Work-related Mental Health Problems Research Articles

Continuing the conversation: a cross-sectional study about the effects of work-related adverse events on the mental health of Dutch (resident) obstetrician-gynaecologists (ObGyns)

BackgroundObstetrician-Gynaecologists (ObGyns) frequently face work-related adverse events such as severe obstetric complications and maternal or neonatal deaths. In 2014, the WATER-1 study showed that ObGyns are at risk of developing work-related posttraumatic stress disorder (PTSD), while many hospitals lacked a professional support system. The aim of the present study is to evaluate the current prevalence of work-related traumatic events and mental health problems among Dutch ObGyns, as well as to examine the current and desired support.MethodsIn 2022, an online questionnaire was sent to all members of the Dutch Society of Obstetrics and Gynaecology (NVOG), including resident and attending ObGyns. The survey included questions about experienced work-related events, current and desired coping strategies, and three validated screening questionnaires for anxiety, depression, and PTSD (HADS, TSQ, and PCL-5).ResultsThe response rate was 18.8% and 343 questionnaires were included in the analysis. Of the respondents, 93.9% had experienced at least one work-related adverse event, 20.1% had faced a complaint from the national disciplinary board, and 49.4% had considered leaving the profession at any moment in their career. The prevalence rates of clinically relevant anxiety, depression, and psychological distress were 14.3, 4.4, and 15.7%, respectively. The prevalence of work-related PTSD was 0.9% according to DSM-IV and 1.2% according to DSM-5. More than half of the respondents (61.3%) reported the presence of a structured support protocol or approach in their department or hospital, and almost all respondents (92.6%) rated it as sufficient.ConclusionsThe percentages of anxiety, depression, psychological distress and PTSD are comparable to the similar study performed in 2014. Most Dutch ObGyns experience adverse events at work, which can be perceived as traumatic and, in certain cases, may lead to the development of PTSD. Structured support after adverse work-related events is now available in almost two-thirds of workplaces, and was mostly experienced as good. Despite substantial improvements in the availability and satisfaction of professional support after work-related adverse events, the prevalence rates of mental problems remain considerable, and it is imperative to sustain conversation about the mental well-being of ObGyns.

Work-Related Mental Health Problems in Switzerland.

The study identifies work-related risk factors that are relevant to mental health and quantifies their influence. This allows estimation of risk levels for individual workplaces and of the proportion of occupational causation in the emergence of mental health problems. Swiss Health Survey data, containing information on several potential risk factors and health indicators that cover aspects of mental health, were used in multiple multivariate logistic regression analyses. Stress was the predominant risk factor, followed by exposure to violence, unergonomic work processes, and work that conflicted with family life. Hotel and restaurant industries and health and social services had high exposure to risk factors. One of 20 workplaces was deemed high-risk based on an odds ratio >4. Up to one-third of mental health problems within the active workforce may have highly predominant occupational causation.

Are retired persons fitter in their psychological capacities than unemployed? A cross-sectional representative study in Germany

ObjectivesBeyond specific aspects of numerical or verbal intelligence or cognitive speed, a broad range of psychological capacities are generally important in school, job and social life for all age groups....

The development and evaluation of an intervention to promote the uptake of preventive tasks by occupational physicians targeting work-related mental health problems: protocol for the IM-PROmPt-study

ObjectiveWork-related mental health problems are a major and growing public and occupational health issue. Although prevention of work-related disease is a central task in the work of occupational physicians, implementation of preventive tasks can still improve. The aim of this paper is to present the development of an intervention to support occupational physicians in the execution of preventive tasks and a protocol for its evaluation.MethodsAn intervention to support occupational physicians has been developed making use of the implementation mapping protocol. The intervention was based on barriers and facilitators for the execution of preventive tasks, input from stakeholders, and evidence-based strategies from literature.ResultsThe intervention consists of three peer group supervision meetings directed to preventive tasks. During these meetings, occupational physicians will receive materials and will use goal-setting to formulate their own action plans. The IM-PROmPt-study (Implementation of PReventive tasks by Occupational Physicians) is a two-armed cluster randomized controlled trial, comparing peer group supervision directed to the implementation of preventive tasks for occupational physicians with usual peer group supervision. The evaluation will include an effect and process evaluation to examine if the intervention is successful in supporting OPs to implement preventive activities, specifically aimed to prevent work-related mental health problems.DiscussionThe intervention is expected to lead to more knowledge and awareness of the value of prevention among OPs, anticipated to lead to both organizational and individual gains.Trial registrationISRCTN registry; ISRCTN15394765. Registered on 27 June 2023.

