Work-related Psychosocial Stress Research Articles

The Relationship Between Work-Related Stress and Depression: A Scoping Review.

Work-related stress is highly prevalent. Recent systematic reviews concluded on a significant association between common work-related stress measures and depression. Our scoping review aims to explore whether work-related psychosocial stress is generally associated with depression or depressiveness, the extent and methodology of the primary research undertaken on this topic and to elucidate inconsistencies or gaps in knowledge. We searched for literature in Pubmed, PsycInfo and Web of Science including full reports in seven languages published between 1999 and 2022 and applied the PRISMA statement for scoping reviews criteria. Of 463 primarily identified articles, 125 were retained after abstract and full-text screening. The majority report significant associations between work-related stress and depression. Cross-sectional studies are most prevalent. Sufficient evidence exists only for job strain and effort-reward imbalance. Most studies are from Asia, North America and Europe. The health sector is the most studied. Several research gaps such as the lack of interventional studies were identified. The consistency of most studies on the significant association between work-related stress and depression is remarkable. More studies are needed to improve evidence and to close research gaps.

“Always Look at the Clock”: Psychosocial Working Conditions in Outpatient Care—A Qualitative Study

Background: In view of demographic change, there is a growing need for qualified nursing professionals. More and more people in need of care prefer to be cared for at home. A shortage of skilled workers and constantly changing and increasing professional requirements are some of the consequences. The aim of this study is to generate further insights into work-related psychosocial stress factors and the resources of outpatient caregivers in their subjective perceptions to derive approaches for possible health-promoting interventions for practice and research that promote healthier and more sustainable work. In addition, coping strategies and needs should be inquired about in order to determine support offers. Methods: Using a semi-structured interview guide, thirty outpatient nursing professionals in Germany were interviewed in 2022. The subject of this interview was the psychosocial working conditions and resources in outpatient care. The collected data were evaluated by means of the Kuckartz qualitative content analysis. Results: This qualitative study identified work-related job demands and resources in outpatient care. The way nurses are treated in the companies they work for and the appreciation of patients were explored as important resources. Physical demands, the time factor, and dealing with personal fates are primarily mentioned as stress factors. The learning effect plays an important role in dealing with these. Conclusion: This study contributes to a better understanding of current job strain and resources as well as job satisfaction in outpatient care. In any case, it became clear that the nursing staff love their profession, which they see more as a vocation. Future quantitative studies are necessary to build on these findings. First ideas of implications for health promotion measures in research and practice have already been derived.

Biological Embedding of Psychosocial Stressors Within a Sample of Canadian Firefighters: An Exploratory Analysis.

We wanted to determine whether the biological embedding of perceived psychosocial stress could be observed within a sample of Canadian firefighters. We collected sociodemographic and general health-related information from 58 firefighters. In addition, measures of work-related and general life psychosocial stress, perceived social support, and physiological parameters thought to reflect the embedding of stress were gathered and analyzed using analysis of variance and linear regression models. Despite observing a positive relationship between psychosocial stress and allostatic load, the association was not significant; however, age did significantly predict allostatic load ( B = 0.09, P = 0.04). Notably, our participants reported abundant social support that was inversely associated with perceived stress. Although perceived stress did not significantly affect allostatic load in our sample, high levels of social support may have provided an important countervailing force.

Perceived stigma, substance use and self-medication in night-shift healthcare workers: a qualitative study

BackgroundMany risk factors related to altered circadian rhythms impact the health of night-shift hospital workers (NSHW), resulting in mental and somatic disorders. Easy access to psychoactive substances (PS) may facilitate addictive behaviors in NSHW. They are also exposed to a stressful work environment, which may further affect sleep quality. This study aimed to explore the link between sleep deprivation, work-related psychosocial stress and psychoactive substance use as a self-medication response in NSHW.MethodsQualitative study to verify the plausibility of the self-medication theory applied to addictive behaviors. Semi-structured interviews (N = 18 NSHW) and thematic analysis, following consolidated criteria for reporting qualitative research recommendations.ResultsStigma against NSHW was a primary element of a stressful work environment. The stressful and stigmatizing environment, together with night-shift work, further affected NSHW sleep and their mental and physical health. The use of PS appeared to be for self-medication, encouraged by social and professional environments, source(s) of stress, discrimination, and isolation. The work environment, through aggravated sleep disorders, led NSHW to use non-prescribed sleeping pills. Alcohol after work and smoking were used as a social break but also as a means to reduce stress. ConclusionAnti-stigma interventions in the healthcare setting and screening of mental/somatic disorders in NSHW can help reduce harmful self-medication behaviors and improve hospital care in the COVID-19 era.

