Quantitative Demands Research Articles

Risk factors for musculoskeletal and depressive symptoms among Brazilian healthcare workers from the HEROES cohort – a prospective longitudinal study

Objectives. This study aimed to identify occupational, personal and psychosocial risk factors associated with musculoskeletal and depressive symptoms in a cohort of Brazilian healthcare workers (HEROES). Methods. The prospective cohort study included 125 healthcare workers from the Brazilian Healthcare System (SUS). Data were collected via e-surveys using a sociodemographic questionnaire, Nordic musculoskeletal questionnaire, Beck depression inventory, Copenhagen psychosocial questionnaire and Pittsburgh sleep quality index. The follow-up response was 64, 52, 50 and 49% at 3, 6, 9 and 12-month follow-up, respectively. Multivariate logistic regression identified the main risk factors for musculoskeletal and depressive symptoms. Results. At 3 months, sleep quality, burnout, age, stress, quantitative demands, skill development and emotional demands were associated with musculoskeletal symptoms and recognition was associated with depressive symptoms. At 6 months, justice, stress and age were associated with musculoskeletal symptoms and recognition was associated with musculoskeletal and depressive symptoms. At 9 months, burnout, stress, sleep quality and emotional demands were associated with musculoskeletal symptoms. At 12 months, sleep quality was associated with musculoskeletal symptoms and recognition was associated with depression symptoms. Conclusion. Personal and psychosocial risk factors were significantly associated with musculoskeletal and depressive symptoms. Future intervention studies should emphasize these factors, with larger samples.

Psychosocial work exposures as risk factors for skin problems in a general working population: cross-sectional and prospective associations.

The potential contribution of psychosocial work exposures to skin problems is largely overlooked in the occupational health literature. To address this knowledge gap, we examined cross-sectional and prospective associations between six psychosocial work exposures (i.e., quantitative demands, job control, social support, emotional demands, role conflict, and interpersonal conflict) and self-reported skin problems. Data came from a probability sample of the general working population in Norway surveyed in 2016 (N = 7833) and 2019 (N = 8038). The prospective sample comprised 3430 participants. Data were analysed with ordered logistic regression, adjusting for age, sex, occupation, and exposure to cleaning products, water, and dry indoor air. Cross-sectional analyses indicated statistically significant associations with skin problems for emotional demands, role conflict, and interpersonal conflict in 2016 and 2019, and for social support in 2019. In prospective analyses, emotional demands (OR 1.12, 95% CI 1.01-1.23), role conflict (OR 1.14, 95% CI 1.00-1.29), and interpersonal conflict (OR 1.24, 95% CI 1.01-1.52) significantly predicted subsequent skin problems. Interpersonal conflict (OR 1.26, 95% CI 1.01-1.57) was a significant predictor above and beyond baseline levels of skin problems. Quantitative demands and job control was generally non-significant, except for a significant interaction in the 2019 sample. Exposure to certain psychosocial work stressors may be a risk factor for experiencing skin problems, particularly if you are exposed to interpersonal conflict. Preventive efforts to reduce the occurrence of skin problems in work settings should also target psychosocial stressors.

Occupational history of psychosocial work environment exposures and risk of autoimmune rheumatic diseases - a Danish register-based cohort study.

This population-based cohort study examined the association between psychosocial work environment exposures and autoimmune rheumatic diseases, including rheumatoid arthritis (RA), systemic sclerosis (SS), and systemic lupus erythematosus (SLE). The total Danish working population, 19-58 years of age (N=2 319 337) was followed from 1997-2018 (37 529 977 person years). Quantitative demands, decision authority, emotional demands, job insecurity, physical violence, role conflicts and possibilities for development at work, as well as a combined psychosocial index were assessed by job-exposure matrices (JEM) and linked with diagnoses of autoimmune rheumatic diseases, ie, RA, SS, and SLE identified in The Danish National Patient Registry. For each psychosocial work environment exposure, recent exposure, accumulated exposure, and number of years with high exposure level were calculated for every employee. Associations with autoimmune rheumatic diseases were assessed by Poisson regression analyses. The results show that employees in occupations with higher decision authority and, to some degree, possibilities for development at work, have lower risks of autoimmune rheumatic diseases, while employment in occupations with high risk of physical violence involves a higher risk of rheumatoid arthritis. No association was observed for job insecurity or role conflicts at work. The results on quantitative demands, emotional demands and the psychosocial index were less conclusive. These findings generally do not support that psychosocial work environment exposures are major risk factors for autoimmune rheumatic diseases, but low decision authority, possibilities for development at work, physical violence and possibly the sum of recent adverse psychosocial exposure may be of importance.