Managers' experience of causes and prevention of sick leave among young employees with Common Mental Disorders (CMDs)-A qualitative interview study with a gender perspective.

Young adults entering the workforce have an almost 40% greater risk of work-related mental health problems than other working age groups. Common mental disorders (CMDs) constitute the majority of such mental health problems. Managers are crucial in promoting a good psychosocial work environment and preventing sick leave. The study aims to explore managers' experience of 1) causes of sick leave in the personal and work-life of young employees with CMDs, and 2) prevention of such sick leave. A gender perspective is applied to examine managers' experience of causes and prevention of sick leave in relation to male and female employees and male and female-dominated occupations. A qualitative design was applied and 23 semi-structured interviews were conducted with Swedish managers experienced in supervising young employees with CMDs. The interviews were analysed with conventional content analysis and the managers' experience of similarities and differences between young female and male employees and occupations were explored through reflective notes. Four main categories and eight subcategories describe the managers' experience of the causes of sick leave due to CMD among young employees. The main categories are: 1) entering work life when already worn-out, 2) struggling with too high expectations at work, 3) having a challenging personal life, and 4) being unable to manage specific occupational challenges and demands. Gender differences were found in six subcategories regarding, e.g., work demands and problems in personal relationships. One main category and three subcategories describe how this type of sick leave might be prevented, with managers emphasizing the need to ease the transition into work life. Gender differences in the prevention of sick leave were found in one subcategory regarding communication about workers' health and problems at work. Our findings show that gender norms and the expectations of young men and women are factors of importance in managers' experience of the development and prevention of CMDs. These results can inform their preventive work and their supervision and introduction of newly-employed young adults.

Developing prognostic models for health care utilization in patients with work-related mental health problems

BackgroundThe long-term prognosis for employees with work-related mental health problems is unclear. We aim to describe long-term trends in health care utilization (HCU) and develop multivariable prognostic models for long-term mental health care utilization.MethodsFrom the Danish Occupational Medicine Cohort we included mental health patients (N = 17,822) assessed from 2000 to 2013 at Departments of Occupational Medicine. Outcomes were general health (general practitioner, somatic hospital) and mental health (psychiatrist/psychologist, psychiatric hospital) HCU obtained from registries five years before/after assessment. The 10-year period was divided into phases relative to assessment: 5 − 3 years before, 2 years before/after, and 3–5 years after. We developed gender-stratified Lasso-penalized multivariable prognostic models for HCU 3–5 years after assessment assessing both calibration and discrimination.ResultsPrevalent HCU for general practitioner, psychiatrist/psychologist and psychiatric hospital services was relatively stable 5 − 3 years prior to assessment, then rising during the 2 years before/after. At 3–5 years after assessment prevalent general practitioner HCU declined to previous levels, while prevalent HCU for psychologist/psychiatrist and psychiatric hospital services remained elevated compared to previous levels during years 5 − 3. Prognostic models for long-term psychologist/psychiatrist and psychiatric hospital HCU indicated acceptable calibration and modest discrimination.ConclusionsPrevalent HCU rose two years before/after assessment and remained elevated for psychiatrist/psychologist and psychiatric hospital HCU 3–5 years after. Gender-stratified prognostic models were developed for long-term mental health HCU, but discrimination and calibration should be further improved before out-of-sample application for personal prognosis.Trial registrationThe study was registered at clinicaltrials.gov (Identifier: NCT04459793) prior to analyses.

Work-life balance and work engagement across the European workforce: a comparative analysis of welfare states.

