Psychosocial Work Stress Research Articles

Psychosocial work load and stress in the geriatric care

BackgroundDue to the decrease in informal care by family members and the demographic development, the importance of professional geriatric care will rise considerably. Aim of this study was to investigate the psychosocial workplace situation for employees in this profession.MethodsThe German version of the COPSOQ (Copenhagen Psychosocial Questionnaire) was used for the assessment of psychosocial factors at work. The instrument includes 22 scales and 3 single items concerning demands, control, stress, support, and strain.Results between two study groups of geriatric care were compared to each other as well as to employees in general hospital care and a general population mean (COPSOQ database).Statistical analysis included t-tests, ANOVA and multiple comparisons of means. Statistical significance (p < 0.01, two-tailed) and a difference of at least 5 points in mean values were defined as the relevant threshold.ResultsIn total 889 respondents from 36 institutions took part in the study. 412 worked in Home Care (HC), 313 in Geriatric Nursing Homes (GNH), 164 in other professions (e.g. administration).Comparison between HC and GNH showed more favourable values for the first group for the most scales, e.g. lower quantitative and emotional demands and less work-privacy conflict, better possibilities for development etc. Compared to external values from the German COPSOQ database for general hospital care (N = 1.195) and the total mean across all professions, COPSOQ-total (N = 11.168), the results are again positive for HC workers on most of the scales concerning demands and social support. The only negative finding is the very low amount of social relations at work due to the obligation to work alone most of the time. Employees in GNH rate predictability, quality of leadership and feedback higher when compared to general hospital care and show some further favourable mean values compared to the COPSOQ mean value for all professions. A disadvantage for GNH is the high rating for job insecurity.A supplementary subgroup analysis showed that the degree of negative evaluation of psychosocial factors concerning demands was related to the amount of working hours per week and the number of on-call duties.ConclusionsCompared to employees in general hospital care and the COPSOQ overall mean value across all professions, geriatric care employees and especially home care workers evaluate their psychosocial working situation more positive for most aspects. However, this seems partly due to the very high proportion of part-time workers. Critical results for the two study groups are the relatively high job insecurity in nursing homes and the lack of social relations for the HCrs.

Qualified and Unqualified (N-R C) mental health nursing staff--minor differences in sources of stress and burnout. A European multi-centre study.

BackgroundUnqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care.MethodsA total of 196 nursing staff - 124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds - working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ).Results(a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems.ConclusionThe differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard to stress and burnout seem necessary. The results also suggest that centre-specific problems may cause more stress among N-R Cs compared to the qualified staff (e.g. professional self-doubt).

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Since the 1990s work-related rehabilitation programs have gained more importance in orthopaedic rehabilitation. Although inception cohort studies of patients with low back pain have indicated the prognostic relevance of psychosocial work-related factors for return to work, these factors and the interaction of these factors with restrictions in functional capacity have been less extensively considered during the rehabilitation process so far. Systematic reviews on the course of low back pain were reviewed concerning the prognostic relevance of psychosocial work-related factors for return to work. Seven reviews were comparable concerning the outcome analysed (return to work) and the populations considered (acute/subacute). These reviews confirmed that patients with low back pain and low social support from supervisors and colleagues, low decision latitude, high psychosocial work demands and a poor subjective prognosis have a lower chance of returning to work. The prognostic relevance of job satisfaction was contradictory. Rehabilitation should be aimed at supporting and developing strategies for coping with psychosocial work stress.