The application of psychological and pedagogical methods in the formation of cognitive skills

Since the beginning of the 20th century, world history has entered a new era of globalization. This has brought new qualitative and quantitative demands on the outcomes of human activity in education and various labor fields. In a rapidly changing environment where modern innovations replace one another, individuals face the necessity of understanding problematic situations and acquiring the necessary cognitive skills to address them. The answers to questions about how these skills are formed, how the cognitive structure inherent to the concepts of a "new human" and a "new personality" is developed and how to ensure effective, results-oriented cognitive activity lie within the emerging field of cognitive psychology. For this reason, current research in cognitive psychology, particularly studies on the formation of cognitive structures within educational environments at various stages of ontogenesis, holds special relevance. Applying these findings to the learning process is a priority. Since the beginning of the 21st century, another notable issue has emerged in this context. It has become evident that it is essential to create new pedagogical practices that integrate concepts such as "artificial intelligence", "computer metaphors" and "cognitive skills", proposed by cognitive psychology. Consequently, cognitive psychology has become a key discipline for studying changes in human psyche and addressing critical, yet unresolved, issues. One such issue is identifying the psychological and pedagogical conditions for forming learners' cognitive activity during the educational process. The new findings in this area can help identify the methods, tools and environmental standards required to organize conscious, results-oriented and effective activities among learners during the learning process. This would allow for a more efficient organization of cognitive activity. The acquisition of knowledge, skills and abilities by learners – the main subjects of the educational system occur during the learning process. Each problem related to this process is studied within the psychological activity of learners and educators. Therefore, addressing cognition in the learning process and, in modern approaches, exploring the cognitive domain and cognitive activity begins with identifying the connections and relationships between the psychopedagogical structure and other domains. Cognitive skills develop in parallel with adolescents' self-identification, their alignment with images close to their emotions, tendencies, desires and ultimately, their self-awareness. New skills emerge during adolescents' systematically, purposefully and methodically structured cognitive activity within the learning process. In other words, effective cognitive activity during learning helps adolescents achieve their life goals. Thus, there is a growing need to explore adolescents' cognitive activity within the learning process and the factors that stimulate it by referencing the activity approach, a critical direction in cognitive psychology. Adolescents' cognitive activity depends on the motivations driving it. It should not be regulated by random motivations. If learning activity is motivated by inner feelings, desires and emotions, difficulties may arise in completing the activity with willpower. To achieve positive results, adolescents' cognitive activity should align with their value-motivation domain and their needs for self-identification, self-development and self-affirmation, accompanied by emotional and volitional efforts from beginning to end. The research highlights this level of motivation as one of the crucial conditions that shape the psychological structure of cognitive activity. In pedagogical psychology, the issue of how adolescents' learning activities are motivated by needs and interests to acquire a cognitive nature is one of the topics requiring comprehensive study.

Can an organizationally anchored, multilevel intervention improve perceived stress and psychosocial factors in the workplace? A pre-post study assessing effectiveness and implementation

