Psychosocial Risk Assessment Research Articles

Drawing a Line between Hope and Accountability: Midwives’ Response to a “Psychosocial Antenatal Care” Pilot Project in Gauteng, South Africa

Psychosocial care during pregnancy is embedded in women-centred care, and the improvement of quality care based on compassion has become a top priority for healthcare providers. Compassion is a deep feeling of connecting to human beings’ suffering, a moral response that leads to patient care with comfort. Such caring is skilful and worthy, respects the dignity of individuals and is intertwined with professional competency. The purpose of the pilot project was to raise the midwives’ awareness of the importance of psychosocial care during pregnancy, to assess the use of the psychosocial assessment tool, to fill the gap between routine physical antenatal care and psychosocial care, and to enhance the use of psychosocial services. An exploratory and descriptive study design was applied. The study population consisted of 34 midwives who participated in the implementation of the assessment tool in the 12 participating health facilities in Gauteng, South Africa. The data collection was conducted in two phases. Phase 1 consisted of a self-administered questionnaire to establish competency when using the assessment tool. Phase 2 consisted of focus group discussions. The four main themes that emerged were the importance of psychosocial risk assessments, experiences of the implementation of the assessment tool, challenges and barriers, and identified risk factors. The results reflected the midwives’ ability and willingness to implement the tool as part of their accountability, despite the challenges experienced. Moreover, the midwives hoped that the tool will be incorporated as part of routine antenatal care.

Description and application of a method to quantify criterion-related cut-off values for questionnaire-based psychosocial risk assessment

PurposeThe psychosocial risk assessment is a systematic intervention process for organizations that aims at improving psychosocial working conditions as well as employee health. Based on a screening of working conditions, interventions to reduce risk factors are implemented and evaluated. What is missing for most screening instruments however are cut-off values to categorize working conditions into uncritical vs. critical, whereas the latter indicates an elevated risk for illness. To estimate and evaluate cut-off values, two studies were conducted using the receiver operating characteristic (ROC) analysis.MethodsIn Study 1, a sample of 229 participants answered an online survey on depression (PHQ) and psychosocial working conditions using a questionnaire (DYNAMIK) that covers five factors important to workers' health: workload, boundary permeability, participation, leader support, and usability. Using the ROC analysis, criterion-related cut-off values were generated to predict depressive symptoms. In Study 2, these cut-off values were used to classify working conditions in the two categories of ‘critical’ and ‘uncritical’ in an independent sample (N = 295). It was tested for differences in the results of the two groups concerning the direct criterion of depressive symptoms and the indirect criterion of effort-reward imbalance.ResultsIn Study 1, cut-off values differed between the five scales and showed different values for sensitivity and specificity. In Study 2, participants exposed to critical working conditions reported more depressive symptoms as well as an effort-reward imbalance.ConclusionsCut-off values are useful to identify working conditions as either critical or uncritical. This knowledge is important when deciding which working conditions should be optimized within the context of psychosocial risk assessment.

Mapping and assessing psychosocial risk factors for individual- and organizational-level occupational stress intervention

Various international organizations have raised awareness regarding psychosocial risks and work-related stress. From January 1, 2019, an amendment to the Estonian Occupational Health and Safety Act came into force, obliging the employer to ta ke measures to improve the psychosocial environment of the company in order to prevent health damage caused by psychosocial hazards. In current paper the focus is on: a) developing a mapping tool for psychosocial risk factors at work (Organizational Psychosocial Factors Indicator, OPSTI); b) delivering automatic feedback for the OPSTI test taker; c) evaluating workplace psychosocial risks at work by developing an organizational level psychosocial risk assessment system compliant with the requirements of European Agency for Safety and Health at Work (EU-OSHA); and d) developing different occupational stress interventions.

