Need For Recovery Research Articles

The need for recovery: An investigation into short-term work-related fatigue in veterinary nurses.

Veterinary nursing is physically and emotionally demanding, putting veterinary nurses at risk of acute work-related fatigue (AWRF). Despite the increased recognition of chronic occupational syndromes such as burnout and compassion fatigue in recent years, few studies have investigated how AWRF impacts individuals and the profession. An anonymous survey open to all UK-based registered veterinary nurses (RVNs) was distributed via email and social media. The survey investigated work patterns, hobbies, opinions about work and intentions to leave the veterinary profession. An English translation of the need for recovery (NFR) scale was used to quantify the AWRF. The median NFR score from 387 responses was 81.8, indicating high levels of AWRF. Long shifts, sole-charge work and overtime were associated with higher scores, while having support at work and a better work-life balance were associated with lower scores. Higher scores were correlated with intentions to leave the profession. Although validated as a measure of AWRF, the unidimensional NFR scale oversimplifies the complexities of fatigue. A limited number of RVNs responded to the survey, reducing statistical power. Although there is no single solution to staff turnover, the results from this survey suggest that addressing AWRF may improve retention of RVNs.

Different Methods to Detect Stress in Knowledge Workers: A Pilot Study for Long-term Monitoring.

Stress is a common part of working life, but knowledge is lacking on how to identify it early and with little effort on the part of the employee. We investigated whether simple stress reports and computer usage data could be useful tools for long-term assessment of stress in real life. 38 experts responded to a baseline questionnaire on need for recovery (NFR) and psychological distress (General Health Questionnaire, GHQ12). Their computer usage for work was recorded for 5 months, during which they filled in a 4-month simple diary and a 2-week detailed diary on, for example, stress and productivity. Salivary cortisol and heart rate variability were collected on 3 consecutive days. Generalized estimating equations models were used for the analyses. High NFR and GHQ12 predicted self-reported stress during work, and a decrease in (some) mouse usage features, but not keyboard usage features, over the following months. Some mouse usage features were associated with stress and productivity. The results provide some support for the usefulness of simple stress questions and mouse usage features in assessing long-term stress in real life.

Exploring Associations Between Device-Based Occupational Sedentary Behavior and Need for Recovery in White Collar Workers: A Compositional Data-Analysis.

White collar workers spend an increasing amount of time in occupational sedentary behavior (OSB) and are thereby at risk for adverse health outcomes. Nevertheless, the association between OSB and the need for recovery (NFR), an important indicator of wellbeing, is unknown and therefore examined. Baseline data from a cluster randomized controlled trial was used. A subgroup of 89 white collar workers wore a triaxial accelerometer for 7days. NFR was measured using the Questionnaire on the Experience and Evaluation of Work. Compositional data analysis was applied to determine the composition of different OSB bouts (short, medium and long) and occupational physical activity (OPA) (light, moderate and vigorous and standing). Linear regression analyses were performed to explore the associations between occupational compositions and NFR. Relatively more time spent in long OSB bouts was associated with a lower NFR (β: -11.30, 95% CI: -20.2 to -2.4). Short and medium OSB bouts and OPA were not associated with NFR. Associations between OSB bouts, OPA and NFR hinted at contrasting trends, suggesting the need to consider different bout lengths of OSB in future studies.

The relationship between hearing status, listening effort, and the need for recovery in employees of a manufacturing company

ObjectiveHearing screening can be used to detect hearing loss, but its value for identifying employees with work functioning difficulties is unclear. The objective of this study was to assess the association between the hearing status measured with an occupational hearing-in-noise screening test, Listening Effort (LE), and Need For Recovery (NFR) in employees of a manufacturing company, and to examine whether these associations depend on the perceived noise level at the workplace.MethodsEmployees of coatings and paints manufacturing company were included. Their hearing status was assessed with an occupational hearing-in-noise screening test. An online survey was used to assess their LE, NFR, and the perceived noise level at the workplace. Responses from 143 employees were analyzed (mean age = 53 years) using hierarchical multiple regression analysis with the outcomes LE and NFR.ResultsRegression analysis—with adjustments for gender, age, educational level, health status, pace/amount of work, job variety, and work pleasure—revealed that hearing status was significantly associated with LE, but the interaction between hearing status and the perceived noise level was not. Hearing status nor the interaction between hearing status and the perceived noise level was significantly associated with NFR.ConclusionThe results confirm that poorer hearing is associated with higher LE, but not with higher NFR. These associations were unrelated to the perceived noise level at the workplace. Therefore, the value of occupational hearing screening appears to be early identification of hearing loss in employees, but not identification of work functioning difficulties.

