time period following baseline. The survey response rate was 56% (n = 1974), where 80.6% (1591) gave consent to link survey data to data on sickness absence. Exposure to the attack was assessed as “Directly-”, or “Indirectly exposed”. Psychological and social work factors were measured by the General Questionnaire for Psychological and Social factors at Work (QPSNordic). Data were analyzed with negative binominal hurdle regressions.ResultsDirect exposure to the attack increased the odds of becoming sick-listed if role clarity was average (OR = 1.50) or high (OR = 2.13), but not if low (OR = 1.17). Direct exposure was associated with higher sickness absence rates if control over work pace was low (RR = 1.61). Role conflict, support from co-workers, and -superior showed weaker evidence of moderating effects of exposure on sickness absence.ConclusionsExposure to the bomb explosion, as well as psychosocial working conditions affect the risk of employee sickness absence. Psychosocial working conditions seems to moderate effects of exposure to workplace terrorism on subsequent sickness absence. Organizations would benefit from striving for good psychological and social working conditions both as preventions against illness and sickness absence, and as measures in the aftermath of a workplace terrorist attack.

Early work-environmental indicators of bullying in an academic setting: a longitudinal study of staff in a medical university

ABSTRACT The purpose of this study was to use a longitudinal approach to investigate the association between work-related psychosocial factors and workplace bullying in an academic setting. A questionnaire was sent out three times to about 4500 academic- and non-academic staff in a medical university. Those two group were analyzed together and separately. Logistic regression analyses were used to calculate odds ratios (OR). In the study, we found that factors such as lack of support, low control, inconsistent role demands, poor leadership, poor organizational climate, high sickness absence and high sickness presence can be important predictors of future bullying. We found that factors in an academic setting differ somewhat for academics and non-academic staff. This might indicate that type of job should be take into consideration in attempts to successfully prevent bullying at an early stage.

Cardiorespiratory Fitness and Device-Measured Sedentary Behaviour are Associated with Sickness Absence in Office Workers.

Physical activity reduces the risk of several noncommunicable diseases, and a number of studies have found self-reported physical activity to be associated with sickness absence. The aim of this study was to examine if cardiorespiratory fitness, device-measured physical activity, and sedentary behaviour were associated with sickness absence among office workers. Participants were recruited from two Swedish companies. Data on sickness absence (frequency and duration) and covariates were collected via questionnaires. Physical activity pattern was assessed using ActiGraph and activPAL, and fitness was estimated from submaximal cycle ergometry. The sample consisted of 159 office workers (67% women, aged 43 ± 8 years). Higher cardiorespiratory fitness was significantly associated with a lower odds ratio (OR) for both sickness absence duration (OR = 0.92, 95% confidence interval (CI) 0.87–0.96) and frequency (OR = 0.93, 95% CI 0.90–0.97). Sedentary time was positively associated with higher odds of sickness absence frequency (OR = 1.03, 95% CI 0.99–1.08). No associations were found for physical activity at any intensity level and sickness absence. Higher sickness absence was found among office workers with low cardiorespiratory fitness and more daily time spent sedentary. In contrast to reports using self-reported physical activity, device-measured physical activity was not associated with sickness absence.

Work-relatedness of the presented health problem and sickness absence.

BackgroundPerception by workers of their health problems as work-related is possibly associated with sickness absence (SA). The aim of this study was to to study the relationship between perceived work-relatedness of health problems and SA among workers who visit their GP, taking the influence of other potential determinants into account and to study the influence of these determinants on SA. Design and setting prospective cohort study in 32 Dutch GP practices.MethodsA secondary analysis of RCT data among workers, aged 18–63 years, who visited their GP. We measured self-reported SA days in 12 months and high SA (>20 days in 12 months) and compared workers who perceived work-relatedness (WR+) with workers who did not (WR−). With multivariable linear and logistic regression models, we analyzed the influence of age, gender, experienced health, chronic illness, prior SA, number of GP consultations and perceived work ability.ResultsWe analyzed data of 209 workers, 31% perceived work-relatedness. Geometric mean of SA days was 1.6 (95% CI: 0.9–3.0) for WR+− workers and 1.2 (95% CI: 0.8–1.8) for WR− workers (P = 0.42). Incidence of high SA was 21.5 and 13.3%, respectively (odds ratio 1.79; 95% CI: 0.84–3.84). SA was positively associated with chronic illness, prior SA, low perceived work ability and age over 50.ConclusionsPerceived work-relatedness was not associated with SA. SA was associated with chronic illness, prior SA, low perceived work ability and age over 50.

