Skill Discretion Research Articles

Body mass index trajectories among the Canadian workforce and their association with work environment trajectories over 17 years

ObjectiveTo determine the number of latent body mass index (BMI) trajectories from 1994 to 2010 among working Canadians and their association with concurrent trajectories in work environment exposures.MethodsData of employed...

Abstract P293: Work Ability in Adults With Diabetes: A Mixed Methods Study

Introduction: Over 30 million Americans have a diagnosis of diabetes. The estimated cost of diagnosed diabetes in 2012 was $245 billion, including $69 billion in reduced productivity. Although many adults with diabetes are productive members of the workforce, loss of work productivity has been associated with the presence of diabetes. Hypothesis: We tested the hypothesis that work-related factors were associated with work ability in a sample of working adults with diabetes. Methods: This was a cross-sectional mixed methods descriptive design used to study a national convenience sample of 101 working adults with diabetes. Subjects were recruited through the online tool ResearchMatch, and completed surveys using the secure web application REDCap. Valid surveys assessed job content, work-life balance, work limitations and work ability, followed by qualitative telephone interviews in a sub-sample of 30 adults. Adjusting for hemoglobin A1c and diabetes duration, factors significant in the bivariate statistics were included in the stepwise logistic regression with the outcome of excellent work ability. Lastly, quantitative and qualitative data were integrated for analysis. Results: The sample was 65% female with mean age 54.1±10.5. The majority were White (74%), non-Hispanic (93%), married (51%), worked full-time (65%) and had type 2 diabetes (87%) with a mean duration of 12.4±9.5 years. Less than half (42%) reported their most recent hemoglobin A1c was <7%. They worked 36±14 hours per week and the majority rated their current work ability as either good (42%) or excellent (33%). Factors associated with work ability included co-worker support (p=.007), work-life balance (p<.0001), skill discretion (p=.02), psychological demands (p=.006), and supervisor support (p=.03). Two factors were independently associated with self-reported excellent work ability: increasing co-worker support improved the odds of excellent work ability (OR: 1.4; 95% CI: 1.04-1.9; p=0.025) and poorer work-life balance decreased the odds or excellent work ability (OR: 0.77; 95% CI: 0.67-0.89; p <.0001). Qualitative: Several themes emerged from the data. Most reported no impact of work on keeping medical appointments or managing diabetes at work, and diabetes management was better during a work day since they were on a schedule. Very few report wellness programs at work, and if they exist (e.g. exercise or weight loss program), most do not engage in them. Data integration: Those who reported an excellent work ability also expressed less stress and more control over their daily routine. Conclusions: The majority of the sample reported good or excellent work ability which was related to less stress and more job control. Workers may benefit from wellness programs that address not only diabetes self-management but also job stress, ways to improve co-worker support, and maintaining optimal work-life balance.

Changes in work factors and concurrent changes in leisure time physical activity: a 12-year longitudinal analysis

ObjectivesThere is a paucity of longitudinal population-based studies examining whether changes in work factors are associated with concurrent changes in leisure time physical activity (LTPA). This study examines this issue...

Work-family conflict and psychophysical health conditions of nurses: Gender differences and moderating variables.

This study aims to investigate the associations of perceived work-family conflict with nurses' psychophysical health conditions, exploring gender differences and analyzing the potential moderating effects of perceived job control (skill discretion and decision authority), social support, and job satisfaction. The study was carried out in five hospitals of the Italian Public Health Service. Participants were 450 nurses (206 men, 244 women). Self-administered questionnaires were used to collect data. Descriptive statistics and hierarchical regression analyses were conducted. Female nurses perceived significantly higher levels of work-family conflict, anxiety, depression and somatization. Significant gender differences emerged in the associations between work-family conflict and nurses' psychological health conditions and in moderating variables. Work-family conflict was significantly associated with anxiety and depression in male nurses and with somatization in both genders. The associations of work-family conflict with nurses' psychophysical health conditions were moderated by decision authority and job satisfaction, in male nurses, and by social support, in female nurses. Findings suggest including gender-specific moderating variables for defining tailored policies and interventions within healthcare organizations to reduce perceived work-family conflict and to promote nurses' wellbeing.