Few large-scale, comparative studies have examined both the positive mental well-being outcomes of work-life balance and the broader socio-economic context by which it is shaped. Therefore, the aim of this study was to investigate the association between work-life balance and work engagement across a wide range of European welfare states, as well as to examine whether work-life balance varies across European countries and whether this variance can be explained by welfare regime, controlling for individual-level factors. This study utilized data from the 2015 European Working Conditions Survey. In total, 35401 workers from 30 European countries could be classified into the adopted welfare regime typology. Work engagement was measured using an ultra-short version of the Utrecht Work Engagement Scale, and work-life balance with a question on the fit between working hours and family or social commitments. Due to the hierarchical structure of the data, multilevel regression models were applied. A statistically significant positive association between work-life balance and work engagement across the European workforce was found. Between-country variance in work-life balance was demonstrated and this can in part be explained by welfare regime. While it has long been recognized that occupational stress and work-related mental health problems are shaped by the socio-economic context and thus regarded as public health concerns in Europe, our results suggest that this applies to well-being at work and related support factors as well.

Evaluation of a Group Therapy for Work-Related Mental Disorders.

Objectives: Work-related mental distress is one of the most dominant reasons for sick leave and early retirement. Specialized therapy programs for work-related mental health problems are rare, especially in a group setting. This study evaluates the severity of depression, anxiety, somatization and burnout symptoms before and after a work-related group therapy program. Methods: Patients of a psychosomatic outpatient clinic with work-related mental disorders completed 12 sessions of a manual-based group training with reference to the workplace. Data were collected using the Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), General Anxiety Disorder Scale-7 (GAD-7) and the Maslach Burnout Inventory (MBI) before (T1) and directly after the intervention (T2). Results: Overall, 48 participants completed the intervention. The participants' symptoms of depression (T1: M = 11.06, SD = 6.19, T2: M = 8.92, SD = 8.17; p < 0.001, d = 0.53) and anxiety (T1: M = 9.94, SD = 5.18, T2: M = 7.13, SD = 5.69; p = 0.001, d = 0.49) as well as their emotional exhaustion (T1: M = 4.63, SD = 0.95, T2: M = 4.05, SD = 1.35; p < 0.001, d = 0.55) decreased significantly, and the difference was clinically relevant at T2. For cynicism (T1: M = 3.93, SD = 0.99, T2: M = 3.70, SD = 1.32; p = 0.14, d = 0.22) and personal fulfillment at work (T1: M = 4.30, SD = 0.83, T2: M = 4.41, SD = 0.94; p = 0.24, d = 0.17), the difference between T1 and T2 was not significant. Women benefited more than men (PHQ-9: p < 0.001, d = 0.96; GAD-7: p < 0.001, d = 0.91; PHQ-15: p < 0.001, d = 0.76) from the training. Conclusions: Participants' mental health symptoms were substantially reduced during the course of the work-related group therapy. As mental health problems account for the largest group of work disability days, the potential of group therapy should be better exploited in health care services.

Long-term Consequences of the Psychological Distress in Iranian Emergency Medical Personnel: A Qualitative Research

Background: Iran is exposed to several kinds of hazards throughout the country. Disasters cause mental health distress among survivors and disaster rescuers. Most psychological symptoms may decrease in time, but they could persist for months or even years in some individuals. Therefore, the present study aimed to explore the consequences of exposure to traumatic events with its components, which are derived from rescuers’ life experiences. Materials and Methods: A qualitative study based on content analysis was conducted according to Landman and Graneheim approach. Through the purposive sampling method, 17 semi-structured interviews were applied until reaching data saturation. Interviews were transcribed verbatim. In the next steps, data condensing, labeling, coding, and defining categories were conducted. Results: Based on the experience of the study participants, two main concepts with four categories and 12 subcategories were developed. Two main concepts included regression and resilience consequences. Conclusion: Emergency departments should be aware of work-related mental health and behavioral problems and provide appropriate support programs to prevent ineffective consequences of incidence scene psychological distress and empower the rescuer’s resiliency.

Work-related stress, self-efficacy and mental health of hospital nurses.

