Effects of organizational justice on depressive symptoms and sickness absence: A longitudinal perspective

A longitudinal three-wave study among a large representative sample of 1519 employees of various companies in The Netherlands examined how organizational justice (as measured by distributive and procedural justice) was related to depressive symptoms and sickness absence. It was predicted that perceived justice would contribute to lower depressive symptoms and sickness absence, whereas depressive symptoms and absenteeism in turn would contribute to lower perceptions of organizational justice. In line with the predictions, we found that both distributive and procedural justice contributed to lower depressive symptoms, and distributive justice contributed to lower sickness absence in the following year. With regard to reversed effects, sickness absence contributed to lower perceptions of distributive justice to some extent. Moreover, sickness absence was related to higher depressive symptoms a year later. This research shows the importance of justice in organizations as a means to enhance the wellbeing of people at work and to prevent absenteeism.     

Job decision latitude, organizational justice and health: multilevel covariance structure analysis

A total of 2969 hospital employees from 162 wards participated in a 2-year follow-up study that examined the relationship between job decision latitude, organizational justice and employee health in Finland. We used medically certified sickness absence records as indicators of health problems. Multilevel covariance structure analysis was applied to take into account the hierarchical nature of the data. Responses from individuals within work units seem not always to be independent, and any models that ignore this lack of independence may incorrectly estimate the between individual relationships. Our results suggest that both job decision latitude and organizational justice varied considerably between work units in addition to individual level variation. Furthermore job decision latitude was associated with organizational justice both at individual and work unit level. Justice evaluations predicted sickness absence only at the individual level.     

Organizational Justice: Evidence of a New Psychosocial Predictor of Health

OBJECTIVES: This study examined the justice of decision-making procedures and interpersonal relations as a psychosocial predictor of health. METHODS: Regression analyses were used to examine the relationship between levels of perceived justice and self-rated health, minor psychiatric disorders, and recorded absences due to sickness in a cohort of 506 male and 3570 female hospital employees aged 19 to 63 years. RESULTS: The odds ratios of poor self-rated health and minor psychiatric disorders associated with low vs high levels of perceived justice ranged from 1.7 to 2.4. The rates of absence due to sickness among those perceiving low justice were 1.2 to 1.9 times higher than among those perceiving high justice. These associations remained significant after adjustment for behavioral risks, workload, job control, and social support. CONCLUSIONS: Low organizational justice is a risk to the health of employees.     

Organizational Characteristics as Predictors of Work Disability: A Prospective Study Among Sick Employees of For-Profit and Not-For-Profit Organizations

INTRODUCTION: This article reports a prospective study that focused on the influence of organizational structure and organizational culture on the outcome of sickness absence, return to work or work disability. Former studies of determinants of work disability hardly have given attention to organizational characteristics and, if so, not following a appropriate prospective design. METHODS: The study population consisted of 455 employees of 45 for-profit and not-for-profit companies participating in the Maastricht Cohort Study on fatigue at work who were on sick leave for at least 6 weeks. Both independent variables which were type of company, size, centralization of decision making and organizational culture, and covariates, which were sex, age, educational level, fatigue, and chronic illness, were all measured before employees reported sick. The dependent variable outcome of the sickness absence, mainly return to work or work disability, was measured 15 months after reporting sick. RESULTS: Multilevel logistic regression analysis, with organizational characteristics as level 2 independent variables and demographic and health characteristics as covariates, suggested that the type of company (for-profit/private or not-for-profit/public) is predictive of the outcome of sickness absence (crude OR = 2.21; CI: 1.16-4.20), but this may be partially due to a higher proportion of fatigued and chronically ill employees in not-for-profit companies (adjusted OR = 2.09; CI: 0.93-4.37). Findings about the role of some other organizational characteristics, like organizational culture, were inconclusive. CONCLUSIONS: Organizational characteristics should next to health characteristics be included in the models of studies which aim at predicting which sick employees are at risk for work disability. To prevent work disability not-for-profit companies might be stimulated to more active return-to-work policy by charging them with the costs of it.     

