Impact of the psychosocial work environment on registered absence from work: A two-year longitudinal study using the IPAW cohort

During the Intervention Project on Absence and Well-being (IPAW), a 5-year project conducted in Denmark, we investigated psychosocial work environment factors as independent predictors of the number of absence days per year. The present two-year longitudinal study used the IPAW cohort, but was not intended to study intervention effects, which will be reported later. Data were derived from baseline questionnaires and employers’ registers of absence for 1919 participants (1305 women, 614 men, mainly in low-skilled jobs) in different occupations from 52 workplaces. These workplaces included municipal care, municipal technical services and a large pharmaceutical company. Analyses were performed by Poisson regression accounting for over-dispersion. After controlling for age, family type, health behaviours and physical work environment variables, we found that high levels of decision authority predicted low absence rates in both women and men. We tested two new psychosocial constructs developed for this study: Predictability (relating to being informed on future events at work) and Meaning of Work (relating to how meaningful and useful the work is perceived to be). Higher Predictability was a significant predictor of lower absence rates in men. This study adds to the body of evidence that the psychosocial working environment influences absence and should therefore be considered to be an important target for intervention.     

The Intervention Project on Absence and Well-being (IPAW): Design and results from the baseline of a 5-year study

This paper presents the background, design and baseline results of the Intervention Project on Absence and Well-being (IPAW). IPAW is a 5-year psychosocial work environment intervention study including 22 intervention and 30 control work-sites from three different types of work-site (a large pharmaceutical company, municipal technical services, and municipal nursing homes) in Copenhagen, Denmark. The baseline survey reported in this paper was conducted in 1996-97, and the cohort was followed until 2002. Interventions took place during 1996-98 at the organizational and interpersonal level and focused on psychological demands, social support, control, meaning of work, and predictability. The main end-points are self-rated health, perceived stress, absence from work, job satisfaction, and labour turnover. Analyses of the baseline data show good reliability of the psychosocial scales and a number of clear associations between psychosocial work environment factors and health indicators. The baseline data also demonstrate several discrepancies between the planned design of the study and the actual implementation of the project in practice.     

The contribution of the psychosocial work environment to sickness absence in human service workers: Results of a 3-year follow-up study

We investigated to what extent psychosocial work characteristics predict sickness absence in a cohort of 890 human service professionals (84% women), followed-up for 3 years. We measured 16 different psychosocial work characteristics at baseline and analysed their associations with number of sickness absence days at follow-up using multivariate Poisson regression. In addition, we computed a psychosocial work environment index, summarizing eight psychosocial scales. Participants with exposure to violence and threats, high emotional demands, high demands for hiding emotions, low influence at work, low meaning of work, low quality of management, and role conflicts had an increased number of sickness absence days at follow-up, after adjustment for numerous confounders. Adjusting for sickness absence history caused little change in most effect estimates. Scoring in the most adverse quartile of the psychosocial work environment index was associated with a 71% increase in sickness absence days. Improving the psychosocial work environment index and eliminating exposure to violence and threats would have prevented 32% of all sickness absence days in the study population. In particular we found that exposure to violence was a strong predictor of absence. This study shows that a wide range of psychosocial work characteristics contribute to sickness absence in human service workers. Improving the psychosocial work environment might help to reduce sickness absence in this population.     

The contribution of the psychosocial work environment to sickness absence in human service workers: Results of a 3-year follow-up study

Abstract

We investigated to what extent psychosocial work characteristics predict sickness absence in a cohort of 890 human service professionals (84% women), followed-up for 3 years. We measured 16 different psychosocial work characteristics at baseline and analysed their associations with number of sickness absence days at follow-up using multivariate Poisson regression. In addition, we computed a psychosocial work environment index, summarizing eight psychosocial scales. Participants with exposure to violence and threats, high emotional demands, high demands for hiding emotions, low influence at work, low meaning of work, low quality of management, and role conflicts had an increased number of sickness absence days at follow-up, after adjustment for numerous confounders. Adjusting for sickness absence history caused little change in most effect estimates. Scoring in the most adverse quartile of the psychosocial work environment index was associated with a 71% increase in sickness absence days. Improving the psychosocial work environment index and eliminating exposure to violence and threats would have prevented 32% of all sickness absence days in the study population. In particular we found that exposure to violence was a strong predictor of absence. This study shows that a wide range of psychosocial work characteristics contribute to sickness absence in human service workers. Improving the psychosocial work environment might help to reduce sickness absence in this population.     