Psychosocial Risk Management in the Teaching Profession: A Systematic Review

Teachers are facing various job demands with psychosocial aspects being fundamental due to the nature of the occupation. Although teachers' work is associated with different psychosocial health risks, little is known on how to identify and tackle those.Thus, a systematic literature search as per the PRISMA statement was conducted via MEDLINE (PubMed), PSYNDEX (PubPsych), and ScienceDirect. Two reviewers independently screened 2261 titles and abstracts and 169 full-texts. According to the inclusion criteria established a priori, articles from peer-reviewed journals (English or German) on psychosocial risk management in teachers were incorporated.Despite a comprehensive and sensitive search, only four publications could be identified, outlining a process to implement risk management and different assessment tools. Taken together, data presented in the articles were scarce.Recommendations for process steps and the assessment of psychosocial risks can be derived from the findings. To implement effective psychosocial risk management in the teaching profession, further research is needed, though. Effective and practicable approaches, which are accepted by the target group, should be further developed and investigated. Relevant causes of occupational strain in the teaching profession must be identified and assessed reliably. Low-threshold interventions should be implemented, and the outcome must be evaluated afterward.

Opening the door: midwives\u2019 perceptions of two models of psychosocial assessment in pregnancy- a mixed methods study

BackgroundOne in five women experience psychological distress in the perinatal period. To support women appropriately, Australian guidelines recommend routine depression screening and psychosocial risk assessment by midwives in pregnancy. However, there is some evidence that current screening processes results in higher rates of false positives. The Perinatal Integrated Psychosocial Assessment (PIPA) Project compared two models of psychosocial assessment and referral – Usual Care and the PIPA model – with a view to improving referral decisions. This paper describes midwives’ perspectives on psychosocial assessment, depression screening and referral at the antenatal booking appointment and compares midwives’ experiences with, and perspectives on, the two models of care under investigation.MethodsA two-phase, convergent mixed methods design was used. Midwives providing antenatal care completed a self-report survey in phase one prior to implementation of the new model of psychosocial assessment (n = 26) and again in phase two, following implementation (n = 27). Sixteen midwives also participated in two focus groups in phase two. Quantitative and qualitative data were compared and integrated in the presentation of results and interpretation of findings.ResultsMidwives supported psychosocial assessment believing it was a catalyst for ‘Opening the door” to conversations with women. Midwives were comfortable asking the questions and tailored their approach to build rapport and trust. Overall. midwives expressed favourable views towards the PIPA model. A greater proportion of midwives relied mostly or entirely on the suggested wording for the psychosocial questions in the PIPA model compared to Usual Care (44.4% vs 12.0%, χ2=5.17, p=.023, φ =-.36). All midwives reported finding the referral or action message displayed at the end of the PIPA psychosocial assessment to be ‘somewhat’ or ‘very’ helpful, compared to 42.3% in Usual Care (χ2 = 18.36, p < .001, φ = −.64). Midwives were also more likely to act on or implement the message often or all of the time) in the PIPA model (PIPA = 69.2% vs Usual Care = 32.0%, (χ2 = 5.66, p < .017, φ = −.37).ConclusionThe study identified benefits of the new model and can inform improvements in psychosocial screening, referral and related care processes within maternity settings. The study demonstrates that psychosocial assessment can, over time, become normalised and embedded in practice.

Implementation of family psychosocial risk assessment in pediatric cancer with the Psychosocial Assessment Tool (PAT): study protocol for a cluster-randomized comparative effectiveness trial

BackgroundChildhood cancer affects and is affected by multiple levels of the social ecology, including social and relational determinants of health (e.g., economic stability, housing, childcare, healthcare access, child and family problems). The 2015 Standards of Psychosocial Care in Pediatric Cancer outline optimal psychosocial care sensitive to these ecological factors, starting with assessment of psychosocial healthcare needs to promote medical and psychosocial outcomes across all children with cancer. To address the first standard of family psychosocial assessment, the Psychosocial Assessment Tool (PAT) is a validated screener ready for broad implementation.MethodThe PAT will be implemented across a national sample of 18 pediatric cancer programs ranging in size (annual new patients) in a mixed methods, comparative effectiveness study, guided by the Interactive Systems Framework for Dissemination and Implementation, comparing two implementation strategies. It is hypothesized that implementation will be more successful at the patient/family, provider, and institutional level when training (strategy I) is combined with implementation expanded resources (strategy II). There are three aims: (1) Refine the two implementation strategies using semi-structured qualitative interviews with 19 stakeholders including parent advocates, providers, pediatric oncology organization representatives, healthcare industry leaders; (2) Compare the two theoretically based and empirically informed strategies to implement the PAT in English and Spanish using a cluster-randomized controlled trial across 18 sites. Stratified by size, sites will be randomized to cohort (3) and strategy (2). Outcomes include adoption and penetration of screening (patient/family), staff job satisfaction/burnout (provider), and cost-effective use of resources consistent with family risk (institution); (3) Based on the results of the trial and feedback from the first and second aim, we will develop and disseminate a web-based PAT Implementation Toolkit.DiscussionUse of the PAT across children’s cancer programs nationally can achieve the assessment standard and inform equitable delivery of psychosocial care matched to family need for all patients.Trial RegistrationClinicalTrials.gov, NCT04446728, registered 23 June 2020