Identifizierung und Prüfung von Instrumenten zur Durchführung der Gefährdungsbeurteilung psychischer Belastung in Unternehmen

Identification and evaluation of tools for implementing psychosocial risk assessment at the workplace Objective: One difficulty for companies in the implementation of psychosocial risk assessments in the workplace lies in the selection of suitable tools for assessing work-related psychosocial stress factors. The aim of the project was to identify psychosocial risk assessment tools and to develop and apply criteria for examining these tools. Methods: The first step was to conduct a search for tools by using the BAuA-Toolbox, PSYNDEX, Google Scholar and websites of accident insurance providers. The second step was to develop criteria for examining the inclusion of tools and criteria for further evaluation. Existing quality policies and feedback from experts were considered in the process. All the identified tools were then examined independently by two reviewers using the developed criteria. Results: Overall, 170 tools were identified. Six criteria that tools must meet in order to be included were developed: 1. goal orientation through the assessment of psychosocial stress, 2. and 3. user orientation through comprehensible information for the application and the analysis, 4. user orientation for respondents through, e.g. comprehensible questionnaires, 5. involvement of employees in the psychosocial risk assessment process and 6. empirically tested validity and reliability. Eleven further evaluation criteria regarding information on possible areas of application, consideration of work patterns from the Joint German Occupational Safety and Health Strategy (GDA) and support in deriving measures are used as information for the presentation of the tools. Overall, 51 tools were included. The majority determine psychosocial stress by means of a questionnaire (n = 24), workshop (n = 13) or observational interview (n = 12). Conclusions: The search results show the existing variety of psychosocial risk assessment tools in German-speaking countries. The criteria developed for examining these instruments can be confirmed by comparable projects and significantly reduced the number of tools included. These will be made available to companies in an online tool. Keywords: occupational safety and health – risk assessment – psychosocial stress – assessment tools – inclusion and evaluation criteria

Exploring effort\u2013reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study

BackgroundIn the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality, sustainable health systems, this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town.MethodsThis mixed-methods, cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town. Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers. The survey included demographic as well as effort–reward imbalance (ERI) and professional quality of life (PROQOL) questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life, as well as differences between lay and professional health workers. Qualitative data was analysed using a thematic content analysis approach. Quantitative data was analysed using STATA 12.ResultsFindings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers. Corroborating these findings, our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work (61.1% of professional and 70.2% of lay health workers; p = 0.302). There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers. Although Compassion Satisfaction was high for all health worker groups, lay health workers also showed elevated levels of burnout and compassion fatigue, with community-based health workers particularly affected.ConclusionsFindings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to ‘re-engineer’ South Africa’s Primary Health Care system. Furthermore, they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems.

Job stress and chronic and widespread musculoskeletal pain: a cross-sectional analysis from the Brazilian Longitudinal Study of Adult Health Musculoskeletal.

Musculoskeletal pain is a global health concern, and work-related psychosocial stress might be a potential contributing factor. This cross-sectional study investigates whether job stress is associated with chronic and widespread musculoskeletal pain in 2051 Brazilian active civil servants included in the Brazilian Longitudinal Study of Adult Health Musculoskeletal (ELSA-Brasil MSK). Job stress was assessed using the Effort-Reward Imbalance (ERI) questionnaire. Associations between ERI domains, categorized into tertiles, and chronic musculoskeletal pain (CMP) at any site and per number of affected sites (0, 1-2, ≥3-multisite pain) and body regions (0, 1-2, 3-generalized pain), were investigated using binary and multinomial logistic regression, adjusted for sociodemographic, occupational, and health covariates. The prevalence of CMP at any site, multisites, and generalized regions was 52.9%, 18.2%, and 9.5%, respectively. After adjustments, the lower the reward and the greater the overcommitment, the higher the odds of CMP at any site. The ERI domains were more strongly associated with multisite and generalized CMP than with CMP at any site. Multisite CMP was associated with lower reward and with greater effort, overcommitment, and effort-reward imbalance ratio. Chronic musculoskeletal pain according to body regions, especially generalized pain, was also associated with ERI domains effort (OR = 2.06; 95%CI = 1.33-3.21), overcommitment (OR = 3.44; 95%CI = 2.20-5.39), and effort-reward imbalance ratio (OR = 2.06; 95%CI = 1.30-3.27). Results reveal an association between job stress not only with CMP at any site but notably with the pain spread to other body sites or regions. Our findings suggest that lowering stress at work and discouraging overcommitment may help reduce the CMP burden, including reduction of CMP spread from one site or region of the body to another.