The Danish psychosocial work environment and symptoms of stress: the main, mediating and moderating role of sense of coherence

The aim of this cross-sectional study was to explore the main, mediating and moderating role of sense of coherence (SOC) on stress symptoms and on the association between perceived psychosocial work environment and stress symptoms. The sample includes 2053 Danish employees from 52 workplaces. Hierarchical regression models were applied for each measure of stress. The results strongly supported the presence of a main effect for SOC. People with high levels of SOC experienced fewer stress symptoms. A mediating effect of SOC was also supported. Thus, SOC in part explained the association between work environment and stress symptoms. In addition, some support for a moderating effect of SOC was found, suggesting that people with higher SOC coped more efficiently with work environmental strain that people with lower SOC. Taken together the regression models explained 11-32% of the variance in stress symptoms. The results suggest that measures of individual factors such as SOC should be included in analyses of the effects of work environmental factors on stress and well-being.     

The Danish psychosocial work environment and symptoms of stress: The main,mediating and moderating role of sense of coherence

The aim of this cross-sectional study was to explore the main, mediating and moderating role of sense of coherence (SOC) on stress symptoms and on the association between perceived psychosocial work environment and stress symptoms. The sample includes 2053 Danish employees from 52 workplaces. Hierarchical regression models were applied for each measure of stress. The results strongly supported the presence of a main effect for SOC. People with high levels of SOC experienced fewer stress symptoms. A mediating effect of SOC was also supported. Thus, SOC in part explained the association between work environment and stress symptoms. In addition, some support for a moderating effect of SOC was found, suggesting that people with higher SOC coped more efficiently with work environmental strain that people with lower SOC. Taken together the regression models explained 11–32% of the variance in stress symptoms. The results suggest that measures of individual factors such as SOC should be included in analyses of the effects of work environmental factors on stress and well-being.     

Childcare involvement, job characteristics, gender and work attitudes as predictors of emotional exhaustion and sickness absence

Reports in the literature vary regarding the existence of gender differences in relation to burnout and sickness absence. To investigate this, the present study was aimed at investigating the role of several gender-relevant variables, particularly childcare obligations, job characteristics, and work attitudes in emotional exhaustion and sickness absence in 404 male and female nurses in an institution for people with learning difficulties. Questionnaires were administered reflecting demographic and job characteristics, work and non-work attitudes, and emotional exhaustion (as measured by the Emotional Exhaustion Scale of the Maslach Burnout Inventory). Female nurses were expected to report higher levels of emotional exhaustion and to be absent through sickness more often than men. Also, childcare investment, job characteristics, and (non) work attitudes were expected—via emotional exhaustion—to predict gender differences in sickness absence. It was found that women did not have higher sickness absence rates, and although a gender difference appeared in emotional exhaustion it was in the opposite direction from that predicted. For both genders, emotional exhaustion had a significant positive effect on sickness absence, and especially childcare investment and number of work hours appeared to contribute to both outcomes. These results are of interest because, despite current stereotypes, sickness absence was not higher in women, and neither were women more at risk for emotional exhaustion. In particular, load—workload as well as care load—appeared to predict emotional exhaustion and thus sickness absence.     

