Sickness Absence Research Articles

Exploring line managers’ perspectives on using data in managing sickness absence: a qualitative study

PurposeThe purpose of this study is to explore line managers’ perspectives on data as tool in the management of sickness absence in public sector workplaces in Denmark.MethodsThe study is a qualitative study based on 19 semi-structured interviews with line managers from four public sector workplaces characterized by high levels of sickness absence or poor work environment. The interviews were analysed inductively using thematic analysis.ResultsThe findings show that line managers primarily use data to identify employees at risk of sickness absence. The experiences highlighted related to how and when data are perceived as a valuable tool by the line managers, and that nuances in the data, accessibility of the data and how data are presented are important factors to ensure appropriate follow-up on sickness absence.ConclusionsThe findings suggest that for line managers to use data to manage sickness absence appropriately, the data must be easily accessible, simple for line managers to understand and provide line managers with a sufficient overview of sickness absence in their work units. It is also important to consider other factors affecting sickness absence, such as the work environment, when aiming to reduce sickness absence.

What are the barriers and facilitators for health and social care professionals accessing organizational wellbeing support services? A mixed-methods study

Recent years have seen increases in workers’ stress levels and sickness absence rates. Organizations have increased the number of wellbeing support services they offer employees, but uptake has been poor. This study investigated barriers and facilitators to accessing organizational wellbeing support services. A two-study, mixed-methods design in health and social care employees was used. Study 1 conducted a directed content analysis of qualitative interview data based on the Theoretical Domains Framework (TDF) to identify barriers and facilitators. These were translated into survey items. Study 2 conducted a quantitative cross-sectional survey to assess whether the number of barriers and facilitators was associated with the likelihood of service use. Study 1 (n = 20) created a survey list of 23 barriers and 23 facilitators. Study 2 (n = 162) found that a greater number of facilitators was associated with a greater likelihood of service access, but number of barriers was not. We concluded that increasing facilitators may increase employee uptake of wellbeing support services. Facilitators include making access routes to services simple and efficient and circulating regular information to staff about available services.

The association between leisure-time physical activity and cardiorespiratory and muscular fitness and job strain-Study with a Northern Finland birth cohort of 1966.

Job strain is a major concern in the workplace. Work-related stress is an increasing challenge worldwide as it is the leading cause of long-term sickness absences, disability pensions and lower productivity. Rarely studied simultaneously, both leisure-time physical activity (LTPA) and physical fitness (PF), which comprises cardiorespiratory fitness (CRF) and muscular fitness (MF), may have potential in preventing and managing job strain. The current study aimed to investigate whether LTPA, CRF and MF predict perceived job strain. In addition, the study examines reverse associations, that is, whether job strain predicts LTPA, CRF and MF. We used longitudinal population-based data from a Northern Finland birth cohort of 1966 (n=5363) to analyse LTPA, CRF and MF as well as job strain and its components, job demands and job control, at age 31years (1997) and 46years (2012). Leisure-time physical activity was measured with a self-reported questionnaire whereas CRF and MF were measured as part of clinical examination. Linear regression analyses were used to analyse the data. In both men (n=2548) and women (n=2815), higher baseline MF predicted lower job strain and job demands 15years later. In women, higher baseline total LTPA predicted higher job demands, whereas in men, higher CRF predicted lower job strain and higher job control. These associations remained significant, also when adjusted for education and occupational status. In the analyses on reverse associations, higher job control and higher job demands were linked to higher leisure-time moderate-to-vigorous physical activity (MVPA) and total LTPA 15years later among both men and women, except for the association between job demands and total LTPA among women. These associations remained significant after adjustment for education and occupational status, except for the association of job control with MVPA and total LTPA among men. The association of higher job demands and total LTPA became significant in women. We conclude that LTPA and PF seem beneficial in preventing and managing job strain.

Do return-to-work trajectories differ by mental disorder diagnosis? A register study among 37 523 Dutch workers.

