High Work Demands Research Articles

Stress in novice nurses in new work environments: a systematic review.

Inexperienced nursing care can compromise the quality of care and the well-being of patients. The aim of this study was to assess the main sources of stress encountered by nurses and novice nurses in a setting not previously experienced. A systematic review was conducted following the PRISMA format in Pubmed, Scopus, Web of Science, and CINAHL electronic databases in March 2024. A total of 395 studies were identified, of which 16 met the inclusion criteria. Selection was made on the basis of topic relevance and methodological quality, assessed using the critical tools of the Joanna Briggs Institute (JBI). A total of 16 studies were included in this review. Of the 16 selected, 10 were cross-sectional studies, 3 were cohort studies, 2 were qualitative, and 1 was a systematic review. The studies revealed that the main stressors for novice nurses included time management, workload, and interpersonal relationships. The results underline that organizational factors, such as lack of support and high work demands, play a key role in generating stress. Identifying and addressing the key challenges faced by novice nurses, such as workload, adjustment to the environment, professional expectations, and interpersonal relationships, is crucial to sustain their professional engagement and ensure the quality of health care. This understanding is essential for creating efficient policies and practices that enhance the occupational well-being and stability of nurses in the workforce. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024520651, CRD42024520651.

The impact of work-family conflict on occupational fatigue among endoscopy nurses in China: a moderated mediation model.

Endoscopy nurses in China face significant work-family conflicts, where the clash between high work demands and family responsibilities markedly increases the risk of occupational fatigue. This not only affects the nurses' physical and mental health and overall well-being, but also poses a threat to the quality of care and patient safety. This study, grounded in the Conservation of Resources theory, constructs a moderated mediation model to examine the mediating role of positive coping style in the relationship between work-family conflict and occupational fatigue among endoscopy nurses in China, as well as the moderating effect of perceived social support. A convenience sampling method was employed to select 315 endoscopy nurses from 25 tertiary hospitals across 14 provinces in China. A questionnaire survey was conducted using the Fatigue Assessment Instrument, the Work-Family Conflict Scale, the Simplified Coping Style Questionnaire, and the Perceived Social Support Scale. The moderated mediation model was validated using Stata16.0. Our findings reveal that work-family conflict is a significant predictor of occupational fatigue, with a negative impact on positive coping style. Positive coping style, in turn, is negatively associated with occupational fatigue. Furthermore, positive coping style partially mediates the relationship between work-family conflict and occupational fatigue, accounting for 35.52% of the total effect. Additionally, perceived social support mitigates the negative effects of work-family conflict on positive coping style and occupational fatigue. There exists a moderated mediation effect between work-family conflict and occupational fatigue among endoscopy nurses in China, wherein positive coping style serve as a mediating variable. Perceived social support mitigates the negative impact of work-family conflict on positive coping style, while enhancing the alleviating effect of positive coping style on occupational fatigue. Therefore, improving endoscopy nurses' levels of perceived social support and coping strategies may help to prevent and alleviate the occurrence of occupational fatigue.

Effect of a smartphone self-management digital support system for low-back pain (selfBACK) among workers with high physical work demands - secondary analysis of a randomized controlled trial.

This study aimed to investigate whether physical work demands modify the effect of the selfBACK app, which is designed to support self-management of low-back pain. In a secondary analysis of the selfBACK trial with 346 employed participants, we stratified into low (N=165) and high physical work demands (N=181). Outcomes included the Roland-Morris Disability Questionnaire (0-24), a numeric rating scale for low-back pain intensity (0-10), the Pain Self-Efficacy Questionnaire (0-60), and work ability (0-10). Intervention effects were assessed at three- and nine-month follow-ups using a linear mixed model. At three months, high physical demand workers with selfBACK showed a significant reduction in pain intensity [-0.8, 95% confidence interval (CI) -1.3- -0.2] compared to usual care. By nine months, the high physical demands workers with selfBACK reported reduced pain-related disability (-1.4, 95% CI -2.7- -0.1), improved pain self-efficacy (3.5, 95% CI 0.9-6.0), and lower pain intensity (-1.0, 95% CI -1.6- -0.4) compared to usual care. Low physical demands workers with selfBACK also improved pain self-efficacy [2.8 (95% CI 0.3-5.3)] compared to usual care. The impact of selfBACK was more noticeable among workers with high physical demands compared to their low physical demand counterparts, but no statistically significant differences were found in any outcome. The selfBACK intervention had consistent effects across workers with high and low physical work demands, indicating that these demands did not modify its impact. Both groups experienced similar positive effects, highlighting the intervention's effectiveness across varying levels of physical work demands.