BackgroundOrganizational multilevel interventions have been called for as a means to improve psychosocial working conditions, reduce stress, and enhance wellbeing in organizations. However, these types of interventions are highly complex to implement and evaluate, and they remain scarce in the literature. In this study, we present the evaluation of a multilevel intervention conducted in a municipality setting.MethodsThe intervention was based on a train-the-trainer principle and participatory risk assessment workshops on all organizational levels. Action plans were subsequently developed at the team level, and identified risks, which could not be addressed at the team level, were reported to the management for further action planning or escalation to the next management level. Using a pre-post study design, we evaluated changes in proximal outcomes related to the psychosocial working environment, and distal outcomes related to stress and job satisfaction. Changes over time in outcome measures were analyzed using linear mixed models. A quantitative process evaluation was used to examine the degree of implementation of the intervention.ResultsSmall improvements over time were observed with regard to quantitative demands, overall perception of the psychosocial work environment, job satisfaction, and the psychosocial safety climate. We also observed an increase in empowering leadership. Positive tendencies were also found for predicatability at work, possibilities for solving work tasks and support from closest manager. The effect sizes were small in all cases. No improvements in perceived stress or stress symptoms were found. The study revealed several practical and methodological challenges in conducting and implementing this type of multilevel intervention in a municipal setting.ConclusionsOverall, our study suggests that the intervention was associated with small positive changes in certain aspects of the working environment but no improvements were observed in stress outcomes. The study highlights a number of challenges in relation to implementing this type of multilevel intervention in a municipal setting.Trial RegistrationThe study was prospectively registered at ISRCTN84940247 on April 23, 2019.

Combinations of job demands are associated with increased risk of depression in clinical veterinary practice: a cross-sectional study

BackgroundVeterinarians have a high prevalence of mental health disorders, such as depression. Previous research suggests that veterinarians are highly exposed to emotional demands at work and that these emotional demands are associated with adverse mental health outcomes. However, little is known about the consequences of the simultaneous exposure to emotional demands and other types of job demands in clinical veterinary practice. In this cross-sectional study, we investigate the combined effect of simultaneous exposure to emotional demands and other types of job demands on the risk of depression. We invited 1,757 employees in clinical veterinary practice in Denmark to participate in an online survey in the spring of 2022.ResultsWe obtained response from 885 employees (50.4%). Mean age was 38.2 years and 90.2% of the sample identified as women. The majority of the respondents worked in small animal practice (80.6%). We assessed psychosocial job demands (emotional demands, quantitative demands, role conflicts, work pace, and threats) and depressive symptoms in the study questionnaire, and defined depression as a score of ≥ 21 on the Major Depression Inventory. Data were analyzed using logistic regression analysis. 15.1% of the participants had an indication of depression. Results showed an increased risk of depression for participants reporting high emotional demands in combination with high quantitative demands (OR:8.37; 95%CI:4.31–16.24), high role conflicts (OR:8.95; 95%CI:4.71–16.99), threats at work (OR:7.06; 95%CI:4.06–12.28) and high work pace (OR:14.24; 95%CI:6.51–31.15). The combined effects indicated additive but not synergistic interaction.ConclusionsCombinations of emotional demands and other types of job demands are associated with an increased risk of depression among employees in clinical veterinary practice in Denmark. The results have implications for preventing negative health-related consequences of adverse psychosocial working conditions among employees in clinical veterinary practice. Preventive strategies and initiatives to promote a healthy psychosocial work environment and well-being among veterinary employees are discussed, and we further encourage employers and relevant authorities in veterinary practice to prioritize efforts to enhance the psychosocial work environment and employee well-being in clinical veterinary practice.

What about neurodiversity among nurses? A cross-sectional exploration of work environment and health among nurses with ADHD and/or autism.

Employees who have ADHD and/or autism frequently encounter difficulties in their workplace and with their health. Nevertheless, there is a dearth of research focusing on nurses who have ADHD and/or autism, even though the nursing profession presents various significant organizational and social challenges that may potentially have an impact on nurses with ADHD and/or autism. The aim of the present study was to describe and examine associations between work environment, perceived health and satisfaction with given care among nurses who have ADHD and/or autism. Recruitment of participants took place through Swedish social media groups, and data collection was carried out via a web-based questionnaire. A total of 99 nurses who self-reported a diagnosis of ADHD and/or autism were included in the study. Descriptive statistics, binary correlations and linear regression analyses were conducted to analyze the data. The nurses reported high quantitative demands at work, low sense of social community and managerial social support, low perceived health and high satisfaction with given care. Regarding associations between variables, nurses with more inattention (ADHD trait) reported higher quantitative demands at work, and nurses with more social anxiety (autistic trait) reported lower perceived health. Among nurses with ADHD and/or autism, the organizational and social work environment and health are challenging, and these challenges seem to be partly connected to the ADHD and autistic traits. However, patient care was perceived to work well. More research is needed to evaluate how the perceived health of nurses with ADHD/autism can be improved.

