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.     

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.     

Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health

ABSTRACT

The aim of the study was to identify trajectories of effort-reward imbalance (ERI), to examine these with respect to demographic (age, gender, socio-economic position) and work-related (employment contract, work hours, shift work, sector) factors, and to investigate associations with different health indicators (self-rated health, depressive symptoms, migraine, sickness absence). The study used four waves of data (N?=?6702), collected biennially within the Swedish Longitudinal Occupational Survey of Health (SLOSH). Using latent class growth modelling, we identified four trajectories: a stable low imbalance trajectory, which comprised 90% of all participants, and three change trajectories including a decreasing trajectory (4% of the participants), an inverted U-shaped trajectory and an increasing imbalance trajectory, both in 3% of the participants. Results indicate that a sizeable proportion of Swedish employees’ experience imbalance between efforts and rewards at work. The most favourable trajectory comprised relatively more men and was characterised by better work-related characteristics than the less favourable ERI trajectories. All change trajectories were dominated by women and employees in the public sector. Health developments followed ERI trajectories, such that less favourable trajectories associated with impaired health and more favourable trajectories associated with better health. Sickness absence increased among all ERI trajectories, most so for the decreasing and increasing ERI trajectory.     

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.     

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.     

Work satisfaction,health, and stress: A study of Dutch nurses

Abstract

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Signs of struggle (SOS): The development and validation of a behavioural mental health checklist for the workplace

ABSTRACT

For managers to successfully support employee access to mental health resources, they must first be able to recognise if and when an employee may need help. To manage employees effectively, managers must be able to recognise changes in employees’ work behaviour that may indicate when an employee is struggling at work. In study 1, we develop and establish the structure of the 20-item Signs of Struggle (SOS) checklist as comprising five factors that describe the warning signs of health impairment at work (i.e. distress, withdrawal, reduced attendance, degradations in performance, extreme behaviours). In study 2, we show that manager-rated signs of struggle correlated substantially (r?=?.72) with participant-reported strain. The SOS tool provides managers a way to recognise when employees may be struggling and could benefit from workplace resources. We recommend that for maximal benefit, managers also receive training on how to use the SOS, and also on how to approach and assist employees who are displaying warning signs.     

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.     

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.     

The role of stress and social support in Sick Building Syndrome

Sick Building Syndrome (SBS) involves seemingly healthy individuals experiencing long-lasting symptoms of physical distress in their work settings and is estimated to exist in 20 to 30% of all work settings in the USA. We examined differences in stress, social support and both physical and psychological symptoms reported by hospital personnel working in known SBS sites in Halifax, Nova Scotia (n = 297) with control employees working in relatively SBS-free settings (n = 228). We found that employees reporting that their health had been affected by the building in which they worked and those complaining of poor air quality were more likely to be found in SBS locations. In addition, those people with higher levels of organizational support and marginally higher levels of union support were also more likely to be found in SBS locations. Further analyses revealed that employees with higher role overload and greater family support, but lower levels of organizational support were more likely to report that their own health had been adversely affected by their place of work. Perceptions of poor air quality were predicted by higher levels of role conflict, role overload, and organizational stress and lower levels of organizational support. These results suggest that SBS may not be solely dependent on environmental factors.     

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.     

Implementing workforce development in health care: A conceptual framework to guide and evaluate health service reform

Abstract

The term ‘workforce development’ is increasingly popular in the health-care field. It appears to encompass a range of human and organizational development activity. However, there has been limited explication of the concept of workforce development in Australian health care at area health service levels. It is timely to develop a framework for workforce development and processes to guide any evaluation of the implementation of workforce development strategies. This paper presents a framework that has been developed through consultative processes in an area health service and an associated review of literature.     

Evaluation of an intervention programme based on empowerment for eldercare nursing staff

Abstract

This study evaluated the impact of an intervention programme at individual, worksite, and organizational level, for eldercare nursing staff at 12 eldercare units. The project aimed at empowering auxiliary nurses and nursing assistants, thus promoting good working conditions, health and well-being of eldercare staff, and improving their evaluation of the quality of nursing care. Questionnaire responses from the nursing staff (n=200) before and after an 18-month intervention programme evaluated the effects using ANOVA, repeated measures for the statistical analyses. Although the improvements were limited, the intervention seemed to impact on work conditions and on the perceived quality of nursing rather than on the health and well-being of staff. Work at nursing homes or at home-care was shown to modify the outcome due to different needs and priorities for work unit improvements. Staff turnover and multiple reorganizations are discussed as inhibiting factors for performance as well as for the evaluation of workplace interventions. The sharing of power between occupational groups or organizational levels must be carefully considered. The study emphasizes the importance of involving the middle management in early project planning and decisions.     

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.     

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.     

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.     

Work satisfaction, health, and stress: A study of Dutch nurses

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

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.     

Physical exercise,employee fitness and the management of health at work

Abstract

This paper presents some recent data on why organizations invest in exercise and physical fitness programmes for their stiff. These data suggest that, owing to a lack of evaluation studies, organizations act mainly on the basis of assumption and belief. However, from a subsequent review of the available literature on the personal and organizational effects of such programmes, it appears that these assumptions and beliefs are not altogether unfounded. The paper concludes by discussing the ways in which exercise and employee fitness programmes might help die individual and their organization in terms of the management of health at work.     

Personality and organizational health: the role of conscientiousness

Organizational health research identifies processes through which the work environment and individual differences combine to influence both individual and organizational outcomes. This study investigated the contribution of conscientiousness to organizational health. Research in the areas of occupational stress, work performance, and organizational climate was used to develop a framework for integrating different elements of organizational health. Within this framework, the work environment was assessed by perceptions of workload and role clarity ; individual well-being was assessed by psychological distress and job satisfaction ; and behaviour important for organizational success was assessed by contextual performance. Conscientiousness was investigated within the framework using self-reports from a sample of 104 Australian employees. Conscientiousness directly influenced contextual performance but did not influence well-being or perceptions of the work environment. Conscientiousness also reduced the impact of role clarity on both psychological distress and job satisfaction. The role of conscientiousness in a comprehensive model of organizational health is discussed.