A daily exercise prescription when work gets tough: The moderating effect of work demands on the relationship between daily physical exercise and next-day well-being and job performance.

Physical exercise is widely recognized for its benefits to individuals' general health, yet its implications for in-role and extrarole job performance, especially on demanding workdays, have rarely been explored. This oversight is concerning as high work demands can deter employees from exercising when they are unaware that exercise can improve their job performance on demanding workdays. In this research, we draw on the effort-recovery model to propose that daily physical exercise not only promotes next-day well-being but also enhances next-day in-role job performance and extrarole organizational citizenship behavior (OCB) by fostering positive affect and work engagement the following day. Moreover, these benefits of daily physical exercise are more pronounced on days with high rather than low work demands. Results from two experience sampling studies generally support our hypotheses, revealing that daily physical exercise contributes to next-day well-being, both self- and leader-rated in-role job performance and self-rated, but not leader-rated, extrarole OCB, through the sequential mediation of next-morning positive affect and next-day work engagement. Furthermore, these benefits of physical exercise are more evident on days when employees face high overall work demands (Study 1) and in particular on days with high-hindrance demands but on days with low-challenge demands (Study 2). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Positive Perspective: The Role of Narsism and Job Stressors on Work Productivity at Muhammadiyah University of Makassar

Many have carried out comprehensive testing. High work demands, but not accompanied by a conducive work environment can affect a person's productivity. This research is very important considering that work productivity is a demand, especially for study programs as a driver for the development and progress of a study program. Study programs have very extreme working hours which often cause some individuals to become stressed. This research emphasizes narsism in negative perceptions, uses secondary data and tries to construct other dimensions of narsism through positive perceptions which can stimulate work productivity both individually and in the surrounding environment. The objectives of this research are focused on 1) obtaining empirical evidence of the influence of narsism and job stressors on work productivity, 2) To check the tendency for narcissistic behavior to have a negative or positive value on work productivity. The research was analyzed using Structural Equation Modeling (SEM) with the Partial Least Squares (PLS) approach. The research results show that Narsism has no effect on work productivity, while Job Stressors have a positive and significant effect on work productivity at the Muhammadiyah University of Makassar.

Work Engagement: A Descriptive Qualitative Study on the perception of teachers

Work engagement is a state of mental motivation that allows workers to achieve success in the workplace. However, due to high work demands and exhaustion, teachers might find it difficult to engage in work. Teachers can develop work engagement if they intervene in the barriers that prevent them from doing their work by providing facilitators. The aim of this study was to describe teachers' perceptions of work engagement at different stages of education. A descriptive qualitative study was designed. Four focus groups were conducted with a total of 26 Spanish teachers. Three main themes and six sub-themes emerged from the analysis of the data: (1) Causes of the generation of work engagement: personal facilitators and facilitators of the environment; (2) Barriers to generating work engagement: individual and environmental; (3) Effects of work engagement: positive consequences and negative consequences. These findings indicate that there are several facilitators and barriers that promote and/or hinder the generation of work engagement in Spanish teachers. However, it should be noted that the study presents transferable results for other countries dealing with similar issues. In conclusion, training teachers in certain skills would improve their ability to solve complex situations and increase their levels of work engagement.

Work-, lifestyle-, and health-related factors among women and men working in the emergency medical services

Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.

