IGLOO: An integrated framework for sustainable return to work in workers with common mental disorders

ABSTRACT

Current research on return to work (RTW) for employees with common mental disorders suffers from two limitations. First, research mostly focuses on the influence of resources during the absence period ignoring the resources which may facilitate sustainable RTW, i.e. employees continuing to work and thrive at work post-return. Second, research tends to view the work and non-work domains separately and fails to consider the interaction of resources at the individual, group, leader and organisational levels, once back at work. In the present position paper, we present an integrated framework and a preliminary definition of sustainable RTW. Based on current occupational health psychology theory and existing research on RTW, we develop ten propositions for the resources in and outside work, which may promote sustainable RTW. In addition to the individual, group, leader, and organisational levels, we also argue for the importance of the overarching context, i.e. the societal context and the culture and legislation that may promote sustainable RTW. Our framework raises new questions that need to be addressed to enhance our understanding of how key stakeholders can support employees with common mental health disorders staying and thriving at work.     

Work and mental disorders in a German national representative sample

Abstract

Most previous studies concerning the associations between work and mental ill-health have used dimensional self-report questionnaires for mental health problems (e.g., depressive symptoms). This study contributes to occupational health research by providing standardized clinical diagnoses based on DSM-IV criteria. A total of 2329 employees (age 18–65 years) took part in a structured, computer-assisted clinical interview (DIA-X/M-CIDI). Further, they specified whether their job was characterized by physical workload, overtime, or stress, and evaluated whether they feel impaired by each job characteristic. Results show that substance abuse/dependence (including nicotine dependence) was the highest prevalent mental disorder in German employees (12 month prevalence: 14.4%; only alcohol and illicit substance abuse/dependence: 4.9%) followed by anxiety (12.0%) somatoform (9.7%), and affective (9.3%) disorders. Sequential logistic regression analyses showed significant associations between the presence of stress at work and affective and somatoform disorders. Furthermore, feeling impaired by stress at work was strongly associated with anxiety, affective, somatoform disorders, and substance abuse/dependence. Beside work, personal characteristics, primarily gender, were associated with mental disorders in employees. However, except for affective disorders, gender did not modify the association between job characteristics and mental disorders. Taken together, results corroborate the necessity of considering mental disorders at work. Further studies to define the relation between work and mental disorders in employees are strongly recommended and should include objective analyses of job characteristics.     

The manager's role in employees' successful return to work following back injury

Abstract

This study reports on the short-term effects of an educational programme for immediate supervisors on employees' back pain problems. The course was designed to help supervisors more efficiently deal with employees returning to work after being treated for back pain. Forty-seven supervisors who had personnel either undergoing treatment for back pain problems or were candidates for this treatment were invited to attend a one-day course. This educational package consisted of information about back pain and stressed specific behaviours which supervisors could use to help their employees successfully return to work. The results showed that 78% of the supervisors found the course to be satisfactory enough to recommend it to a colleague without hesitation. Furthermore, independent ratings made by the supervisors and their employees suggested that supervisors complied with the recommended programme. Returning employees, moreover, gave their supervisors significantly higher ratings of support than a control group whose supervisors had not attended the educational programme. It was concluded that an educational programme which alters specific supervisory behaviours may be an effective method of assisting employee return to work after treatment for back pain. Further research is needed to determine the long-term effects of such a programme on absenteeism due to illness.     

Signs of struggle (SOS): The development and validation of a behavioural mental health checklist for the workplace

ABSTRACT

For managers to successfully support employee access to mental health resources, they must first be able to recognise if and when an employee may need help. To manage employees effectively, managers must be able to recognise changes in employees’ work behaviour that may indicate when an employee is struggling at work. In study 1, we develop and establish the structure of the 20-item Signs of Struggle (SOS) checklist as comprising five factors that describe the warning signs of health impairment at work (i.e. distress, withdrawal, reduced attendance, degradations in performance, extreme behaviours). In study 2, we show that manager-rated signs of struggle correlated substantially (r?=?.72) with participant-reported strain. The SOS tool provides managers a way to recognise when employees may be struggling and could benefit from workplace resources. We recommend that for maximal benefit, managers also receive training on how to use the SOS, and also on how to approach and assist employees who are displaying warning signs.     

Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health

ABSTRACT

The aim of the study was to identify trajectories of effort-reward imbalance (ERI), to examine these with respect to demographic (age, gender, socio-economic position) and work-related (employment contract, work hours, shift work, sector) factors, and to investigate associations with different health indicators (self-rated health, depressive symptoms, migraine, sickness absence). The study used four waves of data (N?=?6702), collected biennially within the Swedish Longitudinal Occupational Survey of Health (SLOSH). Using latent class growth modelling, we identified four trajectories: a stable low imbalance trajectory, which comprised 90% of all participants, and three change trajectories including a decreasing trajectory (4% of the participants), an inverted U-shaped trajectory and an increasing imbalance trajectory, both in 3% of the participants. Results indicate that a sizeable proportion of Swedish employees’ experience imbalance between efforts and rewards at work. The most favourable trajectory comprised relatively more men and was characterised by better work-related characteristics than the less favourable ERI trajectories. All change trajectories were dominated by women and employees in the public sector. Health developments followed ERI trajectories, such that less favourable trajectories associated with impaired health and more favourable trajectories associated with better health. Sickness absence increased among all ERI trajectories, most so for the decreasing and increasing ERI trajectory.     

Employee reactions to behavioural control under conditions of stress: The moderating role of self-efficacy

Extensive research conducted in the occupational stress literature has failed to provide convincing support for the stress-buffering effects of work control on employee adjustment. Drawing on research conducted in the laboratory context, it was proposed that the stress-buffering effects of work control on employee adjustment would be more marked at high, rather than low, levels of self-efficacy. In a sample of 100 customer service representatives, a significant three-way interaction among role conflict, work control and self-efficacy (measured at Time 1) was observed on (low) depersonalization (measured at Time 2). Consistent with expectations, work control reduced the negative effects of work stress on this outcome measure only for employees who perceived high levels of self-efficacy at work. In addition, there was evidence to suggest that self-efficacy moderated the main effects of work control on job satisfaction and somatic health. These findings are discussed in terms of their theoretical contribution to the job strain model, and also in relation to workplace interventions designed to improve levels of employee adjustment.     

Job demands,job control,and mental health in an 11-year follow-up study: Normal and reversed relationships

Abstract

Despite numerous studies of the demand-control model, there is a need for more longitudinal studies to test not only the normal, but also the reversed and reciprocal relationships between work characteristics and mental health. There is also a need for more studies of the multiplicative interaction between demands and control with respect to mental health, which is different from the simple additive effect of the two variables. This is a longitudinal study with an exceptionally long period of follow-up (11 years), with the focus on normal as well as reciprocal and reversed causality between work characteristics and mental health, as measured by reliable instruments close to the original definitions of Karasek. The study was based on a sample of 439 Norwegian employees of different occupations who had stayed in the same profession during the follow-up period. The results were in agreement with the hypothesis that low job control, and in particular low control in combination with high demands (“high strain jobs”), has a negative effect on mental health. There was a significant multiplicative interaction between demands and control, indicating a “buffering” effect of job control. Job demands alone were not significantly associated with mental health. The reversed relationship hypothesis was supported for job demands, but not for job control.     

Women,men, VDU work and health: A questionnaire survey of British VDU operators

Abstract

This paper presents the results of a questionnaire survey of male and female VDU operators distributed through Health & Safety at Work magazine. 3819 questionnaires were analysed using the SPSS computer program. 57% of the sample were female, 68% were under 35 years old and 73% were members of a trade union or staff association. The large number of male respondents meant that it was possible to compare work patterns, types of work and health effects for men and women. It appears that women are engaged in more repetitive and less varied tasks at the VDU and that they work longer hours and for longer periods without a break than men. The most frequently reported health problems were eyestrain, painful or stiff neck and shoulders, fatigue and irritated eyes. The incidence of symptoms was related to hours of work at the VDU. Women were more likely to report health effects than men. This difference remains when hours of work, type of work and hours worked without a break are taken into account. Ergonomically designed equipment such as adjustable chairs, lighting or keyboard did not have an obvious effect on the reporting of symptoms. It appeared that there is a complex interaction between the physical, ergonomic and psychosocial factors associated with new technology. All these factors need to be taken into account in further research into the health problems of VDU operators.     

