Psychological stress-factors and concentration of immunoglobulins and complement components in Norwegian nurses

Psychological stress produces immunological changes in animals, and increasing evidence suggests that this may also be true for humans. In the present study of 34 nurses in a busy ward of a Norwegian hospital, significant relationships have been demonstrated between die plasma levels of immunoglobulins and complement components and work-related 'stress', anxiety, and cognitive defence strategies. The main components of die work-related stress experience were role-stress and nonparticipation in decision-making.

The results indicate chat immunological parameters may perhaps be used as a psychological stress indicator, but the relationships are complex and can best be understood if individual coping and defence mechanisms are considered. Health symptoms were also examined, but these were not related to stress experience or immunological measures.     

Specific relationships between psychosocial job conditions and job-related stress: A three-level analytic approach

This cross-sectional questionnaire study presents a multi-level analysis on 2565 workers in 188 departments in 36 organizations in the Netherlands. A three-level model is used in which individual workers are nested within departments, which in turn are nested within organizations. Research questions concern (1) the amount and distribution of variance in job-related stress explained for the three levels in the study (individuals, departments, organizations), and (2) the specificity of relationships between psychosocial job demands and job-related stress in the three-level model. Well-being showed slightly more raw variance to be explained at supra-individual levels than strain. The full regression model explained about 35% of the total variance in both work-related strain and well-being. Psychosocial job conditions did not exceed the expected amount of 10 to 15% contribution to this explained variance. These results do not differ from comparable studies that do not use multi-level analysis. The variance distribution in the full model, however, showed unexplained variance to be located at the individual level for both strain and well-being, and at the departmental level only for well-being. This last finding shows a direction for possible improvement of work stress models. Specificity of relationships was also shown: psychological job demands were more strongly related to strain, whereas job content variables (i.e. job variety, job control) were more strongly related to well-being. Results also suggested that social support was more strongly associated with well-being than with strain. Well-being appeared to have a more widely varying range of predictors than strain.     

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 effects of new dimensions of psychological job demands and job control on active learning and occupational health

Abstract

Recent changes in job content may have led to changes in job demands and control, and earlier operationalizations of the demand concept may be too general (MT). The aim of this paper is to show how new dimensions of psychological job demands are related to two sets of outcome variables, employee health and active learning, and how these relationships are modified or interact with social support and types of job control. The study was carried out as a survey among employees of 13 electric companies in Norway, N=2435. Lisrel was used to assess the fit of the proposed models. Compared to the traditional demands control model, an extended version used in this study increased the explained variance on an average by 4% on various occupational health variables. It was found that various dimensions of demands were differentially related to the outcome variables. Skill discretion uniformly reduced the effect of the demands: for groups low in skill discretion there was a stronger relationship between demands and outcomes than for groups high in skill discretion. The interaction pattern for the remaining control and support variables was however more complicated and warrants further study. The practical implications are that employers should carefully consider the quality of work. Special attention should be given to the quantitative demands of the jobs, since there seems to be few moderators for the relationship between those demands and job stress and subjective health complaints.     

Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed

Abstract

We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions were based on CBT; however, one was conducted by psychotherapists and involved extensive CBT, while the other was delivered by “labour experts” and consisted of a brief CBT-derived intervention combined with both individual-focused and workplace interventions. One hundred and twenty-two self-employed people who had applied for sickness benefit from an insurance company enrolled in a randomized controlled design. These individuals were assessed before the intervention and then at 4 months and 10 months after the onset of the intervention. The outcome was assessed based on duration of sick leave until partial and full return to work and on psychological complaints. Significant effects on partial and full return were found in favour of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group, respectively. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition but we found no significant interaction effects. The results suggest that work resumption should be addressed earlier in individuals receiving CBT. This insight is of value for the (scarce) literature concerning interventions for individuals who are on sick leave owing to work-related psychological complaints.     

Violence in the nursing profession: Occupational and lifestyle risk factors in Swedish nurses

Abstract

In a national study of the work environment, physical, and mental well-being of more than 2600 Swedish nurses, 30% reported having experienced violence at work. Possible association between violence and a range of occupational, demographic, and lifestyle characteristics were studied. Stepwise multiple linear and logistic regressions were used to further examine risk factors for violence. Occupational factors with significant correlations to workplace violence were nursing discipline (type of ward or facility), years of work experience, supervisory responsibilities, night work, work dissatisfaction, work-related musculoskeletal injury, and frequency of patient handling. Demographic/lifestyle factors related to violence were age, gender, smoking, coffee consumption at work, and use of alcohol to relax after work. The best fit linear regression model explained 17% of the variance in violence, 13%, of the variance in threat of violence. The logistic regression model confirmed an increased risk of violence and threats in psychiatric and geriatric settings. However, much remains unexplained about the aetiology of violencc in health carc settings. This report provides the basis for a pilot intervention study currently in progress.     