Influence of Perceived Job Demands on Professional Quality of Life and Turnover Intentions of Haematology Nurses: A Cross-Sectional Study

Background. Haematology nurses in Singapore experience a highly stressful work environment and increased workload due to the growing number of patients and complex treatment regimens. High job demands can lead to burnout and high staff turnover rates, which compromises the quality of patient care. Aims. To assess perceived work demands, levels of social support from colleagues, professional quality of life (ProQOL), and turnover intentions among haematology nurses and examine whether demographic and occupational characteristics, perceived job demands, and support were associated with ProQOL and turnover intentions. Design. A descriptive, correlational, and cross-sectional design was used in this study. Methods. A convenience sample of 60 haematology nurses working at a tertiary hospital in Singapore completed a self-administered survey. Perceived job demands, support from colleagues, ProQOL, and turnover intentions were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ III), Professional Quality of Life Scale version 5 (ProQOL5), and Turnover Intention Scale (TIS-6). Descriptive statistics, chi-square test, and multiple linear regressions were employed for data analysis. Results. Haematology nurses face high cognitive and emotional demands and receive high levels of support from colleagues at work. The majority of the participants reported moderate to high levels of compassion satisfaction (78.3%), burnout (76.7%), and secondary traumatic stress (81.7%). 53.3% of the participants expressed their intention to leave. Perceived job demands were significant predictors of haematology nurses’ ProQOL and turnover intentions. Compassion fatigue also significantly predicts turnover intentions. Conclusion. The high levels of burnout and secondary traumatic stress reported by haematology nurses highlight an urgent need to implement strategies to help nurses cope with the high work demands and reduce their levels of compassion fatigue. Implications for Nursing Management. The findings in this study can help nursing leaders understand haematology nurses’ perceived job demands and ProQOL, to develop strategies to improve the workplace environment and retention.

The Psychosocial Workplace Atmosphere Experienced by Nurses in General Practice: Lithuanian Nurses Cases

Introduction: In the current era, evading heightened job demands has become nearly impracticable. The impact of these elevated expectations on mental health can vary for each individual; they may yield positive effects, fostering alertness and motivation. However, when these demands surpass manageable limits, they can lead to stress, posing risks to an individual's well-being. Furthermore, nurses are not exempt from this phenomenon. Nurses constitute approximately half of the workforce in healthcare facilities globally (HCF). Looking back, it's a recurring pattern for nurses to be at the forefront in addressing global health crises. Moreover, the COVID-19 pandemic has served as a stark reminder to everyone regarding the pivotal role nurses play in society. Methods: A quantitative research method was chosen. The analysis of scientific literature aims to uncover the concept and significance of the psychosocial work climate while exploring the specifics of psychosocial risks and nurse relationships. Through a quantitative study employing a questionnaire, the objective is to evaluate the psychosocial work environment. This quantitative research, utilizing a questionnaire survey, employs descriptive statistical calculations to scrutinize the study's findings. There were 300 nurses involved in the study. Results: The study findings indicated that the psychosocial work climate for nurses exhibits both positive and negative facets. While most nurses enjoy positive relationships with their supervisors and colleagues, challenges arise due to certain team members who may not consistently offer the needed social support, sometimes fostering gossip or conflicts. Instances of verbal aggression were noted, while physical aggression cases were absent. Occasional reports of sexual harassment and mobbing were isolated. Identified predominant psychosocial risks for nurses encompass physical strain, ergonomic deficiencies, exposure to biological materials, as well as adverse effects from protective latex gloves and disinfectants. Conclusion: High work demands, heavy workloads, rapid pace, and a prevailing lack of time were observed. Nurses expressed discontent with their salaries and reported minimal influence on work decisions despite a positive perception of work control. Concerns regarding an uncertain future and fear of medical errors were prevalent. However, nurses felt adept at balancing work and personal life.