Sickness absence and disability pension in relation to first childbirth: three cohorts in Sweden

Abstract Background Childbirth is suggested to be associated with elevated levels of sickness absence (SA) and disability pension (DP). However, knowledge about patterns of SA/DP before and after childbirth as compared to patterns among women who remain nulliparous is limited. We aimed to compare SA/DP across several periods among women with different childbirth status. Methods We analysed three population-based cohorts of all women aged 18-39 years who had not previously given birth and who lived in Sweden on 31 December 1994, 1999, or 2004, respectively. We compared crude and standardized annual mean SA and DP net days during three years preceding to three years after the date of first childbirth, among women having (1) their first and only birth during the subsequent three years, (2) their first birth and at least another delivery, and (3) no childbirths before, nor during the study period. Results Despite an increase in SA in the year preceding the first childbirth, women who gave birth, and especially women with multiple births, tended to have lower levels of SA/DP days throughout the years than women without childbirths. SA/DP days varied across age groups; young women (aged 18-24 years) without childbirths had fewer SA days, but more DP days than their same-aged counterparts who gave birth, regardless of year. These results did not differ across the three cohorts, suggesting that the results were not affected by period effects. Conclusions Women with more than one childbirth had fewer days of SA and DP, as compared to women with one childbirth and to women having no births. Thus, childbirth does not seem to be associated with higher levels of SA and DP. Some of these results can be due to a health selection into giving birth, especially having more births. Key messages Except for the year before delivery, i.e., when pregnant, women giving birth had fewer SA and DP days than women with no births. Thus, childbirth does not seem to be associated with higher SA and DP. Women who had more than one childbirth had less SA/DP days than those with one childbirth.

A panel study of sickness presence and sickness absence among secondary school students.

This article investigates sickness presence among secondary school students in 5 European countries. The research questions asked are: What characterizes students with high sickness presence in secondary schools? Does high sickness presence influence future sickness absence? A group of 7008 students aged 16-19 years participated in the first study (2016), and 5002 of them also participated in the follow-up study (2017). The participants came from 25 schools in Belgium, Estonia, Finland, Italy and Latvia. The response rate was high. A multivariate binomial logistic regression analysis was used. In 2016 high sickness presence (≥ 5 incidents) was reported by 16% of the students, and in 2017 by 15% of them. In 2016 there were significant differences between countries, and students from Latvia were most likely to report high sickness presence (adjusted odds ratio [aOR] = 3.45). Students with high absence (aOR = 1.86) and high school motivation (aOR = 1.16, for 1 pt increase on a 5-point scale) were overrepresented among those reporting high sickness presence. Country, absence and motivation were also significant factors for sickness presence in 2017. Furthermore, there was a significant positive association between high sickness presence and high sickness absence the following year. Country, absence, and motivation were important factors for high sickness presence in secondary schools. Engaging in high sickness presence seemed to influence future sickness absence. Int J Occup Med Environ Health. 2019;32(6):797-804.

Work-Related Exposures and Sickness Absence Trajectories: A Nationally Representative Follow-up Study among Finnish Working-Aged People.

The contribution of physically demanding work to the developmental trajectories of sickness absence (SA) has seldom been examined. We analyzed the associations of 12 physical work exposures, individually and in combination, with SA trajectories among the occupationally active in the Finnish nationally representative Health 2000 survey. We included 3814 participants aged 30–59 years at baseline, when exposure history to work-related factors was reported. The survey and interview responses were linked with the annual number of medically confirmed SA spells through 2002–2008 from national registries. Trajectory analyses identified three SA subgroups: 1 = low (54.6%), 2 = slowly increasing (33.7%), and 3 = high (11.7%). After adjustments, sitting or use of keyboard >1 year was inversely associated with the high SA trajectory (odds ratio, OR, 0.57; 95% 95% confidence interval, CI, 0.43–0.77). The odds of belonging to the trajectory of high SA increased with an increasing number of risk factors, and was highest for those with ≥4 physical workload factors (OR 2.71; 95% CI 1.99–3.69). In conclusion, these findings highlight the need to find ways to better maintain the work ability of those in physically loading work, particularly when there occurs exposure to several workload factors.

