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.     

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.     

The relationship between perceived employability and subsequent health

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.     

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.     

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.     

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.     

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan the 8-h shift nurses. It is suggested that this may be associated with their longer daily exposure to the stress of work. The increased number of rest days of 12-h shift nurses seems tobe insufficient to dissipate the adverse health and well-being effects that built up over their longer shifts.     

Relationships between psychological,physical, and behavioural health and work performance: A review and meta-analysis

The relationships between health and job performance problems have received increased attention in business and scientific communities. This paper attempts to synthesize theoretical and empirical work in this arena. First, the theoretical links between health and work performance are presented. This is followed by a meta-analysis of the relations between psychological, physical, and behavioural health variables and work performance criteria. Meta-analytic results from 111 independent samples obtained from a search of the literature indicate that psychological health, in the form of psychological well-being, depression, general anxiety, and life satisfaction, is a moderate-to-strong correlate of work performance. Associations between physical health, particularly somatic complaints and hypertension, and performance were weak-to-moderate. Regarding health behaviour, alcohol consumption, and smoking were weakly and sleep problems moderately associated with performance problems. Effect sizes sometimes differed across performance dimensions and data sources. The results are consistent with the notion that ill-health is associated with substantial reductions in work performance. This implies that interventions to improve health may have an impact on performance. However, as most of the research in this area has been cross-sectional, more longitudinal research is needed to test theoretical and alternative causal explanations for the relations summarized in this review.     

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.     

The relationship between employee motivation and psychological health at work: A chicken-and-egg situation?

Although employee motivation and psychological health at work have been found to be related, it remains unclear whether motivation precedes psychological health or vice versa, and to which extent different manifestations of mental health relate to different forms of motivation at work. Using the self-determination theory and the bidimensional theory of psychological health, this complete panel design study tested the directionality of the relationship between motivation at work and psychological health at work, with a dedicated focus on the specific predictive patterns observed between 4 types of motivation at work and positive and negative indicators of psychological health at work. Eight hundred and five Canadian workers completed questionnaires at 2 times, separated by a 6-month interval. Structural equation modelling analyses indicated that only identified regulation and psychological well-being at work have a fully reciprocal relationship. Only psychological well-being at work was positively associated with the 3 most self-determined types of motivation at work 6 months later, and only identified regulation predicted psychological health at work after 6 months. External regulation was unrelated to all indicators of psychological health at work over time. By integrating 2 theoretical frameworks, this study clarified the relationships between psychological health at work and motivation at work over time.     

The effects of transformational leadership on followers' perceived work characteristics and psychological well-being: A longitudinal study

Transformational leaders employ a visionary and creative style of leadership that inspires employees to broaden their interest in their work and to be innovative and creative. There is some evidence that transformational leadership style is linked to employee psychological well-being. However, it is not clear whether this is due to (1) a direct relationship between leadership behaviour and affective well-being outcomes, or (2) a relationship between leadership behaviour and well-being that is mediated by followers' perceived work characteristics. (Such characteristics include role clarity, meaningfulness, and opportunities for development.) This study aims to extend previous work by examining the validity of these two mechanisms in a longitudinal questionnaire study. The study was carried out within the elderly care sector in a Danish local governmental department. A theory-driven model of the relationships between leadership, work characteristics, and psychological well-being was tested using Structural Equation Modelling. The results indicated that followers' perceptions of their work characteristics did mediate the relationship between transformational leadership style and psychological well-being. However, there was only limited evidence of the existence of a direct path between leadership behaviour and employee well-being. These findings have implications for design, implementation, and management of efforts to improve employee well-being.     

What is a Healthy Sustainable Built Environment? Developing Evidence-Based Healthy Built Environment Indicators for Policy-Makers and Practitioners

Abstract

Healthy built environments place people and communities at the heart of urban planning, encouraging decision-making based on human health, well-being and environmental sustainability. This paper describes the development of a set of indicators to assist in this endeavour—by translating and linking the research evidence base with policy-makers and other practitioners. The paper describes how the indicators were chosen, contextualized and subsequently structured to maximize useability for urban planners and health professionals working together to improve community health and neighbourhood sustainability.     

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.     