Return to work (RTW) of workers with mental disorders is often a process of gradually increasing work hours over time, resulting in a RTW trajectory. This study aimed to investigate 2-year RTW trajectories by mental disorder diagnosis, examining the distribution of age, sex and contracted work hours across the diagnosis-specific RTW trajectories. Sickness absence episodes diagnosed within the ICD-10 chapter V (mental and behavioral disorders) and ICD-10 Z73.0 (burnout) were retrieved from a Dutch occupational health service register, together with age, sex and contracted work hours. Sickness absence episodes due to adjustment disorders (N=25 075), anxiety disorders (N=1335), burnout (N=3644), mood disorders (N=5076), and post-traumatic stress disorders (N=2393) were most prevalent and included in latent class growth analysis (LCGA) to estimate 23-month RTW trajectories. Four main RTW trajectories were identified for all mental disorder diagnoses: fast full RTW [range 82.4% (mood disorders) to 92.0% (adjustment disorders) of the study population], slow full RTW [3.5% (burnout) to 6.1% (mood disorders)], slow partial RTW [0.6% (adjustment disorders) to 1.6% (mood disorders)] and no RTW [2.2% (adjustment disorders) to 9.7% (mood disorders)]. Trajectories with a late onset of fast full RTW included higher percentages of women and lower percentages of full-time workers. RTW trajectories were similar for different mental disorder diagnoses although the distribution differed across diagnoses, with more partial and no RTW trajectories among workers with mood disorders. To better guide workers back to work, more knowledge is needed of factors associated with late, partial, or no RTW.

Sickness absence after work accidents and post-traumatic stress among white-collar workers in the retail and wholesale industry; a longitudinal Swedish cohort study

BackgroundMost studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers.AimTo examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry.MethodsA prospective population-based cohort study of all 192,077 such workers aged 18–67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012–2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit.Results35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly.ConclusionsAbout a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD.

Associations between work-related factors and sickness presenteeism: a prospective study using the national French working conditions survey

ObjectivesThe objectives were to assess the prospective associations between work-related factors, including psychosocial and physical work factors and working time/hours factors, and sickness presenteeism alone or combined with sickness absence.MethodsThe...

Occupational Stress and Its Effect on Health Status Among Karnataka State Road Transport Corporation (KSRTC) Bus Drivers: A Cross-Sectional Study.

Occupational stress is a critical health concern across various professions, often linked to adverse health outcomes and increased risk-taking behaviors. Bus drivers are especially vulnerable due to prolonged shifts, exposure to environmental pollutants, and higher rates of sickness absenteeism. This study aimed to assess the prevalence of occupational stress among Karnataka State Road Transport Corporation (KSRTC) bus drivers and the factors contributed. In addition, it explores the relationship between job-related stress and overall health status, providing insights into the occupational challenges faced by this workforce. A cross-sectional study was conducted over two years from June 1, 2022, to June 30, 2024, at the KSRTC depot in Kolar, serving urban and rural areas. A representative sample of 235 bus drivers was selected from a total of 654 using simple random sampling. Socio-demographic details, including age, gender, education, religion, family type, and per capita income, were collected using a pre-tested semi-structured self-administered questionnaire. Stress levels were assessed using the American Institute of Stress (AIS) questionnaire, a widely used tool for evaluating various stress dimensions. Data were collected through interviews, entered into Excel, and subsequently analyzed using IBM SPSS Statistics for Windows, Version 22 (Released 2013; IBM Corp., Armonk, New York, United States). The study revealed that 65% of KSRTC bus drivers experienced moderate to severe stress. Significant factors associated with occupational stress included urban residency, divorce, chronic alcohol consumption, current tobacco chewing, hypertension, higher BMI, long working hours, and high waist-hip ratio. Binary logistic regression showed urban residents had higher stress odds than rural residents (OR=1.27, p=0.03). Divorced individuals and chronic alcoholics also had higher odds of stress (OR=1.24, p=0.05 and OR=1.33, p=0.04, respectively). Stress was significantly associated with hypertension (OR=1.40, p=0.01), obesity (OR=1.30, p=0.03), morbid obesity (OR=1.47, p=0.01), high-risk waist-hip ratios (OR=1.42, p=0.01), and longer working hours (>12 hours, OR=1.30, p=0.03). Health assessments revealed a high prevalence of hypertension (39%) and obesity (65%). The study highlights a high prevalence of occupational stress among KSRTC bus drivers in Kolar, with 65% experiencing moderate to severe stress. Factors such as urban residency, lifestyle habits, and physiological parameters significantly contribute to stress. These findings underscore the need for targeted health promotion programs and policy changes to enhance the health of essential workers and improve road safety.