\u201cThe importance of awareness, support and inner strength to balance everyday life\u201d - a qualitative study about women\u2019s experiences of a workplace health promotion program in human service organizations in Sweden

BackgroundIn many European countries, women have a higher sickness absence rate than men.Women also report higher levels of work-life conflict, which has a negative impact on women’s self-perceived health. Interventions studies on work-life balance literature are scarce. This research adds knowledge about work-life balance by examining female employees’ experiences of a newly developed intervention program, the BELE program (Balance in Everyday Life Empowerment program), aiming to enhance the work-life balance and wellbeing of female employees.MethodsAll participants in the BELE program were included in the sample (n = 55) of the study. The methods used for gathering data were focus group interviews (n = 8) and semi-structured individual interviews (n = 8). A qualitative content analysis was used for the analyses.ResultsThe results showed that a majority of the participants experienced a process of change for enhancement of wellbeing and balance in their everyday life when taking part in the BELE program. In the analyses, three main themes emerged. Reflecting and strengthening inner resource, Trying to change everyday patterns and habits and Experiencing more balance and well-being.ConclusionsThe results point out the importance of awareness and reflection on everyday life to promote work-life balance and wellbeing. The BELE program was described as a wakeup call to one’s own life and as an enhancer of empowerment processes and equality in the homes. Moreover, the results showed the need for health education in the workplace focusing on both work and private life to enhance balance and wellbeing among female employees’. The findings indicate that it is important to work at individual and group levels in work-life balance interventions and not merely at the organizational level or in the workplace setting.

Does lifestyle matter for sickness absence?

Does lifestyle matter for sickness absence?

Commuting and Sickness Absence

We investigate the causal effect of commuting on sickness absence from work using German panel data. To address reverse causation, we use changes in commuting distance for employees who stay with the same employer and who have the same residence during the period of observation. In contrast to previous papers, we do not observe that commuting distances are associated with higher sickness absence, in general. Only employees who commute long distances are absent about 20% more than employees with no commutes. We explore various explanations for the effect of long distance commutes to work and can find no evidence that it is due to working hours mismatch, lower work effort, reduced leisure time or differences in health status.

Shift work and sickness absence—the mediating roles of work–home conflict and perceived health

This study investigates the relationship between sickness absence and shift work. It is hypothesized that the effect of shift work is linked to sickness absence by two mediators: perceived health and work‐family conflict (WFC). Shift work was hypothesized to have an adverse effect on health, as well as making work‐family balance harder to obtain, both in turn resulting in higher sickness absence. The study distinguishes between self‐declared (short‐term) and doctor declared (long‐term) sickness absence. A survey was conducted covering all employees in a Norwegian hospital working more than 30 % of a full position (N=5272) in January 2012, yielding 1864 valid responses (% response = 36). Survey data was coupled with register data on days of sickness absence in 2014. A model with perceived health and WFC as mediating variables between shift work and sickness absence was tested. The findings indicate no direct effect of shift work on sickness absence, but indirect effects both through WFC and perceived health.

Examination of the double burden hypothesis-a systematic review of work-family conflict and sickness absence.

Background: Women consistently have higher sickness absence than men. The double-burden hypothesis suggests this is due to higher work–family burden in women than men. The current study aimed to systematically review prospective studies of work–family conflict and subsequent sickness absence. Methods: A systematic search was conducted in the electronic databases Medline, PsycINFO, and Embase with subject heading terms and keywords with no language or time restrictions. Two reviewers independently screened abstracts and read full-texts with pre-defined inclusion and exclusion criteria. Results: Eight included studies (n = 40 856 respondents) measure perceived work–family conflict and subsequent sickness absence. We found moderate evidence for a positive relationship between work–family conflict and subsequent sickness absence, and that women experience higher levels of work–family conflict than men. Conclusion: Work–family conflict is associated with later sickness absence, and work–family conflict is more common for women than for men. This indicates that work–family conflict may contribute to the gender gap in sick leave. However, further studies are needed to confirm whether this relationship is causal.