Beyond demand and control: The contribution of organizational risk factors in assessing the psychological well-being of health care employees

Abstract

The job demand–control(–support) model is frequently used as a theoretical framework in studies on determinants of psychological well-being. Consequently, these studies are confined to the impact of job characteristics on worker outcomes. In the present study the relation between work conditions and outcomes (job satisfaction, emotional exhaustion, psychological distress, and somatic complaints) is examined from a broader organizational perspective. This paper reports on an analysis that examines both the unique and the additional contribution of organizational characteristics to well-being indicators, beyond those attributed to job characteristics. A total of 706 care staff from three public residential institutions for people with mental or physical disabilities in the Netherlands took part in this research. To assess organizational risk factors a measurement instrument was developed, the organizational Risk Factors Questionnaire (ORFQ), based on the safety-critical factors of the Tripod accident causation model. Factor analyses and reliability testing resulted in a 52-item scale consisting of six reliable sub-scales: staffing resources, communication, social hindrance, training opportunities, job skills, and material resources. These organizational risk factors explained important parts of the variance in each of the outcome measures, beyond that accounted for by demographic variables and job demand–control–support (JDCS) measures. Communication and training opportunities were of central importance to carers’ job satisfaction. Social hindrance, job skills, and material resources explained a substantial amount of unique variance on the negative outcomes investigated.     

Musculoskeletal discomfort and work-related stress in New Zealand dentists

Abstract

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.     

Changes in the structure of health complaints as related to shiftwork exposure

Abstract

Factor analyses of health complaints in groups with different length of shiftwork exposure show that the structure of these complaints changes with increasing shift experience, indicating the emergence of a shift-specific pattern of health complaints. After about 15 years of shiftwork, complaints related to disturbances of circadian-controlled functions can be found in the first factor whereas other complaints have their dominant loadings on a separate factor, representing general, non-shift-specific impairments. The results indicate that in this way shift-specific components of health impairment can be separated from other non-shift related components.     

Is tolerance to shiftwork predictable from individual difference measures?

Abstract

This study was aimed at evaluating the most important relations between individual characteristics of shiftworkers and their subjective health complaints, obtained by cross-sectional and longitudinal procedures. A total of 604 shiftworkers and 185 young subjects who were going to enter shiftwork were examined by means of individual difference and subjective health questionnaires. The questionnaires were administered concurrently to the group of workers already involved in shiftwork. In the other group studied, the questionnaires were administered before they entered shiftwork, and subjective health was re-examined after the first and third year of work on shifts. More health complaints were reported by the group of older workers and those with longer shiftwork experience, with higher scores of neuroticism, hard-driving and competitiveness, speed and impatience, and rigidity of sleeping habits, and lower scores on relaxedness, efficiency and vigorousness. However, the correlations between these dimensions, when taken before entering shiftwork, and subjective health complaints obtained after a few years working on shifts were small or absent, indicating low validity of the individual difference measures for predicting subsequent health problems in shiftworkers.     

The validity of the occupational stress indicator

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.     

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.     

Subjective health and its relationship with working time variables and job stressors: Sequence or general factor model?

Abstract

This study compares two theoretical models that make different assumptions about the structure of subjective health constructs and about the effects of job stressors and working time variables on health. The first model, the sequence model, is based on sequential models of the development of ill-health and posits that chronic fatigue and sleep problems mediate the effects of job stressors and working time variables on depression and somatic complaints. The second model, the general strain factor model, posits that specific health constructs (e.g. fatigue, depression, and somatic complaints) are reflections of a common general strain factor (i.e. detrimental job conditions increase the individual's sensitization to strain). In this way the study expands traditional models of stress-related effects on health. The analyses were carried out in a sample of 365 individuals in Germany. Although both models fitted the data, the general strain factor model was found to be superior. Furthermore, the effects of job stressors and working time on the health constructs fatigue and sleep quality were mediated by the general strain factor. Also, a negative relationship emerged between working time duration and general strain. It is suggested that the general strain model could be useful in future health psychology research.     