The limited research has focused on the relationship between work-related stress and self-efficacy in relation to mental health problems in nurses. This multi-hospital cross-sectional survey investigated the relationships between work-related stress, self-efficacy and mental health status of hospital nurses in Tabriz, Iran. Four hundred hospital nurses completed a questionnaire including demographic and job details, Health & Safety Executive (HSE) Management Standards Revised Indicator Tool (MS-RIT), General Self-Efficacy (GSE-10) scale, and General Health Questionnaire (GHQ-28). A three-step hierarchical logistic regression modelling was used. Work-related stress, self-efficacy and mental health problems were significantly related to each other. The results of the regression modelling revealed that working overtime and number of patients cared for were significant positive predictors, while job tenure as well as control and relationships dimensions of work stress were significant negative predictors of mental health problems, with the final model explaining 21% of the variance in the outcome measure. Addition of self-efficacy at step 3 did not result in a significant change in the variance from previous steps. The results provide further support for stress prevention strategies focused at the job (e.g., better organisation of work demands) and organisational (e.g., improving employee participation and involvement in work) levels.

Health status of young construction workers in the Global South: The case of Ghana

Poor health is increasing significantly among young construction workers worldwide. However, the case of young workers in the Global South is not well understood. We sought to identify the physical and mental conditions that affect young workers and measure their levels of prevalence. We also sought to analyze the influence of age and work location on young workers’ work-related mental health. Using a sequential exploratory mixed methods approach, a survey instrument was first developed through interviews and a focus group, and subsequently used to measure a range of physical and mental health conditions among 445 young workers in Ghana’s construction industry. Prevalence levels and sub-group differences were analyzed using descriptive statistics and multivariate analyses respectively. The results indicated a high prevalence of work-related musculoskeletal disorders and skin problems. There was also a high prevalence of the work-related substance abuse disorder, sleep problems, schizophrenia, and mania. No significant differences in the levels of work-related mental health problems were exhibited among different youth age sub-groups. Work location however accounted for significant differences in the levels of substance abuse disorder, sleep problems, anxiety disorder, and somatic symptoms exhibited. The findings of this study can be used to promote an awareness of the poor health of young construction workers, and can help policymakers, health practitioners, and researchers in low resource settings to know the specific health issues that ought to be prioritized.

Survive and thrive wellbeing programme: an innovative experiential wellbeing programme for trainees in Health Education England- Thames Valley (HEE-TV)

AimsThe aim of this project was to develop an experiential programme which encouraged trainees to develop their own processes for mental resilience acting to mitigate difficult work and life environments.BackgroundDoctors are at considerable risk of work-related stress, burnout and mental health problems, particularly trainees, many of whom are experiencing symptoms earlier in their career. The Thriving at Work Review, the British Medical Association and HEE all call for cultural and organizational change that works to prioritise, promote and enhance wellbeing by providing good working conditions and an atmosphere that encourages open discussion about mental health with access to appropriate support that destigmatises mental health.MethodAcross HEE-TV we identified that there were no regular wellbeing initiatives for trainees, and specifically no psychologist-facilitated Cognitive Behavioural Therapy-style sessions to enhance resilience. Six schools identified a specific need for HETV-targeted resources focused on enhancing trainee mental wellbeing.The current course has morning sessions that cover self-awareness, and afternoons are psychologist-facilitated sessions. The initial pilot was run for the School of Anaesthetics, and later offered to specialties with a General Medical Council-survey identified need. Multiple improved iterations of the course have been driven by detailed trainee feedback, including adding the psychology sessions to give trainees tools for self-help.ResultWe triangulated feedback from attendees at the sessions, nominated trainee representatives from all specialties across Thames Valley via the Trainee Advisory Committee (TAC), and HEE-TV quality assessors. Feedback from trainees who attended was almost universally positive. The Quality Committee noted improvement of trainee morale in Anaesthetics and direct improvement in aspects of the learner environment that would not have happened without this intervention. The TAC endorsed this as one of the measures to support trainees in difficult learner environments. They also recommended it be rolled out for all as a preventative measure as there can be a time lag before items appear on the Risk Registers and are officially recognized as requiring support. The biggest measure of success is that HEE-TV have agreed to fund these sessions ongoing.ConclusionWe learned that an iterative response to trainee feedback and careful co-ordination is key to successful engagement via the training programme directors who arrange regional training programmes. This, and making the SAT course free at the point of use, makes it easier for trainees to access this programme. In addition we will be including the trainee voice is shaping bespoke aspects of the day for each specialty.