Staff perceptions and changing role of pre-hospital profession in the UK ambulance services

PurposeThere is a growing academic interest in the examination and exploration of work intensification in a wide range of healthcare settings. The purpose of this paper is to explore the differing staff perceptions in emergency ambulance services in the UK. It provides evidence on the challenges for the paramedic professionalisation agenda and managing operational demands and work intensity in emotionally challenging circumstances, with significant implications for patient safety.Design/methodology/approachDrawing on the evidence from an empirical study in a large National Health Service ambulance trust in England, this paper examines the challenges and differing staff perceptions of the changing scope and practice of ambulance personnel in the UK. Amidst the progress on the professionalisation of the paramedic agenda, individual trusts are facing challenges in form of staff attitudes towards meeting performance targets, coupled with rising demand, fear of loss of contracts and private competition.FindingsResearch findings highlight differing perceptions from various sub-cultural groups and lack of clarity over the core values which are reinforced by cultural and management differences. Need for greater management to explore the relationship between high sickness levels and implications for patient safety including the need for policy and research attention follows from this study. The implications of work intensity on gender equality within the ambulance settings are also discussed.Research limitations/implicationsAmbulance services around the world are witnessing a strain on their operational budgets with increasing demand for their services. Study evidence support inconclusive evidence for patent safety despite the growing specialist paramedic roles. Organisational implications of high staff sickness rates have been largely overlooked in the management literature. This study makes an original contribution while building upon the earlier conceptions of work intensification.Practical implicationsThe study findings have significant implications for the ambulance services for better understanding of the staff perceptions on work intensity and implications for patient safety, high sickness absence rates amidst increasing ambulance demand. Study findings will help prepare the organisational policies and design appropriate response.Social implicationsSocietal understanding about the organisational implications of the work intensity in an important emergency response service will encourage further debate and discussion.Originality/valueThis study makes an original contribution by providing insights into the intra-organisational dynamics in an unusual organisational setting of the emergency ambulance services. Study findings have implications for further research inquiry into staff illness, patient safety and gender issues in ambulance services. Evidence cited in the paper has further relevance to ambulance services globally.

Gendered effects of intensified care burdens: employment and sickness absence in families with chronically sick or disabled children in Norway

Using longitudinal register data from Norway, the article examines the impact of having a child with intensified care needs on maternal and paternal employment, within a gender equality promoting welfare state. The hypothesis is that parents with a chronically sick or disabled child will have lower employment probabilities, lower labour earnings and higher sickness absence than parents with a healthy child, and that mothers are more affected than fathers when having a child with extra care needs. A quasi-experimental difference-in-difference regression model shows that the employment probabilities of parents with a sick or disabled child are comparable to those of parents with a healthy child, both for mothers and fathers. The analyses further reveal that having a chronically sick or disabled child reduces labour earnings and increases long-term sickness absence among mothers, while fathers’ labour earnings and sickness absence are less affected.

Sickness absence in workplaces: Does it reflect a healthy hire effect?

Sickness absence in workplaces may reflect working conditions. It may also reflect a "healthy hire effect," i.e., that workplaces recruit individuals with experience of sickness absence differently. The purpose of the study was to determine if a history of sickness absence among recruits is associated with the average level of sickness absence in workplaces. In a register-based follow-up study, Swedish workplaces with at least 5 employees in 2006 were selected (approximately 127 000 workplaces with 3.9 million employees). The workplaces were categorized according to the average workplace sickness absence in 2006 and the recruits were categorized according to the individual sickness absence in 2005. The workplaces with a high average level of sickness absence were more likely than those with a low level to hire employees with high sickness absence in the year preceding employment: men - odds ratio (OR) = 7.2, 95% confidence interval (CI): 6.6-7.8, women - OR = 7.5, 95% CI: 6.9-8.1. The results show that there is a greater likelihood of employing individuals with high levels of sickness absence in the workplaces with many days of the average sickness absence than in the workplaces with few days of the average sickness absence. The results suggest that sickness absence in workplaces may reflect a healthy hire effect.