A longitudinal study of changes in interactional justice and subsequent short-term sickness absence among municipal employees

Objectives:Level of perceived interactional justice has been shown to be associated with sickness absence, but less is known about the effects of changes in interactional justice. It is also unknown to what extent unmeasured, time-invariant differences contribute to the association. We investigated the association between interactional justice changes and subsequent short-term (1–3 days) sickness absences over a 12-year follow-up using between- and within-individual modeling among ageing municipal employees.Methods:The data was derived from Helsinki Health Study cohort with baseline survey in 2000–2002 (N=8960, response rate 67%) and follow-up surveys in 2007 and 2012 (response rates 79% and 83%, respectively). At baseline, participants were 40–60-year-old employees of the City of Helsinki, Finland. Sickness absences from the employer’s registry were linked with the responses (78%). The analytic sample was 2109 and 2070 individuals for between-individual and 4433 individuals and 8425 observations for within-individual associations.Results:Negative change in interactional justice was associated with an increased risk of short-term sickness absence in between-individual models after adjusting for age and gender. Adjustment for sickness absence history attenuated the association. In within-individual models, a negative change in perceived interactional justice was associated with an increased risk of short-term sickness absence spells [incidence rate ratios (IRR) 1.05 (95% confidence interval 1.01–1.09)]. This association was robust to adjustments for gender, age, health behaviors and sickness absence history.Conclusions:Paying attention to management principles – especially managerial behavior and treatment of employees to avoid the deterioration of the level of interactional justice – may provide a way of reducing self-certified short-term sickness absence spells.     

Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study

OBJECTIVES: To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence. METHODS: Prospective cohort study of British civil service employees. Job control, job demands, and work social supports were measured in 1985/88 and in 1991/93. Analyses included 3817 British civil servants with sickness absence records at baseline (1985-89) and for two follow up periods, early (1994-95) and later follow up (1996-98). RESULTS: Change in work characteristics predicted subsequent incidence of long spells of sickness absence (>7 days) in the early follow up period after adjustment for covariates including baseline work characteristics, health status, and sickness absence. Adjusted rate ratios were 1.23 (95% CI 1.03 to 1.46) for decreased compared with stable decision latitude; 1.17 (95% CI 1.01 to 1.36) for increased compared with stable job demands and 0.79 (95% CI 0.67 to 0.93) for increased compared with stable work social support. These associations were also seen in a sub-sample who did not change employment grade. In the later follow up period, associations between work change and long spells of sickness absence were similar for decision latitude, less pronounced for job demands, and no longer apparent for social supports. Changes in work characteristics were not associated with subsequent short spells of sickness absence (相似文献   

Work demands,job insecurity and sickness absence from work. How productive is the new,flexible labour force?

BACKGROUND: We investigate one aspect of productivity--sickness absence--and ask whether job insecurity and high work demands are associated with increased sickness absence and, if so, whether mental or physical health mediates this association. We further investigate if having control at work modifies these associations. METHODS: We used cross-sectional survey data from 2,248 employees aged 40-44 years living in two cities of south-eastern Australia. Logistic regressions were used to compare the associations between job insecurity and demands among those with short (1-3 days) or long-term (> 3 days) sickness absence with those who had no sickness absence in the last four weeks. The mediating effects of mental and physical health were assessed by evaluating changes in the magnitude of the association between these work conditions and sickness absence. RESULTS: High job insecurity (OR = 3.28; 95% CI 1.54-6.95) and high work demands (OR = 1.62; 95% CI 1.13-2.30) were significantly associated with long-term, but not with short-term, sickness absence. These associations were unaffected by job control. Depression and anxiety explained 61% of the association between high work demands and long-term sickness absence and 30% of the association between job insecurity and long-term sickness absence. CONCLUSION: Difficult working conditions may reduce productivity by contributing to longer absences from work. IMPLICATIONS: Reforms intended to improve economic performance should address any potential health costs of insecurity or intensification, which could inadvertently decrease productivity, possibly through their impact on mental health.     