Presenteeism and health over time among Chinese employees: The moderating role of self-efficacy

The aim of this study was two-fold: first, to examine both the immediate and the lasting effects of presenteeism on health; second, to explore the moderating effect of self-efficacy on the presenteeism-health relationship in a Chinese context. We employed a two-wave study design in which presenteeism, health (i.e. physical health, mental health and exhaustion), and self-efficacy were assessed at Time 1; health was measured again at Time 2 three months later. We surveyed a diverse sample of 345 full-time Chinese employees working in Taiwan and mainland China. Hierarchical regression analyses showed that presenteeism over the previous six months was negatively related to employees' physical health, mental health and exhaustion at Time 1. However, we found no association between presenteeism and health at Time 2, after controlling for the baseline level of health, indicating that presenteeism may not have a lasting effect. Self-efficacy was found to moderate the relationships between presenteeism and all three aspects of health at Time 2, suggesting that for some individuals presenteeism may not on balance be a bad thing. The study sheds light on the association between presenteeism and health. The findings on self-efficacy also extend the literature to incorporate individual characteristics in the presenteeism context.     

Job satisfaction and mental health of temporary agency workers in Europe: a systematic review and research agenda

ABSTRACT

The current systematic literature review aimed to analyse the associations between temporary agency work (TAW), job satisfaction, and mental health in Europe, as well as to outline a future research agenda. Twenty-eight scientific articles were identified by searching different data bases (i.e. PSYNDEX, PsycINFO, PubMed, and Web of Science) for the time span from January 2000 to December 2016. Our review reveals first that TAW is not consistently negatively related to job satisfaction. However, job insecurity and working conditions are important mediators in the relation of TAW and lowered job satisfaction. Second, TAW is not consistently related to all investigated types of mental health impairments. However, when focusing on specific outcomes and comparing temporary agency workers to permanent employees, we still find consistent evidence regarding higher levels of depression and fatigue among temporary agency workers. Inconsistent associations between TAW, job satisfaction and mental health can partly be attributed to unfavourable methodological aspects of the included primary studies. To address these aspects, future research should consider applying a standard measurement of TAW, including a minimum of meaningful confounding variables, improving the operationalisation of outcome variables and the study design.     

Shiftwork locus of control: Scale development

Abstract

Shiftwork is a significant feature of occupational life for many people. It can have disruptive effects on sleep, health, social activity and performance. It is likely that beliefs about personal control will influence the individual-shiftwork relationship. This paper has two aims; first, to put forward the thesis that shiftwork-specific personal control expectancies may moderate the disruptive impact of shiftwork, and second, to report the development and preliminary validation of a shiftwork-specific locus of control scale. The scale demonstrated satisfactory psychominary qualities in terms of factor structure, internal reliability, construct validity and test-retest reliability. Variables associated with better coping with shiftwork such as alertness, flexibility of sleeping habits and the structured use of time correlated positively with shiftwork locus of control. In contrast, shiftwork locus of control was found to be inversely related to shiftwork problems such as sleep disturbance, poor mental well-being and work stress.     

Associations between overtime and psychological health in high and low reward jobs

This study focused on the relationship between overtime and psychological health in high and low reward jobs, and in jobs with high and low external pressure to work overtime. Data were collected for 535 full-time employees of the Dutch Postal Service. In general, overtime was associated with negative work-home interference and negative home-work interference. Split-sample logistic regression analyses showed that employees reporting low rewards had elevated risks of burnout, negative work-home interference and slow recovery. In addition, the combination of overtime and low rewards was associated with negative home-work interference. A second analysis was conducted separately for employees who reported overtime in order to study the effects of external pressure to work overtime. In this subgroup, low rewards were associated with elevated risks of health complaints, emotional exhaustion and negative home-work interference. Moreover, employees who reported overtime and a high pressure to work overtime in combination with low rewards had elevated risks of poor recovery, cynicism, and negative work-home interference. The results suggest that even a limited number of hours of involuntary overtime is associated with adverse mental health, but only in low reward situations.     

