Musculoskeletal discomfort and work-related stress in New Zealand dentists

There has been little research into the stressors, psychological distress and musculoskeletal symptoms experienced by dentists. The present study was carried out among a random sample of New Zealand dentists (N=413). The present study aimed to identify the severity of work psychosocial stressors, examine the occurrence of musculoskeletal discomfort and psychological disturbance, and determine relationships between these factors. The average age of the dentists was 43 years, with 74% being male. The annual prevalence of symptoms in both the lower back or neck was 63%, with 49% experiencing symptoms in the shoulders. Older dentists were no more likely to suffer musculoskeletal discomfort than younger dentists. The highest ranking dentistry-specific work-related stressor was 'patients having a medical emergency' with 78% scoring this stressor very highly. Dentists scored mental demands as the highest general work-related stressor. One-fifth of the dentists scored highly for psychological disturbance, which was very similar to the general population. Dentists with high scores for dentistry-specific work-related stressors were more likely to have evidence of psychological disturbance. The relationships between psychological disturbance and musculoskeletal discomfort needs to be taken into account when considering any multidisciplinary approach to prevention.     

The New Zealand government approach to stress and fatigue

Abstract

Self-control involves inhibiting undesired behaviours and emotions, and it can be particularly relevant in the service sectors. Recent theoretical developments in cognitive and social psychology suggest that the demands on an individual of exercising self-control have an effect as a source of stress at work. In turn, burnout could be associated with being unable to meet those demands. It was expected that cognitive control deficits, as assessed by a questionnaire measure of self-reported failures in perception, memory, and action, would function as a vulnerability factor in the relationship between self-control demands and indicators of job strain. Data from 630 staff members of a German municipal administration revealed significant main effects of both self-control demands and cognitive control deficits on the burnout dimensions of emotional exhaustion and depersonalization. Both predictors were positively related to burnout. In addition, the results provided clear evidence of the vulnerability hypothesis of cognitive control deficits. By way of contrast, musculoskeletal complaints did not reflect similar main and interactive effects of self-control demands and cognitive control deficits. The requirements for self control in the service sector are expected to increase as the sector expands, and the practical implications for this are discussed.     

Cognitive therapy and behavioural coping in the management of work-related stress: An intervention study

Transactional models of stress emphasize the importance of cognitive appraisal of potential stressors in the determination of the stress response. This appraisal can be modified by the use of techniques normally associated with cognitive therapy. The contribution of a specifically cognitive component when intervening in work-related stress has not been well evaluated to date. This research seeks to determine the effectiveness of stress management training in the treatment of the work-related effects of stress by comparing the role of modifying dysfunctional cognitions with the teaching of appropriate behavioural coping strategies. Participants were allocated to one of two intervention conditions or to a waiting list control group. Those in the intervention conditions received group stress management either with the focus on delivering cognitive therapy techniques or with the focus on behavioural coping skills. Measures of general health were taken at the beginning and end of intervention and at 3-month follow-up. Participants in the cognitive therapy groups who were reporting symptoms of general ill-health at the start of the intervention showed a significant improvement at follow-up. Cognitive therapy appears to have been an effective intervention in work-related stress. Those in the behavioural group showed a smaller but still clinically effective improvement. Results are discussed in terms of methodological issues and implications for future research. It is suggested that changes in cognitive appraisal may need to be developed.     

Return to work among employees with mental health problems: Development and validation of a self-efficacy questionnaire

Abstract

Because of the costs to both the organization and the individual, it is important that employees who are sick-listed with mental health problems are facilitated in their return to work (RTW). In order to provide adequate interventions, it is necessary to obtain a better understanding of the RTW process of people with mental health problems. Work-related self-efficacy (SE) might play a key role within this process. This paper describes the development and validation of the return-to-work self-efficacy’ scale (RTW-SE) for employees with mental health problems. Three Dutch samples of sick-listed employees were used to validate the 11-item instrument (N=2214). Based on the factor structure and reliability results, RTW-SE was conceptualized as a unitary construct. The associations with general SE, locus of control, coping, physical workload and mental health problems support the construct validity of this scale. Most importantly, RTW-SE proved to be a robust predictor of actual return to work within three months. The encouraging preliminary psychometric properties of the scale make it a potentially valuable tool in research and in clinical practice and occupational health care settings, both before and after employees have returned to work.     

