The health of health care organizations

Abstract

This paper explores the nature and development of health care organizations in terms of a model of organizational healthiness. The model places particular emphasis on the psychosocial subsystems which describe the subjective organization. These represent the perceived internal functioning of the organization in terms of task completion, problem solving and staff development. The implications of such a model for the well-being of health care staff and for the evaluation of service delivery are discussed.     

Work & stress: Information

The aim of this study was to investigate whether psychosocial factors at work are related to low-back pain among nursing personnel. It was conducted as a short-term follow-up study of 200 Danish female nursing personnel, providing care for the elderly. Self-reported measures of psychosocial factors such as time pressure, emotional demands of clients, control and social support were obtained by questionnaire at baseline, while stress, physical exertion and low-back pain were reported by diary records made in two, three-day periods in the subsequent 6 months. The study examines the possible influence of psychosocial factors preceding low-back pain as well as stress and physical exertion reported simultaneously with low-back pain. Only stress was associated with low-back pain (Odds Ratio (OR)=2.3; Confidence Interval (CI)=1.3-3.9) while neither physical exertion or any of the psychosocial factors were related to low-back pain. A possible pathway connecting emotional demands of clients to low-back pain through the mediation of stress was suggested.     

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.     

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.     

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.     

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.     

Mediating role of mentoring functions on linking personality and occupational commitment in Indian organizations

ABSTRACT

This study investigated the mediating effect of mentoring on the relationship between the Five Factor Model (FFM) Personality traits and occupational commitment (OC). The study used cross-sectional survey-based research design. Data were collected from 362 managers of public and private sector organizations located in North India. The results indicated that psychosocial mentoring acts as a partial mediator for facilitating the linkage between all the FFM traits and OC. Contrary to this, career mentoring was found to partially mediate the link between only conscientiousness-OC, agreeableness-OC and emotional stability-OC. No mediating effect of career mentoring was found for personality factors of openness and extraversion. HRD practitioners are encouraged to implement train-for-trainers’ sessions for raising awareness among senior managers/mentors about the importance of psychosocial mentoring functions. This study is unique, because it is among the few to appropriately capture the mediating role of mentoring functions vis a vis the personality and OC relationship. Further, it also enriches the existing body of research on workplace mentoring and careers, especially in the South-Asian context.     

Does change process healthiness reduce the negative effects of organizational change on the psychosocial work environment?

Abstract

This study aimed to investigate whether the detrimental effects of organizational change on the psychosocial work environment are reduced by the “healthiness” of change processes. This includes the management's awareness that the change may be experienced differently by various individuals and groups (diversity); availability of the manager during the process; the degree to which conflicts are resolved constructively; and the degree to which the new roles to be taken on are clarified. Two studies are presented. Using a randomized sample of the Norwegian working population (N = 2389), the first study showed that there were both direct and indirect positive relationships between organizational change and stress, with job demands (but not control and support) as a mediator. In the second study a healthy change process index (HCPI) was developed from dimensions of healthy change that had emerged in an earlier qualitative study. Using data from seven Norwegian enterprises undergoing change (N = 561), this study showed that the healthiness of the change process was related negatively to stress and positively to Control and Support, but not to Demands. Overall, these findings support the idea that a healthy process may not reduce the additional demands produced by organizational change. However, a healthy process may still be able to reduce the experience of stress and facilitate coping with stress and associated increased demands through enhancing the psychosocial work environment.     

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 factors and safety behaviour as predictors of accidental work injuries in farming

Abstract

Farming is one of the most hazardous occupations in terms of the incidence and seriousness of accidental injuries. Research with other occupational groups has drawn attention to the role of psychosocial factors and stress. Such research needs to be extended to agriculture. Since stress may be a problem faced by farmers, there is a particular need to investigate the associations between farm accidents and work stressors and stress reactions. Using multivariate logistic regression analyses, this study aimed to uncover the best psychosocial predictors of injury, while controlling for exposure-related confounders. From a randomly selected sample of 794 farms, 10% of all farms in Ringkoebing County, Denmark, 393 farmers completed completed weekly accident registration over 12 months. The study sample consisted of 310 farmers who also completed questionnaires on psychosocial factors. Results indicated that farm stressors (including perceived economic problems), stress symptoms, and safety behaviour were predictors of occupational farm accidents. Higher levels of stressors and stress symptoms and poor safety behaviour were all associated with an elevated risk of injury. In the case of stress symptoms, the relation with accidents occurred via an interaction with safety behaviour. The combination of high levels of stress symptoms and poor safety behaviour was associated with a particularly high accident risk.     

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.     

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.     

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.     

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.     

