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.     

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.     

Book reviews and books received

Abstract

In the field of stress research it is often assumed that social support as well as coping behaviour contributes to feelings of health and well-being. However, until now it has not been altogether clear whether a main-effect model or a buffer model was the more appropriate for explaining the role of these factors in response to stressful situations. In this paper, a research project is described in which both the direct and indirect effects of social support and coping were studied in the work situation of nurses. The results offer more support for a main-effect model than for a buffer or moderating-effect model, especially with regard to the coping strategies ‘active problem-solving’ and ‘palliative behaviour’. However, some moderating effects on nurses‘ reactions to their work situation were found for social support and for ‘comforting cognitions’ as a coping strategy.     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

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.     

Identifying the causes of nurses' stress: A survey of New Zealand nurses

Abstract

A nationwide survey of 2500 general and obstetric nurses identified five potential sources of stress. These included work overload, difficulties relating to other staff, the difficulties involved in nursing the critically ill, concerns over the treatment of patients, and dealing with difficulty or helplessly ill patients. These findings support earlier work which suggested that a number of stressful situations are commonly encountered by all nurses. In terms of intervention strategies these results point to a number of important issues which are discussed in this paper. They include the difficulties and conflicts inherent in the nurses' role, the multidimensional nature of the different stressors, aspects of the work environment which give rise to different stressors and the relationship between stressors.     

Are they lonely at the top? Social relationships and social support among Australian managers

This research tested the possibility that managers may be lonely at the top. A total of 572 Australian managers responded to a questionnaire-based survey. Results showed that social support was more frequently available from non-work relationships than from work relationships. The support available from work and non-work sources was also qualitatively different. Workplace relationships offered mainly distraction, whereas non-work sources also offered care, acceptance, and consolation. Within the workplace, co-workers were the primary source of support. Moreover, support for work stressors was received from within the workplace, or from a spouse or partner. However, support was seldom received from within the workplace for non-work stressors. Concerns about social relationships also contributed to most of the nominated stressful situations.     

How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Relationships between stressful work environments and bullying: Results of a large representative study

Abstract

This paper contributes to the relatively sparse knowledge about relationships between stressful work environments and bullying. Relationships between job stressors and leadership behaviour were analysed as possible predictors of bullying at work on the basis of the work environment hypothesis, which states that stressful and poorly organized work environments may give rise to conditions resulting in bullying. Analyses of a representative sample (n=2539) of the Norwegian workforce showed role conflict, interpersonal conflicts, and tyrannical and laissez-faire leadership behaviour to be strongly related to bullying, and that the strength of associations to a high degree differed for various measures of bullying. Support was found for an interactive relationship between decision authority and role conflict at different levels of laissez-faire leadership. Not only targets and bully/targets but also bystanders assessed their work environment more negatively than did non-involved employees, while perpetrators of bullying did not differ significantly from non-involved employees as regards their perception of the work environment. Hence, bullying is likely to prevail in stressful working environments characterized by high levels of interpersonal friction and destructive leadership styles. In addition, bullying is particularly prevalent in situations where the immediate supervisor avoids intervening in and managing such stressful situations.     

Psychosocial work environment and mental health among travelling salespeople

Travelling salespeople have a rather unusual working environment, with long periods of absence from their firm and a low level of social contacts with colleagues. Furthermore, they are exposed to high demands in their work, which may conflict with a normal family life. In this paper a cross-sectional study of psychosocial work environment and mental health of Danish travelling salespeople is described. A sample of 1,306 travelling salespeople filled in a questionnaire (response rate 68%). The results indicate that poor mental health is associated with a number of demand indicators: number of working hours per week, number of customers per week, non-day work, and a high level of perceived job demands. On the other hand, the number of hours spent with customers per week is positively associated with mental health. The authors did not find the expected associations between poor mental health and several factors such as number of hours away from firm, nights away from home, and a low degree of perceived support from colleagues and superiors. It is concluded that the main stressors of travelling salespeople are long working hours, many customers, non-day work and high perceived psychological demands in general.     

Psychosocial stress and job satisfaction in female office employees with and without neck-shoulder symptoms

The objective of this research performed in a Finnish occupational health care setting was to describe the annual prevalence of neck and shoulder symptoms in female office employees and to test whether or not these symptoms were associated with psychosocial stress, job satisfaction and health locus of control. The subjects consisted wholly of female office employees (n = 232) at one local bank and three insurance offices, chosen on a voluntary basis. The annual prevalence of disturbing neck-shoulder symptoms among female office employees was 43.3%. An association of these symptoms with psychosomatic symptoms, poor general job satisfaction and its two subdimensions, work content and perception of the healthiness of the working environment, was noticed. The subjects with neck-shoulder symptoms had a significantly higher score of feelings of external control (fatalism) than those without symptoms. The results lead to the conclusion that neck-shoulder symptoms are common amongst female office employees. These symptoms are associated with some psychosocial stress factors and job dissatisfaction. In future, it would be important to pay attention to these factors when trying to reduce the prevalence of neck-shoulder symptoms in office work.     

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.     