Cardiovascular risk among nursing workers: a cross-sectional study.

to assess cardiovascular risk among nursing workers at a public hospital. a cross-sectional study, with 324 nursing workers, using a questionnaire composed of two information blocks. The first covered issues related to sociodemographic and occupational and health characteristics, and the second, the Revised Framingham Risk Score (FRS), to stratify cardiovascular risk. To assess work-related psychosocial stress, the Swedish Social Control Demand Scale was used. the most prevalent modifiable risk factor for CVDs was waist circumference (75.9%), followed by overweight (43.8%), obesity (29.3%), alcohol consumption (21.9%), lipoprotein cholesterol low density (LDL) > 130 (20.7%) and hypertension (20.4%). it was found that 96% of workers had a low risk of developing cardiovascular disease in the next ten years, and male workers aged >40 years with shorter working hours are more likely to have cardiovascular disease.

Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape.

Background and ObjectivesMuch of the research surrounding firefighter health has concerned the hazards intuitively associated with the occupation, such as physical, thermal, and chemical risks. However, an additional aspect of their work environment, psychosocial stressors, has begun to attract a growing level of attention. Work‐related psychosocial stress may best be described as mental and emotional strain caused by a combination of workplace events and characteristics, and the objective of our review was to identify the health outcomes associated with these stressors in firefighters.MethodsA systematic review was performed of studies reporting on the psychosocial stressors and the associated health outcomes experienced by firefighters. Data sources included the MEDLINE, PsychInfo, and CINAHL databases.ResultsTwenty‐nine studies met the inclusion criteria. Upon analysis, we found that firefighters experienced a range of psychosocial stressors (including interpersonal conflict and concerns over organizational fairness) and observed that these stressors were associated with a number of health‐related outcomes that could be arranged into six areas: depression‐suicidality, non‐depressive mental health problems, burnout, alcohol use disorders, sleep quality, and physiological parameters and somatic disorders.ConclusionOur findings strongly suggest that work‐related psychosocial stressors can affect the health and well‐being of those in the fire service, and highlight that interventions meant to address these psychosocial risk factors should focus upon promoting self‐esteem, enhancing self‐efficacy, and strengthening social support.

Work-Related Psychosocial Stress in Small and Medium-Sized Enterprises: An Integrative Review.

Background: Work-related psychosocial stress can cause mental and physical illnesses resulting in high costs for the individual, the economy and society. Small and medium-sized enterprises (SMEs) employ the majority of the world’s workforce and often have fewer financial and human resources compared to larger businesses. The aim of this review is to summarize current knowledge on work-related stress in SMEs according to well-established guidelines categorizing psychosocial factors at work. Methods: A systematic database search was carried out in PubMed, PsycINFO, PSYNDEX and Business Source Premiere from March to June 2019, updated in January 2020. Data of included studies were analyzed and mapped into five themes: “work content and task”, “organization of work”, “social relations”, “working environment” and “new forms of work”. Results: After full-text screening, 45 out of 116 studies were included for data extraction. Studies were very heterogeneous and of varying quality, mostly applying a cross-sectional study design. Psychosocial factors in SMEs have been researched with a focus on the work patterns “work organization” and “work content and task”. Conclusions: This review underlines the need for more and better quality research of psychosocial factors in SMEs, particularly in relation to ongoing and new challenges in the workplace, including stressors related to the process of digitalization or the development of safe working conditions during the emerge of new infectious diseases.

Storytelling Through Music to Improve Well-being in Oncology Nurses: A Feasibility Study.