Relationships between bullying, psychosocial work environment and individual stress reactions

It is frequently assumed that a poor psychosocial working environment will create conditions that encourage bullying. However, few studies have examined this assumption while comparing work environment ratings of bullied and non-bullied employees who work in the same organization and/or department. The objectives of this study were therefore, first, to investigate relationships between bullying and other psychosocial work environment factors within a particular organizational setting and, second, to investigate if bullied employees reported higher levels of stress than non-bullied employees. A total of 186 blue-collar employees from a Danish manufacturing company participated in the study (response rate of 93%). Results showed significant differences in bullied and non-bullied employees' ratings of psychosocial factors such as job control, management style, role clarity, social climate, social contact and work centrality. In order to investigate assumptions that a poor psychosocial work environment creates conditions that encourage bullying, a number of analyses compared the company's manufacturing departments with either high, medium or low levels of bullying. Results showed significant departmental differences. Yet, when bullied employees were removed from the statistical analyses, with regard to the perceived psychosocial environment these same departments could be differentiated only on the basis of rated job demands and management style. The results therefore bring into question the assumption that a generally poor work environment contributes to bullying. None the less, they do suggest that management style may directly or indirectly have contributed to a higher level of bullying. Also, bullied employees reported significantly more symptoms of psychological stress and mental fatigue than non-bullied employees.     

Relationships between bullying,psychosocial work environment and individual stress reactions

It is frequently assumed that a poor psychosocial working environment will create conditions that encourage bullying. However, few studies have examined this assumption while comparing work environment ratings of bullied and non-bullied employees who work in the same organization and/or department. The objectives of this study were therefore, first, to investigate relationships between bullying and other psychosocial work environment factors within a particular organizational setting and, second, to investigate if bullied employees reported higher levels of stress than non-bullied employees. A total of 186 blue-collar employees from a Danish manufacturing company participated in the study (response rate of 93%). Results showed significant differences in bullied and non-bullied employees’ ratings of psychosocial factors such as job control, management style, role clarity, social climate, social contact and work centrality. In order to investigate assumptions that a poor psychosocial work environment creates conditions that encourage bullying, a number of analyses compared the company's manufacturing departments with either high, medium or low levels of bullying. Results showed significant departmental differences. Yet, when bullied employees were removed from the statistical analyses, with regard to the perceived psychosocial environment these same departments could be differentiated only on the basis of rated job demands and management style. The results therefore bring into question the assumption that a generally poor work environment contributes to bullying. None the less, they do suggest that management style may directly or indirectly have contributed to a higher level of bullying. Also, bullied employees reported significantly more symptoms of psychological stress and mental fatigue than non-bullied employees.     

Reciprocal relationships between psychosocial work characteristics and sleep problems: A two-wave study

Sleep problems are common and impair the health and productivity of employees. Work characteristics constitute one possible cause of sleep problems, and sleeping poorly might influence wellbeing and performance at work. This study examines the reciprocal associations between sleep problems and psychosocial work characteristics. The participants were 1744 full-time employed individuals (56% women; mean age 38 years in 2007) from the Young Finns study who responded to questionnaires on work characteristics (conceptualised by the demand–control model and effort–reward imbalance model) and sleep problems (Jenkins Sleep Scale) in 2007 and 2012. Cross-lagged structural equation models are used to examine the associations. The results show that low control and low rewards at baseline predicted sleep problems. Baseline sleep problems predicted higher effort, higher effort–reward imbalance, and lower reward. Sleep problems also predicted lower odds for belonging to the low (rather than high) job strain group and active jobs group. The association between work characteristics and sleep problems appears to be reciprocal, with a stressful work environment increasing sleep problems, and sleep problems influencing future work characteristics. The results emphasise the importance of interventions aimed at both enhancing sleep quality and reducing psychosocial risks at work.     

Working shifts—different effects for women and men?

Abstract

Results are reported of a survey on the effects of shiftwork on women and men working rotating shifts under comparable job conditions. Discriminant analyses revealed that gender-related effects of shiftwork could not be found. However, off-the-job work stress, e.g. a gender-related unequal division of domestic duties, clearly differentiated between women and men and the presence or absence of children in the house. The ‘double burden’ for women, in particular for those with children, did not result in more severe psychosocial or subjective health impairments.     