A qualitative study of young workers’ experience of the psychosocial work environment and how this affects their mental health

BackgroundThe evidence base for the relationship between psychosocial work factors and mental health focuses primarily on the general working population but little is known about young workers. The aim of this qualitative study is to identify psychosocial work factors that affect the mental health of young workers, with a focus on (1) novel factors of the psychosocial work environment that are relevant for young workers but have not been described in the literature and (2) experiences of psychosocial work factors associated with mental health that are specific to and typical for young workers.MethodsSemi-structured interviews were held with 36 workers aged up to 30. Participants were asked to describe work situations that affected their mental health. Factors were identified using a combination of inductive and deductive coding and open-coded factors were mapped onto the Copenhagen Psychosocial Questionnaire (COPSOQ), which is widely used as a framework for psychosocial work factors.ResultsMost of the psychosocial factors mentioned by the young workers could be mapped onto the COPSOQ framework and were therefore similar to the general working population. Novel factors identified by this study were “Procedural support” and “Responsibility for others”. We also identified young-worker-specific experiences of psychosocial work factors associated with mental health (i.e. Quantitative Demands, Influence at Work, Commitment to the Workplace, Job Insecurity, Quality of work, Job satisfaction, and Vertical Trust). Lastly, young workers did not report the COPSOQ factor Insecurity over working conditions and Work-life conflict was reported as an indicator of mental health status rather than being perceived as a factor of the psychosocial work environment.ConclusionsPsychosocial work factors and their influence on mental health reported by young workers in this qualitative study are comparable to what is reported for the general working population. There are however some young-worker-specific experiences of psychosocial work factors and two novel factors. The novel factors, “Procedural support” and “Responsibility for others” are not found in common psychosocial work factor frameworks and might be studied specifically in relation to young workers. Our results provide organisations with levers that can be used to create a psychosocial work environment that benefits the mental health of young workers.

Associations between Psychosocial Working Conditions and Work-Specific Self-Efficacy Beliefs Among Employees Receiving Psychotherapeutic Consultation at Work.

By considering work-related aspects during early intervention and treatment of employees with (subclinical) symptoms of common mental disorders, psychotherapeutic consultation at work (PT-W) aims to increase work-specific self-efficacy (SE) to finally reduce sickness absence and contribute to successful return to work. This study, thus, aims to investigate interrelations between working conditions and work-specific SE among employees before receiving PT-W. The study uses baseline data of a randomized controlled trial testing the efficacy of PT-W in Germany (n = 535). Working conditions were assessed by six scales of the validated Copenhagen Psychosocial Questionnaire (COPSOQ). SE was assessed by the validated general short occupational self-efficacy (OSE) scale and return-to-work self-efficacy (RTW-SE) scale, two specific forms of self-efficacy. Multiple linear regression models were calculated using working conditions as independent and self-efficacy as dependent variables. Interactions between working conditions and age, gender and current extent of work were added to those models. Results suggest that quantitative job demands are negatively and development opportunities are positively related to OSE and RTW-SE. Age did not moderate those relationships. The association between development opportunities and OSE was stronger among employees indicating working less number of hours than specified in their contract compared to employees indicating working their full contract hours. Furthermore, interactions with gender were found with social support being only (positively) associated with OSE among male and decision authority being only (positively) associated with OSE among female employees. The associations between working conditions and work-specific SE support the usefulness of addressing potential reciprocal relationships between those two variables during PT-W to improve mental health of employees. Registered at the German Clinical Trial Register (DRKS) at 01.03.2021-DRKS00023049.