Professional grief is one cause of psychosocial stress that, if not attended to, may contribute to burnout and compassion fatigue. Oncology nurses often avoid their emotions and learn to cope with professional grief in isolation. Interventions aimed at professional grief are limited. To determine the feasibility of implementing a multidimensional intervention, Storytelling Through Music, with oncology nurses. This was a 2-group, quasi-experimental design utilizing both qualitative and quantitative methods. The 6-week intervention combined storytelling, reflective writing, music, and psychoeducation. Descriptive statistics and conventional content analysis were used to analyze the feasibility data. Most participants (n = 43) were female, white, working full-time in the outpatient oncology setting, with an average 8.5 years (range, 2-36 years) of oncology experience. Ninety-eight percent of the intervention was completed, and 98% of participants were retained. Analysis indicates that the intervention was acceptable, the participants learned they were not alone in their feelings, and they were supported by the group. Results indicate that Storytelling Through Music is a feasible and acceptable intervention to address work-related emotions and psychosocial stress in this group of oncology nurses. In 2017, the National Academy of Medicine stated clinician well-being must be a priority. Participation in this study was independently sought out by the oncology nurses and completed during their personal time. A future policy recommendation is to make participation in wellness interventions part of the mandatory competency training required by accrediting bodies so that institutions ensure the well-being of clinicians as a priority.

The Contributions Made by Job Satisfaction and Psychosocial Stress to the Development and Persistence of Depressive Symptoms: A 1-Year Prospective Study.

The purpose of this study was to determine the factors that contributed to the development and persistence of depression over the course of 1 year in work environment. The subjects were 992 Japanese civil servants aged between 19 and 65 years. Baseline data and linked with data collected at 1-year follow up. After adjusting for baseline depression levels, job satisfaction, and work-related psychosocial stress (job control and job demand) were significantly related to depression at 1-year follow up. Moreover, those who reported job dissatisfaction were at higher risk of developing depression (odds ratios [ORs]: 1.94) and persistent depression associated with low job control (ORs: 2.64) and high job demand (ORs: 2.20). Job satisfaction, and psychosocial stress at baseline predicted development of and recovery from depression at 1-year follow up, respectively.

Work-related acute physical injuries, chronic overuse complaints, and the psychosocial work environment in Danish primary care chiropractic practice \u2013 a cross-sectional study

BackgroundLittle is known about the physical and psychosocial work environment of chiropractors and their work-related health complaints, and this has never been described for Danish chiropractors. The aim of this study was, therefore, to describe work-related acute physical injuries, overuse complaints, and psychosocial stress in Danish chiropractic work settings.MethodsWe developed a questionnaire specifically for this study and distributed it electronically in August 2016 using SurveyXact to all 575 members of the Danish Chiropractors’ Association working in primary care clinics. Chiropractors were asked about their work-related acute physical injuries and overuse complaints as well as any psychosocial stress they experienced at work during the previous year. We described our sample and variables using means, medians, ranges, and confidence intervals where appropriate. Statistically significant differences between genders, types of complaints and injuries, and between clinic owners and associates were examined using Chi-square and Fischer’s exact tests, where appropriate, or by examining confidence intervals for non-overlap.Results355 (65.2%) chiropractors answered the survey. Of these, 216 (61%, 95% CI 56–66) had experienced a work-related acute physical injury and/or overuse complaint during the previous year. Work-related overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder, and were more common among women (63%, 95% CI 56–70) than men (51%, 95% CI 43–59). Chiropractors with more than five years in practice (59%, 95% CI 52–64) reported significantly fewer work-related acute injuries and overuse complaints during the previous year compared with chiropractors with less than five years in practice (83%, 95% CI 73–91). In general, these practicing Danish chiropractors reported having a good psychosocial work environment, and 90% of chiropractors “always” or “often” felt that they were motivated and committed to their work.ConclusionThis sample of Danish practicing chiropractors commonly reported work-related acute physical injuries or overuse complaints. Overuse complaints were most commonly reported in the low back, wrist, thumb, and shoulder and were more common among women than men. Newly educated chiropractors reported more overuse complaints than experienced chiropractors. Collectively, this sample of Danish chiropractors reported that they had a good psychosocial work environment.