Opioid use disorder, job strain, and high physical job demands in US workers

Little is known about the work environmental risk factors for opioid use disorder (OUD) in working populations. The purpose of this study is to examine whether adverse physical and psychosocial working conditions are associated with OUD in a working population of the United States (US). Among the participants of the National Survey of Midlife Development in the United States (MIDUS) II Study (2004-2006), 2134 workers (1059 men and 1075 women; mean age, 51years) were chosen for this study. OUD was measured with self-administered questions in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSD-5). Physical demands (physical efforts, heavy lifting, and crouching/stooping/kneeling) and psychosocial work stressors (skill discretion, decision authority, job control, psychological job demands, supervisor and coworker support at work, job insecurity, and work hours) were measured with a standard questionnaire. The prevalence of OUD was 3.8%. In multivariate analyses, low skill discretion, high psychological job demands, job strain (a combination of low control and high demands), and high physical job demands were significantly associated with OUD. The multivariate prevalence ratios for OUD by job strain and frequent heavy lifting were 1.98 (1.27-3.10) and 2.23 (1.22-4.10), respectively. Job strain was more strongly associated with OUD in men, while high physical job demands were more strongly associated with OUD in women. This study implies that adverse physical and psychosocial working conditions may be important risk factors for OUD in US working populations. Future longitudinal and mechanistic studies are urgently warranted.

Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach.

This longitudinal study aimed at exploring the direct and indirect relationships between organizational, psychosocial, biomechanical, and personal factors and carpal tunnel syndrome (CTS) in French workers. Between 2002 and 2005, 3710 workers were included in the Cosali cohort. Between 2007 and 2010, 1611 workers were re-examined using the same standardized clinical protocol. Subjects free from CTS at baseline were studied (804 men and 563 women). We used structural equation models to examine the relationships between incident CTS cases and organizational (machine-paced work or work pace dependent on customers' demand), psychosocial (job strain model), biomechanical (Borg's rating perceived exertion, wrist bending, pinching, and hand-transmitted vibrations), and personal factors at baseline. Symptomatic CTS risk was directly increased by biomechanical factors (standardized coefficient = 0.19, P = 0.011), female gender (0.25, P < 0.001), and age (0.15, P = 0.042). No psychosocial factors had a direct impact on CTS, but decision authority and skill discretion had an indirect impact by influencing biomechanical exposure. Exposure to machine-paced work had an indirect impact on increasing CTS, either by raising biomechanical exposure (0.19, P < 0.001) or by lowering decision authority (-0.18, P < 0.001) and skill discretion (-0.20, P < 0.001), which in turn increased biomechanical exposure. Similar complex relationships were observed between risk factors and CTS defined by a more strict case definition. Biomechanical exposure had a direct impact on CTS, while organizational factors and psychosocial factors had an indirect impact on CTS. The findings support conceptual models linking work organization to CTS.

Psychosocial areas of worklife and chronic low back pain: a systematic review and meta-analysis

BackgroundThe aim of this review was to synthesize the evidence on the potential relationship between psychosocial work factors from the Areas of Worklife (AW) model (workload, job control, social support, reward, fairness, and values) and chronic low back pain (CLBP; unspecific pain in the lumbar region lasting 3 months or longer).MethodsWe conducted a systematic literature search of studies in Medline, PsycINFO, Web of Science, and CINAHL (1987 to 2018). Three authors independently assessed eligibility and quality of studies. In this meta-analysis, we pooled studies’ effect sizes using a random-effects model approach and report sample size weighted mean Odds Ratios (ORs).ResultsData from 18 studies (N = 19,572) was included in the analyses. We found no studies investigating associations between fairness or values and CLBP. CLBP was significantly positively related to workload (OR = 1.32) and significantly negatively related to overall job control (OR = 0.81), decision authority (OR = 0.72), and two measures of social support (ORs = 0.75 to 0.78), even in prospective studies. Skill discretion and reward did not significantly relate to CLBP. Moderation analyses revealed several variables (e.g., exposure time, mean age and sex) affecting these relationships.ConclusionsOur results support employees’ workload, job control, and social support as predictors of CLBP. In this line, these work factors should be considered when developing programs to prevent chronic low back pain. Future studies should apply measures of CLBP that are more precise, and investigate the full areas of work life (AW) factors in combination.