Mental health of Australian frontline nurses during the COVID-19 pandemic: Results of a large national survey

This paper investigates the effects of work demands on burnout indices of emotional exhaustion, depersonalization and personal accomplishment, and mental health indices of anxiety, depression and stress, among Australian nurses and midwives. We used de-identified self-reported survey data from approximately 11,000 Australian nurses and midwives during the pandemic. Linear and quantile regression analyses explored how working conditions affect different aspects of nurses and midwives' burnout and mental health. Results show how working conditions affect burnout and mental health heterogeneously depending on the severity of the mental health symptoms. Increased quantitative and emotional work demands significantly impact occupational burnout indices of emotional exhaustion and depersonalization, and mental health indices of anxiety, depression, and stress among Australian nurses and midwives. Quantitative and emotional demands have more significant effects on people with higher levels of anxiety, depression, stress, and depersonalization than on those with milder or lesser symptoms. Given recent national and international policy focus on psychosocial hazards at work, this paper suggests that governments and health care providers need to monitor such hazards among nurses and midwives and introduce policies that reduce excessive quantitative or emotional burden to minimise risk of burnout and poor mental health and support good mental health among nurses and midwives.

Contextualising the job demands-resources model: a cross-sectional study of the psychosocial work environment across different healthcare professions.

The deteriorating psychosocial work environment among healthcare workers in Sweden, influenced by demanding working conditions and resource constraints, affects individual well-being and patient care quality. Healthcare workers, including physicians, registered nurses, and nursing assistants, often work interdependently and share workplaces, yet are three completely different professions. Nonetheless, comprehensive studies comparing their psychosocial work environments are scarce; often focusing on healthcare workers either separately or as a homogenous group, but rarely comparative. Utilising the job demands-resources model, this study investigated variations in the psychosocial work environment among Swedish healthcare workers. We wanted to identify how the antecedents of individual well-being, in the form of demands and resources, differed between healthcare workers. Data from the 2022 Longitudinal Occupational Health Survey for Health Care in Sweden were analysed; the participants included 7589 physicians, registered nurses, and nursing assistants. The analysis involved descriptive statistics, including measures of means and analysis of covariance (ANCOVA), employing the Bonferroni correction for multiple post hoc comparisons. The ANCOVA was also stratified by working factors, including years of work experience and employment within the private/public sector. The study revealed significant variations in how healthcare workers perceive their psychosocial work environment. Physicians faced the highest level of Quantitative Demands (mean (x̄) 3.15; 95% CI 3.11-3.19), while registered nurses reported the most Emotional Demands (x̄ 3.37; 95% CI 3.32-3.41). Nursing assistants had the highest grand means for the imbalance between Efforts and Rewards (Effort Reward Imbalance) (x̄ 1.49; 95% CI 1.49-1.49) and an imbalance between Work and Private Life (Work-Life Interference) (x̄ 3.20, 95% CI 3.15-3.25), along with limited resources. The stratified analysis showed that years of experience and the sector affected healthcare workers' perceptions of their psychosocial working environment. For example, registered nurses working in the private sector reported better working conditions thanregistered nurses working in the public sector. The situation for nursing assistants was reversed. Psychosocial work environments are experienced differently between and within healthcare professions in Sweden. This study provides crucial insights for improving workplace conditions and consequently enhancing healthcare professionals' well-being and quality of patient care.

Explaining presenteeism behaviour with the theory of planned behaviour – a longitudinal study

PurposeThis study uses the Theory of Planned Behaviour (TPB) to explore presenteeism, where individuals work despite being ill. The research seeks to understand how attitudes, subjective norms, and perceived behavioural control are associated with presenteeism behaviours.MethodsA longitudinal design was employed, involving 2814 employees from 16 companies. Data were collected using a survey on two measurement points, which included validated scales and vignettes to assess attitudes toward presenteeism. The data were analysed using cluster analysis and a linear mixed effects regression to evaluate the TPB model.ResultsThree clusters of attitudes toward presenteeism were identified through cluster analysis. The model explained 27.8% of the variance in the fixed effects and 52.6% in the combined fixed and random effects. The regression model found associations between presenteeism and factors such as quantitative demands, work-privacy conflict, and leadership culture. Attitudes towards presenteeism were a strong predictor, with specific clusters showing differing propensities to work while ill.ConclusionThe study confirms the suitability of the TPB in explaining presenteeism. It highlights the importance of individual attitudes, subjective norms, and perceived behavioural control in shaping presenteeism. The findings suggest that promoting a health-supportive workplace culture, including open communication about illness, might reduce presenteeism.