Psychosocial predictors of health status

This prospective study examined, in a sample of male and female adults, the relationship between specific psychosocial factors and health status. Measures of stress, health habits, social support, Type A behaviour, and coping style were collected for 203 professional employees in a large aerospace organization in 1988. One year later a follow-up questionnaire assessing self-reported physical illness and job burn-out was administered resulting in a final sample of 95 employees. When adjustments for age, sex, education, and initial psychological well-being were made, perceived stress, physical exercise, and an avoidant coping style significantly contributed to predictions of physical illness in multiple regression analyses. Employees who possessed less hardy appraisals of work/life and expressed greater Type A behaviour reported significantly more fatigue and exhaustion one year later. Type A individuals also reported being significantly less sensitive and caring towards others. Finally, individuals who perceived less stress and expressed more cognitive hardiness reported significantly greater work/life satisfaction. Overall, the data supported the view that psychosocial factors may be differentially associated with diverse physical and psychological health outcomes.     

Pregnancy, work and women's well-being: A review

Pregnancy is potentially a stressful period for working women for ergonomic, psychological and organizational reasons, yet the well-being of women is seldom the focus of research on working during pregnancy. This paper reviews the literature on women's experience of being pregnant at work. It concludes that, while working conditions are usually not well suited to pregnant women, the majority of women encounter only minor difficulties and regard working in a positive way. However, for a minority of women working during pregnancy adversely affects their well-being. These are likely to be women working during pregnancy adversely affects their well-being. These are likely to be women who are most at risk from work-related stress at other times. The literature suggests that working during pregnancy has still to be accepted and accommodated by employers and colleagues.     

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.     

Is there an optimum number of night shifts? Relationship between sleep, health and well-being

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Psychophysical conditions of air traffic controllers evaluated by the standard shiftwork index

Abstract

In the ambit of a large epidemiological survey on the Italian population of air traffic controllers, an evaluation of their health conditions was carried out using the Standard Shiftwork Index (SSI). The study took into consideration 572 male air traffic controllers, aged between 23 and 59 years, of whom 301 were engaged in three large Regional Centres, 189 in thirteen Airport Towers and 82. formerly active controllers, were working in administrative offices. The former controllers showed worse health levels, in particular minor psychological disorders and chronic fatigue. Sixteen of them had been transferred to administrative jobs because of health impairment, owing to severe diseases of the nervous, gastrointestinal and cardiovascular systems. Such disorders, and musculoskeletal ones, were mostly reported by the active controllers. The controllers engaged in Regional Centres showed more sleep disturbances than those engaged in towers. Beside age, some personal characteristics appeared to influence health and well-being. Neuroticism was correlated with chronic fatigue, digestive and cardiovascular complaints, minor psychological disorders, cognitive and somatic anxiety. On the other hand, morningness was correlated negatively with sleep disturbances on morning shift, and positively with sleep duration both on morning shift and rest days.     

Comparing three alternative types of employment with permanent full-time work: How do employment contract and perceived job conditions relate to health complaints?

Previous research has found that alternative employment arrangements are associated with both impaired and improved well-being. Since such inconsistencies are likely to derive from the type of employment contract as well as the characteristics of the job, this paper compares permanent full-time work with forms of alternative employment (permanent part-time, fixed-term and on-call work) in order to investigate how different employment contracts and perceptions of job conditions relate to individual well-being. This study contributes to the literature by addressing several questions. Different forms of alternative employment are distinguished and individual background characteristics that might be intertwined with the employment contract are controlled for. Moreover, the scope of this study extends to the effects of perceived job conditions, and possible interactive effects with type of employment are tested. Analyses of questionnaire data from 954 Swedish healthcare workers show that perceptions of the job (job insecurity, job control and demands), but not the type of employment contract, predicted health complaints. However, type of employment interacted with perceptions of job insecurity, in that insecurity was associated with impaired well-being among permanent full-time workers, while no relationship was found for on-call or core part-time employees. Despite the absence of interactions between employment contract and job demands or job control, it can be concluded that knowledge about the relationship between alternative employment arrangements and the well-being of workers can be enhanced when the combined effects of employment contract and job conditions are studied.