The perception of work stressors is related to reduced parasympathetic activity

The aim was to examine the perception of work stressors in relation to ambulatory measures of heart rate variability (HRV). Results are based on a sample of 653 healthy male workers aged 40-55 from the Belgian Physical Fitness Study conducted in 1976-1978. Data were collected by means of self-administered questionnaires and bio-clinical examinations. An index of physical and psychosocial work stressors containing five items was constructed based on the job stress questionnaire. Data on HRV were collected by means of 24-h ambulatory ECG recordings on a working day. Both time and frequency domain measures of HRV were calculated. Associations between work stressors and HRV measures were assessed by means of correlations, multiple linear regression analysis and analysis of (co)variance. The work stressor index was significantly associated with lower pNN50 (the percentage of differences between adjacent normal RR intervals > 50 ms), lower high frequency power and a higher ratio of low frequency over high frequency power. Very similar results were obtained after adjusting for age, language, occupation, smoking, body mass index, total cholesterol, systolic blood pressure and leisure time physical activity. No significant associations were found with SDNN (the standard deviation of all normal RR intervals) and low frequency power. The perception of work stressors was related to reduced parasympathetic activity in a sample of 653 healthy male workers. These findings support the idea that particularly the parasympathetic component of the autonomic nervous system is related to work stress.

Do early life exposures explain associations in mid-adulthood between workplace factors and risk factors for cardiovascular disease?

Workplace factors (night work, long working hours, psychosocial work stress) have been reported to be associated with increased risk of cardiovascular disease (CVD). We investigated whether (i) workplace factors are associated with CVD risk factors independently of each other, (ii) workplace factors interact, thereby modifying associations and (iii) associations are explained by early life exposures. A total of 7916 employed participants in the 1958 British birth cohort underwent a clinical assessment at age 45 years. Regression analysis was used to examine associations between workplace factors and CVD risk factor levels with adjustment for early life exposures. Night work was associated with adverse levels of most CVD risk factors. Working > or =48 h/week was positively associated with body mass index (BMI) and waist circumference (WC). Low job control was positively associated with glycosylated haemoglobin (HbA1c) and inflammatory factors, and inversely associated with high-density lipoprotein (HDL)-cholesterol. Low demands were positively associated with systolic blood pressure (SBP), triglycerides and inflammatory factors and inversely associated with HDL-cholesterol. Several associations were weakened when workplace factors were adjusted for each other. Night workers in low-demand jobs had higher BMI [0.78 kg/m(2); 95% confidence interval (CI) 0.35, 1.21], WC (1.49 cm; 0.45, 2.52) and SBP (1.38 mmHg; -0.04, 2.81). HDL was lower for low control plus night work (-0.04 mmol/l; -0.08, -0.01) or long hours (-0.12; -0.18, -0.69). Adjustment for early life exposures explained 30-50% of most associations, e.g. night work/low demands associations reduced by 50% for BMI and WC, and by 39% for SBP. Associations between workplace factors and CVD risk factors in mid-adulthood arise in part from social and health disadvantage originating earlier in life.

Worksite environmental interventions for obesity control: an overview.

In 2004, the National Heart, Lung, and Blood Institute funded seven independent research projects to test the effectiveness of multicomponent weight control interventions at worksites that include environmental changes alone or in combination with individually targeted strategies (Pratt et al, Obesity. 2007;15:2171-2180). The studies were conducted in a variety of worksites across the United States. This supplement to the Journal of Occupation and Environmental Medicine includes a series of manuscripts that evaluate various aspects of the funded studies, including environmental and cost-related findings, process evaluation, and the impact of acute and chronic psychosocial work stressors on body mass index.

Work Performance of Employees with Depression: The Impact of Work Stressors

Depressed employees are vulnerable to adverse work outcomes. We hypothesized that work performance is impaired by depression and is worsened by exposure to psychosocial work stressors. Longitudinal cohort study with surveys administered at baseline, 6, 12, and 18 months. Recruitment in primary care offices. A total of 14,268 were screened; 286 depressed, employed adults (18-62 years) and 193 controls were enrolled. At-work limitations (presenteeism) and absenteeism were measured with the Work Limitations Questionnaire (WLQ) and WLQ Work Absence Module, respectively. Work stressors were assessed using a modified version of the Job Content Questionnaire. Univariate and multivariate tests assessed the degree to which at-work limitations were related to depression and/or stressful work. Presenteeism and absenteeism were significantly worse for the depression group at each time point (p < or = .001). In cross-sectional models, presenteeism was associated with more severe depression symptoms, poorer general physical health, psychologically demanding work, the interaction ofpsychologically demanding work with depression, and less job control (r2 range = .33-.54). Absences were explained by depression symptom severity and poorer general physical health but not work stressors (r2 = .19). Because of minimal change in the work stressors, their longitudinal effects on outcomes were mostly nonsignificant. This study found that depression symptoms are related to work absences and impaired work performance, and results partly confirmed that work stressors add to this impact. Results suggest that workers with depression may benefit from care involving medical and vocational interventions.