Sick of Leading? Supervisory Responsibility and Its Consequences for Sickness Absenteeism and Sickness Presenteeism

Sick of Leading? Supervisory Responsibility and Its Consequences for Sickness Absenteeism and Sickness Presenteeism

RESTART: a stepped-care approach to facilitate return to work for employees with psychological distress: design of a randomized controlled trial

BackgroundCommon mental health problems, such as stress, anxiety and depression, are highly prevalent among workers and often lead to long-term absenteeism and work disability. Effective elements found in previous researched interventions were to explicitly focus on return to work (RTW) and not solely on symptom reduction, to take into account the employees’ cognition towards RTW and to include the workplace environment. Based on these elements, a stepped-care approach was developed. The aim of this paper is to present the study design of a randomized controlled trial (RESTART), evaluating the effectiveness of the stepped-care approach on lasting RTW and the implementation process.MethodsRESTART is a randomized controlled trial with a 2 × 2 factorial design and a follow-up of one year. Employees eligible for this study are those who reported sick within 2 to 8 weeks with psychological distress based on a distress screener. Participants will be randomized to a group receiving a tailored e-Health app or usual care, as well as randomized to a group receiving a Participatory Approach (PA; conversational method) in the workplace or usual care. The PA will however only be provided in case of persistent sickness absence at 8 weeks. Measurements take place at baseline, after the e-Health intervention period (3 months), and after the PA intervention period (6 months) and 12 months. Primary outcome is lasting RTW, defined as full RTW in previous or equal work for at least four consecutive weeks. Secondary outcomes are (the severity of) stress-related symptoms, total number of sickness absence days, self-efficacy for RTW and self-reported health. A process evaluation including a realist evaluation will also be conducted.DiscussionEarly intervention that focuses on RTW, the cognition towards RTW despite symptoms and involves the workplace environment, plays a crucial role in managing sickness absence among employees with psychological distress. If effective, the stepped-care approach is relevant for employees, employers and society as a whole.Trial RegistrationISRCTN: 90663076. Registered on 5 October 2023.

Airport security personnel's working hour characteristics and associations with sickness absence-a retrospective cohort study in 2016-2019.

We aimed to investigate the associations of working hour characteristics based on the international and local definitions with sickness absence (SA) among airport security personnel. The payroll-based registry data of daily working hours for 2016-2019 at one airport was limited to those with ≥30 work shifts in a year (n=377-687 employees). The conditional Poisson model for incidence rate ratios (IRR) with 95% confidence intervals (CI) was used for analyses. Based on the international definitions, only a few associations were found: each one-unit increase in weekly working hours and the number of consecutive working days were associated with a lower likelihood of SA. The local definitions were more consistently associated with SA: Each one-unit increase in shift length and time between shifts, higher variation in shift length, and the number of consecutive evening and night shifts were associated with a higher likelihood of SA. To conclude, especially the local definitions of working hour characteristics seem to be important limits for short SA. Thus, high variability of shift lengths and prolonged shifts could be avoided to reduce the risk of SA. Overall, keeping the working hours within any of the recommendations among airport security personnel could support well-being and health.

Reducing sickness absence: a work environment intervention in Norwegian hospitals

BackgroundHigh rates of sickness absence is a challenge within the healthcare sector, highlighting the need for effective interventions. Despite this, limited research has been conducted on the impact of such interventions within the healthcare context. This study evaluates an intervention aimed at improving the work environment influences sickness absence rates in Norwegian hospital units. The intervention is a comprehensive framework for discovering and tailoring solutions to each units’ specific needs, with a focus on employee involvement and collaboration between leader, union representatives and safety delegates.MethodsWe employed two methodological approaches. Method 1 involved using HR-registered sickness absence data to track changes in sickness absence across all intervention units and matched control groups over a three-year period. In Method 2, we used a pre- and post-survey design in 14 intervention units, focusing on employees’ job satisfaction and self-reported health.ResultsThe results of the intervention were mixed. There was a significant decrease in total sickness absence in the intervention units the first year after the intervention, and a significant decrease in long-term sickness absence both in the first and second year after the intervention, measured with HR registries. However, we did not see a significant larger decrease in total sickness absence in the intervention units compared to the control units and only partial support for a larger decrease in long-term absence in the intervention units. In the subsample of units that also participated in the survey, we observed significant improvements in employee job satisfaction post intervention.ConclusionsThere is a need for research on effective interventions to reduce sickness absence in the healthcare sector. “Where the shoe pinches” provides a potential methodological framework for reducing sickness absence by addressing challenges in the work environment, however with uncertain results. Further exploration is warranted to refine strategies for effectively managing sickness absence within healthcare organizations.