Riscos Psicossociais, Saúde e Bem-estar: análise de uma empresa de Cablagem em Portugal

Objectives The aim of the study was to assess the psychosocial risks to which workers in a wiring firm in Portugal are exposed, and to assess their impact in terms of worker’s health and well-being. The exposure to risks, the risk levels and the health and well-being status were self-reported. Methods Data was collected using the short version of the Copenhagen Psychosocial Questionnaire. Data analysis was descriptive: the scale’s reliability was assessed, traffic light analysis was performed, and relative risk of exposure to psychosocial risks was calculated. Workers perceive exposure to several psychosocial risks, in particular in the production line and women. In general, the deteriorating psychosocial work environment is associated with lower health and well-being. Results The study identifies job demands and job insecurity as the main psychosocial risk factors. However, some of the risk factors that are perceived less frequently, such as Social Relations and Leadership, Quality of Leadership, Rewards, Work/ Family Conflict and Self-efficacy, have a strong impact on the health and well-being of the workers who perceive them. Conclusions The results highlight the need for a multidimensional approach to the assessment and management of psychosocial risks, to facilitate targeted intervention that take into account different risk factors, as well as different groups of workers.

Corrigendum to “Comparability of Self-Ratings and Observer Ratings in Occupational Psychosocial Risk Assessments: Is There Agreement?”

[This corrects the article DOI: 10.1155/2019/8382160.].

Does staff-assessed care quality predict early failure of dental fillings? A prospective study.

The aim of this study was to evaluate staff-assessed care quality as an indicator of register-based measures of care quality at dental clinics, more specifically register-based measures of survival of dental fillings and initiation of preventive treatments for caries patients. This prospective study includes data from cross-sectional workplace psychosocial risk assessment surveys at dental clinics and register data on survival of dental fillings, and initiation of preventive treatment for caries patients obtained from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa) Demographic background data on the age, gender, income level and place of birth of patients was obtained from Statistics Sweden (SCB). The data were analysed using discrete-time multilevel survival analysis and multiple linear regression analysis. The results showed that staff-assessed care quality rated by the total staff or by dental nurses at the clinic predicted the risk of replacement of dental fillings made due to a caries diagnosis during the 3-year follow-up period, controlling for potential confounding due to patient demographic characteristics (age, sex, income and country of birth). In contrast, the better the staff-assessed care quality at the clinic, the smaller the proportion of the patients received preventive care in addition to operative caries therapy when controlling for potential confounding due to patient demographics. Care quality assessed by dentists at the clinic did not predict either of these outcome measures. Premature failure of dental fillings is costly for both patients and society, which leads to a need for relevant measures for following dental care quality. Our findings indicate that staff-assessed care quality - a cheap and easy measure to collect and follow continuously in dental practice - can be used to monitor aspects ofquality in real time in order to facilitate continuous improvement and quickly amend quality problems. Also, it can be used for integrating quality improvement in systematic work environment risk management.

Instability of Personality Traits of Teachers in Risk Conditions due to Work-Related Stress.

The following study aims to verify whether psychosocial risk conditions determine a variation in personality traits. The sample consisted of 301 teachers, comprising 84 men (27.1%) and 217 women (72.9%). The Big Five Questionnaire (BFQ) was used to measure personality traits, while the Organizational and Psychosocial Risk Assessment (OPRA) questionnaire was used to measure psychosocial risk. The ANOVA results notice the change of BFQ traits. These are significant (Extraversion = 0.000; Agreeableness = 0.001; Neuroticism = 0.000; Openness = 0.017), with the exception of the Conscientiousness trait (Conscientiousness = 0.213). The research supports the approach of seeing personality as the result of the interaction between the individual and the environment; this position is also recognized by work-related stress literature. Stress conditions can lead to a change in the state of health and possibly determine the onset of work-related stress diseases. In the future, it would be useful to start a series of longitudinal studies to understand in greater detail the variability of personality traits due to changes in the Risk Index.