Differential Exposure to Job Stressors: A Comparative Analysis Between Migrant and Australia-Born Workers.

Previous studies have suggested that migrants have higher exposures to psychosocial job stressors than native-born workers. We explored migrant status-related differences in skill discretion/job complexity and decision authority, and whether the differences varied by gender, age, and educational attainment. Data were from Wave 14 of the Household Income and Labour Dynamics in Australia (HILDA) Survey. A total number of 9031 persons were included in the analysis. Outcomes included skill discretion/job complexity and decision authority. Exposure included migrant status defined by (i) country of birth (COB), (ii) the combination of COB and English/Non-English dominant language of COB, and (iii) the combination of COB and years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age, and educational attainment. These covariates were also analysed as effect modifiers of the relationship between migrant status and job stressor exposure. In the unadjusted analysis, only migrant workers from Non-English-speaking countries (Non-ESC-born) had significantly lower skill discretion and job complexity than Australia-born workers (-0.29, 95% CI: -0.56; -0.01); however, results from fully adjusted models showed that all migrant groups, except migrant workers from Main-English-speaking countries, had significantly lower skill discretion and job complexity than Australia-born workers (overseas-born workers, -0.59, 95% CI: -0.79; -0.38; Non-ESC-born, -1.01, 95% CI: -1.27; -0.75; migrant workers who had arrived ≤5 years ago, -1.33, 95% CI: -1.94; -0.72; arrived 6-10 years ago, -0.92, 95% CI: -1.46; -0.39; and arrived ≥11 years ago, -0.45, 95% CI: -0.67; -0.22). On the contrary, the unadjusted model showed that migrant workers had higher decision authority than Australia-born workers, whereas in the fully adjusted model, no difference in decision authority was found between migrant workers and Australia-born workers. Effect modification results showed that as educational attainment increased, differences in skill discretion and job complexity between Australia-born workers and Non-ESC-born migrants progressively increased; whereas Non-ESC-born migrants with postgraduate degree showed significantly lower decision authority than Australia-born workers. This study suggests that skill discretion and job complexity but not decision authority is associated with migrant status. Migrants with high educational attainment from Non-English-speaking countries appear to be most affected by lower skill discretion/job complexity and decision authority; however, differences in skill discretion and job complexity attenuate over time for Non-ESC-born migrants, consistent with an acculturation effect. Low skill discretion and job complexity, to the extent that it overlaps with underemployment, may adversely affect migrant workers' well-being. Targeted language skill support could facilitate migrant integration into the Australian labour market.

Psychosocial working conditions and depressive disorder: disentangling effects of job control from socioeconomic status using a life-course approach

PurposeJob control, the combination of skill discretion and decision authority, is considered a central component of the psychosocial working environment. This longitudinal study examines the relation between job control and risk of incident depressive disorder using a life-course approach.MethodsWe analyze data from The Danish Work Life Course Cohort study, including all Danish individuals aged 15–30 who entered the Danish labor market during 1995–2009 and were free from depressive disorder at entry (955,573 individuals). We measured job control using a job exposure matrix. Depressive disorders were measured using information from nationwide registers of psychiatric in- and outpatient admissions. Using Cox regression models we estimated the prospective association between job control and risk of incident depressive disorders. Analyses accounted for a range of potential confounders prior to workforce entry including socioeconomic status in adolescence and parental psychiatric and somatic diagnoses prior to labor market entry, together with potential confounders in adulthood including income, education, and demographics.ResultsLower levels of past year job control were associated with a higher risk of depressive disorder after adjustment for all covariates (HR = 1.27, 95% CI 1.16–1.38). Results stratified by gender showed associations for both men (HR = 1.38, 95% CI 1.19–1.61) and women (HR = 1.19, 95% CI 1.08–1.32). Conclusions: Our findings suggest that the level of job control at work affects the risk of clinically diagnosed depressive disorder, and that this association is not due to confounding by socioeconomic status.