Moving toward an integrated prevention approach for mental health at work: Promoting workers' involvement through concrete actions.

Work-related mental health problems are a primary cause of disability and lead to the absence of 500,000 workers each week in Canada. There is a growing body of literature suggesting integrated approaches of prevention are necessary to improve mental health at work. The involvement of numerous stakeholders inclusive of government agents, employers, and workers is recommended. However, only minimal information is available to suggest actions workers may adopt toward an integrated approach of prevention to improve mental health at work. The aim of the study was to identify behaviors workers may adopt to foster mental health at work. Following a descriptive qualitative research design, semi-structured interviews were conducted with researchers, professionals, and workers. Data were analyzed using a template analysis strategy. A total of 49 concrete behaviors were identified, grouped into ten sub-themes, and three broad themes. These main themes identify those behaviors that appear to be useful throughout the prevention continuum: 1) adopting a reflexive practice, 2) acting for one's own mental health, and 3) acting for mental health of others. In harmony with the integrated prevention approach, this study offers a framework to organize workers' concrete actions contributing to mental health.

Fostering mental health at work: the butterfly effect of management behaviors

With the growing number of work-related mental health problems occurring worldwide, a call for all stakeholders to contribute to improving these problems has emerged. Managers’ behaviors may act as a resource to promote the involvement of employees to foster mental health at work through their behaviors. This study aims to identify the behaviors of managers supporting the behaviors of employees fostering mental health at work. Following a qualitative research design, data were collected through interviews (n = 22) and analyzed using a template analysis strategy. The results reveal 20 concrete, specific and fairly simple behaviors that managers may adopt to support the involvement of their employees in behaviors fostering mental health at work. For example, consulting employees, providing room for mistakes and organizing social activities are behaviors managers may adopt to support the engagement of employees in behaviors fostering mental health at work. According to social exchange theory, the results of this study propose levers to implement a favorable context in which the behaviors of managers and those of employees interact. Given the potential influence of managers’ behaviors on mental health at work, including this new knowledge in manager training would be judicious to foster shared responsibility for mental health at work.

Nursing Perspectives on the Impacts of COVID-19

Nursing Perspectives on the Impacts of COVID-19

Occupational Health among Swedish Occupational Therapists: A Cross-Sectional Study.

The Swedish public sector is facing great challenges in recruiting and retaining healthcare professionals, due to increasing sick leave numbers. The aim of this study was to describe Swedish occupational therapists’ occupational health in terms of risk factors in the social and organizational work environment, occupational balance, and work-related mental health problems. A web survey was emailed to all working members of the Swedish Association of Occupational Therapists (n = 7600) and 3658 answered the survey. The web survey included questions on sociodemographic characteristics, social and organizational environment, occupational balance, and work-related health. The occupational therapists in general rated their workload as high, which was described as leading to increased stress, difficulties doing a good job, and increased job turnover. They also reported having difficulties maintaining occupational balance. Almost a fifth reported having symptoms related to mild incipient exhaustion or a pronounced exhaustion disorder. Almost 60 percent reported having, during the last year, seriously considered seeking new employment as an occupational therapist and 35 percent had seriously intended to leave their profession. In conclusion, there is an urgent need to improve the work situation of occupational therapists. If not, increases in mental health problems, sick leave and job turnover rates may seriously jeopardize the welfare system by eroding healthcare.

Job demands, resources and work-related well-being in UK firefighters.

There is evidence that firefighters are at risk of work-related stress and mental health problems, but little is known about the organizational hazards they experience. Insight is needed into the work-related factors that are most likely to threaten or protect their work-related well-being. To identify levels of job demands and resources (including demands relating to workload, work patterns and the working environment, relationship conflicts, control, support, role clarity and change management) among firefighters, and to use a job demands-resources framework to examine their impacts on work-related well-being. The role played by recovery strategies in predicting work-related well-being was also considered. Job demands and resources were assessed by the Health & Safety Executive (HSE) Management Standards Indicator Tool. Validated scales measured recovery strategies (detachment, affective rumination and problem-solving pondering) and work-related well-being (anxiety-contentment and depression-enthusiasm). The impact of job demands, resources and recovery strategies was tested by multiple linear regression. The sample comprised 909 firefighters across seven Fire and Rescue Services in the UK (85% male). Levels of job demands and resources did not meet HSE benchmarks. The main risk factors for poor work-related well-being were relationship conflicts and affective rumination, but resources such as role clarity and job control and the use of problem-solving pondering and detachment were beneficial. Interventions that aim to reduce relationship conflicts at work and promote problem-solving rather than affective rumination, and detachment from work when off-duty, are likely to improve work-related well-being. Attention to enhancing job resources may also be beneficial.