Correlation of Cranio-vertebral Angle with Scapular Dyskinesia in Goldsmith Workers

This study was undertaken to investigate the forward head posture and scapular dyskinesia in goldsmith workers due to their precision work. To keep the small cut diamond in proper mould and polish the gold requires precision and continuous forward bending of the neck. This posture requires high work demand of the neck musculature which leads to continuous upper back curved and neck in flexion and this position is maintained for long working hours.

Effort-reward and overcommitment at work and psychiatric symptoms in healthcare professionals: The mediation role of allostatic load

BackgroundDespite decades of advancement to support interventions for managing work-related stress, mental health issues have significantly escalated among healthcare professionals. Effort-reward imbalance (ERI) and overcommitment in the workplace are linked to several psychiatric disorders. However, the underlying biological mechanisms remain unclear. This study investigated whether ERI and overcommitment among healthcare professionals were linked to Allostatic Load (AL) and whether AL mediates the relationship between ERI, overcommitment and mental health issues. MethodsOne hundred forty-two nursing workers (n = 142; 90.1 % female, mean age: 39.5 ± 9.6) were randomly recruited from a university hospital in Sao Paulo, Brazil, and applied the ERI scale that assesses work effort, reward, and overcommitment. The Perceived Stress Scale (PSS), The Beck Depression Inventory (BDI), and the Self-Report Questionnaire for psychiatric symptoms (SRQ-20) evaluated the mental health outcomes. Ten neuroendocrine, metabolic, immunologic and cardiovascular biomarkers were analyzed, and values were transformed into an AL index using clinical reference cutoffs. ResultsLinear regression adjusted for covariates showed that higher scores for overcommitment were associated with higher AL indexes, which in turn were associated with higher SRQ-20, but not with PSS and DBI scores. As expected, higher scores for effort, lower for reward, and higher ERI were associated with higher scores for PSS, SRQ-20, and DBI, but not with AL index. Direct effect estimates showed that overcommitment was directly associated with higher SRQ-20 scores, and indirectly via AL. ConclusionOur study reveals that overcommitment, rather than ERI, was linked to increased AL in healthcare workers. Additionally, AL mediates the relationship between overcommitment and higher psychiatric symptoms, highlighting a key mechanism by which work stress can lead to mental health problems. Individual's responses to high work demands need to be considered when designing predictive models and interventions for mental health issues.

Why did middle-aged and older people retire since the first COVID-19 lockdown? A qualitative study of participants from the Health and Employment After Fifty study

BackgroundGovernments of Western countries need people to work to older ages, however the COVID-19 pandemic impacted the workforce by pushing older adults to retire. Socio-demographic factors that influence the decision to retire in the pre-pandemic period were, poor or good health, finances, marital status, and gender. The aim of this study was to explore aspects that contributed to the decision to retire among middle-aged and older people in England who retired during the COVID-19 pandemic.MethodsIn September 2022 semi-structured interviews were conducted with a sample of participants from the Health and Employment After Fifty (HEAF) study who retired since March 2020. Consenting participants were purposively selected to achieve a wide spread of characteristics deemed important in the retirement process. Telephone interviews were conducted, audio-recorded, transcribed and then thematically analysed.Results24 interviews were conducted (10 men and 14 women, mean age 65 years). Six themes were identified: four of them were non-COVID-19 aspects while two can be interpreted as impact of COVID-19 on the workforce. Work-related factors were of major importance. A sense of appreciation and attachment in relation to their employer, and conversely high work demands and stress, as well as changes in work responsibilities and work practices since lockdown and/or perception of personal safety in the workplace during the pandemic influenced their retirement decision, as did physical and mental health issues. Another theme suggested that some participants felt they had reached the ‘right’ age and needed to spend more time with family. Having the financial capacity to retire was widely mentioned but was never the main factor.ConclusionsThe decision to retire during the pandemic was multi-factorial although changes to work during lockdown were of great importance. Post-pandemic, our findings suggest that there are modifiable aspects of work, including appreciation and fair pay and work conditions, that employers and policy makers could encourage to retain their older workers.