Making sense of work: finding meaning in work narratives

AbstractThis study examined how individuals make sense of their work narratives – autobiographical stories about their work lives – and the implications for individual well-being. A mixed methods approach was used to investigate relationships between meaning making, pathways to meaningfulness, job characteristics, job involvement, and psychological well-being. Survey responses and narrative themes from life story interviews were collected from 119 adults. A narrative coding scheme was developed to identify pathways to meaningful work. Results show that people made sense of their work lives most often by constructing themes about personal agency. The findings support prior research suggesting that socioeconomic factors, access to resources, and working conditions increase the likelihood of finding and benefiting from meaningful work. For individuals wishing to find meaning in their work, job design characteristics (e.g., decision authority, skill discretion), and developing a sense of agency can be levers for fostering meaning and well-being.

Drivers of working longer: Results from a large-scale and representative German employee survey

AbstractMost research on the factors driving employees to work longer than expected or preagreed has focused on behaviors of work extension and has widely neglected work intensification. Therefore, the aim of this study is to investigate whether job demands, as well as employees' job-related resources and personal resources (skill discretion, educational level), predict behavioral indicators of work extension (total working hours, overtime) and work intensification (skipping mandatory rest breaks). We use data from the sixth wave of a large cross-sectional and representative German employee survey (N = 10 148). The findings suggest that job demands and skill discretion are positively associated with the different behaviors of working longer. The relationship between work extension and skill discretion is stronger for higher-educated employees than for lower-educated employees. Our findings suggest that specific job demands and resources must be considered simultaneously to explain working longer and to differentiate between behaviors of working longer.

JD-R model on psychological well-being and the moderating effect of job discrimination in the model

PurposeThe purpose of this study was to investigate the moderating effect of chronic job discrimination on the relationships among job demands, job resources, personal resources and psychological well-being among aged workers.Design/methodology/approachThis study used “National Survey of Midlife Development in the United States (MIDUS Refresher)” data collected from 862 aged workers in the United States from 2011-2014. A moderated multiple regression analysis was adopted.FindingsThe results of the multiple regression analysis show that skill discretion, self-esteem, optimism and active coping had positive effects on psychological well-being, while chronic job discrimination had a negative effect on psychological well-being. Co-worker support, supervisor support, job demands and decision-making authority were not significant. Among the interaction terms, the moderating effect between optimism and chronic job discrimination was significant.Originality/valueBased on the results, this study offers implications for understanding the effects of job discrimination in the workplace among aged workers and their perceived psychological well-being, in the context of job demands and resources (JD-R) model.

Mental Health Before and After Retirement-Assessing the Relevance of Psychosocial Working Conditions: The Whitehall II Prospective Study of British Civil Servants.

ObjectivesRetirement could be a stressor or a relief. We stratify according to previous psychosocial working conditions to identify short-term and long-term changes in mental health.MethodUsing data from the Whitehall II study on British civil servants who retired during follow-up (n = 4,751), we observe mental health (General Health Questionnaire [GHQ] score) on average 8.2 times per participant, spanning up 37 years. We differentiate short-term (0–3 years) and long-term (4+ years) changes in mental health according to retirement and investigate whether trajectories differ by psychosocial job demands, work social support, decision authority, and skill discretion.ResultsEach year, mental health slightly improved before retirement (−0.070; 95% CI [−0.080, −0.059]; higher values on the GHQ score are indicative of worse mental health), and retirees experienced a steep short-term improvement in mental health after retirement (−0.253; 95% CI [−0.302, −0.205]), but no further significant long-term changes (0.017; 95% CI [−0.001, 0.035]). Changes in mental health were more explicit when retiring from poorer working conditions; this is higher psychosocial job demands, lower decision authority, or lower work social support.DiscussionRetirement was generally beneficial for health. The association between retirement and mental health was dependent on the context individuals retire from.

