Demanding work schedules and mental health in nursing assistants working in nursing homes

Nursing home assistants have physically and emotionally challenging jobs, and they often work demanding schedules in order to provide 24-h care. While the physical effects of demanding work schedules have been studied, little is known about the impact on mental health. This study explored the relationship between demanding scheduling variables and mental health indicators of depression, anxiety and somatization. A cross-section of 473 US female nursing assistants working in nursing homes was surveyed. Work schedule characteristics included shiftwork, hours per day and week, days per week, number of weekends per month, number of double shifts per month, breaks, and number of jobs worked. Working two or more double-shifts per month was associated with increased risk for all mental health indicators, and working 6–7 days per week was associated with depression and somatization. There was a trend for increasing odds of adverse mental health with increased numbers of demanding work schedule factors. The odds of depression was increased four-fold when working 50+ h/week, more than two weekends/month and more than two double shifts/month. Providing work schedules that are less unhealthy may have implications for both worker retention and the quality of care delivered to nursing home residents.     

The associations between work stress and mental health: A comparison of organizationally employed and self-employed workers

This study examined the associations between work stressors and mental health in organizationally employed and self-employed workers, and with the numbers of general practitioner (GP) services used by these two employment groups. The participants were selected from those already taking part in the PATH Through Life Project, in Australia. A total of 2275 men and women aged from 40 to 44 years participated in a community survey and were in the labour force at the time of the interview. Those who participated entered responses into a hand-held computer under the supervision of an interviewer. A total of 14.2% of the group identified themselves as self-employed. Respondents also provided details of their occupation and the extent to which they experienced work stressors. Some 72.6% of these participants gave consent for information on their use of GP services over a 12-month period to be obtained from national insurance records. We found that self-employed men and women reported more decision authority than the organizationally employed, while self-employed women also had more manageable job demands. Self-employment offered men no health benefit. However, women who were self-employed reported worse physical health than their organizationally employed counterparts. While work stress factors were most likely to be associated with the use of GP services by self-employed men, the use of those services by women was more strongly associated with their experiences of stress in organizational employment. Overall, self-employment was found to be associated with relatively few mental health benefits.     

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 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.     

A conceptual framework for the study of work and mental health

Abstract

The key features which influence mental health both in jobs and unemployment are brought together within a single perspective. Three principal axes of affective well-being are identified as warranting investigation, and it is suggested that nine environmental features are of primary importance. The impact of these features on mental health is viewed as analogous to the influence of vitamins on physical health, with an explicit non-linearity in the relationship. This ‘vitamin model’ is extended to permit examination of individual differences (for example, in terms of baseline values and specific matching characteristics), and empirical evidence is summarized. It is concluded from previous research that job features do not interact synergistically in relation to employee well-being, although this possibility may not yet have been adequately tested. The framework is suggested to be adequately comprehensive, but, as is the case with other models, it requires development in respect of the specific mechanisms operating between environmental features and mental health.     

A conceptual framework for the study of work and mental health

The key features which influence mental health both in jobs and unemployment are brought together within a single perspective. Three principal axes of affective well-being are identified as warranting investigation, and it is suggested that nine environmental features are of primary importance. The impact of these features on mental health is viewed as analogous to the influence of vitamins on physical health, with an explicit non-linearity in the relationship. This 'vitamin model' is extended to permit examination of individual differences (for example, in terms of baseline values and specific matching characteristics), and empirical evidence is summarized. It is concluded from previous research that job features do not interact synergistically in relation to employee well-being, although this possibility may not yet have been adequately tested. The framework is suggested to be adequately comprehensive, but, as is the case with other models, it requires development in respect of the specific mechanisms operating between environmental features and mental health.     

Job stress, satisfaction and mental health of factory workers in Bangladesh

The present study examined the relationship between job stress, job satisfaction and mental health, and attempted to assess the effects of job stress on different parameters of satisfaction and mental health in the context of two groups of Bangladeshi factory workers. There were 26 subjects in a 'high stress' group and 33 in a 'low stress' group. Individual data were collected by using the Stress and Arousal Checklist, the Job Satisfaction Scale, the General Health Questionnaire, absenteeism by sick leave, a self-esteem at work scale and heart rate monitor. Chi-square and t-tests were applied in the analyses of these data by group. The results, quite expectedly, showed that a greater number of high stress subjects were dissatisfied and had poorer mental health than low stress subjects. The results also showed that low stress subjects were significantly more satisfied and possessed better mental health than the high stress subjects. It would appear that the experience of stress plays an important role in determining the quality of working life of Bangladeshi factory workers having similar consequences in terms of health and well-being to those observed in developed countries. The dynamics of absenteeism in Bangladesh are discussed.     