Occupational stress and body composition of hospital workers: a follow-up study.

This study sought to analyze the influence of occupational stress on the body composition of hospital workers after one year of follow-up. This prospective cohort study included 218 workers from one of the leading private hospitals in the municipality of Santo Antônio de Jesus, Recôncavo da Bahia region, Northeast Brazil. Body composition was analyzed by proxy (Body Mass Index and Waist Circumference) and Bioelectrical Impedance Analysis. The primary exposure adopted in the present study was the perception of occupational stress, assessed with the adapted and reduced version of the Job Content Questionnaire evaluating demand and control dimensions. The covariates were work characteristics; biological characteristics; sociodemographic characteristics and lifestyle. Statistical analyses were performed using descriptive, bivariate and multivariate analysis. At the first stage of the study, we identified that 55.96% (n = 122) of workers had high work demand and 25.22% (n = 55) had low control. Among those who had high demand and low control at the beginning of the study, the majority were women, non-white, with low educational and income levels, sleeping less than 7 h/day. After 12 months of follow-up, the median value for demand continued as 13 (IQR: 5-25) and for control, it increased to 16 (IQR: 9-23). In this second moment of the study, 62.38% (n = 136) of workers showed high demand and 45.87% (n = 100) low control. The characteristics of workers with high demand and low control were similar to those of the first moment. The results indicate that high demand and low control at work are risk factors for changes in body mass index, fat mass and fat-free mass in hospital workers. This study shows the importance and need for clinical and epidemiological assessments regarding the body composition of professionals working in hospitals, since high rates of overweight and obesity are triggers of chronic health problems such as dyslipidemia, diabetes mellitus and cardiovascular diseases, among others. Therefore, managers must promote adequate working conditions and understand the need for periodic body composition assessments.

Health and job-related factors associated with work ability in older working populations of Korea.

Knowledge about determinants of workability is crucial for designing interventions to increase the participation of older employees in the workforce and maintain or increase their productivity levels at work. This study explored the impact of health conditions and job characteristics on poor work ability. This study used data from the Korean Longitudinal Study of Aging (KLoSA) from 2014 to 2020, which is a nationally representative population-based panel study of Korean citizens aged ≥45 years. The KLoSA survey assessed subjective work ability using work ability score. The participants were asked if they had been diagnosed with any underlying diseases by a physician. The job characteristics were assessed in terms of working conditions and satisfaction. Generalized estimating equations were used to calculate the odds ratios (ORs) and 95% confidence intervals for workers' health-related variables and job characteristics associated with poor work ability. The results showed that workers' health-related factors were associated with poor work ability; poor vision (OR = 1.52) and bad hearing ability (OR = 2.37); low gripping strength (OR = 2.29); poor self-rated health (OR = 3.77) and various diseases such as hypertension, diabetes, cancer, chronic lung disease, liver disease, heart disease, cerebrovascular disease, mental illness, arthritis, prostate disease, gastrointestinal disease and disc disease. Additionally, high physical work demands (OR = 1.51) and low job satisfaction (OR = 4.23) were highly correlated with poor work ability. The findings addressing poor work abilities caused by individuals' health- and job-related factors can help prioritize worker health management and the development of more effective human capital investment strategies at the workplace.

Effects of the “ICU Support” team meeting concept on patient-centered and staff-centered outcomes: study protocol for a randomized controlled multicenter study