Evaluating different measures of sickness absence with respect to work characteristics

AIMS: Four different measures of sickness absence were related to psychosocial and physical work characteristics in workplaces with high, intermediate, and low sickness absence. The relationships between work characteristics and sickness absence were hypothesized to differ depending the sickness absence measure used. METHODS: Questionnaire data on physical work environment, physical load, support, influence at work, and worry were collected from 1,726 employees at 48 dental clinics in Stockholm, Sweden and were related to registry-based sickness absence obtained at the workplace level. The sickness absence measures included: (1) frequency, (2) one-day absence, (3) overall duration, and (4) duration between 2 and 21 days. RESULTS: For frequency, significant differences were found for all work characteristics, with poor work characteristics being associated with a high frequency of sickness absence. Considering duration between 2 and 21 days, there were significant differences in support, influence at work and physical work environment; for one-day absence, support, influence at work and physical load differed significantly. Conversely, there were no significant differences for the overall duration measure. CONCLUSIONS: The results show that frequency of sickness absence is most consistently related to work characteristics, that short-time sickness absences have more inconsistent relationships and that relationship with overall duration is lacking. This highlights the need for further differentiation between different sickness absence measures, the behavioral patterns associated with different types of absences and the implication of such processes for prevention and intervention.     

Sickness absence in relation to psychosocial work factors among daytime workers in an electric equipment manufacturing company

Associations between psychosocial work factors and sickness absence were investigated in a cross-sectional study of 833 daytime workers. Participants completed a questionnaire regarding psychosocial work factors using the US National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (job control, quantitative workload, cognitive demands, variance in workload, intragroup conflict, intergroup conflict, supervisor support, coworker support, family support, job satisfaction and depressive symptoms) and the number of days of sickness absence within the previous year. Multivariate analyses of covariance with age and occupation as covariates (MANCOVA) were used to test the relationships between psychosocial work factors and sickness absence stratified by sex. In men, the age-adjusted MANCOVA showed that, quantitative workload was highest in the 0.5-4.5 d of sickness absence group (p<0.001). However, the levels of stress reactions (job satisfaction and depressive symptoms) in this group were almost identical to the levels recorded in the no sickness absence group. In contrast, low levels of job control (p<0.01), supervisor support (p<0.05), and job satisfaction (p<0.01) and higher symptoms of depression (p<0.001) were associated with 5 d or more sickness absence. In women, only high job satisfaction was associated with 5 d or more sickness absence (p<0.10). This study suggests that appropriate use of sickness absence at times of being exposed to high quantitative workload may help male workers to recover from stressful situations.     

Can individual health differences be explained by workplace characteristics?-A multilevel analysis

Research on work-related health has mainly focused on individual factors. The present study expands the focus by exploring the role of organizational characteristics of workplaces for different individual health outcomes. The aim of the study was to look at differences in relative effect of workplace variations on five health outcomes, and to explain those differences in health outcomes by organizational characteristics. The sample encompassed 90 workplaces in Sweden and about 4300 individuals employed within these workplaces. Measurement of the workplace characteristics was carried out independently of the measurement of the individual's working conditions and health. Organizational data were collected by interviews with local managers at participating workplaces, and individual data were obtained by means of a survey of the employees. The results showed that a significant proportion of the variance in sickness absence, work ability, general health, and musculoskeletal disorders was attributed to the workplace. Of eight tested organizational characteristics, customer adaptation, lean production, and performance control could explain some of this workplace variance. The results also showed that only one organizational effect remained significant when controlled for the individual confounder of age and gender. High customer adaptation is associated with higher sickness absence. This association is not mediated via differences in mental and physical job strain.     