Fear of Non-Employability and of Economic Crisis Increase Workplace Harassment through Lower Organizational Welfare Orientation

There is a growing body of evidence suggesting that economic crisis is a preeminent stressor (i.e., economic stress) that may worsen working conditions and expose individuals to negative acts at work (i.e., workplace bullying). Following an occupational health perspective that considers contextual factors as risk factors for workplace bullying, this study aims to examine the mediation effects of organizational orientation to employee welfare in the economic stress-workplace bullying relationship. A cross-sectional study with the participation of 1004 Italian workers from several organizations was conducted. Our results indicate that economic stress (composed of two dimensions: fear of the economic crisis and perceived non-employability) is associated with workplace bullying through the total mediation of organizational orientation to employee welfare. These results have relevant implications for psychosocial risk assessment in turbulent times.

Aboriginal and Non-Aboriginal Emergency Department Presentations Involving Suicide-Related Thoughts and Behaviors.

Background: Rates of hospital admission for suicide-related thoughts and behaviors (SRTBs) are elevated in the Northern Territory (NT) of Australia, especially by Aboriginal people, but very little is known about emergency department (ED) presentations. Aim: We aimed to profile ED presentations in the NT involving SRTBs by Indigenous status and compare discharge arrangements. Method: Logistic regression analyses were performed on data from electronic patient records of consecutive ED presentations involving SRTBs. Results: During the study period, 167 presentations were observed. Aboriginal patients were more likely to present from remote areas and to report substance misuse and family conflict or violence compared with non-Aboriginal patients. In both groups, males were more likely than females to be admitted as were persons presenting with self-harm compared with those who had suicidal thoughts only. No differences in discharge arrangements were identified by Indigenous status. Limitations: The small scale of the study and use of administrative records points to the need for further research to improve the quality of the evidence. Conclusion: While presentations by high-risk groups are more likely to be admitted for further care, the assessment of psychosocial risks and needs in EDs is vital to informing decisions for aftercare that support recovery in the community for Aboriginal patients and patients discharged from EDs.

Informal and formal social support during pregnancy and joint maternal and paternal postnatal depression: Data from the French representative ELFE cohort study.

Insufficient social support has been intensively studied as a risk factor of postpartum depression (PPD) among mothers. However, to date, no study has examined the role of informal and formal dimensions of social support during pregnancy with regard to joint maternal and paternal depression after birth. Study associations between insufficient informal and formal support during pregnancy and joint parental PPD. Using data from the nationally representative French ELFE (Etude Longitudinale Française depuis l'Enfance) cohort study (N = 12,350), we estimated associations between insufficient informal and formal support received by the mother during pregnancy and joint parental PPD in multi-imputed multivariate multinomial regression models. In 166 couples (1.3%), both parents were depressed. The likelihood of joint parental PPD was increased in case of insufficient informal support (insufficient partner support: odds ratio (OR) = 1.68 (95% confidence interval (CI): 1.57-1.80); frequent quarrels: OR = 1.38 (95% CI: 1.19-1.60)). We also observed associations between formal support during pregnancy and joint parental PPD (early prenatal psychosocial risk assessment: OR = 1.13 (95% CI: 1.05-1.22); antenatal education: OR = 1.13 (95% CI: 1.05-1.23)), which disappeared when analyses were restricted to women with no psychological difficulties during pregnancy. Insufficient informal social support during pregnancy appears to predict risk of joint PPD in mothers and fathers and should be identified early on to limit complications and the impact on children.

Mejorar la calidad de las evaluaciones de riesgos psicosociales mediante el control de sesgos

The assessment of workplace psychosocial risk factors is complex and controversial. The main criticism is focused on the validity of the tools used in their evaluation; basically, self-report measures which are subject to several sources of error. While there has been an increase in efforts to provide evidence on the reliability and the validity of the available assessment instruments, bias is often ignored as an important source of error. Although bias may be a novel topic to many prevention technicians, their detection and control is a traditional and well-studied theme in the field of work psychology. This article gives lay practitioners a better understanding of the concept of bias, as well as the related modes of identification and control, to improve the quality of psychosocial risk assessments.