BackgroundProviding optimal care for critically ill patients is an extremely important but also highly demanding task, both emotionally and physically. The “ICU Support” team meeting concept aims to support intensive care unit (ICU) teams by promoting interprofessional communication, peer support, and patient safety by providing a structure for daily team meetings. This protocol describes a study to explore the effectiveness of “ICU Support” for patient- and staff-centered outcomes.MethodsICU Support will be implemented at nine university hospitals located in Germany, following a two-arm randomized parallel group design with an intervention and a control condition and three data collection periods. In the intervention arm, leading ICU personnel (physicians and nurses) will be trained in ICU Support and implement the ICU Support elements into the daily work routine of their units upon completion of data collection period T0 (baseline). In the control arm, ICU Support will not be implemented until the completion of the data collection period T1 (1 month after study start). Until then, the regular daily schedule of the ICU teams will be maintained. The final data collection period (T2) will take place 4 months after the start of the study. Primary outcomes include the number of intensive care complications per patient during their ICU stay during T1 and the sick-related absence of ICU staff during T1. Secondary outcomes include, among others, the average severity of intensive care complications per patient and employee self-reported data regarding their teamwork and patient safety behaviors.DiscussionThe need for healthy and well-trained ICU staff is omnipresent; thus, structured and evidence-based interventions aimed at supporting ICU teams and facilitating patient safety are required. This multicenter study aims to explore the effectiveness of ICU Support for patient- and staff-centered outcomes. The insights derived from this study have the potential to significantly improve ICU patient safety, staff communication, and connectedness and decrease sickness-related expenses and social costs associated with high work demands among ICU staff.Trial registrationGerman Clinical Trials Register DRKS00028642. Registered on 4 April 2022.

HUBUNGAN STRES KERJA DENGAN KINERJA BIDAN SELAMA PANDEMIK COVID-19 DI KOTA PONTIANAK

Work stress on midwives during the COVID-19 pandemic can occur due to high work demands, long working hours, mindset, limited number of health workers. While the number of patients continues to grow and work safety procedures continue to change along with the development of the virus COVID-19. If a midwife does not manage work stress properly this will have an impact on her performance in providing health services to patients. This study aims to analyze the relationship between work stress and the performance of midwives during the COVID-19 pandemic in Pontianak City in 2021. In order to find and analyze the relationship between work stress and midwife performance, it is used methods quantitative with adesign cross sectional. The sample of this research was 43 midwives in Pontianak City. Sampling withmethod total sampling. Data analysis uses univariate and bivariate. The results of this study were 23 respondents (53.5%) who experienced work stress and 20 respondents (46.5%) who did not experience work stress. On the performance of midwives there are 25 respondents (58.1%) with good performance and 18 respondents (41.9%) with poor performance. Based on the Chi-square test, the p value = 0.004 means that the sig value is smaller than 0.05 (0.004 <0.05) indicating that work stress is related to the performance of midwives during the COVID-19 pandemic in Pontianak City. So that work stress is related to the performance of midwives during the COVID-19 pandemic in Pontianak City.

Exploring the aftermath: Work demands, workplace violence, and job satisfaction among nurses in a public hospital in the post-COVID-19 era.

Despite the shift from the COVID-19 pandemic to an endemic phase, many individuals, including nurses, may still be facing psychosocial challenges after enduring three years of the pandemic. Although the anticipation that psychosocial issues, such as work demand and workplace violence, have diminished and nurses' job satisfaction has improved, there is a scarcity of studies in Indonesia investigating this matter. This study aimed to 1) explore the current state of nurses' work demands, workplace violence, and job satisfaction and 2) examine the relationships between work demands, workplace violence, and respondents' characteristics with nurses' job satisfaction. The study employed a cross-sectional survey design involving 247 nurses from a regional general hospital in Jakarta, Indonesia. Simple random sampling was used to select the participants, and the Copenhagen Psychosocial Questionnaire (COPSOQ) III was used for data collection. Data were analyzed using multiple linear regression. The types of cognitive demands (M = 12.46, SD = 3.461), demands for hiding emotion (M = 11.66, SD = 3.554), and work pace (M = 9.87, SD = 2.847) scored an average close to or within the "sometimes/quite extensive" range on the scale. All types of workplace violence and conflicts occurred among nurses (Mean range = 1.21-2.57). Nurses perceived themselves as fairly satisfied with their job (M = 18.47, SD = 3.18). The results of the multiple linear regression indicated that nurses' job satisfaction was predominantly influenced by workplace violence (β = -0.191), followed by the type of care unit (β = -0.167) and work demands (β = -0.126). These factors collectively accounted for 9.1% of the variance in the job satisfaction variable (R2 = 0.091, p <0.005). Despite the decreasing number of COVID-19 cases, nurses still experience high work demands and continue to face workplace violence. These factors, as well as the type of care unit, influence nurses' job satisfaction. Therefore, further actions need to be taken by hospital management to address these psychosocial conditions. It is recommended that future research explore the role of nurse managers in managing the psychosocial factors associated with these three factors.