Psychosocial factors and work related sickness absence among permanent and non-permanent employees

STUDY OBJECTIVE: To examine the association between psychosocial work factors and work related sickness absence among permanent and non-permanent employees by sex. DESIGN: A cross sectional survey conducted in 2000 of a representative sample of the European Union total active population, aged 15 years and older. The independent variables were psychological job demands and job control as measures of psychosocial work environment, and work related sickness absence as the main outcome. Poisson regression models were used to compute sickness absence days' rate ratios. SETTING: 15 countries of the European Union. PARTICIPANTS: A sample of permanent (n = 12 875) and non-permanent (n = 1203) workers from the Third European Survey on Working Conditions. RESULTS: High psychological job demands, low job control, and high strain and passive work were associated with higher work related sickness absence. The risks were more pronounced in non-permanent compared with permanent employees and men compared with women. CONCLUSIONS: This work extends previous research on employment contracts and sickness absence, suggesting different effects depending on psychosocial working conditions and sex.     

The effect of training for a participatory ergonomic intervention on physical exertion and musculoskeletal pain among childcare workers (the TOY project) – a wait-list cluster-randomized controlled trial

ObjectiveMany employees have high physical exertion at work and suffer from musculoskeletal pain (MSP) leading to sickness absence with large costs. Participatory ergonomics is a potentially effective intervention for reducing physical exertion, MSP and sickness absence. The main aim of this study was to investigate the effectiveness of a 20-week workplace participatory ergonomic intervention among childcare workers on physical exertion and MSP.MethodsIn a two-arm cluster-randomized trial, 190 workers were recruited from 16 childcare institutions and randomly assigned to either a 20-week participatory ergonomics intervention consisting of three training workshops or a control group receiving usual care. Primary outcomes were physical exertion during work, maximal pain intensity, number of pain regions, and pain-related work interference. Secondary outcomes were MSP-related sickness absence, need for recovery (NFR), employee involvement, and self-efficacy. We followed the intention-to-treat principle and adhered to the registered study protocol (ISRCTN10928313).ResultsAfter 20 weeks, half the workers noticed some positive changes in their work. However, there were no statistically discernible effects in physical exertion, maximum pain intensity, pain-related work interference, or number of pain regions. We found a significant reduction of MSP-related sickness absence in the intervention compared to the control group [-0.48 days per month (95% confidence interval (CI), -0.8– -0.1]. We found no significant effects in NRF or involvement of employees, but self-efficacy was reduced in the intervention compared to the control group [-0.2 (95% CI, -0.3– -0.0)].ConclusionThis 20-week training for a participatory ergonomic intervention in childcare workers did not show effects on physical exertion and MSP, but was both feasible and effective in reducing MSP-related sickness absence.     

Emotional dissonance and sickness absence: a prospective study of employees working with clients

Purpose

(1) Determine the relationship between emotional dissonance and medically certified sickness absence among employees working with clients and (2) compare the impact of emotional dissonance on medically certified sickness absence with the impact of other psychological and social work factors.

Methods

A sample of 7758 employees was recruited from 96 Norwegian organizations in the period 2004 to 2014, all working with clients. The study design was prospective with emotional dissonance measured at baseline and then linked to official registry data of medically certified sickness absence for the year following the survey assessment. Quantitative demands, decision demands, role clarity, role conflict, control over work intensity, and decision control were included as additional work exposures. The impact of the study variables on the presence and duration of medically certified sickness absence was investigated with a negative binomial hurdle model.

Results

In the fully adjusted model, emotional dissonance and role conflict significantly predicted the presence of medically certified sickness absence. Control over work intensity and decision control were negatively related to presence of sickness absence. Only role conflict was a risk factor for the duration of sickness absence when all factors were analysed simultaneously.

Conclusion

Emotional dissonance is a risk factor for the presence of medically certified sickness absence in client-driven work environments. Theoretical models of sickness absence, as well as interventions aiming to prevent sickness absence in such environments, should be aware of the effect emotional dissonance may have on employees.