Work motivation,organisational identification,and well-being in call centre work

Abstract

Previous work has not considered the interplay of motivational forces linked to the task with those linked to the social identity of employees. The aim of the present study is to combine these approaches. Two studies with call centre agents (N=211, N=161) were conducted in which the relationships of objective working conditions (e.g., inbound vs. outbound work), subjective measures of motivating potential of work, and organisational identification were analysed. Job satisfaction, turnover intentions, organisational citizenship behavior (OCB), health complaints, and burnout were assessed as indicators of the agents’ work motivation and well-being. In both studies it was found that objective working conditions substantially correlated with subjective measures of work motivation. Moreover, employees experiencing a high motivating potential at work reported more OCB, higher job satisfaction, and less turnover intentions. As hypothesized, organisational identification was a further independent predictor of job satisfaction, turnover intentions, OCB, and well-being. Highly organisationally identified employees report higher work motivation and more well-being. Additionally, interactions between the motivating potential and organisational identification were found. However, all the results indicate that interventions seeking to enhance work motivation and well-being in call centres should improve both the motivating potential of the job and organisational identification. These two factors combined in an additive way across both studies.     

Health and well-being of older workers: comparing their associations with effort–reward imbalance and Pressure,Disorganisation and Regulatory Failure

Work organisation has well-established associations with health. This study compares the associations of Pressure, Disorganisation and Regulatory Failure (PDR) and effort–reward imbalance (ERI) with health and well-being among older workers. Participants were 714 Australian workers aged 45–65 (56.3% female), with a mean age of 54.6 years (SD = 5.0) and a mean of 34.7 working hours per week (SD = 13.9). Hierarchical regression analyses tested the strengths of the associations of both ERI and PDR with work–life conflict and mental health. Independent variables were entered in blocks: demographic characteristics (age and gender), working hours and then ERI or PDR (measured using the four subscales: financial pressure, reward pressure, disorganisation and regulatory failure). Compared to ERI, the PDR subscales collectively accounted for slightly less variance in work–life conflict and slightly more variance in mental health. The PDR subscales also accounted for extra variance in both dependent variables when ERI was included in the model. These findings indicate that PDR is a promising construct that includes elements of work organisation not addressed by ERI.     

Job demands and work-related psychological responses among Malaysian technical workers: The moderating effects of self-efficacy

Abstract

Job design has long been found to affect the work-related psychological responses of employees, such as psychological strain, job satisfaction, and turnover intentions, but scholars have begun to question whether established theoretical relations regarding job design continue to hold given the enormous changes in the nature of work during the past two decades. It is also increasingly recognized that individual differences affect work behaviours in substantial ways, but few studies on work design have investigated these differences. We addressed these concerns with a two-wave longitudinal study among 245 technical workers at a telecommunications company in Malaysia, a country that has a collectivist culture and a high power distance between managers and subordinates. We examined the moderating effects of job control and self-efficacy on the relationships between job demands and employee responses. The results failed to support the job demands-control model, as job control variables did not moderate the impact of demands on employee work-related psychological responses. However, self-efficacy moderated their impact on psychological strain (although not on job satisfaction or turnover intentions). Our findings provide insight into the moderating effect of self-efficacy, and suggest that practitioners interested in reducing psychological strain should consider making efforts to increase self-efficacy among employees.     