Working characteristics and cardiovascular disease: are associations confounded by early life risk factors?

Work characteristics, such as night work, long hours and psychosocial work stress, have been found to be associated with cardiovascular disease (CVD) but the pathways from work to increased CVD...

Psychosocial Stress at Work Doubles the Risk of Type 2 Diabetes in Middle-Aged Women

OBJECTIVETo investigate the effect of psychosocial stress at work on risk of type 2 diabetes, adjusting for conventional risk factors, among a sample of British, white-collar, middle-aged men and women.RESEARCH DESIGN AND METHODSThis was a prospective analysis (1991–2004) from the Whitehall II cohort study. The current sample consists of 5,895 Caucasian middle-aged civil servants free from diabetes at baseline. Type 2 diabetes was ascertained by an oral glucose tolerance test supplemented by self-reports at baseline and four consecutive waves of data collection including two screening phases. The job strain and iso-strain models were used to assess psychosocial work stress.RESULTSIso-strain in the workplace was associated with a twofold higher risk of type 2 diabetes in age-adjusted analysis in women but not in men (hazard ratio 1.94 [95% CI 1.17–3.21). This effect remained robust to adjustment for socioeconomic position and outside work stressors and was only attenuated by 20% after adjustment for health behaviors, obesity, and other type 2 diabetes risk factors.CONCLUSIONSPsychosocial work stress was an independent predictor of type 2 diabetes among women after a 15-year follow-up. This association was not explained by potential confounding and mediating factors. More evidence from prospective studies using the same work stress models is needed to support the current findings and provide further information on sex differences.

Physical and psychosocial work stressors, health-related control beliefs and work ability: cross-sectional findings from the German Sociomedical Panel of Employees

The aim of this paper was to analyse the cross-sectional associations between work-related stressors and work ability and to investigate moderator-type effects of internal health-related control beliefs (IHRCB). A total of 1,348 working men and women aged 30-59 years from the baseline survey of the German Sociomedical Panel of Employees were included in the analyses. Work ability was assessed by the Work Ability Index (WAI). Work-related stressors were defined as physical demands and in terms of the demand-control model and the effort-reward imbalance model. Restrictions of work ability were explained independently by physical demands and by work stress exposure due to high demand and low control and due to effort-reward imbalance. These effects were more serious for workers with low IHRCB than those with high IHRCB. IHRCB are an important personal resource that might moderate the effect of work-related stressors on work ability. However, longitudinal analyses are required to confirm these results.

Night work, long working hours, psychosocial work stress and cortisol secretion in mid-life: evidence from a British birth cohort

Objectives:To examine the relationships between exposure to workplace factors (night work, extended working hours, psychosocial work stress) and cortisol secretion, and to test whether workplace factors interact, resulting in combined...

Quality of work life and impact on well-being: the role of mental fatigue

psychosocial risk factors, mental fatigue, health, stress - Many studies focused on the relationship between psychosocial risk factor at work and health outcomes. The aim of the present research is to verify the direct effect of the psychosocial work environment on the well-being of workers and the mediating effect of mental fatigue between the workplace characteristics and physical and psychological symptoms. An Italian version of the Questionnaire for Psychosocial Work Environment and Stress (PWSQ) has been administered to 314 public employees. The results showed that job demands, job control, role and social environment are related to psychological symptoms. Furthermore, the mental fatigue has a total mediating effect especially between job demand and control, and subjective wellbeing.