Using computerized ambulatory diaries for the assessment of job characteristics and work-related stress in nurses

Abstract

Much research into work-related stress is based on retrospective self-reports, whereas records made at the time could be more valuable. In this study the primary components of two models of work stress, Karasek's demand-control (DC) model and Siegrist's effort-reward imbalance (ERI), were assessed in trained nurses using ambulatory diaries and traditional questionnaire methods. The diaries were entered on small hand-held computers and the method used has been termed ecological momentary assessment (EMA), in which recordings are made in real time in the working environment. The participants were 36 nurses who completed standardized questionnaires evaluating ERI, strain (from DC model), and, over three shifts, computerized behavioural diaries that measured effort-demand, control, reward, and stress every 90 minutes on average, enabling determination of strain and ERI repeatedly in the work situation. A total of 674 observations were recorded. Using multilevel linear modelling, it was found that the questionnaire and computerized diary derived measures of strain (DC) and ERI were reliably correlated. In addition, the ambulatory measures of both strain (DC) and ERI correlated with ratings of stress taken at the same time. From this study it would appear that ambulatory diaries could be a powerful and flexible way of assessing work related stress and its putative determinants in a real life work setting.     

Using computerized ambulatory diaries for the assessment of job characteristics and work-related stress in nurses

Much research into work-related stress is based on retrospective self-reports, whereas records made at the time could be more valuable. In this study the primary components of two models of work stress, Karasek's demand-control (DC) model and Siegrist's effort-reward imbalance (ERI), were assessed in trained nurses using ambulatory diaries and traditional questionnaire methods. The diaries were entered on small hand-held computers and the method used has been termed ecological momentary assessment (EMA), in which recordings are made in real time in the working environment. The participants were 36 nurses who completed standardized questionnaires evaluating ERI, strain (from DC model), and, over three shifts, computerized behavioural diaries that measured effort-demand, control, reward, and stress every 90 minutes on average, enabling determination of strain and ERI repeatedly in the work situation. A total of 674 observations were recorded. Using multilevel linear modelling, it was found that the questionnaire and computerized diary derived measures of strain (DC) and ERI were reliably correlated. In addition, the ambulatory measures of both strain (DC) and ERI correlated with ratings of stress taken at the same time. From this study it would appear that ambulatory diaries could be a powerful and flexible way of assessing work related stress and its putative determinants in a real life work setting.     

Work-related stress,coping resources,and heavy drinking in the restaurant business

Abstract

This study aimed to test whether curvilinearity would add explanatory power to the long-term relationships between job characteristics and mental well-being. The study was based on cross-sectional and longitudinal data from phases 3 and 5 of the Whitehall II sample (N=4154 for job satisfaction and 6000 for context-free mental well-being, mean follow-up 5.8 years). The curvilinear components of the job characteristics were introduced after controlling for the baseline outcome measure, demographic factors, and the linear measures of the job characteristics. The cross-sectional analyses showed only a curvilinear association with the expected U-shape between job demands and context-free mental well-being. The longitudinal analyses showed no curvilinear relationships between the job characteristics and context-free mental well-being. While small non-linear relationships were found between social support and decision latitude and job-related mental well-being, the shape of these relationships was the reverse of that expected. Post hoc analyses revealed that only the positive segment of the relationship between decision latitude and job satisfaction was significant, while both segments of the relationship between social support and job satisfaction were significant. The findings from this study, based on a large sample with high variety in working conditions, provide little support for the assumption of curvilinearity in the long-term relationship between psychosocial working conditions and mental well-being. This has practical implications, as if associations are linear this would indicate that it would be reasonable to take a population (rather than individually targeted) approach to stress management interventions.     

The downside of organizational identification: Relations between identification,workaholism and well-being

Abstract

Employee organizational identification has been proposed and found to be positively related to employee health and well-being. The empirical evidence, however, is not unequivocal, and some authors have suggested possible downsides of identification with the organization as a whole or with a group within it. The potential negative effect of over-identification was tested empirically for the first time in the present paper. Two studies were conducted; Study 1 was cross-sectional and used a sample of Italian law court clerks (N=195) and Study 2 was longitudinal and employed a sample of Italian teachers (N=140 at T2). We proposed a curvilinear mediation model with identification curvilinearly predicting workaholism, and workaholism, in turn, negatively affecting employee well-being. This curvilinear link between organizational identification and workaholism means that workaholism at first decreases with growing identification, but when identification becomes too strong, workaholism increases. The results confirmed our hypotheses, and we discuss theoretical and practical implications.     