Communication strategies, personal adjustments, and need for recovery in employees with hearing loss who receive a communication group-training

Purpose Communication group-trainings are part of current aural rehabilitation practices, but their effect has not yet been investigated systematically in working adults. The purpose of this study was to describe the communication strategies (CS), personal adjustments (PA) and need for recovery (NFR) of employees with hearing loss before and directly after a communication group-training. Methods Nine employees were included at two audiological centres that provided a different group-training. Two online questionnaires were completed, at baseline and after completing the training. Results Most employees used more adequate CS after the group-training, but there seems to be a difference between the improvement in PA between the centres. No trends towards a decrease in NFR were observed. Conclusion It is still challenging to reduce the work difficulties that are encountered by employees with hearing loss. The inter-centre differences point out a need for standardization. Suggestions for improvements are provided and should be further investigated in a larger population.

Are Psychosocial Resources Buffering the Relation Between Physical Work Behaviors and Need for Recovery?

Objectives: We investigate whether job control and/or social support at work play a buffering role in the relation between various physical work behaviors and Need for Recovery (NFR) among employees with physically demanding jobs. Methods: Our findings are based on data from 332 workers. The Job Content Questionnaire was used to assess job control, social support and specific physically demanding tasks. General physical work behaviors were measured by two Axivity AX3 accelerometers. The NFR Scale (0-11) was used to assess NFR. We used multiple linear regression models. Results: Sitting at work turned out to be negatively associated with NFR, whereas physically demanding tasks were associated positively with NFR. Our results show a significant buffering role for job control on the correlation between sitting, physically demanding tasks and NFR, but not for social support. Conclusion: Our findings suggest that higher job control might be beneficial to reduce high NFR and eventually may help to reduce early drop-out and sickness absence. Further research is called for to confirm the buffering role of job control and to investigate the underlying mechanisms.

Evaluating the need for recovery from work for site-based construction practitioners in Australia

Site-based construction practitioners face high levels of job stress and need to recuperate from work-induced fatigue. Insufficient recovery from work will lead to work fatigue and health problems. While need for recovery (NFR) is an important concept to the wellbeing of construction practitioners, there is limited study in this area. Thus, this study aims to evaluate NFR for site-based construction practitioners in Australia and identify patterns of NFR as a function of demographics and work characteristics. A survey was conducted with site-based construction practitioners in Australia. Descriptive statistics, correlation analysis, and analysis of variance (ANOVA) were employed to analyse collected data. Results showed that the mean NFR of site-based construction practitioners in Australia was 17.96 (range = 6 – 30, 6 items). Age and work hours explained differences in NFR mean scores according to both the one-way ANOVA and correlations. NFR increased with work hours and decreased with age, with r = 0.19 and r = -0.24 respectively. The correlation analysis also indicated the negative relationship between work experience and NFR (r = -0.21). Work experience and work hours interacted to influence NFR according to the two-way ANOVA. The positive relationship between work hours (≤ 60 hours) and NFR was weaker in those with more work experience while this moderating effect of work experience did not apply to people working more than 60 hours. The significance of the study lies in providing insights to increase the work capacity of construction practitioners and help them to recover from job stress.

Factors associated with change in the need for recovery and subjective listening effort in employees with hearing loss receiving aural rehabilitation

ObjectiveCompared to normally-hearing employees, those with hearing loss suffer from higher Need For Recovery (NFR) after work. The aims of this study are to assess the NFR of employees with hearing loss before and after aural rehabilitation and to examine to what extent change in the NFR can be explained by changes in subjective listening effort, personal adjustments, communication strategies, auditory work demands, and self-reported hearing ability.MethodsWe included patients who received aural rehabilitation in two audiological centers in the Netherlands because of hearing complaints in their work situation. Outcomes were measured by questionnaires at baseline and 3 month follow-up. The NFR before and after the rehabilitation was compared with a t test. Hierarchical multiple analyses were performed.ResultsIn total, 60 patients (aged 22–63, working hours ≥8 per week) participated in the study, of which 50 completed the follow-up questionnaires. The NFR was significantly lower after the aural rehabilitation (M = 45.03) compared to before the aural rehabilitation (M = 51.89), t = −3.43, p < 0.01). Change in NFR could best be explained by the change in personal adjustments (R2 = 0.45, B = −1.23, p < 0.01).ConclusionThe NFR of employees with hearing loss can be improved by aural rehabilitation, but this study shows that current practices reduce the NFR only in part of the employees. Therefore, improving current practices should be considered and evaluated, for example by applying a different combination of rehabilitation components. Especially, interventions that affect personal adjustments may be promising to further reduce the NFR in employees with hearing loss.