Assisting employees with drinking problems: Changes in mental health, job perceptions and work performance

A sample of 104 British transportation employees with alcohol-related problems were examined for changes in mental health and job perceptions before and after a company-based counselling programme. Data was mainly obtained by means of structured interviews. When clients were assessed at a 6-month follow-up, significant positive changes were found for the group as a whole in terms of context-free mental health, self- and supervisor ratings of work performance as well as measures of absenteeism. Small positive differences were observed for measures relating to perceived work demands. However, no significant differences were observed for the measures of job satisfaction and job commitment. The findings are discussed in relation to the expected client and organizational outcomes of workplace counselling interventions.     

Burnout and work organization in hospital wards: A cross-validation study

The relationship between nurses' work organization in hospital wards and the level of burnout experienced by them was analysed in two independent and highly comparable samples of nurses. The hypothesis that the greater the number of nurses who are responsible for, or are having contact with, one patient during one work shift, the higher their experienced level of burnout will be, was partially confirmed in one of the two samples. We have attributed the contradictory results to differences in the management of nurses' work organization, and warned against fashionable ideas concerning the ideal type of nurses' work organization in hospital wards.     

Moderating effects of social support in shiftworking and non-shiftworking nurses

The effects of social support on the job stress (role ambiguity)-strain (job dissatisfaction, intent-to-turnover, health problems) relationship were investigated in shiftworking (second and third shifts) and non-shiftworking (first shift) groups of nurses (N = 191). Previous research indicates that shiftworkers frequently report problems of social integration as a negative aspect of their jobs. Additionally, shiftworkers demonstrate a number of stress-related illnesses. Social support has been hypothesized to show its strongest stress-buffering (i.e. moderating) effects in high stress environments. In other words, persons with higher levels of social support are less likely to be negatively affected by high stress environments. It was hypothesized that individuals working on shiftwork would demonstrate stronger moderating effects of social support on the job stress-strain relationship than non-shiftworkers because of the stressful nature of shiftwork and the importance of social integration difficulties to shiftworkers. The dependent measures used in the analyses were global job satisfaction, intent-to-quit, and perceived health problems. Main and moderating effects of social support were found for several of the analyses. For shiftworkers, this buffering effect was significantly greater for supervisor social support on global job satisfaction and intent-to-quit. Implications of the findings are discussed.     

Caring for profit: Alienation and work stress in nursing assistants in Canada

Personal care work in proprietary nursing homes was contrasted with similar work in non-profit long-term care facilities. One quarter of Manitoba long-stay beds are operated by proprietary (profit-making) institutions. In both types of home, the nursing assistants were younger women with children; essential wage earners for their families. Wages were low, but nursing assistants said they worked because they liked taking care of elderly people. Nursing home residents have cognitive and mobility impairments and need help with activities of daily living. The proportion of cognitively-impaired residents is higher in profit-making homes, and probably contributed to job pressure and workload, which were taken as markers of potential alienation experienced by these workers.     

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.     

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 distinction between work pace and working hours in the measurement of quantitative demands at work

During recent years many researchers have criticized the widely used scales on psychological job demands. For instance, they comment that in most cases different types of demand seem to be mixed in one measure. In this paper we analyse the scale on quantitative job demands in the recently developed Copenhagen Psychosocial Questionnaire (COPSOQ), with special emphasis on Differential Item Functioning (DIF). DIF refers to basic differences between groups of respondents, which may affect how they respond to questionnaire items. The data material for our study comprised a representative sample of Danish employees. The respondents were categorized into 32 specific jobs according to the International Standard Classification of Occupations (ISCO 1968). We analysed DIF with respect to the respondents' jobs with logistic regression analyses. These analyses showed that the items used in the original demand scale functioned very differently for different jobs in the population. The conclusion is that scales on quantitative demands are very sensitive to the choice of specific items. If many items on fast work pace and tempo are included in a scale, a number of blue-collar jobs will be identified as high-demand jobs. If, on the other hand, many questions on long working hours and overtime are included, the use of the scale will result in an entirely different picture. This issue has so far received little attention in occupational health psychology. The results have wide theoretical and methodological implications for research on quantitative job demands.     