The shortest path improvement problems under Hamming distance

In this paper, we consider the shortest path improvement problems under Hamming distance (SPIH), where the weights of edges can be modified only within given intervals. Two models are considered: the general SPIH problem and the SPIH problem with a single pair of required vertices. For the first problem, we show that it is strongly NP-hard. For the second problem, we show that even if the network is a chain network, it is still NP-hard.This paper is dedicated to Dr. Yong He.     

Job characteristics as predictors of ill-health and sickness absenteeism in different occupational types--a multigroup structural equation modelling approach

The objective of the present study was to test for multigroup invariance in measurement models and structural models between job characteristics, psychosocial intervening variables, health outcomes and sickness absenteeism. Four types of occupation were represented in the study: blue-collar workers ( n = 241), white-collar workers ( n = 209), elderly-care workers ( n = 338) and child-care workers ( n = 336). A first-order, six-factor multigroup confirmatory factor analysis model (i.e. measurement model) composed of two perceived job characteristics ( job autonomy and skill discretion), appraised workload, job satisfaction, stress-related ill-health and sickness absenteeism provided a good model fit. Invariance tests showed that the six-factor model fits well for all occupations. A partially recursive mediated multigroup structural model showed both similarities and differences across occupations as regards the relationships between independent latent variables ( job autonomy, skill discretion), intervening latent variables (appraised workload, job satisfaction) and dependent latent variables (stressrelated ill-health, sickness absenteeism). By comparing a generic model with occupation-specific models across occupations, this study showed that occupation-specific models were more plausible. The results indicate that it is important to examine different occupational contexts in detail to better understand how certain psychosocial factors at work influence strain in different occupations. Since job characteristics can potentially be amended, the findings have important implications for the differentiation of prevention and intervention in different occupations.     

Regulations,policies and practices concerning work stress in five European countries

Abstract

A comparative inventory of regulations, policies and practices in The Netherlands, Sweden, UK, Germany and France with regard to the prevention of work stress was carried out. In each country data were collected by means of interviews with key informants and through exploring relevant documents and literature. It was found that Sweden, The Netherlands and the UK—those countries with framework legislation in the field of health and safety—recognize stress as an important health and safety topic, whereas Germany and France do not yet recognize stress as an important policy issue. However, even in the first group of countries less attention is being paid towards psychosocial work characteristics when compared with traditional health and safety issues, such as noise, machine safety and toxic agents. There is a clear lack of well-documented (national) ‘examples of good preventive practice’, even in Sweden and The Netherlands. Recommendations are being formulated concerning type of legislation, guidance and information, monitoring and risk assessment, costs and benefits, examples of good practice and European networking.     

Work-related psychosocial,physical and individual factors associated with musculoskeletal symptoms in computer users

The aim of this study was to study associations between psychosocial, physical and individual factors, and musculoskeletal symptoms in the neck, shoulder and hand/wrist regions of computer users. Questionnaires were distributed to 5033 employees in 11 Danish companies; these employees all used computers for at least some of their work time. The response rate was 69% ( n = 3475). The analyses were based on employees working 32-41 h/week ( n = 2579). Symptomatic respondents reported symptoms for at least 8 days within the previous year. Multiple logistic regression analyses were used. Gender (female), age and duration of employment in the same job were associated with an increased prevalence of symptoms. High quantitative job demands and low possibilities for development at work were predictors of neck and hand/wrist symptoms. A high degree of repetitiveness and disturbing reflections on the computer screen were associated with symptoms in all three body regions. Repetitive movements were defined as the same finger, hand or arm movements performed many times per minute for at least 75% of their work time. Repetitiveness was the only factor that could partly explain associations between symptoms and duration of computer use, i.e. respondents who used the computer almost all the time at work reported more repetitive movements than those who used it less. Thus, long hours of computer use may be associated with musculoskeletal symptoms, due to physical factors such as repetitive movements, whereas psychosocial factors appeared to be associated with the symptoms independently of the duration of computer use.     

Stress,health and the working environment of Swedish prison staff

Abstract

A random stratified sample of just over 2000 was drawn from staff working in 67 different prisons in Sweden. Questionnaires on working conditions and symptoms of ill health were administered and subjects were given health examinations. Morning plasma Cortisol and gamma glutamyltransferase (g GT) levels were measured and factual information on the prisons was collected for use in the analyses.

There were differences between prisons in terms of both objective and self-reported working conditions which appeared to affect health status, physiological state and sick leave rate. Cardiovascular and hypertensive conditions were found more often among prison staff than among a large reference group made up of many different occupations. Sick leave rates among prison staff, especially those over 45 years old, were very high compared with this reference group. The situation appeared particularly difficult in prisons with a high proportion of drug abusing inmates.

The data allowed the identification of several factors which might counteract the effects of stress at work: a proactive management style, goal consensus among staff, a high degree of decision latitude, satisfaction with work performance and a supportive psychosocial climate.     

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.