Advanced clinical practitioners' inter-shift need for recovery: a cross-sectional survey in emergency medicine.

Healthcare settings are high-risk environments for fatigue and staff burnout. The Need For Recovery (NFR) scale quantifies inter-shift recovery, which contributes to cumulative fatigue and may precede occupational burnout. Advanced clinical practitioners (ACPs) are an established feature of the emergency medicine workforce in the UK, however, little is known about factors affecting their inter-shift recovery, fatigue or how NFR correlates with formal burnout inventories. A prospective cross-sectional online survey of UK emergency medicine ACPs from 1 September to 30 September 2020. The primary aim was to determine the NFR of these ACPs. The secondary aims were to determine any statistical associations between NFR and selected variables, and whether NFR could reliably predict burnout using the Copenhagen Burnout Inventory (CBI) as a comparator. There were 529 responses to the survey from 50 sites (response rate: 88%). The median NFR was 63.6 (95% CI 54.5-63.6). Lower NFR scores were found in ACPs who see both adults and children (54.5, 95% CI 45.4-63.6), work shifts of 7-10 hours (54.5, 95% CI 36.3-63.6) and who found it easy to park before work (54.5, 95% CI 45.5-54.5). Linear regression modelling indicated significant associations between shift length, ease of parking, ability to get breaks and feeling overwhelmed. Spearman's rho between NFR and CBI for personal and work-related burnout was 0.741 and 0.766 respectively. Correlation between NFR and patient-related burnout was less at 0.471. This study has shown the second highest NFR score reported in any occupational group. Several factors have been identified that may potentially reduce NFR and could be changed by organisations. NFR could also be used to identify those suffering with occupational burnout.

Need for recovery and physician well-being in emergency departments: national survey findings.

Need for recovery (NFR) describes an individual's need to physically and psychologically recuperate following a period of work. Physicians working in emergency departments (EDs) have higher NFR scores than other occupational groups. Increased NFR may precede occupational burnout and identification provides opportunities for early interventions. To identify the incidence of well-being characteristics for ED physicians and to determine if NFR score is associated with these characteristics, whilst adjusting for potential confounders. This is a secondary analysis of a survey study. Responses to 11 items were summated into the NFR score, from 0 (lowest NFR) to 100. Additional items (n = 44) explored well-being, demographic and occupational characteristics. Physicians working within 112 EDs in the UK and Ireland were surveyed in June-July 2019. The outcome measure was self-perceptions of well-being including; current burnout, risk of future burnout and feeling overwhelmed at work. Descriptive statistics are presented alongside findings of a multiple regression analysis. In 4365 participants, the self-perceived incidence of current burnout, high risk of future burnout and feeling overwhelmed at work more than once a week was 24.8, 62.7 and 45.1%, respectively. For every unfavourable response of the NFR scale there was an increase in odds of 34.0% (95% CI, 31.0-37.1) for frequency of feeling overwhelmed; 53.8% (95% CI, 47.5-60.4) for current burnout; 56.2% (95% CI, 51.1-61.6) for high risk of future burnout. This study confirms an association between increased NFR score and self-perceived well-being characteristics. Factors previously reported to reduce NFR could therefore be important initiatives to improve well-being of the ED workforce.

Assessment of Need for Recovery and Its Relationship With Work Characteristics and Health in a Sample of Chinese Doctors: A Cross-Sectional Survey.