Understanding Physical Activity Behavior in Ghanaian Adults with Type 2 Diabetes: A Qualitative Descriptive Study.

Despite a relatively low prevalence rate, sub-Saharan Africa bears a substantial diabetes burden. Physical activity (PA) plays a crucial role in managing type 2 diabetes mellitus (T2DM). However, PA levels among this population remain suboptimal. This study aimed to explore patients' perspectives on the barriers and facilitators to PA participation among Ghanaian adults with T2DM. Thirteen adults with T2DM were recruited from Korle-Bu Teaching Hospital, Ghana, for this qualitative descriptive study. Semi-structured interviews were conducted, and the data were analyzed using thematic analysis. Two overarching themes (personal factors and socio-structural factors) and 10 sub-themes relating to PA barriers and facilitators were identified. Participants had limited awareness of the recommended PA guidelines for T2DM management. Chronic illness-related factors hindered exercise participation. Difficulty differentiating between PA and exercise impeded the achievement of PA targets. Socio-structural barriers include concerns about social ridicule or embarrassment, safety during outdoor activities, a lack of culturally appropriate exercise facilities, and high social and work demands. Despite these barriers, participants were motivated by their understanding of the health benefits of PA. They emphasized integrating PA into daily routines through walking, work-related tasks, and household chores. Motivation and PA education from healthcare professionals are valued supports in achieving PA targets. Our findings showed that PA behaviour in Ghanaian adults with T2DM is influenced by both personal and external factors. Tailored PA interventions for this population should address identified barriers while leveraging facilitators to implement successful PA programs.

Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses.

To investigate how NGNs perceived and applied an intervention for preventing stress-related ill health embedded in a transition-to-practice programme when entering their professional life. A qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention. In this qualitative methodology process evaluation, semi-structured and audio-recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis. The analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better-organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward. This process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work. When entering a new profession, it is crucial to receive a well-thought-out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies.

Longitudinal profiles of occupational physical activity during late midlife and their association with functional limitations at old age: a multi-cohort study

ObjectiveThe aim was to examine longitudinal profiles of occupational physical activity (OPA) from midlife to retirement and to investigate how the different OPA-profiles are associated with mobility limitations (ML) and activities of daily living (ADL-disability) at old age.MethodsHarmonized data from two cohort studies from Finland and the United States, that have followed people from midlife until old age were used. Repeated measurements of self-reported OPA were collected during approximately 11- to 12-year period. Persons who had data on OPA from ≥ 2 time points during the period from mid-working life to retirement were included. Latent class growth analysis was used to identify OPA-profiles. Risk ratios (RRs) with 95% confidence intervals for the associations of the OPA-profiles and later life MLs and ADL-disability were estimated.ResultsThree OPA-profiles were identified in both cohorts: high-persistent, moderate-fluctuating, and low-persistent. For majority OPA remained stable: for workers reporting high or low levels of OPA at midlife, the physical demands of work likely persisted, whereas people reporting moderate level OPA had high fluctuation in their exposure level. Members of high-persistent and moderate-fluctuating OPA-profiles had increased risk of subsequent MLs at old age. The RRs for ADL-disability did not differ between the profiles.ConclusionsPerceived OPA remains rather stable for workers reporting high or low physical work demands during midlife, yet fluctuating profiles also exist. Workers exposed to high or moderate OPA have higher risk for MLs when they reach old age. Establishing safe and health-promoting levels of OPA during late working life might have positive long-term consequences on healthy ageing.