Perceived work-related psychosocial stress and musculoskeletal disorders complaints among call centre workers in India–a cross sectional study

Context The study was conducted in Chennai India in response to increase in number of health complaints among call centre workers in an organization Aim To assess the relationship between work related musculoskeletal disorders and workplace psychological stress Settings and designs Cross sectional study design Methods and materials After obtaining informed consent data was collected using self reported questionnaire distributed to call centre workers in the organization Statistical analysis used Chi square test t test amp general logistic regression Results From the worker rsquo s perception it was found that of the participants have average level of mental stress at work Among the various work related psychological stressors things happening outside of control at work had the highest impact on most of the subjects The most frequent physical pain discomfort experienced by the study participants in the previous month period concerned the neck region Statistical analysis showed significant association between the prevalence of MSD and occupational mental stress Conclusion Occupational workplace mental stress has a significant positive association with prevalence of MSD among call centre workers A systematic approach to risk reduction addressing the organizational psychosocial and physical work factors is required More research is required to know about the interaction between psychological stress and MSD

Personal, Psychosocial and Environmental Factors Related to Sick Building Syndrome in Official Employees of Taiwan.

Sick building syndrome (SBS) is a combination of symptoms that can be attributed to exposure to specific building conditions. The present study recruited 389 participants aged 20–65 years from 87 offices of 16 institutions to examine if personal factors, work-related psychosocial stress, and work environments, were associated with five groups of SBS symptoms, including symptoms for eyes, upper respiratory tract, lower respiratory tract, skin, and non-specific systems. Indoor environmental conditions were monitored. Data were analyzed using multivariate logistic regression (MLR) analyses and were reported as adjusted Odds Ratios (aOR). SBS symptoms for eyes were associated with older age, sensitivity to tobacco, and low indoor air flow. Upper respiratory symptoms were related to smoking, low social support, longer work days, and dry air. High indoor air flow was associated with reduced upper respiratory symptoms (aOR = 0.29; 95% confidence interval (CI) = 0.13–0.67). Lower respiratory symptoms were associated with high work pressure, longer work hours, chemical exposure, migraine, and exposure to new interior painting. Recent interior painting exposure was associated with a high estimated relative risk of low respiratory symptoms (aOR = 20.6; 95% CI = 2.96–143). Smoking, longer work days, low indoor air flow, indoor dryness, and volatile organics exposure, were associated with other non-specified symptoms including headache, tiredness, difficulty concentrating, anger, and dizziness. In conclusion, there are various SBS symptoms associated with different personal characteristics, psychosocial, and environmental factors. Psychosocial factors had stronger relationships with lower respiratory symptoms than with other types of SBS symptoms. Good ventilation could reduce risk factors and may relieve SBS symptoms.

ASSOCIATION OF PSYCHOSOCIAL WORK STRESS WITH COGNITIVE DECLINE AND BRAIN STRUCTURE DIFFERENCES

Evidence on the influence of psychosocial work stress on cognitive function and brain structure is limited. This study examined whether work-related stress is associated with structural brain changes and cognitive decline in old age. In a population-based prospective cohort study, 2876 dementia-free participants aged ≥60 years were followed-up for up to 9 years. A subsample (n=436) underwent brain magnetic resonance imaging (MRI) at baseline. Global cognitive function was measured by the Mini-Mental State Examination at baseline and all follow-ups. Levels of job control and demands in the longest held job over the whole working life were assessed by a validated matrix. Data were analyzed using mixed-effects linear regression. People with low levels of job control and demands exhibited greater cognitive decline (β: -0.13, 95% CI: -0.19 to -0.07; β: -0.10, 95% CI: -0.16 to -0.04), compared to those with high levels. Relative to persons who had active job strain, faster cognitive decline was found in those who had high job strain (β: -0.11, 95% CI: -0.18 to -0.05,) and passive job strain (β: -0.16, 95% CI: -0.23 to -0.09). MRI data showed that low levels of job demands and passive job strain were both related to smaller total hippocampal volume (β: -0.23, 95% CI: -0.39 to -0.08; β: -0.19, 95% CI: -0.37 to -0.01). Work-related psychosocial stress is associated with smaller hippocampal volume and may accelerate cognitive decline even in the eight decade of life, suggesting that neural alterations play a role in the work stress-cognitive decline link.

Work-related psychosocial stress and the risk of type 2 diabetes in later life.

