Dataset Information

Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study.

ABSTRACT:

Background

Adverse psychosocial working conditions-in particular poor job decision latitude and poor social support at work-may impair the effective implementation of asthma self-management behaviour at work and may be associated with increased asthma morbidity. In this study, we investigate for the first time the association of job decision latitude and social support at work with (1) four asthma-specific self-management behaviours at work (i.e., physical activity, trigger avoidance, acute symptom management, and communication) and with (2) asthma morbidity.

Methods

A total of 221 employees with asthma recruited through three rehabilitation clinics completed questionnaires (response rate?=?29.3%). Job decision latitude and social support were measured using items from the Copenhagen Psychosocial Questionnaire. The four asthma self-management behaviours were mainly assessed by self-developed items. We used the Asthma Control Test and the Marks Asthma Quality of Life Questionnaire to measure asthma morbidity. We dichotomized all variables and conducted logistic regression analyses to calculate odds ratios with 95% CIs.

Results

Low job decision latitude and low social support were significantly associated with poorer trigger avoidance (odds ratios???2.09) and poorer acute symptom management (odds ratios???2.29); low social support was further related to significantly less communication (odds ratio?=?2.82). Low job decision latitude and low social support were also associated with significantly poorer asthma control (odds ratios???1.95) and poorer asthma-specific quality of life (odds ratios???2.05). The relationships with asthma morbidity were attenuated after adjustment for the four asthma self-management behaviours (odds ratios ranging from 1.1 to 1.9).

Conclusions

Adverse psychosocial working conditions are associated with poorer asthma self-management behaviour at work and with increased asthma morbidity. The latter association may be mediated by asthma self-management behaviour.Trial registration German Clinical Trials Register, registration number: DRK S00011309, date of registration: 22.12.2016.

SUBMITTER: Heinrichs K

PROVIDER: S-EPMC6509772 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study.

Heinrichs Katherina K Hummel Stefan S Gholami Jalal J Schultz Konrad K Li Jian J Sheikh Aziz A Loerbroks Adrian A

Clinical and translational allergy 20190509

<h4>Background</h4>Adverse psychosocial working conditions-in particular poor job decision latitude and poor social support at work-may impair the effective implementation of asthma self-management behaviour at work and may be associated with increased asthma morbidity. In this study, we investigate for the first time the association of job decision latitude and social support at work with (1) four asthma-specific self-management behaviours at work (i.e., physical activity, trigger avoidance, ac ...[more]

PMID: 31168356

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Project description:BackgroundChronic low-grade inflammation has been suggested as a key factor in the association between stress exposure and long-term health. Care work is recognized as a profession with a high degree of job stress and health risks. However, for care professionals, the study base on inflammatory activity due to adverse working conditions is limited.ObjectiveThe aim of this study was to explore associations between self-reported psychosocial working conditions and care professionals' biomarkers of systemic low-grade inflammation.MethodsN = 140 geriatric care professionals (79.3% females, mean age = 44.1 years) of six care facilities were enrolled in a cross-sectional study consisting of standardized medical examinations and employee surveys. Standardized questionnaires were used for evaluation of psychosocial work characteristics (work overload, job autonomy, social support) based on Karasek's job strain model. Blood samples were drawn for two biomarkers of inflammatory activity: C-reactive protein (CRP) and leukocyte count. Analyses comprised uni- and multivariate logistic and linear regression analyses.ResultsWe determined a proportion of 5.4% of care professionals with increased low-grade inflammation. We further observed a relationship between job autonomy and CRP, such that reports of high job autonomy were associated with increased levels of CRP (adjusted OR = 4.10, 95% CI [1.10, 15.26], p = .035), which was robust in additional analyses on further potential confounders. No significant associations with participants' leukocyte numbers were found.ConclusionsThis exploratory study contributes to the research base on links between workplace stress and ensuing illness in care professionals. Our findings may help to identify risk and protective factors of the work environment for chronic low-grade inflammation. The results require further scrutiny, and future prospective studies on associations of psychosocial working conditions, low-grade inflammation and long-term health outcomes in care professionals are needed.

