Poor Psychosocial Working Conditions Research Articles

Psychosocial working conditions, perceived patient safety and their association in emergency medical services workers in Germany - a cross-sectional study.

Emergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety. For this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c). The most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress. Work stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.

Trajectories of psychosocial working conditions and all-cause and cause-specific mortality: a Swedish register-based cohort study.

While psychosocial working conditions have been associated with morbidity, their associations with mortality, especially cause-specific mortality, have been less studied. Additionally, few studies considered the time-varying aspect of exposures. We aimed to examine trajectories of job demand-control status in relation to all-cause and cause-specific mortality, including cardiovascular diseases (CVD), suicide, and alcohol-related mortality. The study population consisted of around 4.5 million individuals aged 16-60 years in Sweden in 2005. Job control and demands were respectively measured using job exposure matrices (JEM). Trajectories of job control and demands throughout 2005-2009 were identified using group-based trajectory modelling, and job demand-control categories were subsequently classified. Deaths in 2010-2019 were recorded in the national cause of death register. Cox regression models were used. A total of 116 242 individuals died in 2010-2019. For both job control and demands, we identified four trajectories, which were parallel to each other and represented four levels of exposures. Low control and passive jobs were associated with higher all-cause, CVD, and suicide mortality among both men and women. High strain jobs were associated with higher all-cause and CVD mortality among men, while low control, passive jobs, and high strain jobs were associated with higher alcohol-related mortality among women. The trajectories identified may suggest stable levels of job control and demands over time. Poor psychosocial working conditions are related to all-cause and cause-specific mortality, and these patterns vary to some extent between men and women.

Burnout among midwives—the factorial structure of the burnout assessment tool and an assessment of burnout levels in a Swedish national sample

BackgroundMany workplaces, within the healthcare sector, experience high rates of mental health problems such as burnout, anxiety, and depression, due to poor psychosocial working conditions and midwives are not an exception. To develop preventive interventions, epidemiologic surveillance of burnout levels, and their relation to professional specific working conditions is needed. Aims of this study is to assess the construct validity of the Burnout Assessment Tool (BAT) in the context of Swedish midwives, to evaluate whether the item responses can be combined into a single score and differential item functioning regarding age. Another aim was to assess the burnout levels of Swedish midwives.MethodsData come from a national cohort of Swedish midwives (n = 1664). The construct validity was evaluated using Rasch analysis. Burnout levels were presented by median and first (Q1) and third (Q3) quartiles for the BAT total score and the four subscales (exhaustion, mental distance, cognitive and emotional impairment).ResultsIn the analysis including all 23 items the fit to the Rasch model was not obtained. Items within each subscale clustered together in a residual correlation matrix in a pattern consistent with the underlying conceptualization of the BAT, indicating multidimensionality. The Rasch analysis was re-run using the four testlets as input variables which resulted in a good fit. The median burnout level was 2.0 (Q1 = 1.6, Q3 = 2.4). The four subscales differentiated the picture (elevated levels on exhaustion and low levels on the other three subscales).ConclusionsThe construct validity of the BAT for use in the context of Swedish midwives was confirmed. The results indicated a strong general factor, meaning that the responses can be combined into a single burnout score. The scale works invariantly for different age groups. The results of this study secure access to a validated instrument to be used for accurate assessment of the burnout levels among midwives in Sweden.

The role of managerial leadership in sickness absence in health and social care: antecedent or moderator in the association between psychosocial working conditions and register-based sickness absence? A longitudinal study based on a swedish cohort

BackgroundThe prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence.MethodsFour biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence).ResultsA direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence.ConclusionsPoor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.

Importance of the Working Environment for Early Retirement: Prospective Cohort Study with Register Follow-Up.

Background: This study investigates the role of physical work demands and psychosocial work factors for early retirement among older workers. Methods: Data from three Danish surveys on work environment and health among employed older workers (age 55–59) were merged with a national register containing information on labour market participation. Robust Poisson regression modelled the risk ratios (RR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and early retirement, that is, not working after the age of 64. Results: Of the 2800 workers, 53% retired early. High physical work demands (RR 1.33, 95% CI 1.19–1.48), poor overall psychosocial working conditions (RR 1.43, 95% CI 1.26–1.61), and access to early retirement benefits (RR 1.79, 95% CI 1.53–2.10) predicted early retirement. Subgroup analyses revealed that poor overall psychosocial working conditions were a stronger predictor for early retirement among workers with seated jobs than those with physically active jobs. Conclusions: High physical work demands and poor psychosocial working conditions are factors that can push older workers out of the labour market prematurely. Poor psychosocial working conditions seem to be a particularly strong push factor among workers with seated work.