Dimensions of the psychosocial work environment in a sample of the US metropolitan population

The present study investigates the dimensional structure of the psychosocial work environment as assessed by Karasek's job characteristics scales and a set of factorial scales derived from the Dictionary of Occupational Titles (DOT) observers' ratings of occupational characteristics for census occupations. Scale scores on the Karasek and DOT were linked to information on occupation from the Epidemiologc Catchment Area (ECA) study sample. Scale intercorreladons and factor analysis were performed on those ECA subjects who reported ever having a full-time job (n=11,789). DOT'sS Substantive Complexity scale was positively correlated with Karasek's Skill Discretion and Decision Authority scales, and DOT's Physical Demands and Hazards scale was positively correlated with Karasek's Physical Demands scale. In addition, the DOT system compared to the Karasek system seems to assess psychosocial work domains less characteristic of traditional industrial jobs (interpersonal stress, expressive work). The content validity of the Karasek scales might be increased with the assessment of these domains. Giving support to Karasek's Demand/Control Model, the factor structure of the psychosocial work enviromnent in the probability sample of five US metropolitan populations yielded two major dimensions: Control, and Physical Demands.     

Psychosocial work environment and psychosomatic health of nurses in Hungary

The main goal of this preliminary study was to detect the relative effects of sociodemographics, socio-economic factors and some variables of psychosocial work environment on an overall index of psychosomatic symptoms as an indicator of psychosomatic health in a sample of female Hungarian nurses. The participants were registered nurses and student nurses chosen at random from public hospitals ( n =420). Self-administered questionnaires contained various items on psychosomatic symptoms, sociodemographics, socio-economic variables, work schedule, the frequency of stressful situations and emotionally provoking problems at work, and social support from peers. Multiple regression models revealed that the frequency of stressful situations and emotionally provoking problems, and the lack of social support from peers, i.e. measures of psychosocial work environment, proved to be the only significant contributors to psychosomatic health complaints, after controlling for other variables in both registered and student nurses.     

The contribution of supervisor behaviour to employee psychological well-being

Many employees affirm that supervisors affect employee well-being, and research has demonstrated associations between supervisor behaviour and employee psychological well-being. However, what hasn't been clear is the extent to which the association with supervisor behaviour compares with that of other variables known to affect well-being. This exploratory study addresses that issue. Our hypothesis was that supervisor behaviour can contribute to the prediction of psychiatric disturbance beyond the contribution of other influential variables. We created a new, questionnaire-based instrument to measure supervisor behaviour. We tested our hypothesis using stepwise regression with a convenience sample of 167 men and women working in a variety of organizations, occupations, and industries in the USA. Results supported our hypothesis: supervisor behaviour made a statistically significant contribution to the prediction of psychiatric disturbance beyond a step-one variate comprised of age, health practices, support from other people at work, support from home, stressful life events, and stressful work events. This provides additional evidence that supervisor behaviour can affect employee well-being and suggests that those seeking to create healthier workplaces should not neglect supervision. We believe that there is now ample justification for those concerned with psychosocial working conditions to consider supervisor behaviour as a potentially influential variable.

Furthermore, we believe that we have presented a new instrument for assessing supervisor behaviour that has the potential to be of value in future studies.     

The contribution of supervisor behaviour to employee psychological well-being

Many employees affirm that supervisors affect employee well-being, and research has demonstrated associations between supervisor behaviour and employee psychological well-being. However, what hasn't been clear is the extent to which the association with supervisor behaviour compares with that of other variables known to affect well-being. This exploratory study addresses that issue. Our hypothesis was that supervisor behaviour can contribute to the prediction of psychiatric disturbance beyond the contribution of other influential variables. We created a new, questionnaire-based instrument to measure supervisor behaviour. We tested our hypothesis using stepwise regression with a convenience sample of 167 men and women working in a variety of organizations, occupations, and industries in the USA. Results supported our hypothesis: supervisor behaviour made a statistically significant contribution to the prediction of psychiatric disturbance beyond a step-one variate comprised of age, health practices, support from other people at work, support from home, stressful life events, and stressful work events. This provides additional evidence that supervisor behaviour can affect employee well-being and suggests that those seeking to create healthier workplaces should not neglect supervision. We believe that there is now ample justification for those concerned with psychosocial working conditions to consider supervisor behaviour as a potentially influential variable.