Background: China is launching an unprecedented health care system reform. However, the long-term interests of doctors seem to have been ignored during this process especially considering that the work environment and work-life balance for doctors have severely deteriorated over the past decade.Their well-being and health are facing substantial threats due to heavy workloads and inadequate recovery opportunities. This study aimed to investigate the extent of need for recovery (NFR) among Chinese doctors and to examine their work-related fatigue. The study also examines the relationship of NFR with workplace satisfaction and health outcomes among Chinese doctors.Methods: A total of 2,617 doctors from 30 administrative regions in China participated in this study to assess the need for recovery and its relationship with work characteristics and health. A cross-sectional survey was conducted using the Chinese version of the Need for Recovery Scale (NFRS). Participants were invited to complete an anonymous online survey during May 2016. Data were analyzed using descriptive statistics, one-way ANOVA, reliability analysis, Pearson correlations, and hierarchical multiple regression analysis.Results: Significant differences in NFR scores were found across demographic characteristics such as age, service years, hospital levels, educational attainment, professional positions, work shifts, and working time. Regardless of any illnesses they might be experiencing, about 70.0% of participants remained at their job even though many doctors (22.1%) must continue working under the policies of the organization, which led to more pronounced NFR (P < 0.001). Further, a higher NFR was negatively related to workplace well-being and self-reported health outcomes of participants.Conclusions: Work-induced fatigue is a growing threat to doctors in China and their recovery opportunities are extremely limited in the workplace. High NFR exerts a considerable effect on their workplace well-being and health. China's hospital managers should pay close attention to the fact that doctors have little chance of recovery, and should offer doctors' positive encouragement and support to enhance well-being. To improve doctors' working conditions, targeted prevention policies must be introduced by policymakers to control this spreading crisis.

The impact of the first COVID-19 surge on the mental well-being of ICU nurses: A nationwide survey study

ObjectivesTo determine the impact of the first COVID-19 surge (March through June 2020) on mental well-being and associated risk factors among intensive care unit nurses. Research methodologyIn September 2020, a nationwide cross-sectional survey study among Dutch intensive care nurses was carried out to measure prevalence rates of symptoms of anxiety, depression, posttraumatic stress disorder, and need for recovery (NFR), objectified by the HADS-A, HADS-D, IES-6 and NFR questionnaires, respectively. Associated risk factors were determined using multivariate logistic regression analyses. ResultsSymptoms of anxiety, depression, and post traumatic stress disorder were reported by 27.0%, 18.6% and 22.2% of the 726 respondents, respectively. The NFR was positive, meaning not being recovered from work, in 41.7%. Working in an academic hospital, being afraid of infecting relatives and experiencing insufficient numbers of colleagues were associated with more mental symptoms, while having been on holiday was associated with reduced depression symptoms and need for recovery. ConclusionThe first COVID-19 surge had a high impact on the mental well-being of intensive care nurses, increasing the risk for drop out and jeopardising the continuity of care. Effort should be made to optimize working conditions and decrease workload to guarantee care in the next months of the COVID-19 pandemic.

Need for recovery amongst emergency physicians in the UK and Ireland: a cross-sectional survey

ObjectivesTo determine the need for recovery (NFR) among emergency physicians and to identify demographic and occupational characteristics associated with higher NFR scores.DesignCross-sectional electronic survey.SettingEmergency departments (EDs) (n=112) in the UK...

Measuring ‘Need for Recovery’ as an indicator of staff well-being in the emergency department: a survey study

BackgroundThe Need for Recovery (NFR) Scale is an 11-item questionnaire that assesses how work affects intershift recovery. Items are summated to form a score with a maximum value of 100....

High need for recovery from work and sleep problems are associated with workers' unhealthy dietary habits.

We aimed to examine the association of recovery from work and sleep with workers' dietary habits. Cross-sectional study. Need for recovery (NFR) from work was assessed with a validated questionnaire. Sleep was assessed with five questions from the Nordic Sleep Questionnaire and sleep quality question. Dietary habits were estimated using a validated sixteen food groups-containing questionnaire. Ordered logistic regression was used to explore the associations of NFR and sleep with dietary habits adjusted for age, education, marital status, work schedule, working full or part time and occupation. Follow-up visits of type 2 diabetes prevention study cohort in a Finnish airline company. The study included 737 men and 605 women. Poor recovery from work was associated with a higher eating frequency (OR = 1·03, 95 % CI 1·00, 1·06), higher intake of fast food (OR = 1·05, 95 % CI 1·02, 1·08) and sweets (OR = 1·05, 95 % CI 1·02, 1·08) as well as lower intake of vegetables (OR = 0·96, 95 % CI 0·93, 0·98) and fruits (OR = 0·96, 95 % CI 0·93, 0·98) among men. In women, poor recovery from work was associated with higher fast food (OR = 1·06, 95 % CI 1·02, 1·09) and desserts consumption (OR = 1·04, 95 % CI 1·00, 1·07). Among men and women, sleep problems were associated with higher eating frequency (men: OR = 1·04, 95 % CI 1·00, 1·07, women: OR = 1·06, 95 % CI 1·02, 1·11), consumption of fast food (men: OR = 1·07, 95 % CI 1·04, 1·11, women: OR = 1·06, 95 % CI 1·02, 1·10) and sweets (men: OR = 1·05, 95 % CI 1·01, 1·08, women: OR = 1·04, 95 % CI 1·00, 1·08). Poor recovery from work and sleep problems were associated with unfavourable dietary habits especially in men.