Psychosocial Working Conditions in School and Life Satisfaction among Adolescents in Sweden: A Cross-Sectional Study.

Poor psychosocial working conditions in school have consistently been shown to be associated with adverse health among adolescents. However, the relationships between school demands, teacher support, and classmate support and positive aspects of health have not been explored to the same extent. The aim of this study was to examine differences in psychosocial working conditions in school and in life satisfaction by gender and by grade, and to investigate the association between psychosocial working conditions in school and life satisfaction among boys and girls, and among students in different grades. Data from the Swedish Health Behavior in School-Aged Children (HBSC) study of 2017/18 were used, consisting of 3614 students in Grades 5, 7, and 9 (~11, 13, and 15 years). Psychosocial working conditions in school were captured by indices of perceived school demands, teacher support, and classmate support. Life satisfaction was measured by the 11-step Cantril’s ladder (using cutoffs at >5 and >8, respectively). Whereas girls reported higher school demands than boys, higher levels of teacher and classmate support were reported by boys. Students in lower grades reported lower school demands but higher levels of teacher and classmate support compared with students in higher grades. Boys and students in lower grades were more likely to report high life satisfaction compared with girls and students in higher grades. Results from binary logistic regression analyzes showed that school demands were inversely associated with life satisfaction, and that higher levels of teacher support and classmate support were associated with high life satisfaction. These results were found for both boys and girls, and for students in all grades. The findings indicate that schools have the potential to promote positive health among students.

Joint association of physical and psychosocial working conditions with risk of long-term sickness absence: Prospective cohort study with register follow-up

Aims: The interplay between physical and psychosocial working conditions for the risk of developing poor health is not well understood. This study aimed to determine the joint association of physical and psychosocial working conditions with risk of long-term sickness absence (LTSA) in the general working population. Methods: Based on questionnaire responses about physical working conditions and psychosocial working conditions (influence at work, emotional demands, support from colleagues and support from managers) and two-year prospective follow-up in a national register on social transfer payments, we estimated the risk of incident LTSA of >30 days among 9544 employees without previous LTSA from the Danish Work Environment Cohort Study. The analyses were censored for all events of permanent labour market drop-out (retirement, disability pension, immigration or death) and controlled for potential confounders. Results: In the total cohort, more demanding physical working conditions were associated with risk of LTSA in a dose-response fashion (trend test, p<0.0001). The combination of poor overall psychosocial working conditions (index measure of influence at work, emotional demands, support from managers and support from colleagues) and hard physical working conditions showed the highest risk of LTSA. However, poor overall psychosocial working conditions did not interact with physical working conditions in the risk of LTSA (p=0.9677). Conclusions: The results of this study suggest that workplaces should strive to improve both psychosocial and physical work factors in order to ensure the health of workers.

Presenteeism, Psychosocial Working Conditions and Work Ability among Care Workers-A Cross-Sectional Swedish Population-Based Study.

Presenteeism, attending work while ill, has been examined in different contexts in the last few decades. The aim was to examine whether poor psychosocial working conditions and perceived work ability are associated with increased odds ratios for presenteeism, focusing on nursing professionals and care assistants. A cross-sectional population-based study was conducted. The selected individuals were extracted from representative samples of employees, aged 16–64, who participated in the Swedish Work Environment Surveys between 2001 and 2013 (n = 45,098). Three dimensions of psychosocial working conditions were measured: job demands, job control, and job support. Presenteeism and perceived work ability was measured. Using multiple logistic regression analyses, odds ratios for presenteeism with 95% confidence intervals (CI) were estimated. While nurses (n = 1716) showed the same presenteeism level as all the other occupation groups (n = 37,125), it was more common among care assistants (n = 6257). The odds ratio for presenteeism among those with high job demands (OR = 2.37, 95% CI 2.21–2.53), were higher among women than among men. For nursing professionals and care assistants, the odds ratios for presenteeism were highest among those with the lowest work ability level. The problems of presenteeism and low work ability among many health and care workers may be lessened by a reduction in psychosocial demands.