Occupational Morbidities and Health-Seeking Behavior among Automobile Mechanics in the Western Region of Nigeria

Background: Automobile mechanic work is associated with illnesses and injuries. These occupational diseases can result in sickness absence, economic loss, disability, or death of these workers. This study assessed self-reported health problems and health-seeking behavior of automobile mechanics in Surulere, Lagos State. Methods: A cross-sectional study was used in this study carried out in December 2014. A systematic sampling method was employed to select 120 respondents from various workshops within their Local Government Area and were interviewed using a structured questionnaire. Data entry and analysis were done using epi-info3.5.1 Results: About 27.5% of the respondents reported at least one work-related illness or injury. Five percent of the respondents had musculoskeletal disease. About 11.5% of the respondents reported having cuts and crushing injuries. Most (86.7%) of these workers do not have health workers available around their workplaces. Slightly less than half (48.3%) visit health facilities between 6 to 15 minutes of estimated walking distance. Most (70%) respondents visit health facilities when ill or injured; 33.3% patronize traditional healers/ herbs/ prayer houses (spiritualists); 25% patronize patent medicine vendors and practice self-medication. The level of education of the workers was inversely significantly associated with the occurrence of occupational injury or illness. Conclusion: High work-related morbidities were managed by a few available health workers who were majoring in the patent medicine vendor category. The importance of level of education in the control of workplace injuries and illnesses was demonstrated by this study.

Is a Problem-Solving Intervention with Workplace Involvement for Employees on Sickness Absence Due to Common Mental Disorders More Effective, than Care as Usual, in Reducing Sickness Absence Days? Results of a Cluster-Randomised Controlled Trial in Primary Health Care.

The aim was to evaluate the effectiveness of a problem-solving intervention with workplace involvement (PSI-WPI) added to care as usual (CAU) in reducing sickness absence days among employees with common mental disorders compared to CAU alone in Swedish primary health care on a monthly basis over 18-months follow-up. We conducted a cluster-randomised controlled trial including 197 employees blinded to allocation (85 PSI-WPI and 112 CAU). As sickness absence data was skewed and over-dispersed, generalised estimating equations was used to enable a comparison between the intervention and control group for each month of the follow-up period. The median number of sickness absence days over the 18-month follow-up was 78 days, inter-quartile range (IQR) 18-196 for employees receiving PSI-WPI and 64 days, IQR 18-161 for employees receiving CAU. The time x group generalised estimating equations analysis showed no statistically significant difference in sickness absence days per month. The addition of a PSI-WPI to CAU was not more effective in reducing sickness absence days. This may be explained by the primary health care context, lack of specialisation in occupational health and the Swedish social insurance system with specific time limits. The trial was registered at ClinicalTrials.gov, identifier: NCT03346395 on January 12th, 2018.

Identifying pain profiles in employees including work-related factors and pain perceptions: a cross-sectional study in Belgian companies

ObjectivesStudies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of...

Health screening clinic to reduce absenteeism and presenteeism among NHS Staff: eTHOS a pilot RCT.