Effects of hybrid work on psychological detachment

After the coronavirus pandemic, hybrid work has become firmly established in many companies. This study investigated the relation of hybrid work and relevant working conditions with the psychological detachment of employees. A written online survey was conducted among 250 employees of a company in the mechanical engineering industry in Germany who worked from home at least part of the time. Multiple hierarchical regression was used for the analysis. The results show that, as expected, the quality of manager-employee communication has a positive (β = 0.13, p < 0.05) and extended work availability a negative effect (β = −0.35, p < 0.001) on psychological detachment. Contrary to the assumptions, however, the proportion of work from home has a positive effect on detachment (β = 0.15, p < 0.05). Regarding the demographic variables, female employees are better able to detach from work (β = −0.36, p < 0.01). The quantitative demands initially show a significant effect, but this disappears as soon as the extended work availability and the proportion of work from home are included in the analysis. The included predictors explain 19% (p < 0.001) of the total variance.Practical Relevance Hybrid work offers the opportunity to organize work more flexibly and thus to adapt it more closely to the needs of employees. The results of this study show that work from home can foster psychological detachment from work, provided that health-promoting working conditions are in place.

A longitudinal study of health-impairment and motivational processes in the psychosocial work environment and the subsequent influence on teachers’ intention to remain at their workplace

ABSTRACT This study examines the concurrent influence of health-impairment and motivational processes proposed by the Job Demands-Resource model on teachers’ intention to remain at their workplace at 12 and 24 months among 308 certified teachers in Sweden. Teachers’ perceptions of job demands (quantitative demands, emotional demands, work pace) and job resources (possibilities for development, social support from supervisor, social support from colleagues, recognition) were measured at baseline whereas exhaustion, work engagement, and retention intention were measured at 12 months and 24 months. Data was analysed using structural equation modelling and subsidiary analyses explored the moderating effects of job resources on the health-impairment process at 12 and 24 months. The findings indicate that the health-impairment process is a stronger predictor of teachers’ retention intention at 12 and 24 months than the motivational process and that the primary focus of teacher retention policies should be optimising teachers job demands rather than enhancing teachers’ job resources.

Do job demands and resources differ between permanent and temporary eldercare workers in Sweden?

Eldercare organizations face high sickness absence rates and staff turnover and rely heavily on temporary workers to fill staffing gaps. Temporary workers may experience differences in job demands and resources compared with permanent workers, but this has been largely understudied. To compare perceived job demands and resources between permanent and temporary Swedish eldercare workers. Permanent and temporary eldercare workers in a Swedish municipality were invited to answer a digital survey on work environment conditions. Differences between permanent and temporary workers in job demands and resources were analyzed using multivariate analysis of variance adjusted for age, sex, place of birth, and percent of full-time work and univariate analyses were conducted to consider differences in specific factors. A total of 1076 permanent and 675 temporary workers received the survey, and the final study sample included 451 permanent and 151 temporary workers. Multivariate analyses revealed that temporary workers reported statistically significant lower job demands compared to permanent workers, but no statistically significant differences in resources were found between the groups. Univariate analyses showed that temporary workers reported lower quantitative demands, perceived exertion, and time spent bending forward, than permanent workers. These data suggest comparable support across groups, but a higher workload among permanent workers. Our findings indicate that temporary workers experienced lower job demands than permanent workers, but that no notable difference was found in resources. Interventions aimed at distributing job demands more evenly among eldercare workers with different employment forms may be necessary.