Project description:ObjectivesThe objectives of this study are twofold. First, to examine the direct effect of psychosocial work characteristics (as measured by job autonomy and work-related pressure) in relation to self-reported psychological morbidity symptoms and early retirement intentions among a sample of hospital consultants in the National Health Service (NHS). Second, to investigate burnout as mediating variable (ie, indirect effect) of these postulated associations.DesignA cross-sectional observational study.Participants593 NHS consultants (male=63.1%) from hospitals in England, Scotland and Wales.MeasuresSelf-reported online questionnaires on work-related pressure and job autonomy (Job Demands-Resources Questionnaire); emotional exhaustion and depersonalisation (Maslach Burnout Inventory); depressive and anxiety symptoms (State Trait Personality Inventory) and a single-item on early retirement intention.ResultsThis study observed high prevalence rates across all adverse health measures: emotional exhaustion (38.7%), depersonalisation (20.7%), anxiety symptoms (43.1%) and depressive symptoms (36.1%). Multiple linear regressions examined the postulated direct and indirect effects. Job autonomy had significant negative direct effects on the frequency of NHS consultants' anxiety and depressive symptoms, and their intention to retire early. Both emotional exhaustion and depersonalisation mediated the relationships that work-related pressure (full mediation) and job autonomy (partial mediation) had with self-reported symptoms of psychological morbidities. Only emotional exhaustion mediated the relationships where early retirement intention was the outcome. In terms of sociodemographic factors, age and years' experience predicted both burnout dimensions and psychological morbidity.ConclusionsThis is the first study to observe job autonomy to be associated with the number of self-reported psychological morbidity symptoms and early retirement intentions in a sample of NHS consultants. Burnout dimensions mediated these relationships, indicating that interventions need to focus on enhancing working conditions and addressing burnout among NHS consultants before more severe symptoms of psychological morbidity are reported. This study has implications for NHS policy makers and senior leadership.

Project description:BackgroundEmergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety.MethodsFor this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c).ResultsThe most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress.ConclusionsWork stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.

Project description:BackgroundGermany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict--namely work interfering with family conflict (WIF)--which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made.MethodsData were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April-July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences.ResultsGerman hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, p < .01). No significant gender difference was found. Predictors for the WIF were lower age, high quantitative demands at work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, p < .01). High values of WIF were significantly correlated to higher rates of personal burnout, behavioural and cognitive stress symptoms, and the intention to leave the job. In contrast, low levels of WIF predicted higher job satisfaction, better self-judged general health status, better work ability, and higher satisfaction with life in general. Compared to the German general population, physicians showed significantly higher levels of individual stress and quality of life as well as lower levels for well-being. This has to be judged as an alerting finding regarding the state of physicians' health.ConclusionIn our study, work interfering with family conflict (WIF) as part of Work-Family Conflict (WFC) was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.

Project description:BACKGROUND: Attempts to identify particular aspects of psychosocial work conditions as predictors of sickness absence remain inconclusive. A global measure has previously been suggested to be an efficient way to measure psychosocial work conditions in questionnaires. This paper investigates whether satisfaction with specific aspects of psychosocial work conditions explains sickness absence beyond its association with a global measure of psychosocial work conditions. METHODS: The participants were 13,437 employees from 698 public service workplaces in Aarhus County, Denmark. 33 items from a questionnaire fell in groupings around six aspects of psychosocial work conditions: skill discretion, professionalism, management, decision authority, workload and cooperation. A global measure rating satisfaction with psychosocial work conditions on a scale from 0 to 10 was also included in the questionnaire. Individual ratings were aggregated to workplace scores. Analysis of variance and multiple linear regression was used to compare the average number of days of yearly sickness absence with different levels of satisfaction with six aspects of psychosocial work conditions. The covariates included were gender, age, occupation, size of workplace, contact to hospital, civil status and children below 13 living at home. RESULTS: Dissatisfaction with each of the six aspects of psychosocial work conditions was associated with an increase in sickness absence. When all aspects were simultaneously included in the model, only skill discretion and professionalism were negatively associated with sickness absence. When a global measure of satisfaction with psychosocial work conditions was also included in the model none of the specific aspects showed a statistically significant association with sickness absence. CONCLUSION: Low global satisfaction with psychosocial work conditions is associated with increased levels of sickness absence. Including specific aspects of psychosocial work conditions in the model does not provide further information regarding the nature of this association.

Dataset Information

Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study.

Background

Methods

Results

Conclusions

Publications

Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study.

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