Psychosocial work conditions and work stress in an innovating addiction treatment centre. Consequences for the EFQM Excellence Model

In the Job Demand Control Model (JDCM) and the EFQM Excellence Model, psychosocial work conditions are regarded as critical factors for the functioning of the personnel and the organisation. In order to gain insight into the role of work conditions for the development of work strain and well-being, an empirical study was conducted in an innovating addiction treatment centre in Amsterdam, the Netherlands. The Work Stress Monitor on Mental Health (WSMMH) was used as a measure of the JDCM. A cohort of 209 employees of an addiction treatment centre, in which a far-reaching innovation programme was carried out, participated in this study. With the exception of physical demands, job demands, were high, whereas job controls and the organisational supports were low. Seven out of the 18 work condition scales significantly predicted work strain and well-being. Age and educational level were positive related to well-being. Compared with other health care sectors, work in this addiction treatment centre can be characterised as high-demand low-control and thus as a high strain job. Seven important predictors for this undesirable situation were identified. These predictors can be translated into criteria for the EFQM Excellence Model and can be used to enhance the overall quality of addiction treatment services.

The Relationship Between Psychosocial Work Factors, Work Stress and Computer-Related Musculoskeletal Discomforts Among Computer Users in Malaysia

Increasing numbers of workers use computer for work. So, especially among office workers, there is a high risk of musculoskeletal discomforts. This study examined the associations among 3 factors, psychosocial work factors, work stress and musculoskeletal discomforts. These associations were examined via a questionnaire survey on 30 office workers (at a university in Malaysia), whose jobs required an extensive use of computers. The questionnaire was distributed and collected daily for 20 days. While the results indicated a significant relationship among psychosocial work factors, work stress and musculoskeletal discomfort, 3 psychosocial work factors were found to be more important than others in both work stress and musculoskeletal discomfort: job demands, negative social interaction and computer-related problems. To further develop study design, it is necessary to investigate industrial and other workers who have experienced musculoskeletal discomforts and work stress.

Psychosocial work environment and lifestyle as related to lipid profiles in perimenopausal women

Objective The aim of the study was to characterize lipid profiles of perimenopausal women and to relate these to the psychosocial work environment and lifestyle using a longitudinal design.Methods A population-based sample of 107 women, aged 47–53 years, participated in a baseline study and in a follow-up 2 years later. Psychosocial work stress was measured using the Job Content Questionnaire. The women also completed a health questionnaire and participated in a psychological interview. Fasting blood samples were analyzed for concentrations of total cholesterol, high and low density lipoprotein (HDL, LDL) cholesterol and triglycerides.Results Multiple regression analyses showed that work control was a significant predictor of higher HDL cholesterol (p < 0.05), lower LDL cholesterol/HDL cholesterol ratio (p < 0.01) and lower total cholesterol/HDL cholesterol ratio (p < 0.01). Job strain predicted a higher LDL cholesterol/HDL cholesterol ratio (p < 0.01) and higher total cholesterol/HDL cholesterol ratio (p < 0.05). Lifestyle variables smoking, body mass index and waist/hip ratio predicted an unfavorable lipid profile, whereas alcohol consumption predicted a favorable lipid profile. Age but not menopausal status was associated with lipid levels at baseline and on follow-up. Use of hormone replacement therapy was a significant predictor of lower cholesterol levels in the multivariate analyses.Conclusions Our results demonstrated a significant association between the psychosocial work environment and women's cardiovascular health at menopause. Job strain was a significant contributor to an atherogenic lipid profile, whereas work control predicted a favorable profile. Hence, the argument is now compelling that psychosocial factors should be included in the risk profiles for cardiovascular disease in women.

Psychosocial work stressors for insomnia: a prospective study on 50–60-year-old adults in the working population

Work-related stressors are often viewed as being a source for disturbed sleep. This prospective study aimed to examine whether psychosocial work stressors were related to the development and maintenance of insomnia. From a randomly selected sample from the general population (N = 3,600), 1,873 participants aged 50-60 years old in the workforce filled out a baseline and 1-year follow-up questionnaire. Stepwise logistic regressions were used to investigate whether work stressors were related to the development and maintenance of insomnia over 1 year. The results showed that among individuals with no insomnia at baseline, high work demands increased the risk of developing insomnia 1 year later (4% of the variance). Among participants with insomnia at baseline, work stressors did not influence the course of insomnia over 1 year. Finally, low influence over decisions, high professional compromise, and high work demands were related to the maintenance of insomnia (9% of the variance). The findings indicate that perceived work stressors are, although rather weakly, associated with the development and maintenance of insomnia. This might have implications for how insomnia is conceptualized as it places work stressors in the model and for how interventions at different stages of insomnia is implemented.