Staff sickness absenteeism and presenteeism (attending work while unwell) incur high costs to the NHS, are associated with adverse patient outcomes and have been exacerbated by the COVID-19 pandemic. The main causes are mental and musculoskeletal ill health with cardiovascular risk factors common. To undertake a feasibility study to inform the design of a definitive randomised controlled trial of the effectiveness and cost effectiveness of a health screening clinic in reducing absenteeism and presenteeism amongst the National Health Service staff. Individually randomised controlled pilot trial of the staff health screening clinic compared with usual care, including qualitative process evaluation. Four United Kingdom National Health Service hospitals from two urban and one rural Trust. Hospital employees who had not previously attended a pilot health screening clinic at Queen Elizabeth Hospital Birmingham. Nurse-led staff health screening clinic with assessment for musculoskeletal health (STarT musculoskeletal; STarT Back), mental health (patient health questionnaire-9; generalised anxiety disorder questionnaire-7) and cardiovascular health (NHS health check if aged ≥ 40, lifestyle check if < 40 years). Screen positives were given advice and/or referral to services according to UK guidelines. The three coprimary outcomes were recruitment, referrals and attendance at referred services. These formed stop/go criteria when considered together. If any of these values fell into the 'amber' zone, then the trial would require modifications to proceed to full trial. If all were 'red', then the trial would be considered unfeasible. Secondary outcomes collected to inform the design of the definitive randomised controlled trial included: generalisability, screening results, individual referrals required/attended, health behaviours, acceptability/feasibility of processes, indication of contamination and costs. Outcomes related to the definitive trial included self-reported and employee records of absenteeism with reasons. Process evaluation included interviews with participants, intervention delivery staff and service providers. Descriptive statistics were presented and framework analysis conducted for qualitative data. Due to the COVID-19 pandemic, outcomes were captured up to 6 months only. Three hundred and fourteen participants were consented (236 randomised), the majority within 4 months. The recruitment rate of 314/3788 (8.3%) invited was lower than anticipated (meeting red for this criteria), but screening identified that 57/118 (48.3%) randomised were eligible for referral to either general practitioner (81%), mental health (18%) and/or physiotherapy services (30%) (green). Early trial closure precluded determination of attendance at referrals, but 31.6% of those eligible reported intending to attend (amber). Fifty-one of the 80 (63.75%) planned qualitative interviews were conducted. Quantitative and qualitative data from the process evaluation indicated that the electronic database-driven screening intervention and data collection were efficient, promoting good fidelity, although needing more personalisation at times. Recruitment and delivery of the full trial would benefit from a longer development period to better understand local context, develop effective strategies for engaging with underserved groups, provide longer training and better integration with referral services. Delivery of the pilot was limited by the impact of COVID-19 with staff redeployment, COVID-research prioritisation and reduced availability of community and in-house referral services. While recruitment was rapid, it did not fully represent ethnic minority groups and truncated follow-up due to funding limitations prevented full assessment of attendance at recommended services and secondary outcomes. There is both a clinical need (evidenced by 48% screened eligible for a referral) and perceived benefit (data from the qualitative interviews) for this National Health Service staff health screening clinic. The three stop/go criteria were red, green and amber; therefore, the Trial Oversight Committee recommended that a full-scale trial should proceed, but with modifications to adapt to local context and adopt processes to engage better with underserved communities. This trial is registered as ISRCTN10237475. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/42/42) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 23. See the NIHR Funding and Awards website for further award information.

Incidence Rates and Predictors of Recurrent Long-Term Mental Sickness Absence Due to Common Mental Disorders.

Several predictors have been identified for mental sickness absence, but those for recurrences are not well-understood. This study assesses recurrence rates for long-term mental sickness absence (LTMSA) within subgroups of common mental disorders (CMDs) and identifies predictors of recurrent LTMSA. This historical prospective cohort study used routinely collected data from 16,310 employees obtained from a nationally operating Dutch occupational health service (ArboNed). Total follow-up duration was 23,334 person-years. Overall recurrence rates were assessed using Kaplan-Meier estimators. Recurrence rates within subgroups of CMDs were calculated using person-years. Univariable and multivariable Cox proportional hazards models were used to identify predictors. 15.6% of employees experienced a recurrent LTMSA episode within three years after fully returning to work after a previous LTMSA episode. Highest recurrence rates for LTMSA were observed after a previous LTMSA episode due to mood or anxiety disorders. Mood or anxiety disorders and shorter previous episode duration were predictors of recurrent LTMSA. No associations were found for age, gender, company size, full-time equivalent and job tenure. Employees should be monitored adequately after they fully returned to work after LTMSA. It is recommended to monitor high-risk employees (i.e. employees with mood or anxiety disorders and short LTMSA episode) more intensively, also beyond full return to work. Moreover, diagnosis of anxiety and depressive symptoms should be given a higher priority in occupational healthcare.

Separable and controlled direct effects for competing events: Estimation of component specific effects on sickness absence.

In many settings, it is reasonable to think of treatment as consisting of a number of components, either because this is the case in practice or because it is conceptually possible to decompose treatment into separate components due to the way in which it exerts effects on the outcome of interest. For competing events, the treatment decomposition idea has recently been suggested to separate effects of treatments on the outcome of interest from effects mediated through competing events using so-called separable effects. Like the idea of separating effects of exposure, it has been pointed out that ideas from mediation analysis generally may help to clarify the interpretation of existing estimands used in competing events settings. One example is the use of the controlled direct effect, to conceptualize the effects of interventions preventing the competing event from occurring. In this article, we identify the controlled direct effect as a component specific effect and discuss the merits of this estimand when the prevented event is non terminal and other methods of effects separation are problematic. Our motivating example is the study of a policy initiative, introduced in 2001, aimed at reducing long term sickness absence (SA) in Norway. The initiative consists of different components, one being to encourage use of graded SA, which is considered a key tool in the Nordic countries to reduce long term SA. The analysis makes use of longitudinal registry data for 113 808 individuals, followed from the time of first SA.