Using Lempel-Ziv complexity as effective classification tool of the sleep-related breathing disorders

Background and objectivePeople suffer from sleep disorders caused by work-related stress, irregular lifestyle or mental health problems. Therefore, development of effective tools to diagnose sleep disorders is important. Recently, to analyze biomedical signals Information Theory is exploited. We propose efficient classification method of sleep anomalies by applying entropy estimating algorithms to encoded ECGs signals coming from patients suffering from Sleep-Related Breathing Disorders (SRBD). MethodsFirst, ECGs were discretized using the encoding method which captures the biosignals variability. It takes into account oscillations of ECG measurements around signals averages. Next, to estimate entropy of encoded signals Lempel–Ziv complexity algorithm (LZ) which measures patterns generation rate was applied. Then, optimal encoding parameters, which allow distinguishing normal versus abnormal events during sleep with high sensitivity and specificity were determined numerically. Simultaneously, subjects’ states were identified using acoustic signal of breathing recorded in the same period during sleep. ResultsRandom sequences show normalized LZ close to 1 while for more regular sequences it is closer to 0. Our calculations show that SRBDs have normalized LZ around 0.32 (on average), while control group has complexity around 0.85. The results obtained to public database are similar, i.e. LZ for SRBDs around 0.48 and for control group 0.7. These show that signals within the control group are more random whereas for the SRBD group ECGs are more deterministic. This finding remained valid for both signals acquired during the whole duration of experiment, and when shorter time intervals were considered. Proposed classifier provided sleep disorders diagnostics with a sensitivity of 93.75 and specificity of 73.00%. To validate our method we have considered also different variants as a training and as testing sets. In all cases, the optimal encoding parameter, sensitivity and specificity values were similar to our results above. ConclusionsOur pilot study suggests that LZ based algorithm could be used as a clinical tool to classify sleep disorders since the LZ complexities for SRBD positives versus healthy individuals show a significant difference. Moreover, normalized LZ complexity changes are related to the snoring level. This study also indicates that LZ technique is able to detect sleep abnormalities in early disorders stage.

Book review

Book review

Content and quality of workplace guidelines developed to prevent mental health problems: results from a systematic review.

Objectives A wide range of guidelines have been developed to prevent work-related mental health problems (MHP), but little is known about the quality of such guidelines. We systematically reviewed the content and quality of workplace guidelines aiming to prevent, detect, and/or manage work-related MHP. Methods We conducted systematic online and database searches (MEDLINE; Web of Science; PsychNET; occupational safety and health databases) to identify guidelines. Eligibility criteria included guidelines recommending primary, secondary, or tertiary preventive interventions to be implemented at the workplace by employers, employees or organizational staff. A minimum of minimum three independent reviewers assessed the quality of guidelines using the Guidelines for Research and Evaluation (AGREE II). Guidelines rated ≥65% with regards to domain I, II, and III were considered to be of good developmental quality. Results Seventeen guidelines were quality assessed. Guidelines mainly targeted employers: eight guidelines recommended primary preventive interventions (eg, reduction of psychosocial hazards by risk management procedures), three recommended tertiary (eg, stay at work or return to work procedures for management), and six recommended a combination of primary, secondary and tertiary interventions (eg, facilitate return to work by increasing mental health literacy of all staff and coordination of sick-listed employees). Four guidelines had developed recommendations of good quality, but the evidence of two guidelines was outdated and studies documenting the effect of implementation were not yet available. Conclusions Few guidelines have been developed with sufficient rigor to help employers prevent or manage work-related MHP and evidence of their effectiveness remains scarce.