     

Recurrence of Medically Certified Sickness Absence According to Diagnosis: A Sickness Absence Register Study

Introduction Sickness absence is a major public health problem. Research on sickness absence focuses on interventions aimed at expediting return to work. However, we need to know more about sustaining employees at work after return to work. Therefore, this study investigated the recurrence of sickness absence according to diagnosis. Methods We analyzed the registered sickness absence data of 137,172 employees working for the Dutch Post and Telecom. Episodes of sickness absence were medically certified, according to the ICD-10 classification of diseases, by an occupational physician. The incidence density (ID) and recurrence density (RD) of medically certified absences were calculated per 1,000 person-years in each ICD-10 category. Results Sickness absence due to musculoskeletal disorders had the highest recurrence (RD = 118.7 per 1,000 person-years), followed by recurrence of sickness absence due to mental disorders (RD = 80.4 per 1,000 person-years). The median time to recurrent sickness absence due to musculoskeletal disorders was 409 days after the index episode. Recurrences of sickness absence due to musculoskeletal disorders accounted for 37% of the total number of recurrent sickness absence days. For recurrences of sickness absence due to mental disorders this was 328 days and 21%, respectively. Unskilled employees with a short duration (<5 years) of employment had a higher risk of recurrent sickness absence. Conclusions Interventions to expedite return to work of employees sick-listed due to musculoskeletal or mental disorders should also aim at reducing recurrence of sickness absence in order to sustain employees at work.     

Work-related musculoskeletal health and social support

BACKGROUND: This review concerns the relationship between inequalities experienced at work with respect to social support (e.g. poor communication channels, unsatisfactory work relationships, unsupportive organizational culture) and work-related musculoskeletal ill-health. METHODS: Cross-sectional, case control and prospective studies, published between 1985 and 2003, that investigated this association were selected and reviewed. RESULTS: Studies varied greatly in the breadth of definitions of social support used and many measures were employed for the collection of data. There is good evidence for an association between poor social support and an increased risk in musculoskeletal morbidity. There is also limited evidence that poor social support is associated with musculoskeletal sickness absence, restricted activity and not returning to work after a musculoskeletal problem. A small number of studies have shown the effects of good social support and its importance in protecting against musculoskeletal ill-health and helping workers cope with problems. CONCLUSIONS: The overall findings of this review have implications for the design of proactive broad-based prevention programmes and organizational policies for the management of musculoskeletal ill-health and its potential outcomes, i.e. sickness absence and early retirement. Further research, using stronger study designs and more concise definitions of social support, to investigate the importance of social support in the amelioration of musculoskeletal ill-health is identified, e.g. the contribution of social support received away from the workplace.     

Measuring Work Ability with Its Antecedents: Evaluation of the Work Ability Survey

Purpose The revised version of the Work Ability Survey (WAS-R) assesses work ability on several sub-scales at the intersection of personal and organizational capacity, thus adding to the measurement of work ability by integrating the holistic model. It, therefore, improves on two features of the current standard measurement tool of work ability, the Work Ability Index (WAI): (1) a ceiling effect and (2) limited detail due to a focus on physical health and personal capacity. Method In two samples (n ₁?=?1093, n ₂?=?359), psychometric properties and the structure of the WAS-R were analyzed. To evaluate construct validity, inter-correlations of the WAS-R and WAI, sickness absence, expected and desired retirement age, and post-retirement work intention were calculated. Results The WAS-R was found to be distributed closer to normality than the WAI. The structural analyses yielded acceptable results for the hypothesized model. The WAS-R was adequately correlated with the WAI, negatively with sickness absence, and positively with desired retirement age. Conclusions The WAS-R extends the measurement of work ability, reflecting organizations’ work demands. Its broad sub-scales lead to high acceptance of the results within the participating companies. In particular, the organizational capacity scales can be used to guide interventions aiming at organizational characteristics to improve work ability.     

Relapse and short sickness absence for back pain in the six months after return to work.