Predictors of return to work in people with major depression: Results from a supported employment program in Germany

BackgroundDepression is a common mental disorder and is associated with work disability. For the implementation of evidence-based interventions, such as Individual Placement and Support (IPS) for people with depression in Germany, the aim of this study was to investigate client variables that predict return to work. MethodsThe sample consisted of 129 participants, initially treated in a psychiatric hospital due to major depression, who participated in IPS as part of a German clinical trial. Baseline demographic (age, sex, education, sickness absence days, employment status), psychiatric (symptom severity, comorbidity, general physical and mental health, disability), and neuropsychological (self-rated deficits, test performance) variables were included. Return to work within one year was predicted using separate and overall binary logistic regression analyses. ResultsA total of 70 participants (56 %) returned to work within the one-year follow-up period. >100 days of sick leave in the year prior to study entry (vs. <100 days) and higher self-rated cognitive deficits were significantly associated with reduced odds of return to work within one year of IPS. LimitationsThe sample consisted of participants with a relatively good work history who were assigned to IPS by the treatment team, thus, the generalizability of the results is limited. ConclusionsPeople with depression who participate in IPS interventions might benefit from specifically targeting perceived cognitive deficits. Factors associated with prolonged sick leave due to depression and their role in return to work with IPS need further investigation.

The relationship between line manager training in mental health and organisational outcomes.

Line manager (LM) training in mental health is gaining recognition as an effective method for improving the mental health and wellbeing of workers. However, research predominantly focuses on the impacts of training at the employee-level, often neglecting the broader organisational-level outcomes. Most studies derive insights from LMs using self-reported data, with very few studies examining impacts on organisational-level outcomes. To explore the relationship between LM training in mental health and organisational-level outcomes using company-level data from a diverse range of organisations. This study is a secondary analysis of anonymised panel survey data from firms in England, with data derived from computer-assisted telephone surveys over four waves (2020, 1899 firms; 2021, 1551; 2022, 1904; and 2023, 1902). The analysis merged the four datasets to control for temporal variations. Probit regression was conducted including controls for age of organisation, sector, size, and wave to isolate specific relationships of interest. We found that LM training in mental health is significantly associated with several organisational-level outcomes, including: improved staff recruitment (β = .317, p < .001) and retention (β = .453, p < .001), customer service (β = .453, p < .001), business performance (β = .349, p < .001), and lower long-term sickness absence due to mental ill-health (β = -.132, p < .05). This is the first study to explore the organisational-level outcomes of LM training in mental health in a large sample of organisations of different types, sizes, and sectors. Training LM in mental health is directly related to diverse aspects of an organisations' functioning and, therefore, has strategic business value for organisations. This knowledge has international relevance for policy and practice in workforce health and business performance.

Impact of decentralized management on sickness absence in hospitals: a two-wave cohort study of frontline managers in Danish hospital wards

BackgroundThis study explores the impact of decentralized management on the sickness absence among healthcare professionals. Sickness absence is a reliable indicator of employees’ wellbeing and it is linked to management quality. However, the influence of decentralized management on sickness absence has not been adequately studied.MethodsThe research design combined a two-wave, web-survey of frontline managers in two Danish university hospitals with administrative data on sickness absence at the ward-level. The first and second wave included data from 163165 and 137 frontline managers linked to 121 wards and 108 wards. Data was analysed using an ordinal logistic regression model.ResultsWards where frontline managers had the highest level of decentralised decision authority compared to none showed lower odds of ward-level sickness absence (ORcrude: 0.20, 95% CI: 0.05–0.87). A very high extent of cross-functional decision authority showed lower odds of sickness absence (ORcrude: 0.08, 95% CI: 0.01–0.49). Overall, the results showed a clear data trend, although not all results were statistically significant.ConclusionHigher levels of decentralized management in wards were positively associated with lower risks of sickness absence in hospital wards. The study supports future research on how to empower decision autonomy at the frontline level of management.