The Association of Occupational Psychosocial Factors with the Prevalence of Irritable Bowel Syndrome in the Chilean Working Population.

Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce. A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted. IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009. Data on occupational psychosocial aspects were drawn from the Chilean Survey of Employment, Health, and Work of 2009, and allocated to individual survey participants at the occupation-region level. Data on family and community stressors were available at the individual level. Prevalence ratios (PR) for IBS were computed using generalized linear mixed models to account for variability at the group level. The IBS prevalence in the overall working population (weighted n = 5 435 253) was 18.4%, but varied substantially by industry sector. Compared with 'professionals' (IBS prevalence = 7.3%), jobs with high prevalence of IBS included 'health and social work activities' [PR = 4.9; 95% confidence interval (CI) = 1.4-16.7], 'household employment' (PR = 4.8; 95% CI = 1.5-15.9), and 'manufacturing' (PR = 3.5; 95% CI = 1.0-11.8). With Karasek Job Demand Control scores assigned to occupations within regions, high job demand doubled the prevalence of IBS (PR = 2.0; 95% CI = 1.4-2.9), whereas high-skill discretion was associated with lower prevalence of IBS (PR = 0.6; 95% CI = 0.4-0.8). There was also evidence that these two factors were not independent; high-skill discretion appeared to buffer the effect of high job demand on IBS prevalence (P < 0.001). Occupational factors were associated with IBS prevalence, showing effects as important as those for non-occupational stresses such as civic insecurity or having health problems. High job skill discretion appeared to reduce the prevalence of IBS in the presence of high job demands. Given its high overall prevalence and poorly understood risk factors, further research on occupational psychosocial factors of IBS is warranted.

The influences of transformational leadership on employee employability

PurposeThe purpose of this paper is to examine the mediating role of job characteristics and social exchange in transformational leadership (TFL) and employability relationship.Design/methodology/approachThe sample is composed of 760 participants employed in Yangtze Delta and Pearl River Delta in China. The participants have worked under their line manager for more than one year. In order to better prevent data from possible common method bias, two waves of surveys (in 2014) on a stratified sample, included a mix of industries, such as construction, manufacturing, finance, insurance and communications, were used to investigate the proposed relationship between TFL, job characteristics, social exchange and employability.FindingsThe research has empirically tested the relationship between TFL and employability. While previous research has analyzed the relationship between them, the authors have enriched existing literature by exploring the mediating factors and illustrating the importance of indirect effects. Besides the direct effect, the results of this study showed that TFL could also improve employees’ employability through job demands, skill discretion, decision authority, perceived organizational support and team–member exchange, but not leader–member exchange.Originality/valueThe study opens up a debate around the employability of employees as it stands apart from the performance measurement. The authors believe that this new mediating model can provide an insight into complex mechanisms of employability enhancement from the perspective of leader development.

Should psychosocial safety climate theory be extended to include climate strength?

Psychosocial safety climate (PSC; climate for psychological health) is an organizational antecedent to work conditions articulated in the job demands-resources model. We responded to calls for broader consideration of organizational climate in terms of both climate level and strength. We tested PSC level and strength as main and interactive predictors of work conditions, psychological health, and engagement. Using multilevel analysis and cross-sectional data, the effects of unit-level PSC constructs were investigated in 21 hospital work units (n = 249 employees) in Australia. The correlation between PSC levels (measured at the unit mean) and PSC strength (measured as unit -1 × SD) was moderate and positive, suggesting that ceiling effects of PSC scores were not problematic. PSC level was a better predictor than PSC strength or their interactions for job demands (psychological and emotional demands), job resources (e.g., skill discretion and organizational support), and health (emotional exhaustion). For engagement, the interaction was significant-improving engagement, therefore, benefits from high levels of PSC and PSC strength within the work units. So, in answer to the research question regarding PSC theory extension, "it depends on the outcome." Research limitations are acknowledged, and the potential of the PSC model to guide the reduction of workplace psychosocial risk factors and the negative consequences is discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Job design for mindful work: The boosting effect of psychosocial safety climate.