Stress at work and psychological and immunological parameters in a group of Norwegian female bank employees

This study concerned the immunological correlates of stress and work. Self reported stress, emotional state, ego-strength, and defensiveness were examined in relation to measures of cellular immunity (T-cell response to Con A and number of T4 and T8 cells) and humoral immunity (concentrations of immunoglobulins and complement components in plasma) in a group of 96 Norwegian female bank employees. The analyses showed that workload, the stress factor with the highest group mean, was associated with number of T-cells, while strain due to body posture during work was related to concentrations of IgM and C3. Further, depression was significantly correlated with IgM concentration and T-cell number, and anxiety with C3 concentration. T-cell activity was the immunological parameter most consistently associated with psychological well-being, showing positive correlations with defensiveness and ego-strength and negative correlations with anxiety and depression. In conclusion, T-cell number and concentrations of IgM and C3 were sensitive to both work-related stress experience and emotional distress. Coping abilities, indicated by the MMPI Ego-strength scale and emotional distress, were reflected in T-cell activity; insufficient coping was associated with low T-cell activity.     

The relationship between perceived employability and subsequent health

Abstract

Being capable of getting new employment may enable an employee to cope with turbulent situations or deteriorating job conditions. Individuals who have higher perceived employability are likely to appraise a situation at work more favourably, and consequently experience better health and well-being. The aim of the present study was to investigate the relationship between perceived employability and subsequent health, while controlling for baseline health, background factors, and work environment exposures. The study is based on 53 items in the National Working Life Cohort in Sweden from two data collections (2004 and 2005), comprising 1918 individuals. Forced entry hierarchical regression analysis showed that, after controlling for demographics, psychological demands, control, and ergonomic exposures, perceived employability was positively associated with global health and mental well-being, but unrelated to physical complaints. When baseline health status was added, perceived employability was still a significant predictor of two out of three outcome variables. Individuals with higher perceived employability had a tendency to report better health and well-being a year later. It is concluded that how an employee perceives his or her possibilities in regard to acquiring new employment is relevant for well-being at a later stage. Perceived employability, which has been little studied before, is therefore a useful concept in health promotion, both at the individual and at the organizational level.     

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.     

Health habits,type A behaviour and job burnout

Abstract

This study examined the effects of health habits and type A behaviour on psychological health outcomes in the face of daily life stress. Measures of the experience of life stress, health habits, type A behaviour, job burnout and psychological distress were collected for 146 employees at the UCLA Medical Centre. Analyses of covariance revealed that health habits contributed significant main effects to psychological distress but not job burnout. Type A behaviour, but not life stress or health habits, directly affected both job burnout and psychological distress. The implications of the research for employee health programmes are discussed.     

The mediating role of frustration of psychological needs in the relationship between job insecurity and work-related well-being

Abstract

This study aims to test a new process underlying the negative relationship between job insecurity and work-related well-being. Specifically, based on Self-Determination Theory, frustration of the psychological needs for autonomy, belongingness and competence was expected to explain the associations between job insecurity and emotional exhaustion and vigour (i.e. the core energy-related components of burnout and work engagement, respectively). Structural equation modelling using data from a heterogeneous sample of 3185 Flemish employees confirmed that frustration of the three needs mediated the association between job insecurity and both outcomes. These results suggest that job insecurity is related to impaired work-related well-being, because it frustrates employees’ psychological needs. This study contributes to a rather small, but growing body of research on the theoretical explanations of the negative consequences of job insecurity for employees’ work-related well-being.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

The impact of learning opportunities and decision authority on occupational health

In an investigation of 418 employees in the Norwegian Postal Service, employees with high learning opportunities and high decision authority were found to be better off on psychological functioning, health and organizational outcome variables than employees with low scores on these variables. Decision authority and learning opportunities had specific and independent impact on subjective health, psychological functioning, coping style and organizational outcome variables. There were, however, also interaction effects between demands, learning opportunities, and decision authority on subjective health. Learning opportunities and decision authority were operationalized with a questionnaire, supplemented with questions on the opportunities to learn skills beyond the present job situation. It is suggested that this is a particularly important dimension for coping with the present day rapid changes in working life, where the objective for many workers will be to broaden their repertoire and competence to increase their flexibility in the labour market.