Interventions as the centrepiece of psychosocial risk assessment – why so difficult?

PurposeDue to the “European Union Framework Directive on Safety and Health at work” (Directive 89/391/EEC, 1989), every employer is obliged to avoid psychosocial hazards when designing work. Little is known empirically about the barriers that workplace actors experience while developing and implementing OSH measures that prevent psychosocial hazards. The purpose of this paper is to explore barriers, causes and attempts to overcome them and discusses them with reference to relevant theoretical concepts and models that help to explain how these barriers hinder the development and implementation of OSH measures.Design/methodology/approachSemi-structured interviews with workplace actors in charge of psychosocial risk assessment (PRA) were conducted in 41 business cases, and transcripts were analysed using a thematic analysis approach. Barriers, causes and attempts to overcome them were extracted inductively and discussed with reference to relevant theories and explanatory models.FindingsThe complex nature of psychosocial risks, hindering general beliefs, lack of a perceived scope for risk avoidance, lack of assumptions of responsibility among players on all hierarchical levels, discrepancies between formal responsibility and decision authority, and low reflexivity on processes of development and implementation of interventions were described as barriers. Causes and attempts to overcome these barriers were reflected upon by workplace actors.Practical implicationsRecommendations on the organisation of PRA will be given with respect to the reported results and relevant research in this field.Originality/valueThis qualitative study explores the barriers to developing and implementing OSH measures to eliminate psychosocial hazards, from the perspective of actors in charge of PRA, and why they might fail.

Best practices addressing healthcare care access of migrants and refugees in European countries

Abstract Mig-healthCare has identified sources in the countries and languages of the consortium providing guidance for community-based healthcare for migrants and refugees. A total of 54 sources that refer to best practices in seven European countries were identified. Results were categorized along with the themes: organization, communication, training, education and facilities &amp; services. Successful organizational measures were a close collaboration with different governmental authorities, NGOs, community organizations and various local service providers. Moreover, engagement with members from both the host community and the migrant/refugee community in the design and implementation phases is essential. The need to track all activities through data collection and periodic evaluations is important in order to evaluate the effectiveness of systems. Funding was mentioned as important to secure continuity of projects and systems. Bridging communication barriers is a major facilitator to reduce health disparities. Differences in the types of practices and challenges per country were noted. Translators and cultural mediators are a key element in successful implementation, but across EU there is a need for more specialized staff to face the cultural barriers of the large variation in refugee/migrant backgrounds. The empowerment of migrants/refugees in promoting well-being through the engagement of the host community to help reduce stigma and discrimination is a successful strategy facilitating the access to care due to the increase of their health literacy skills. Finally, tailored services to give an answer to the specific needs of migrants and refugees are important, for example at first reception centres, standard medical screening and psychosocial risk assessment was recommended. Through this analysis, we can distinguish community-based care models elements facilitating the access of migrants and refugees to healthcare.

Social inequalities of postpartum depression: the mediating role of social support during pregnancy

Abstract Introduction A disadvantaged socioeconomic position (SEP), as well as insufficient social support during pregnancy (SSP) increase the probability of subsequent postpartum depression (PPD). The aim of this study was to quantify the part of social inequalities in PPD due to insufficient SSP and in particular assess the impact relative to women’s migrant status. Methods The sample included 15,000 women from the nationally representative French ELFE birth cohort study. Depressive symptoms were assessed at two months postpartum by the EPDS. SEP was constructed as a latent factor explaining educational level, occupational grade, employment during pregnancy, household income and financial difficulties. SSP was characterized by informal support (partner perceived support, frequency of quarrels and paternal leave) and formal support (early prenatal psychosocial risk assessment and antenatal classes’ attendance). Causal mediation analyses between SEP, dimensions of SSP and PPD were conducted and stratified on migrant status (categorized as native French, first or second generation migrant or immigrant). Results A disadvantaged SEP and a lack of informal SSP during pregnancy were both associated with an increased risk for postpartum depressive symptoms and a disadvantaged SEP was positively associated with lack of SSP. In immigrant women, a larger proportion of social inequalities in PPD could be attributed to lack of SSP, in comparison to native French women (17.5% vs. 8.8%). Conclusions Both disadvantaged SEP and SSP are risk factors for PPD. We found evidence that disadvantaged women’s increased risk for PPD can partly be attributed to limited social support. Key messages PPD in disadvantaged groups, especially in migrant women, could possibly be prevented early in pregnancy by increasing support from partner and larger family. Access to social support health care systems directed towards pregnant women remains low for women with a disadvantaged SEP, especially in migrant women.