Seeing the Forest for the Trees: The role of Growth-Oriented Leadership in Shaping Public Servants’ Work Experiences in the Post-NPM Environment

In recent years, growth-oriented leadership (GOL) has come to the fore as a salient predictor of positive employee outcomes in public sector contexts. This empirical paper examines the role of GOL in shaping perceptions of quantitative demands as a product of an evolved New Public Management (NPM) context and the subsequent impact on stress and well-being for 419 local government employees working in Western Australia. While latent in previous GOL-oriented studies, this paper is the first to explore the intersection of GOL and quantitative demands, noting that the former has an established positive effect on employee wellbeing, and the opposite case for the latter. Drawing on the challenge-hindrance framework, this article argues that GOL helps to shape employees’ primary appraisals of demands as challenges, rather than hindrances, in the post-NPM environment. The results indicate strong, direct negative relationships linking GOL with quantitative demands and stress, and a strong positive relationship between GOL and well-being. This study establishes GOL as a relevant capability for public leaders in supporting employees to deal effectively with public service demands and subsequently grow. Understanding how leadership capability, and particularly GOL, can shape the employee experience is important in ensuring the effective delivery of public services.

Psychosocial work aspects, work ability, mental health and SARS-CoV-2 infection rates of on-site and remote Brazilian workers during the COVID-19 pandemic – a longitudinal study

BackgroundAt the beginning of the COVID-19 pandemic, some workers had the opportunity to work from home, while others remained in on-site work. The aim of the present study was to compare the psychosocial work aspects, work ability, mental health conditions and SARS-CoV-2 infection rates of Brazilian workers in remote and on-site work through a longitudinal study with quarterly follow-up assessments over a 12-month period.MethodA convenience sample of 1,211 workers from different economic sectors participated in the study, 897 of whom (74.1%) worked from home and 314 (25.9%) remained in on-site work. Psychosocial work aspects were assessed using the Copenhagen Psychosocial Questionnaire (COPSOQ). Work ability was assessed using the Work Ability Index (WAI) and the Work Ability Score (WAS). Mental health conditions and SARS-CoV-2 infection rate were recorded based on self-reported medical diagnoses. Online questionnaires were answered from June 2020 to September 2021, involving two waves of the COVID-19 pandemic. The groups were compared using chi-square tests, t-tests, and two-way ANOVA.ResultsIn the first wave of the pandemic, remote workers reported more quantitative demands and work-family conflicts, whereas on-site workers reported more emotional demands, low development of new skills, low commitment, low predictability, low recognition, and low satisfaction. They also reported greater occurrences of unwanted sexual attention, threats of violence, and physical violence. In the second wave, the remote group continued to report high work-family conflicts, whereas the on-site group reported – in addition to the results of the 1st wave – low influence at work, low quality of leadership, and burnout. No significant difference was found between groups with regards to the WAI in either wave. A significant difference was found for the WAS between the 3rd and 12th months (P < 0.01) in both groups. No significant differences were found between groups for the prevalence of anxiety, depression, burnout/stress, insomnia, panic syndrome, and eating disorders, except for the prevalence of insomnia at the 12-month follow-up, with higher rates in the remote group (P = 0.03). SARS-CoV-2 infection was significantly lower in the remote group (11.3%) compared to the on- site (16.9%) group (P < 0.01).ConclusionsPsychosocial work aspects differed between remote and on-site workers. Work ability and mental health conditions were similar between groups. Remote work might have played a role in limiting the spread of the virus in Brazil had it been more widely available.

Reducing work-related stress among health professionals by using a training-based intervention programme for leaders in a cluster randomised controlled trial.