Furthermore, we believe that we have presented a new instrument for assessing supervisor behaviour that has the potential to be of value in future studies.     

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

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.     

Psychosocial work environment and psychosomatic health of nurses in Hungary

The main goal of this preliminary study was to detect the relative effects of sociodemographics, socio-economic factors and some variables of psychosocial work environment on an overall index of psychosomatic symptoms as an indicator of psychosomatic health in a sample of female Hungarian nurses. The participants were registered nurses and student nurses chosen at random from public hospitals ( n =420). Self-administered questionnaires contained various items on psychosomatic symptoms, sociodemographics, socio-economic variables, work schedule, the frequency of stressful situations and emotionally provoking problems at work, and social support from peers. Multiple regression models revealed that the frequency of stressful situations and emotionally provoking problems, and the lack of social support from peers, i.e. measures of psychosocial work environment, proved to be the only significant contributors to psychosomatic health complaints, after controlling for other variables in both registered and student nurses.     

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.     

Social support at work and its relationship to absenteeism

In this study, the impact of psychosocial work characteristics on illness and work absenteeism has been examined. The study group consisted of 133 civil servants (33 men and 100 women) with a mean age of 43 years (range 21-65 years). Psychosocial work characteristics, social support, quality of life, work absenteeism, psychosomatic and gastrointestinal symptoms were assessed by means of questionnaires. Five different work support or functions were identified by factor analysis: appraisal support, belonging support, instrumental support, emotional support and supportive atmosphere. The analysis showed that work absenteeism was associated with lower belonging support and a less supportive atmosphere. Furthermore, psychosomatic symptoms were associated with lack of support at work, measured as belonging support, instrumental support and supportive atmosphere. Gastrointestinal symptoms were associated with lack of belonging support and lack of social integration outside work. A bad general health status was associated with lack of insrumental support. The association between work absenteeism and social support at work was confirmed in multivariate analysis with control for confounding factors. In this analysis, high work strain and low social support were associated with a lower quality of life, which in turn was associated with increased absenteeism. Although there are well-known difficulties in drawing causal conclusions from cross-sectional studies, it seems reasonable to conclude that social support at work is an important factor to take into consideration when analysing illness and absenteeism from work.     

Social support at work and its relationship to absenteeism

Abstract

In this study, the impact of psychosocial work characteristics on illness and work absenteeism has been examined. The study group consisted of 133 civil servants (33 men and 100 women) with a mean age of 43 years (range 21-65 years). Psychosocial work characteristics, social support, quality of life, work absenteeism, psychosomatic and gastrointestinal symptoms were assessed by means of questionnaires. Five different work support or functions were identified by factor analysis: appraisal support, belonging support, instrumental support, emotional support and supportive atmosphere. The analysis showed that work absenteeism was associated with lower belonging support and a less supportive atmosphere. Furthermore, psychosomatic symptoms were associated with lack of support at work, measured as belonging support, instrumental support and supportive atmosphere. Gastrointestinal symptoms were associated with lack of belonging support and lack of social integration outside work. A bad general health status was associated with lack of insrumental support. The association between work absenteeism and social support at work was confirmed in multivariate analysis with control for confounding factors. In this analysis, high work strain and low social support were associated with a lower quality of life, which in turn was associated with increased absenteeism. Although there are well-known difficulties in drawing causal conclusions from cross-sectional studies, it seems reasonable to conclude that social support at work is an important factor to take into consideration when analysing illness and absenteeism from work.