The effect of training for a participatory ergonomic intervention on physical exertion and musculoskeletal pain among childcare workers (the TOY project) - a wait-list cluster-randomized controlled trial.

ObjectiveMany employees have high physical exertion at work and suffer from musculoskeletal pain (MSP) leading to sickness absence with large costs. Participatory ergonomics is a potentially effective intervention for reducing physical exertion, MSP and sickness absence. The main aim of this study was to investigate the effectiveness of a 20-week workplace participatory ergonomic intervention among childcare workers on physical exertion and MSP.MethodsIn a two-arm cluster-randomized trial, 190 workers were recruited from 16 childcare institutions and randomly assigned to either a 20-week participatory ergonomics intervention consisting of three training workshops or a control group receiving usual care. Primary outcomes were physical exertion during work, maximal pain intensity, number of pain regions, and pain-related work interference. Secondary outcomes were MSP-related sickness absence, need for recovery (NFR), employee involvement, and self-efficacy. We followed the intention-to-treat principle and adhered to the registered study protocol (ISRCTN10928313).ResultsAfter 20 weeks, half the workers noticed some positive changes in their work. However, there were no statistically discernible effects in physical exertion, maximum pain intensity, pain-related work interference, or number of pain regions. We found a significant reduction of MSP-related sickness absence in the intervention compared to the control group [-0.48 days per month (95% confidence interval (CI), -0.8– -0.1]. We found no significant effects in NRF or involvement of employees, but self-efficacy was reduced in the intervention compared to the control group [-0.2 (95% CI, -0.3– -0.0)].ConclusionThis 20-week training for a participatory ergonomic intervention in childcare workers did not show effects on physical exertion and MSP, but was both feasible and effective in reducing MSP-related sickness absence.

Accelerometer-Measured Physical Activity at Work and Need for Recovery: A Compositional Analysis of Cross-sectional Data.

ObjectivesPrevious research has shown strong associations between occupational physical activity (OPA) and need for recovery (NFR). However this research has only utilized self-reported measures of OPA which may be biased. Thus, there is a need for investigating if the previously documented association between self-reported OPA and NFR can be found when using technical measures of OPA. There is also the need to investigate whether older workers are particularly susceptible to increased NFR, since age-related declines in physical capacity mean that it is likely these workers will have a higher NFR for a given physical activity. The aim of this study was to investigate the association between technically measured OPA and NFR, and whether this relationship is modified by age.MethodsThis study utilized data from the Danish Physical Activity Cohort with Objective Measurements cohort—comprising Danish workers (n = 840) from the cleaning, manufacturing, and transportation sectors. OPA was measured by accelerometers attached to the thigh and upper back for at least one work day and classified into four physical behaviour categories (sedentary, standing, light, or moderate/vigorous). NFR was measured using a shortened version of the Danish NFR scale. Analysis was conducted using linear regression and isotemporal substitution analyses for compositional data.ResultsThe overall association between OPA and NFR was statistically significant in the unadjusted model (P < 0.001), but not when adjusted for age, sex, occupation, and shift work (P = 0.166). Isotemporal substitution showed small but significant reductions in NFR when increasing sedentary time relative to other behaviours (adjusted: ΔNFR = −0.010 [−0.019; −0.001]). There were no significant interactions between age and OPA (P = 0.409).ConclusionsThis study found significant associations between OPA and NFR, but the effect sizes were small. Reallocating 30 min to sedentary behaviours from other behaviours was associated with a reduced NFR, but the effect size may not be practically relevant. Moreover, no clear modifying effects of age were identified.