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.     

Psychometric analysis of the UK Health and Safety Executive's Management Standards work-related stress Indicator Tool

Abstract

Numerous tools have been developed that attempt to measure work-related stress and working conditions, but few practical instruments in the literature have been found to have a reliable psychometric factor structure. In the UK, the Health and Safety Executive (HSE) Management Standards (MS) Indicator Tool is increasingly used by organizations to monitor working conditions that can lead to stress. In Health and Safety Executive (2004), a factor analysis was conducted demonstrating the reliability of the scales. However, the authors acknowledged that direct reassessment of the same factor structure was impossible as the questionnaire was split into two separate modules for data collection. Furthermore, the tool is designed to enable comparisons between as well as within organizations to take place, yet reliability has only previously been tested at the individual level. The current study is the first to examine the factor structure of the HSE MS Indicator Tool using organizational-level data. Data collected from 39 UK organizations (N=26,382) was used to perform a first-order Confirmatory Factor Analysis (CFA) on the original 35-item seven-factor measurement scale. The results showed an acceptable fit to the data for the instrument. A second-order CFA was also performed to test if the Indicator Tool contains a higher order uni-dimensional measure of work-related stress. These findings also revealed an acceptable fit to the data, suggesting that it may be possible to derive a single measure of work-related stress. Normative data comprising tables of percentiles from the organizational data are provided to enable employers to compare their organizational averages against national benchmarks.     

Effects of vacation from work on health and well-being: Lots of fun,quickly gone

Abstract

Although vacation from work provides a valuable opportunity for recovery, few studies have met the requirements for assessing its effects. These include taking measurements well ahead of the vacation, during the vacation and at several points in time afterwards. Our study on vacation (after-) effects focused on two related questions: (1) Do health and well-being of working individuals improve during a vacation? and (2) How long does a vacation effect last after resumption of work? In a longitudinal study covering seven weeks, 96 Dutch workers reported their health and well-being levels two weeks before a winter sports vacation, during vacation and one week, two weeks and four weeks after vacation on seven indicators. Participants' health and well-being improved during vacation on five indicators: health status, mood, tension, energy level and satisfaction. However, during the first week of work resumption, health and well-being had generally returned to pre-vacation levels. In conclusion, a winter sports vacation is associated with improvements in self-reported health and well-being among working individuals. However, these effects fade out rapidly after work resumption. We propose a framework for future vacation research and suggest investigating the role of vacation type, duration and means to prolong vacation relief.     

Workforce size and work-related role stress

This paper examines the relationships between workforce size and four work-role stressors, along with two variables that are proposed here to mediate these relationships: objective organizational support and perceived organizational support. A total of 112 clerical workers in organizations of 1-500 employees participated in the study. Workforce size was positively associated with role ambiguity, role conflict, quantitative and qualitative role overload, and objective organizational support; and it was negatively correlated with perceived organizational support. Partial correlations were then computed between workforce size and role stress, controlling sequentially for objective and perceived support. The relationships between workforce size and the four role stressors remained significant when objective support was controlled. However, the corresponding relationships were non-significant after partialling out the effects of perceived organizational support, which suggests that the effect of workforce size on role stressors is indirect, and a function of perceived organizational support.     

In sickness and in health: An exploration of spousal support and occupational similarity

Abstract

While many studies of interventions have focused on their content and immediate effects, less research has focused on the processes that may explain these effects. The purpose of this study was to show how process evaluation can be used to interpret the results of an intervention study in four industrial canteens in Denmark. Two canteens acted as intervention groups and two as comparison groups. Effects were measured by surveys before and after interventions, and observations and interviews were conducted to provide an in-depth understanding of processes. Analyses were conducted based on the responses from 118 employees. Results showed, contrary to expectations, improvements in working conditions and well-being in one intervention group and in one comparison group, whereas no improvements were found in the two remaining groups. Data from the process evaluation enabled a meaningful interpretation of these results, raising the possibility programme failure rather than theory failure, and thereby constituting an example of how process evaluation can shed light over the factors that may influence outcomes in controlled intervention studies.     