Although work-related psychosocial stress and type 2 diabetes mellitus (T2DM) have been investigated, the association between lifelong work stress and T2DM in later life remains unclear. This study examined whether high work stress increased the risk of T2DM risk in later life, accounting also for other sources of stress outside work, such as burden from household chores. From the population-based prospective study SNAC-K, 2719 diabetes-free participants aged ≥60 years were identified and followed up for 6 years. T2DM was ascertained by glycated haemoglobin level, self-report, hypoglycaemic medication use and clinical records. Levels of job control and demands over the whole working life were assessed by a validated matrix. Household chores load was assessed by hours spent on such chores. Multivariate logistic regression models were used to estimate the association between job strain and T2DM. During the 6-year follow-up, 154 incident cases of T2DM were identified. High job strain was associated with T2DM occurrence amongst the 60-year-old cohort (OR = 3.14, 95% CI: 1.27-7.77), and only amongst women (OR = 6.18, 95% CI: 1.22-31.26), but not in men. When taking into account household chores load, a more pronounced risk of T2DM was associated with high job strain in combination with heavy household chores load in women aged 60 years at baseline (OR = 9.45, 95% CI: 1.17-76.53). Work-related psychosocial stress may increase the risk of T2DM only amongst women in their early 60s. The risk can be amplified by high household chores load.

Work-related psychosocial stress and glycemic control among working adults with diabetes mellitus

ObjectiveTo examine the association between glycosylated hemoglobin (HbA1c) and four subscales of work-related psychosocial stress at study baseline and over time. Materials and methodsWe used survey data from a major HMO located in the Southeastern part of the US on health and healthy behaviors linked with patients’ clinical, pharmacy and laboratory records for the period between 2005 and 2009. Study participants (n=537) consisted of working adults aged 25–59 years, diagnosed with diabetes mellitus (DM) but without advanced micro or macrovascular complications at the time of the survey. We estimated the baseline (2005) association between HbA1c and work-related psychosocial stress and their interactions using linear regression analysis. Using individual growth model approach, we estimated the association between HbA1c over time and work-related psychosocial stress. Each of the models controlled for socio-demographic variables, diet and physical activity factor, laboratory factor, physical examinations variables and medication use in a hierarchical fashion. ResultsAfter adjusting for all study covariates, we did not find a significant association between work-related psychosocial stress and glycemic control either at baseline or over time. ConclusionAmong fairly healthy middle aged working adults with DM, work-related psychosocial stress was not directly associated with glycemic control.

Psychosocial stress at work and cardiovascular diseases: an overview of systematic reviews.

PurposeBased on information reported in systematic reviews (SRevs), this study aimed to find out whether psychosocial stress at work leads to cardiovascular (CV) morbidity and mortality.MethodsA systematic search in PubMed and EMBASE (until 2014) used a string based on PICOS components. A manual search was followed. Applying the predefined criteria, two reviewers independently screened the titles, abstracts, selected full texts, and validated their quality. Discrepancies were resolved by discussion between reviewers. Studies of low quality were excluded. Contents of enrolled SRevs were extracted by one reviewer; a second reviewer evaluated their accurateness.ResultsThe search resulted in 462 records. Six SRevs based on 81 studies (total population: ~1,468,670) fulfilled the inclusion criteria, four of “very good” (++) and two of “good” (+) quality. Excluded records were filed, and reasons for exclusion were documented in all cases. Different stress models were used to measure the work-related stress; the “demand-control model” was most commonly used. The two enrolled meta-analysis confirmed a modest (1.32, 95 % CI 1.09–1.59; Virtanen et al. 2013) to moderate evidence (1.45, 95 % CI 1.15–1.84; Kivimäki et al. 2006), predominantly among men, for the association between psychosocial stress at work and CV outcomes. Due to lacking information, it was not possible to give evidence on the dose–response relationship.ConclusionsSame to a SRev, an overview of SRev is used to summarize literature and identify areas in which research is needed. This overview can be used to: (a) Disseminate an up-to-date information on work-related stress as a risk factors for CV morbidity and mortality to government, health care providers, workers, and other stakeholders; (b) Encourage governments to better regulate the working conditions and consider work-related psychosocial stress as a hazardous factor that leads to CV diseases or mortality; and (c) Analyze gaps in the literature and provide a summary of research needs.

The association between job strain and atrial fibrillation in Swedish men

ObjectivesThe purpose of this study was to investigate whether psychosocial stress defined as high strain based on the job demand–control model increases risk for atrial fibrillation.MethodsThe present study comprised 6035...