Need for recovery in relation to effort from work and health in four occupations

ObjectiveTo examine three levels of need for recovery (NFR) after work in relation to effort from work demands, demand compensatory strategies, effort-moderating or -reversing resources, and health including health behaviors. A further purpose was to examine occupational characteristics determining NFR.Methods5000 engineers, carpenters, nurses, and home care nurses were invited to participate. NFR k-means clusters were calculated from 1289 participants. The effect from three levels of NFR regarding demands, compensatory strategies, resources at work, health, and health behaviors was examined using analysis of variance (ANOVA) and post hoc analysis. Prevalence ratios (PRs) of suboptimal health for three levels of NFR were calculated using Poisson regression. Linear stepwise multiple regression predictors explaining NFR were examined also occupation wise.ResultsNFR centroids at 5.8/33, 13.1/33, and 21.0/33 points were identified. ANOVA showed corresponding effects from NFR levels on work demands and compensatory strategies. The inversed proportion concerned levels of resources at work. Only the low NFR cluster negated regular health effects. The other two cluster groups also repeatedly worked while ill and presented PRs concerning health effects from 1.9 to 3.9 when compared to the low NFR group. Making good quality work, recovery opportunities, and thinking of work when off work were the most important predictors of NFR among 1289 participants with also occupation-wise interpretable profiles.ConclusionsThree levels of NFR meant corresponding levels of work demands, work-demand compensatory strategies, and unfavorable health behaviors. An inversed proportion of resources related to the same levels of NFR. Low NFR meant no regular health effects which could guide limit values regarding salutary NFR. Important predictors of NFR were resources making a good quality work, recovery opportunities, and reversely effort from rumination when off work. Occupation-wise predictors could guide interventions.

Validation of a Short-Form Version of the Danish Need for Recovery Scale against the Full Scale.

Introduction: The Need for Recovery (NFR) Scale facilitates the understanding of the factors that can lead to sustainable working and employability. Short-form scales can reduce the burden on researchers and respondents. Our aim was to create and validate a short-form Danish version of the NFR Scale. Methods: Two datasets were used to conduct the exploratory and confirmatory analyses. This was done using qualitative and quantitative methods. The exploratory phase identified several short-form versions of the Danish NFR Scale and evaluated the quality of each through the assessment of content, construct and criterion validity, and responsiveness. These evaluations were then verified through the confirmatory analysis, using the second dataset. Results: A short-form NFR scale consisting of three items (exhausted at the end of a work day, hard to find interest in other people after a work day, it takes over an hour to fully recover from a work day) showed excellent validity and responsiveness compared to the nine-item scale. Furthermore, a short-form consisting of just two items also showed excellent validity and good responsiveness. Conclusion: A short-form NFR scale, consisting of three items from the Danish NFR Scale, seems to be an appropriate substitute for the full nine-item scale.

Need for recovery and different types of early labour force exit: a prospective cohort study among older workers

PurposeThis study examines the relationship between need for recovery (NFR) and labour force exit (LFE) among older workers. Different types of LFE (early retirement, work disability and unemployment) are considered, and the role of potential confounding and modifying factors, including the availability of early LFE schemes, is examined. Also, associations between NFR and the intention and ability to prolong one’s working life, which are known determinants of LFE, are assessed.MethodsA subsample of older workers from the Maastricht Cohort Study was examined (n = 2312). The relationship between NFR and LFE was investigated by means of Cox regression analyses. Logistic regression analyses were performed to investigate cross-sectional associations between NFR and the intention and ability to prolong working life.ResultsElevated NFR was associated with a higher risk of overall LFE during a 4-year follow-up period (HR 1.39, 95% CI 1.09–1.78), and specifically with a higher risk of leaving the labour force through early retirement and work disability. When early retirement schemes were available, strong and significant associations between NFR and LFE were observed (HR 2.79, 95% CI 1.29–6.02), whereas no significant associations were found when such schemes were unavailable. Older workers with a higher NFR also had earlier retirement intentions and lower self-assessed abilities (both physical and mental) to prolong their working life until the mandatory retirement age.ConclusionsBecause this study shows that NFR is a precursor of LFE among older workers, monitoring NFR is important for timely interventions aimed at reducing NFR to facilitate extended labour participation.