Psychosocial work environment and mental health—a meta-analytic review

To clarify the associations between psychosocial work stressors and mental ill health, a meta-analysis of psychosocial work stressors and common mental disorders was undertaken using longitudinal studies identified through a systematic literature review. The review used a standardized search strategy and strict inclusion and quality criteria in seven databases in 1994-2005. Papers were identified from 24,939 citations covering social determinants of health, 50 relevant papers were identified, 38 fulfilled inclusion criteria, and 11 were suitable for a meta-analysis. The Comprehensive Meta-analysis Programme was used for decision authority, decision latitude, psychological demands, and work social support, components of the job-strain and iso-strain models, and the combination of effort and reward that makes up the effort-reward imbalance model and job insecurity. Cochran's Q statistic assessed the heterogeneity of the results, and the I2 statistic determined any inconsistency between studies. Job strain, low decision latitude, low social support, high psychological demands, effort-reward imbalance, and high job insecurity predicted common mental disorders despite the heterogeneity for psychological demands and social support among men. The strongest effects were found for job strain and effort-reward imbalance. This meta-analysis provides robust consistent evidence that (combinations of) high demands and low decision latitude and (combinations of) high efforts and low rewards are prospective risk factors for common mental disorders and suggests that the psychosocial work environment is important for mental health. The associations are not merely explained by response bias. The impact of work stressors on common mental disorders differs for women and men.

Occupational risk factors and reproductive health of women

This in-depth review summarizes and interprets the available recent epidemiologic evidence on the relationship between occupational exposures and negative reproductive outcome among women workers. The studies examined by the review include those published in the international scientific literature since 1990, and were identified through the search of relevant data banks using selected keywords. From the examination of studies dealing with exposures of women to chemical agents, pesticides, physical agents, ergonomic factors and stress, it appears that at present the evidence is sufficient to warrant the maximum protection of pregnant women to several well-documented occupational risk factors. These include exposures to anaesthetic gases, antineoplastic drugs, heavy metals, solvents, heavy physical work and irregular work schedules. For other work risks, such as exposure to non-ionizing radiation and psychosocial work stress, the evidence is often suggestive but not conclusive. Policy makers and health professionals should advise women and employers to avoid exposure to the well-known occupational risk factors, while epidemiologic research should pursue methodological improvements and provide more insight into the magnitude of exposures responsible for detrimental effects.

Mental health and related disability among workers: A population‐based study

In past decades, the nature of work has undergone significant changes including increased psychological demands and job instability. A stressful psychosocial work environment has been shown to have adverse effects on workers' mental and physical health. This goal of this study is to estimate the prevalence of psychiatric syndromes and related disability in a population-based sample of employed adults and investigate associations between psychiatric syndromes and related disability. A random-digit dial provincial wide mental health survey was conducted in Alberta, Canada (n = 5,383). The telephone interview included the Mini International Neuropsychiatric Interview (MINI) and the World Health Organization's Disability Assessment Schedule (WHO-DAS-II). In this analysis, participants who were currently employed were included (n = 4,149). In this population, 6.2% had had at least one MINI-defined psychiatric diagnosis with clinically significant interference. Without consideration of the clinical interference criterion, the prevalence of psychiatric syndromes was higher (33.5%). Psychiatric syndromes were strongly associated with disability. A dose-response relationship between the number of diagnoses and disability was found. Interventional strategies in the workplace should focus on mental disorders at both the clinical and sub-clinical levels.

Building health: an epidemiological study of “sick building syndrome” in the Whitehall II study

Objectives: Sick building syndrome (SBS) is described as a group of symptoms attributed to the physical environment of specific buildings. Isolating particular environmental features responsible for the symptoms has proved...