The manager's role in employees' successful return to work following back injury

This study reports on the short-term effects of an educational programme for immediate supervisors on employees' back pain problems. The course was designed to help supervisors more efficiently deal with employees returning to work after being treated for back pain. Forty-seven supervisors who had personnel either undergoing treatment for back pain problems or were candidates for this treatment were invited to attend a one-day course. This educational package consisted of information about back pain and stressed specific behaviours which supervisors could use to help their employees successfully return to work. The results showed that 78% of the supervisors found the course to be satisfactory enough to recommend it to a colleague without hesitation. Furthermore, independent ratings made by the supervisors and their employees suggested that supervisors complied with the recommended programme. Returning employees, moreover, gave their supervisors significantly higher ratings of support than a control group whose supervisors had not attended the educational programme. It was concluded that an educational programme which alters specific supervisory behaviours may be an effective method of assisting employee return to work after treatment for back pain. Further research is needed to determine the long-term effects of such a programme on absenteeism due to illness.     

Cardiac measures of stress in British prison officers

Abstract

Previous research has found that alternative employment arrangements are associated with both impaired and improved well-being. Since such inconsistencies are likely to derive from the type of employment contract as well as the characteristics of the job, this paper compares permanent full-time work with forms of alternative employment (permanent part-time, fixed-term and on-call work) in order to investigate how different employment contracts and perceptions of job conditions relate to individual well-being. This study contributes to the literature by addressing several questions. Different forms of alternative employment are distinguished and individual background characteristics that might be intertwined with the employment contract are controlled for. Moreover, the scope of this study extends to the effects of perceived job conditions, and possible interactive effects with type of employment are tested. Analyses of questionnaire data from 954 Swedish healthcare workers show that perceptions of the job (job insecurity, job control and demands), but not the type of employment contract, predicted health complaints. However, type of employment interacted with perceptions of job insecurity, in that insecurity was associated with impaired well-being among permanent full-time workers, while no relationship was found for on-call or core part-time employees. Despite the absence of interactions between employment contract and job demands or job control, it can be concluded that knowledge about the relationship between alternative employment arrangements and the well-being of workers can be enhanced when the combined effects of employment contract and job conditions are studied.     

Work-related episodic memories can increase or decrease motivation and psychological health at work

ABSTRACT

Research on the psychological mechanisms underlying employee motivation and psychological health at work has been limited to general and chronic workplace factors, such as job strenuousness or management style. In two studies, we examine how unique and time-specific work life events encoded as episodic memories can influence employee motivation and psychological health at work as a function of how these events are recalled having been experienced in terms of need satisfaction. In Study 1, participants described a self-defining work-related memory and rated it for need satisfaction. They also completed scales of need satisfaction at work, self-determined motivation, and positive and negative indicators of psychological health (i.e. work satisfaction and burnout). In Study 2, participants completed the same tasks and scales, but they did it again two years later. Results revealed that need satisfaction in self-defining work-related memories was associated with self-determined motivation and indicators of psychological health at work, over and above demographics (age, sex, weekly hours worked, education) and general perceptions of need satisfaction at work. Moreover, it predicted increases in self-determined motivation and in work satisfaction and decreases in burnout over two years. The present findings underscore the importance of considering unique work life events encoded in memory.     

Organizational change,health, and sick leave among health care employees: A longitudinal study measuring stress markers,individual, and work site factors

Abstract

This controlled longitudinal study was conducted to investigate the effects of organizational change on employees’ self-reported health, work satisfaction, work-related exhaustion, stress, and sick leave. The population consisted of 226 employees at T1 and 198 at T2, divided into a study group affected by organizational changes, and a reference group not affected by them. Group differences for the outcome measures self-rated health (SRH), work satisfaction, work-related exhaustion, and hormones associated with stress were analysed using a two-factor ANOVA design for repeated measurements. Our findings showed no significant differences, either across time or between groups for SRH, work satisfaction, and work-related exhaustion. However, we did find significant change across time and between groups for the recovery hormone DHEA-S. Days of sick leave increased by 7% for employees in the study group and by 2% in the reference group. Serum cortisol showed significantly decreased levels across time but not between groups. The decreased recovery potential in the study group might have long-term health implications. The study points to the importance of looking at the impact of organizational change on employee well-being from a number of perspectives, such as self-reported health parameters, registered sick-leave data, and biological stress markers.