OBJECTIVES: To measure the incidence of back pain relapse (causing three consecutive days off work on medical advice) and of short sickness absence (less than three consecutive days), and to determine whether the incidence of such events was affected by overall pain and specific pain related to simple daily movements (functional capacity) assessed at discharge. METHODS: A cohort of workers with a first compensated episode of back pain was prospectively followed up from return to work after rehabilitative treatment. Follow up among 230 workers was carried out monthly by phone for a maximum of six months. Crude and adjusted rate ratios (RRs) along with 95% confidence intervals (95% CIs) were estimated with the Cox's proportional hazards model. RESULTS: Within six months of return to work, 29 workers (12.6%) had relapsed, and another 15 workers (6.5%) had a short sickness absence. 50% of relapses had occurred within 42 days of return to work whereas this figure was 28 days for short sickness absence. In a multivariate model that considered pain and clinical variables at discharge only a scale combining all pain variables (specific daily movements as well as the visual analog overall pain scale) contributed to relapse and short sickness absence as the outcome (RR (95% CI)) (1.53 (0.96-2.43)); the same was true in a model considering pain and workers' views on desired changes to work conditions (1.60; 1.08 to 2.36). CONCLUSIONS: Incidence of relapse or short sickness absence in the first six months after return to work was 19.1%. Of all measured prognostic variables (sociodemographic, clinical, workers' views, and pain), only overall pain and pain associated with carrying out simple daily movements were helpful in predicting relapse or short sickness absence.     

The impact of downsizing on remaining workers’ sickness absence

It is generally assumed that organizational downsizing has considerable negative consequences, not only for workers that are laid off, but also for those who remain employed. The empirical evidence with regard to effects on sickness absence is, however, inconsistent. This study employs register data covering a major part of the total workforce in Norway over the period 2000–2003. The number of sickness absence episodes and the number of sickness absence days are analysed by means of Poisson regression. To control for both observed and unobserved stable individual characteristics, we use conditional (fixed effects) estimation. The analyses provide some weak indications that downsizing may lead to slightly less sickness absence, but the overall impression is that downsizing has few if any effects on the sickness absence of the remaining employees.     

Identifying workers at risk of sickness absence by questionnaire

BACKGROUND: Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. AIMS: To determine whether self-report questionnaires can identify those employees at risk of sickness absence METHODS: Prospective study of 238 healthy administrative workers. Participants completed a questionnaire proven to be valid and consistent. The questionnaire consisted of 116 items about health, work and working conditions. Sickness absence was followed-up for a period of 1 year. RESULTS: The questionnaires of 191 workers (80%) were suitable for analysis. The number of reported health complaints was significantly (P < 0.01) associated with sickness absence (OR 2.18; 95% CI 1.32-3.61). Concentration problems were correlated with more frequent absences, and both nervous complaints and coping problems with longer duration. Age (OR 0.96; 95% CI 0.93-0.99; P = 0.02) and job insecurity (OR 0.68; 95% CI 0.47-0.98; P = 0.04) were negatively associated with sickness absence. Psychosocial and physical work factors were not associated with sickness absence. CONCLUSIONS: Questionnaires on health and work can identify employees at future risk of sickness absence. Workers who report multiple health complaints, especially concentration problems, nervous complaints or coping problems, may be at increased risk of sickness absence.     

Workplace levels of psychosocial factors as prospective predictors of registered sickness absence

OBJECTIVE: We sought to investigate whether workplace levels of psychosocial work environment factors predict individual sickness absence. METHODS: Data were collected in a prospective study in 52 Danish workplaces in three organizations: municipal care, technical services, and a pharmaceutical company. Psychosocial factors were aggregated as workplace means. We used multilevel Poisson regression models with psychosocial factors as predictors and individual level sickness absence from absence registries as outcome. RESULTS: High workplace levels of decision authority predicted low sickness absence in the technical services (rate ratio = 0.66, 95% confidence interval = 0.51-0.86) and high workplace levels of skill discretion predicted low sickness absence in the pharmaceutical company (rate ratio = 0.74, 95% confidence interval = 0.62-0.88) after control for relevant confounders. Workplaces in municipal care did not differ with respect to the psychosocial factors. CONCLUSIONS: Psychosocial factors at the workplace level may be important predictors of sickness absence.