Healthcare organisations worldwide are affected by the shortage of health professionals due to work-related stress and health professional leaders play an important role by implementing effective strategies. Therefore, this study aims to investigate whether the STRAIN intervention program (using evidence-based training for health professional leaders) can reduce work-related stress among health professionals. This study is based on a cluster randomised controlled trial, consists of three measurements and includes 165 participating hospitals, nursing homes and home care organisations. A total of 206 health professional leaders took part in the intervention programme and 19,340 health professionals participated in the study. Results showed no significant differences (p > 0.05) between the intervention and control group regarding the effort-reward imbalance ratio, quantitative demands, opportunities for development, bond with the organisation, quality of leadership, social community, role clarity, rewards, difficulties with demarcation and work-private life conflict. Pre-/post-test analysis revealed a tendency for significant positive results (p < 0.05) for stressors, stress symptoms and long-term consequences for organisations with a leaders' participation rate of ≥ 75%. Leaders' awareness, commitment and readiness is essential to implement effective strategies reducing work-related stress.

Stressors during the prodromal phase of major depressive episode (CHR-D).

Early recognition and indicated prevention is a promising approach to decrease the incidence of Major depressive episodes (MDE), targeting the patients during their clinical high-risk state of MDE (CHR-D). The identification of a set of stressors at the CHR-D increases the success of indicated prevention with personalized early interventions. The study evaluated stressors in the early phase of depression, developed on the basis of a patient survey on stressors. Sixty-eight inpatients (ICD10: F3x.xx) with a reported high risk state for major depressive episode (CHR-D) were included in the current study. Stressors during CHR-D were retrospectively explored using a semi-structured clinical interview supplemented by open-ended questions. A qualitative explorative content analysis was provided to identify a pattern of stressors during the prodromal phase of the patients, based on the patient's perspective. A frequency analysis was performed for the evaluation of the prevalence of reported source of stress. All patients reported stressors in the prodromal phase of depression. Results demonstrates that patients with depressive disorder typically report multiple stressors, with the most common number being four. First, 18 stressors-groups were identified during coding. Interpersonal conflicts and disappointments in close relationships were most frequently reported stressors during the prodromal phase at 44.1%. The second most frequent stressor mentioned was the high qualitative or quantitative demands at work (38.2%). The third frequent source of stress was changes in close relationships and in family relationships (33.8%). Based on the categories of stressors described in the patient survey during the prodromal phase we suggested a model of stressors in CHR-D during the prodromal phase of the MDE. The identification of a set of stressors at the early stage of MDE may increase opportunities for early intervention. In everyday clinical practice, preventive psychiatry needs clinical and adapted instruments for recording stressors in today's society. This knowledge is necessary in order to develop precisely indicated prevention for depressive disorders.

High overcommitment and low reward as potential predictors for increased depressive symptoms, suicidal ideation, and suicide risk in German veterinarians.

Higher rates of depression, suicidal ideation and suicide risk have been reported for veterinarians in Germany. In this study, several demographic and job-related factors were examined to determine whether they could be considered possible predictors of depression, suicidal ideation, and suicide risk. For this purpose, a survey was conducted among veterinarians in Germany. The demographic factors surveyed were gender, age, working status (employed/self-employed), income, field of work (practicing/non-practicing veterinarian), weekly working hours and community size. For assessing job-related factors, the Effort-Reward-Imbalance questionnaire (effort, reward, overcommitment), several subscales of the Copenhagen Psychosocial Questionnaire (quantitative demands, emotional demands, demands for hiding emotions, meaning of work, work-privacy-conflict, thoughts of leaving the job) and the Copenhagen Burnout Inventory were used. A hierarchical logistic regression analysis was performed with the demographic and job-related factors as independent variables and depressive symptoms, suicidal ideation, and suicide risk as dependent variables, respectively. A total of 3.118 veterinarians (78.8% female) between 22 and 69 years (mean age 41.3 years) were included in the study. The factors used resulted in the highest variance explanation for depressive symptoms (57%), followed by suicidal ideation (34%) and suicide risk (23%). Low reward and high overcommitment were found to be the most important predictors of depressive symptoms, suicidal ideation, and suicide risk. Significant relationships with depressive symptoms, suicidal ideation, and suicide risk were also found for burnout, demands for hiding emotions, and thoughts of leaving the job. The results of this study point to opportunities for changes in the veterinary working environment, for the development of prevention and intervention programs for veterinarians, and for the further development of the veterinary curriculum to strengthen the mental health of veterinarians in Germany.