The distinction between work pace and working hours in the measurement of quantitative demands at work

During recent years many researchers have criticized the widely used scales on psychological job demands. For instance, they comment that in most cases different types of demand seem to be mixed in one measure. In this paper we analyse the scale on quantitative job demands in the recently developed Copenhagen Psychosocial Questionnaire (COPSOQ), with special emphasis on Differential Item Functioning (DIF). DIF refers to basic differences between groups of respondents, which may affect how they respond to questionnaire items. The data material for our study comprised a representative sample of Danish employees. The respondents were categorized into 32 specific jobs according to the International Standard Classification of Occupations (ISCO 1968). We analysed DIF with respect to the respondents’ jobs with logistic regression analyses. These analyses showed that the items used in the original demand scale functioned very differently for different jobs in the population. The conclusion is that scales on quantitative demands are very sensitive to the choice of specific items. If many items on fast work pace and tempo are included in a scale, a number of blue-collar jobs will be identified as high-demand jobs. If, on the other hand, many questions on long working hours and overtime are included, the use of the scale will result in an entirely different picture. This issue has so far received little attention in occupational health psychology. The results have wide theoretical and methodological implications for research on quantitative job demands.     

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.     

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.     

The four-dimensional symptom questionnaire (4DSQ): measuring distress and other mental health problems in a working population

In non-clinical (working) populations it is important to differentiate between general distress, on the one hand, and psychiatric symptoms—depression, anxiety and somatization—on the other hand. The Four-Dimensional Symptom Questionnaire (4DSQ) is a new instrument that measures these four symptom dimensions (Terluin, ). This study aimed to investigate the psychometric properties of the 4DSQ in a working population. A postal stress and health survey was sent to all employees of a Dutch telecom company, 51% of whom responded (N=3852). The mailing included the 4DSQ, a set of questionnaires concerning job stress (e.g. psychological demands), coping style (e.g. problem-focused coping, avoidant coping), and indicators of strain (e.g. emotional exhaustion, fatigue). Cronbach's α for the four sub-scales of the 4DSQ ranged from .79 to .90. Factor analysis showed four factors corresponding to the four scales of the 4DSQ: distress, depression, anxiety, and somatization. The validity of the 4DSQ was assessed using (partial) correlations with job stress, coping, and strain. As expected, the distress scale showed the strongest correlations with the indicators of strain, as well as with job stress and coping. In conclusion, the 4DSQ is a reliable and valid instrument that can be used in a working population to distinguish between stress-related symptoms and psychiatric illness.     

Psychosocial stressors at work, psychological stress and musculoskeletal symptoms in the care for the elderly

This study was conducted in order to determine how occupational stressors (psychosocial stressors and physical load) are related to psychological stress (symptoms) and musculoskeletal symptoms among staff of Finnish residential homes, nursing homes and home help services (n = 204). Data obtained from questionnaires was used to test two hypotheses: that psychosocial stressors (time pressure, troublesome patients with dementia) are associated with psychological stress, and that musculoskeletal disorders are associated with physical load. The authors also tested whether psychological stress has a mediating effect between psychosocial stressors and musculoskeletal symptoms. The findings supported the hypothesis regarding the mediating effect of psychological stress.     

Work, employment and mental health in Europe

In May 2004 the World Health Organization (WHO European Region) called a consultation meeting of its Collaborating Centres in Occupational Health to discuss mental health in the workplace. The meeting took place in Copenhagen. This paper presents an interpretation of the discussion that took place and the thinking that developed as a result. It was argued that increased interest and research and improved practice in the area of occupational mental health are required to promote good mental health in the European population. A framework of risk management and prevention based on sound evidence and good understanding could provide the basis for the translation of existing research knowledge into effective practice.