Suicide mortality follow-up of the Swiss National Cohort (1990-2014): sex-specific risk estimates by occupational socio-economic group in working-age population.

To identify occupations and socio-economic groups with detrimental or protective effect on suicide mortality. For every occupation and economic activity/industry, we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using national cause-specific mortality rates. We further stratified analyses by socio-economic variables, job-skill level, and by three calendar periods (1990-1998/1999-2006/2007-2014). The study sample comprised 5,834,618 participants (94,918,456 person-years). The highest DSRs were observed among unemployed/job-seeking group, in agricultural, fishery and related male workers, and in health and social activities female workers. The lowest DSRs were observed in real estate and renting, research and development, IT and other business activities in men and in agriculture, hunting and forestry industry in women. A consistent reduction in DSRs across three calendar periods was observed in men. In female corporate managers, DSRs increased over the 2007-2014 period compared with 1999-2006. Compared to general working-age population, unemployed/job-seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife-associated professionals; and agricultural workers as well as among female writers and performing artists. The findings suggest the detrimental effect of low socioeconomic positions, including unemployment, with respect to suicide mortality and a relationship between suicide and poor psychosocial working conditions in elementary occupations. Sex-specific results need further investigation.

A systematic review of working conditions and occupational health among immigrants in Europe and Canada

BackgroundA systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada.MethodsWe established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000–2016 and checked the reference lists of all included papers.ResultsEighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited.ConclusionSome indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies.

Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position: analyses of 64 934 individuals from four prospective cohort studies

ObjectivesPoor psychosocial working conditions increase the likelihood of various types of morbidity and may substantially limit quality of life and possibilities to remain in paid work. To date, however, no...

Psychosocial job quality and mental health among young workers: a fixed-effects regression analysis using 13 waves of annual data.

Objectives Entry into employment may be a time when a young person's well-being and mental health is challenged. Specifically, we examined the difference in mental health when a young person was "not in the labor force" (NILF) (ie, non-working activity such as participating in education) compared to being in a job with varying levels of psychosocial quality. Method The data source for this study was the Household Income and Labor Dynamics in Australia (HILDA) study, and the sample included 10 534 young people (aged ≤30 years). We used longitudinal fixed-effects regression to investigate within-person changes in mental health comparing circumstances where individuals were NILF to when they were employed in jobs of varying psychosocial quality. Results Compared to when individuals were not in the labor force, results suggest a statistically significant decline in mental health when young people were employed in jobs with poor psychosocial working conditions and an improvement in mental health when they were employed in jobs with optimal psychosocial working conditions. Our results were robust to various sensitivity tests, including adjustment for life events and the lagged effects of mental health and job stressors. Conclusions If causal, the results suggest that improving the psychosocial quality of work for younger workers will protect and promote their wellbeing, and may reduce the likelihood of mental health problems later on.

Job strain, bullying and violence at work and asthma in Peruvian cleaners—a cross-sectional analysis

Objectives: An increased asthma prevalence was found in cleaners. Many of them work in precarious employment conditions, potentially leading to stress, a known risk factor for asthma. We aimed to analyze whether asthma in cleaners might partly be explained by psychosocial working conditions. Methods: The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno Province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between psychosocial working conditions and asthma (wheeze without cold or use of asthma medication) was assessed. Results: The 12-months prevalence of asthma was 22% among cleaners versus 5% among unexposed workers (pChi2 = .001). Cleaners were more likely than unexposed workers to work with temporary or sub-contracts, have a high employment insecurity, high strain working conditions and low social support (all pChi2 < .05). Twenty-six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence at work (both pChi2 < .001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5–21.4) and violence (2.4; 1.1–5.4) were the main predictors of asthma. Taking these factors into account, being a cleaner was not statistically significantly associated with the outcome (3.5; 0.9–13.8). Conclusions: Poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma. The underlying mechanism might be a stress-induced inflammatory immune response.