I'm Here, Too: Being an Adolescent Sibling of a Pediatric Cancer Patient in Turkey

PurposeThis study aimed to determine experiences and needs of Turkish adolescent siblings of children with cancer (SCC) and to identify if there is a country/culture-specific risk factor for these siblings. Design and methodIn this qualitative study hermeneutic phenomenological approach was used. Eighteen eligible siblings were selected purposively from two hospitals in Ankara, Turkey. Interviews were conducted with a semi-structured form. Content and thematic analyses were used to analyze the data. ResultsThe data revealed three levels of themes. The main theme was based on “I am here, too”. From the first moment of diagnosis, siblings need to be visible and noticed by others. They seek ways to make sense of the disease as they experience dramatic changes in all aspects of their lives (high level themes - first encounter with the disease and changes in life). They expect their parents and relatives to support them (expectations) when they turn to various methods to cope with the changes (coping styles). ConclusionsThe lack of protective psychosocial care is a basic risk factor for adolescent SCC in Turkey. Despite its various limitations, the strongest aspect of this study is that it is the first publication that determines the experiences of Turkish SCC in their own words. In addition to supporting recent findings about siblings' experiences, obtaining some country-specific findings is a strength of the present study. Practice implicationsProviding psychosocial risk assessment of the siblings' immediately after diagnosis is necessary. It can be helpful to inform parents about the risks.

Psychosocial Risk Prevention in a Global Occupational Health Perspective. A Descriptive Analysis

This study aimed to find out which countries around the world require psychosocial hazards and workplace violence to be assessed by employers through a mandatory occupational risk assessment process and to compare the type of legislation between countries. We systematically searched the International Labour Office (ILO) “LEGOSH” database for documents published during the period between December 2017 and February 2018. The search included 132 countries, of which 23 were considered as developed and 109 as developing according to the United Nations. Our review showed that most countries (85, i.e., 64%) have not included mandatory psychosocial risk assessment and prevention in their national occupational safety and health legislation. Moreover, we found differences between developed and developing countries, showing that developed countries more frequently have legislative measures. Within developed countries, we also found differences between countries following the Scandinavian model of workplace health and safety culture and other countries. Moreover, in many countries, workplace violence was prohibited only if it involves an offence to moral or religious customs. In conclusion, the marked difference in psychosocial hazards and workplace violence regulations among countries leads to unequal levels of workers’ protection, with adverse effects on global health.

Assessing psychosocial risk in pediatric cystic fibrosis

Psychosocial risk factors are known to impact quality of life, treatment adherence, and health outcomes. No standardized comprehensive psychosocial risk screener is routinely utilized in cystic fibrosis (CF) care. The objectives of the study were to describe the range and severity of psychosocial risk within this CF population, investigate the reliability of a comprehensive psychosocial screener in pediatric CF clinical care, and explore relationships between psychosocial risk and key factors affecting health outcomes. It was hypothesized that the PAT-CF total and subscale α coefficients would be similar to those found in other pediatric medical populations. Parents of 154 children with CF completed a CF-specific version of the Psychosocial Assessment Tool_All-lit (PAT-CF), an empirically-based psychosocial risk assessment, during routine CF clinical care. The internal consistency of the PAT-CF Total score was 0.71. Total score and subscale reliabilities reflect findings in other pediatric populations. Total risk scores fell in the following categories: 7% (Clinical-highest risk), 41% (Targeted), and 52% (Universal-lowest risk), respectively. Increased psychosocial risk was associated with Medicaid status and lower parent education, whereas having private insurance was associated with decreased psychosocial risk. The PAT-CF can feasibly be used as an empirically-based comprehensive psychosocial risk tool in routine CF care and is acceptable by parents. In addition to providing universal anticipatory guidance regarding child and family wellness, early identification of risk factors allows care teams to proactively provide targeted support and intervention for specific psychosocial risk factors to promote improved quality of life and ability to sustain daily care.