Health Behaviours As a Mechanism in the Prospective Relation between Workplace Reciprocity and Absenteeism: A Bridge too Far ?

BackgroundThe persistent lack of evidence on causal mechanisms between social capital and health threatens the credibility of the social capital—health association. The present study aims to address this ongoing problem by investigating whether health behaviours (i.e. smoking, alcohol consumption, and physical activity) mediate the prospective relation between workplace reciprocity and future sickness absence.MethodsA cohort of 24,402 Belgian employees was followed up during 12 months for sickness absence. Workplace reciprocity was measured with four indicators—colleague help, colleague interest, supervisor help, and supervisor concern. Three types of multilevel mediation models were applied.ResultsOverall, workplace reciprocity negatively related to high sickness absence (≥ 10 days) mainly independently from health behaviours. Uniquely, colleague interest positively related to smoking (OR = 1.058, 95% CI = 1.019, 1.098) and smoking in turn, positively related to sickness absence (OR = 1.074, 95% CI = 1.047, 1.101). No behavioural pathways could be identified between company-level reciprocity and sickness absence, and company-level health-related behaviours did not mediate the relation between company-level reciprocity and individual sickness absence.ConclusionsThese results suggest that both social capital and health behaviours are relevant for employee health, but health behaviours seem not to be the underlying explanatory mechanism between workplace reciprocity and health.

Documentation Requirements, Intrinsic Motivation, and Worker Absence

ABSTRACTCommand systems are widely used to monitor public service provision, but little is known about unintended effects on individual workers’ motivation and work effort. Using insights from motivation crowding theory, we estimate a SEM model that captures how Danish childcare assistants and social/healthcare assistants perceive documentation requirements. We analyze how this perception relates to intrinsic motivation measured in a survey and sickness absence as reported in administrative registers, and find that individuals who perceive documentation requirements as controlling have lower intrinsic motivation and higher sickness absence. The association is statistically significant, but very small in substantive terms. The result is nevertheless consistent with the expectation in motivation crowding theory and contributes to the literature by including a new, reliable behavioral variable—sickness absence—and by drawing attention to possible downsides of command-and-control. Even though command systems can also have positive disciplining effects, knowledge about potential drawbacks is important for public managers.

A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial.

BackgroundNeed for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers.Methods/DesignA two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period.DiscussionThis study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability.

Trends of sickness certifications in primary health care in muscat, sultanate of oman.

Sickness certification (SC) is common practice in primary health care with proven implications on the health system. To assess the rate of sickness certifications in the Bowsher province and describe related demographic, occupational and medical factors. Our retrospective, cross-sectional study retrieved data for all consultations, with patients aged six to 65 years old, which ended with SC. The data from four primary health care centers in the Bowsher provice were collected during 2011 using the electronic medical record system. Collected data included patient demographics, occupation, date issued, duration of sickness certification, recorded vital signs, and clinical diagnosis. Suitable rates were calculated as percentages and important differences were compared using the chi-square test. The total number of consultation visits for the targeted population was 189,275. Of these 26,096 consultations resulted in SC to a total of 15,758 patients. The overall rate of SC was 13.8 per 100 consultation-years (confidence interval (CI): 13.6-14). SC rates in males were significantly higher than females (17 and 11 per 100 consultations/year, respectively). Patients aged 19-29 years old had the highest rate of SC (18.6/100 consultations/year). School students aged six to 18 years made up 28% of patients, and 24% and 22% of patients were working in the private and public sectors, respectively. No vital signs record was found for 30% of SC visits. The highest rate of SC was in October (17%) and the lowest was in August (9%). Acute respiratory infections were the most frequent diagnoses (31%) resulting in certifications. The rate of SC issued for Omanis and non-Omanis was 14 and 9 per 100 consultations per year, respectively. Sickness certification is a burden on primary health care in the studied health centers with approximately one in seven consultations ending with SC issued. More investigations are needed to identify determinates of high sickness absence. Robust guidelines are important to regulate the number of sickness certificates issued.