Work experiences among nurses and physicians in the beginning of their professional careers – analyses using the effort–reward imbalance model

The aim of the study was to scrutinise how nurses and physicians, employed by the county councils in Sweden, assess their work environment in terms of effort and reward at the start of their career. The aim was also to estimate associations between work satisfaction and the potential outcomes from the effort-reward imbalance (ERI) questionnaire. The study group, 198 nurses and 242 physicians who graduated in 1999, is a subsample drawn from a national cross-sectional survey. Data were collected in the third year after graduation among the nurses and in the fourth year after graduation among registered physicians. The effort-reward imbalance questionnaire, together with a question on work satisfaction, was used to evaluate psychosocial factors at work. The results reveal that nurses scored higher on effort, lower on reward and experienced higher effort-reward imbalance, compared with physicians. Women scored higher on work-related overcommitment (WOC) compared with men. Among the physicians, logistic regression analysis revealed a statistically significant association between WOC and ERI, sex, effort and reward. Logistic regression analysis also revealed a statistically significant association between WOC and ERI and between WOC and effort among the nurses. Dissatisfaction with work was significantly higher among those who scored worst on all three ERI subscales (effort, reward and WOC) and also among those with the highest ERI ratios compared with the other respondents. In conclusion, to prevent future work-related health problems and work dissatisfaction among nurses and physicians in the beginning of their professional careers, signs of poor psychosocial working conditions have to been taken seriously. In future work-related stress research among healthcare personnel, gender-specific aspects of working conditions must be further highlighted to develop more gender-sensitive analyses.

Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers

PurposeThe purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers.MethodsThe data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039).ResultsThe overall prevalence of WRSP was 5.1 % (95 % confidence interval (CI) 4.7–5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95 % CI 1.77–6.81), discrimination due to sex (aOR 2.44: 95 % CI 1.36–4.36) or age (aOR 2.22: 95 % CI 1.52–3.23), violence at work (aOR 1.98: 95 % CI 1.06–3.68), threat of violence (aOR 1.96: 95 % CI 1.05–3.66), poor work-life balance (aOR 1.78: 95 % CI 1.44–2.20), low job satisfaction (aOR 1.69: 95 % CI 1.37–2.09), high cognitive (OR 1.64: 95 % CI 1.32–2.03) and emotional (aOR 1.53: 95 % CI 1.22–1.91) demands, job insecurity (aOR 1.32: 95 % CI 1.07–1.63), and high work intensity (aOR 1.55: 95 % CI: 95 % CI 1.25–1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95 % CI 0.67–1.15).ConclusionThe results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.

The impact of psychosocial work conditions on attempted and completed suicide among western Canadian sawmill workers

Using a large cohort of western Canadian sawmill workers (n = 28,794), the association between psychosocial work conditions and attempted and completed suicide was investigated. Records of attempted and completed suicide were accessed through a provincial hospital discharge registry to identify cases that were then matched using a nested case control method. Psychosocial work conditions were estimated by expert raters using the demand-control model. Univariate and multivariate conditional logistic regression was used to estimate the association between work conditions and suicide. In multivariate models, controlling for sociodemographic (marital status, ethnicity) and occupational confounders (job mobility and duration), low psychological demand was associated with increased odds for completed suicide, and low social support was associated with increased odds for attempted suicides. This study indicates that workers with poor psychosocial working conditions may be at increased risk of both attempted and completed suicide.

The effect of self-reported and observed job conditions on depression and anxiety symptoms: A comparison of theoretical models.

The demand/control/support and effort/reward imbalance models have relied on self-reported methods to describe how poor psychosocial working conditions lead to harmful health outcomes. The hindrance/utilization model uses an observational methodology to assess these relationships. Cross-sectional observational and self-reported data from 98 civil servants participating in the Whitehall II Study of British civil servants were used to test whether work conditions measured by each of the three theoretical models explained a significant amount of the variance in depression and anxiety symptoms. Observational measures were also used to assess potential common methods variance bias between the self-reported job conditions and the outcomes. Results showed that the demand/control/support model explained the most variance in depression and anxiety symptoms and the associations were not wholly due to common methods variance. Moreover, measures associated with job resources (e.g., skill discretion, social support and skill utilization) had a protective effect on depression and anxiety symptoms. Exertion-related conditions (e.g., demands, effort, over commitment) were not consistently associated with depression or anxiety symptoms.

Control at work: A generalized resource factor for the prevention of musculoskeletal symptoms?

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.

Control at work: a generalized resource factor for the prevention of musculoskeletal symptoms?

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.