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.     

Barriers to completion of advance care directives among African Americans ages 25-84: a cross-generational study

Prior studies conducted in the area of Advance Care Directive document completion in African Americans have primarily targeted the elderly who are either institutionalized in skilled nursing facilities or are members of faith communities. Few studies have been done concerning barriers to Advance Care Directive document completion that include non-elderly African Americans. The purpose of this study was to identify the common barriers to advance care directive document completion across generations of African Americans ages 25-84. Using convenience sampling among various Baptist denominations of the African-American faith community of Buncombe County, North Carolina, 40 individuals ranging in age from 25-84 participated in multiple focus group sessions. Findings revealed participants shared three common barriers: 1) surrogate decision-making, 2) lack of education concerning advance care directive discussions and completion, and 3) fear and denial. Also revealed were barriers that varied across generations: 1) fatalism, 2) mistrust of the health care system, 3) spirituality, and 4) economics.     

The long-run effect of part-time work

Unlike most of the literature concerning the effects of nonstandard work, we examine the long-term impact of part-time work. Our main focus is on earnings and several important benefits. As might be expected, voluntary part-time work while in school increases earnings of both women and men, whereas involuntary part-time work has no significant impact. Surprisingly, however, voluntary part-time work while not in school has a substantial positive effect for women but is not significant for men. Furthermore, we find that the provision of health insurance, profit-sharing, defined-benefit and defined-contribution plans is primarily determined by factors other than work experience.     

Disability as a Phenomenon: a discourse of social and biological understanding

This paper addresses conceptualisations of disability and what it constitutes as a category in a social security system. It argues that the conceptualisation of disability involves a discourse about definitions. This means it is an ongoing debate about principles or which determinators to use presenting the 'correct' understanding of disability as a phenomenon. The disability discourse involves a contest between a biological and social understanding of disability. This paper discusses which domains of interest are produced by each of these understandings. They are based on empirical findings when analysing rights of entitlement to a disability programme in the Swedish social security system. The study followed documentation of the public debates for a period of 25 years and extracted what was communicated as constituting disability in these debates. Which definition to give disability by this social security programme appeared as being a continuous contest between medical and social understanding. The paper argues that, rather than approaching the biological understanding as representing an antiquated concept to disability and the social model as a modern conceptualisation, these understandings are competitive. This makes disability into a flexible and heterogeneous concept, a term difficult to give a specified and limited meaning.     

Domestic violence and child abuse: developing sensitive policies and guidance

Domestic violence is everywhere and nowhere. No statutory organization or health service has work with either perpetrators or survivors of domestic violence (usually women and children) as the primary focus of their service, yet all agencies will have very significant numbers among their clients/service users. It is therefore crucial that the policy framework is developed both within and between agencies to address the need, and scope, of intervention in this area and particularly the impact on children. Currently, significant steps have been taken by some agencies in the UK to address this previously neglected issue, though the developments are patchy. This paper draws on a UK‐wide research study which mapped the extent and range of service provision for families where there is domestic violence and also developed a framework of good practice indicators for provision in this area. This article examines one of the indicators of good practice arising from the research—that of policy development—within social service departments and within the multi‐agency arena. Copyright © 2001 John Wiley & Sons, Ltd.     

Quantitative assessment of response shift in QOL research

Two assumptions which characterize the measurements of quality life (QOL) studies, are questioned by the present report: First, the assumption that QOL is the same thing for all subjects, is usually related to health problems and can easily be measured across subjects. Second, when this assumption is given up by introducing subjective base-rates in an intra-subject (before-after) design, researchers still tend to assume that no response shifts occur on the QOL scales, e.g., that these scales maintain the same meaning and values for subjects over time and interventions. In our study we found that QOL had different subjective interpretations [1--4]. While for some certain issues in their family-life determined their quality of life, for others these were issues at their workplace or of their health conditions. Second, when QOL was tested against a subjective base-line (for each individual according to their choices of domains), about eleven percent of the hypertensives and normotensives showed a clear response shift of scale-calibration over the period of one year. When the scores of these subjects were excluded, the significance of certain previously reported results changed. For example, the significant difference between normotensives and hypertensives concerning the change in their subjective evaluation of QOL over the year and their initial depression became more significant, while similar changes in their evaluation of sexual impairment and control at their work-place became insignificant. These results suggest that response shifts have to be traced and quantified, before one can claim any results (or lack of results) in 'before-after' designs, concerning subjective meaningful issues like quality of life.     

Dual/duel identities: Jordanian perceptions of academic equity

This study aimed to address how the sociopolitical climate in Jordan facilitates, perpetuates, and/or alleviates negative or positive views of Palestinians from the perspective of Jordanian university graduates. The qualitative study looked specifically at how education and the ‘hidden curriculum’ addresses coexistence.