Despite a surge in workplace mindfulness research, virtually nothing is known about how organizations can cultivate everyday mindfulness at work. Using the extended job demands-resources model, we explored daily psychological demands and job control as potential antecedents of daily mindfulness, and the moderating effect of psychosocial safety climate (PSC, which relates to the value organizations place on psychological health at work). We also examined the relationship between mindfulness and learning to augment understanding of the benefits of everyday mindfulness at work. A sample of 57 employees, primarily working in education, health care, and finance, completed a diary for five days within a 2-week period, covering mindfulness, psychological demands, job control, and learning. PSC was measured in a baseline survey, with individual ratings combined with those of up to four colleagues to tap objective (shared) climate. Hierarchical linear modeling showed that daily psychological demands were negatively related to daily mindfulness, and daily job control was positively related to daily mindfulness especially as PSC increased. Additionally, daily mindfulness was positively associated with daily workplace learning. This study is one of the first to identify work-related antecedents to everyday mindfulness. The findings suggest that (a) to support everyday mindfulness at work, jobs must be designed with manageable demands and a variety of tasks that allow for creativity and skill discretion, and (b) the benefits of mindfulness interventions for employee psychological health and well-being may not be sustainable unless employees have influence over when and how they do their work, in the "right" climate. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Association between dimensions of the psychosocial and physical work environment and latent smoking trajectories: a 16-year cohort study of the Canadian workforce

BackgroundThis study aimed to determine the number of latent smoking trajectories among Canadians employed in the workforce over a 16-year period, and if latent trajectories in dimensions of the physical...

Prognostic effects of selection, optimization and compensation strategies on work ability: results from the representative lidA cohort study on work, age, and health in Germany.

Regarding the increased need for the retention of older employees in the workforce, this study investigates whether there are main and interactive longitudinal effects of selection, optimization, compensation and working conditions according to the job demand-control model on work ability in older employees. Longitudinal data of computer-assisted personal interviews with one follow-up after 3 years of 3961 participants (born in 1959 and 1965) of the representative German lidA cohort study was used. Multiple linear regressions were performed, analyzing prospective main and interactive effects of selection, optimization, compensation and working conditions during baseline on perceived work ability at follow-up. Regarding selection, optimization and compensation, only compensation had a positive, but weak effect on work ability. Working conditions were more strongly related to work ability: decision authority and skill discretion had independent positive and job demands had independent negative effects on work ability. One interaction effect was observed between loss-based selection and decision authority, such that they mutually enhanced their positive effects on work ability. Only few and weak interactions among the sub-strategies, selection, optimization and compensation, were observed. Results indicate that especially favorable working conditions in terms of high job control and low job demands, but also compensation might help older employees to maintain work ability.

Unique associations of the Job Demand-Control-Support model subscales with leisure-time physical activity and dietary energy intake.

Leisure-time physical activity (LTPA) and dietary energy intake are two important health behaviours, which at too low or high levels respectively, are associated with overweight and obesity. This study explores associations between subscales of the Job Demand-Control-Support (JDCS) model, LTPA and dietary energy intake. A cross-sectional design sampled current employees (N=433) from a South Australian cohort using a computer-assisted telephone interview and a self-completed food frequency questionnaire. In analyses adjusted for sex, age, and sociodemographic variables, higher levels of skill discretion were associated with increased odds for attaining sufficient physical activity (OR=2.45; 95% CI=1.10–5.47). Higher levels of decision authority were associated with reduced odds (OR=0.43; 95% CI=0.20–0.93) for being in the highest tertile of daily energy intake. Higher scores for coworker support were associated with increased odds (OR=2.20; 95% CI=1.15–4.23) for being in the highest tertile of daily energy intake. These findings support the consideration of the individual JDCS subscales, since this practice may reveal novel associations with health behaviour outcomes, thereby presenting new opportunities to improve employee health and wellbeing.