Associations between stress at work and attitudes towards retirement in hospital physicians

Abstract

There is a need to understand the associations between attitudes towards retirement in specific occupations and various psychosocial and work-related factors. This study identified correlates of retirement thoughts and retirement preference in hospital physicians. The sample comprised 447 (251 male and 196 female) physicians from three hospital districts in Finland. After adjustment for gender, age and salary, minor psychiatric morbidity increased likelihood of retirement thoughts and retirement preference. Retirement thoughts and retirement preference were more common in doctors reporting low job control, poor teamwork and unjust supervision than in doctors perceiving their working conditions more favorably. Work preference was associated with high overwork. The associations of work characteristics with retirement thoughts and retirement preference largely persisted after control for indicators of health and social circumstances. In conclusion, in addition to demographic and financial factors and health, retirement attitudes in hospital physicians seem to be related to organizational and managerial factors that are potentially amendable to intervention. This has implications for retaining hospital physicians who might otherwise retire.     

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.     

Associations between stress at work and attitudes towards retirement in hospital physicians

There is a need to understand the associations between attitudes towards retirement in specific occupations and various psychosocial and work-related factors. This study identified correlates of retirement thoughts and retirement preference in hospital physicians. The sample comprised 447 (251 male and 196 female) physicians from three hospital districts in Finland. After adjustment for gender, age and salary, minor psychiatric morbidity increased likelihood of retirement thoughts and retirement preference. Retirement thoughts and retirement preference were more common in doctors reporting low job control, poor teamwork and unjust supervision than in doctors perceiving their working conditions more favorably. Work preference was associated with high overwork. The associations of work characteristics with retirement thoughts and retirement preference largely persisted after control for indicators of health and social circumstances. In conclusion, in addition to demographic and financial factors and health, retirement attitudes in hospital physicians seem to be related to organizational and managerial factors that are potentially amendable to intervention. This has implications for retaining hospital physicians who might otherwise retire.     

Is there support for curvilinear relationships between psychosocial work characteristics and mental well-being? Cross-sectional and long-term data from the Whitehall II study

This study aimed to test whether curvilinearity would add explanatory power to the long-term relationships between job characteristics and mental well-being. The study was based on cross-sectional and longitudinal data from phases 3 and 5 of the Whitehall II sample (N=4154 for job satisfaction and 6000 for context-free mental well-being, mean follow-up 5.8 years). The curvilinear components of the job characteristics were introduced after controlling for the baseline outcome measure, demographic factors, and the linear measures of the job characteristics. The cross-sectional analyses showed only a curvilinear association with the expected U-shape between job demands and context-free mental well-being. The longitudinal analyses showed no curvilinear relationships between the job characteristics and context-free mental well-being. While small non-linear relationships were found between social support and decision latitude and job-related mental well-being, the shape of these relationships was the reverse of that expected. Post hoc analyses revealed that only the positive segment of the relationship between decision latitude and job satisfaction was significant, while both segments of the relationship between social support and job satisfaction were significant. The findings from this study, based on a large sample with high variety in working conditions, provide little support for the assumption of curvilinearity in the long-term relationship between psychosocial working conditions and mental well-being. This has practical implications, as if associations are linear this would indicate that it would be reasonable to take a population (rather than individually targeted) approach to stress management interventions.     

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

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.     

Success or failure? Interpreting and understanding the impact of interventions in four similar worksites

While many studies of interventions have focused on their content and immediate effects, less research has focused on the processes that may explain these effects. The purpose of this study was to show how process evaluation can be used to interpret the results of an intervention study in four industrial canteens in Denmark. Two canteens acted as intervention groups and two as comparison groups. Effects were measured by surveys before and after interventions, and observations and interviews were conducted to provide an in-depth understanding of processes. Analyses were conducted based on the responses from 118 employees. Results showed, contrary to expectations, improvements in working conditions and well-being in one intervention group and in one comparison group, whereas no improvements were found in the two remaining groups. Data from the process evaluation enabled a meaningful interpretation of these results, raising the possibility programme failure rather than theory failure, and thereby constituting an example of how process evaluation can shed light over the factors that may influence outcomes in controlled intervention studies.