Psychosocial safety climate as an antecedent of work characteristics and psychological strain: A multilevel model

Abstract

Psychosocial safety climate (PSC) refers to a specific organizational climate for the psychological health of workers. It is largely determined by management and at low levels is proposed as a latent pathogen for psychosocial risk factors and psychological strain. Using an extended Job Demands-Control-Support framework, we predicted the (24 month) cross-level effects of PSC on psychological strain via work conditions. We used a novel design whereby data from two unrelated samples of nurses working in remote areas were used across time (N=202, Time 1; N=163, Time 2), matched at the work unit level (N= 48). Using hierarchical linear modelling we found that unit PSC assessed by nurses predicted work conditions (workload, control, supervisor support) and psychological strain in different nurses in the same work unit 24 months later. There was evidence that the between-group relationship between unit PSC and psychological strain was mediated via Time 2 work conditions (workload, job control) as well as Time 1 emotional demands. The results support a multilevel work stress model with PSC as a plausible primary cause, or “cause of the causes”, of work-related strain. The study adds to the literature that identifies organizational contextual factors as origins of the work stress process.     

The role of sense of coherence in well-being at work: Analysis of main and moderator effects

Abstract

The aim of this cross-sectional study was to investigate the role of the sense of coherence (SOC) as a main effect on well-being and also its possible moderating role in the relationship between work characteristics and well-being in a sample of Finnish technical designers (n = 989). MANOVA/MANCOVA analysis with hierarchical decomposition was used so that the demographic variables (age, occupation gender) were controlled throughout. The results offered strong support for a main effect model of SOC: the stronger the SOC, the lower the level of psychosomatic symptoms and emotional exhaustion. Also, some support for a moderating role of SOC on the relationships between perceived work characteristics and well-being was found. However, these relationships explained only a small proportion of the variance of well-being was found. However, these relationships explained only a small proportion of the variance of well-being indicators. These results showed that the strong SOC subjects seemed to be better protected from the adverse effects of certain work characteristics (e.g. pressure of time). Furthermore, good social relations at work emphasized well-being among subjects with a very weak SOC, whereas these relations matered less in determining well-being outcomes in subjects with a stronger SOC. Finally, some work characteristics seemed to have salutary effects on well-being when accompained by a strong SOC and, on the contrary, pathogenic effects when accompained by a weak SOC.     

Risk factors for neck and back pain in a working population in Sweden

The relationship between lifestyle, ergonomie and psychosocial workplace factors and musculo-skeletal pain was examined in this cross-sectional study. A total of 22180 employees undergoing screening examinations at their occupational health-care service filled in a series of questionnaires concerning their health, lifestyle and working situation. Of these 31% reported having had neck pain and 18% had seen a health professional for such pain during the previous year. Similarly, 39% reported having had back pain and 16% had seen a professional during the year. Odds ratios were calculated to estimate the relative risk of the various exposure factors. Although not eating regularly and smoking increased the risk for both neck and back pain somewhat, not exercising and consuming alcohol did not increase the risk for these musculoskeletal pains. Lifting, monotonous work tasks, vibration and uncomfortable work postures were the most important ergonomie factors (odds ratios from 1.01 to 2.95). Sitting, however, did not increase the risk for either neck or back pain. A 'poor' psychosocial work environment, as compared to a 'good' one, increased the risk for both neck and back pain (odds ratios from 1.62 to 3.01). Work content and social support were of particular relevance. Finally, a combination of a 'poor' psychosocial work environment and exposure to one of the ergonomic variables produced the highest risk factors (odds ratios from 2.42 to 3.61). Although the conclusions that may be drawn are limited by the cross-sectional nature of this study, the results seem to underscore the complex aetiology of musculoskeletal pain and especially the importance of psychosocial variables. Prevention programmes should therefore be broad-based and include psychosocial as well as ergonomic measures.     

Expanding the HRD Role: Improving employee well-being and organizational performance

Abstract

An important opportunity for the HRD profession lies in assessing and reshaping the psychosocial work environment to create a healthy, mentally focused workforce that provides their organization with a competitive advantage. We explain why HRD professionals should be concerned with employee well-being, offer suggestions for assessing the work environment through a stress audit and discuss four key work factors that affect well-being: job control, role overload, social support and supervisor behaviour. By expanding their role to these concerns, HRD professionals can improve quality of life and contribute to organizational effectiveness. If they do, the result should be healthier employees, healthier organizations and a greater recognition of HRD's potential for transforming organizations.     

Mental load and work stress as two types of energy mobilization

A conceptual framework is presented in which mental load and stress are regarded as two distinct biobehavioural states in the work environment that differ in energy mobilization, mood and coping strategy. The framework combines two types of theory that are based on human performance research using laboratory tasks on the one hand and applied research in the work environment on the other. A high workload is regarded as an important but not a critical factor in the development of stress symptoms. Even under unfavourable conditions it is possible to work intensively and to be highly activated without feelings of strain or psychosomatic complaints. In contrast, working conditions that provide few possibilities for control and little social support or are associated with reduced well-being and increased health risks. The two states differ in activation, coping style and mood. A proper distinction is important not only for theory building but also for the reconstruction of the work environment. It may lead to recommendations that aim to enhance the work efficiency of employees while reducing the probability that stress responses will occur.     

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 role of social support and coping behaviour in nursing work: Main or buffering effect?

In the field of stress research it is often assumed that social support as well as coping behaviour contributes to feelings of health and well-being. However, until now it has not been altogether clear whether a main-effect model or a buffer model was the more appropriate for explaining the role of these factors in response to stressful situations. In this paper, a research project is described in which both the direct and indirect effects of social support and coping were studied in the work situation of nurses. The results offer more support for a main-effect model than for a buffer or moderating-effect model, especially with regard to the coping strategies 'active problem-solving' and 'palliative behaviour'. However, some moderating effects on nurses' reactions to their work situation were found for social support and for 'comforting cognitions' as a coping strategy.     

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.