Everyday hassles and uplifts among women on long-term sick-leave due to stress-related disorders

A balance between different experiences of occupations in everyday life is important for well-being. The study aim was to describe hassles and uplifts in everyday occupations among women on long-term sick-leave due to stress-related disorders. The sample consisted of 77 women and experiences were collected by the THU-5 instrument. The statements were analysed using quantitative content analysis. Data were categorized into three domains of hassles concerning oneself, doings, and social and physical context. The same domains occurred among the uplifts. Hassles were mostly generated by disturbing people around the women and by their limited body functions. The women were uplifted by supportive social relationships and by performing relaxing and calming occupations. The study illuminates the strong need for social support among women on sick-leave, as well as their low level of energy, which was an obvious obstacle for performing occupations. It is suggested that, in order to increase well-being in the target group, the occupational therapist should meet their need for occupations that match their current level of energy. The challenge for the client is to avoid remaining in a pattern of low-demand occupations without exceeding her/his capacity and returning to an unhealthy pattern of occupations.     

Everyday hassles and uplifts among women on long-term sick-leave due to stress-related disorders

Abstract

A balance between different experiences of occupations in everyday life is important for well-being. The study aim was to describe hassles and uplifts in everyday occupations among women on long-term sick-leave due to stress-related disorders. The sample consisted of 77 women and experiences were collected by the THU-5 instrument. The statements were analysed using quantitative content analysis. Data were categorized into three domains of hassles concerning oneself, doings, and social and physical context. The same domains occurred among the uplifts. Hassles were mostly generated by disturbing people around the women and by their limited body functions. The women were uplifted by supportive social relationships and by performing relaxing and calming occupations. The study illuminates the strong need for social support among women on sick-leave, as well as their low level of energy, which was an obvious obstacle for performing occupations. It is suggested that, in order to increase well-being in the target group, the occupational therapist should meet their need for occupations that match their current level of energy. The challenge for the client is to avoid remaining in a pattern of low-demand occupations without exceeding her/his capacity and returning to an unhealthy pattern of occupations.     

Stability in women's experiences of hassles and uplifts: a five-year follow-up survey

Hassles and uplifts, a concept used in measuring daily stress events, was applied to working mothers' everyday life. The aim was to explore the stability in working mothers' experiences in patterns of daily occupations, operationalized as hassles and uplifts, between the year 2000 (baseline) and the year 2005 (follow-up). Further, the intention was to reveal possible differences in the number, origins, and ratings of hassles or uplifts between baseline and follow-up. The baseline study comprised 100 women, of whom 77 agreed to participate in the follow-up study. At baseline the questionnaire THU-5 was applied in the form of an interview, and at follow-up it was adapted to a self-response questionnaire sent home to the respondents. Stability was explored qualitatively by investigating the reported causes of hassles and uplifts, and quantitatively by comparing the numbers and ratings of the experiences at baseline and at follow-up. The results indicate a certain amount of stability, although the cause of the experiences changes in line with changes in life stage. It was concluded that the methodology used (THU-5 and THU-3) was sensitive to these changes and could be applied in clinical settings, providing occupational therapists with a tool for detecting daily hassles that could be dealt with. Likewise, detected uplifts can be useful in the process of re-designing patterns of daily occupations affected by stress.     

Stability in women's experiences of hassles and uplifts: A five-year follow-up survey

Hassles and uplifts, a concept used in measuring daily stress events, was applied to working mothers’ everyday life. The aim was to explore the stability in working mothers’ experiences in patterns of daily occupations, operationalized as hassles and uplifts, between the year 2000 (baseline) and the year 2005 (follow-up). Further, the intention was to reveal possible differences in the number, origins, and ratings of hassles or uplifts between baseline and follow-up. The baseline study comprised 100 women, of whom 77 agreed to participate in the follow-up study. At baseline the questionnaire THU-5 was applied in the form of an interview, and at follow-up it was adapted to a self-response questionnaire sent home to the respondents. Stability was explored qualitatively by investigating the reported causes of hassles and uplifts, and quantitatively by comparing the numbers and ratings of the experiences at baseline and at follow-up. The results indicate a certain amount of stability, although the cause of the experiences changes in line with changes in life stage. It was concluded that the methodology used (THU-5 and THU-3) was sensitive to these changes and could be applied in clinical settings, providing occupational therapists with a tool for detecting daily hassles that could be dealt with. Likewise, detected uplifts can be useful in the process of re-designing patterns of daily occupations affected by stress.     

The relationships of hassles and uplifts to experience of health in working women

Swedish women are more ill than men are, often explained by women's heavier total workload. A balanced pattern of daily occupations is believed to promote health. The aim of this study was to investigate the relationship of aspects of the pattern of daily occupations and lifestyle factors to working mothers' health and well-being, and whether control influenced any relationships. One hundred working, cohabiting mothers took part in semi-structured interviews targeting health and well-being, control, lifestyle variables, and hassles and uplifts in the pattern of daily occupations. All variables were dichotomised according to a median cut and subjected to logistic regression analyses. Working more and having a university diploma were found to be risk factors for experiencing more hassles. Risk factors for fewer uplifts were having more than two children and fewer leisure occupations. Experiencing less control constituted a risk of low self-rated health and with an additional high level of hassles impacted on the experience of well-being.     

Work and family roles of women: Sources of stress and coping strategies

Women's lives are affected by the roles they assume, as well as when and in what sequence and combination they assume these roles. This study described the daily stressors and coping strategies reported by women with differing work and family role configurations. Ninety‐two women representing four common typologies of multiple roles (married working mothers, single working mothers, married workers without children, and homemakers) reported daily hassles and their responses to these hassles in a health diary. The predominant type of hassles reported was related to the self, including physical and emotional symptoms, unfulfilled expectations, and doubts. The major response to hassles was doing nothing, followed by problem solving. While there were no significant differences in the incidence of daily hassles among the four groups, types of hassles and coping responses differed in rank when compared among the four groups.     

Life events and daily hassles and uplifts as predictors of hospitalization and outpatient visitation.

Increased occurrence of major life events and daily "hassles" and "uplifts" have been shown to be associated with several measures of health status and health care utilization. In order to test for such an association with hospital admission, a prospective study was designed. Navajo Indians presenting for either inpatient or outpatient health care at a U.S. Indian Health Service facility were questioned regarding the occurrence of major life events in the preceding six months and of hassles and uplifts in the preceding week. Two years later the subsequent numbers of outpatient visits and of hospital admissions were determined for each subject. An increased number of either major life events (relative risk 1.66) or daily hassles and uplifts (relative risk 1.87) was found to be associated with an increased risk of hospital admission. The effects of major and daily life events were additive on the risk of admission. In addition, hassles were predictive of subsequent outpatient utilization. While further demonstrating the influence of major and daily life occurrences on health care utilization, this study also shows their importance in an additional cultural setting.     

Inequalities in mental health in the working population.

Objectives: To analyze inequalities in mental health in the working population by gender and professional qualifications and to identify psychosocial risk factors and employment conditions related to the mental health of this population. Methods: We performed a cross-sectional study using data from the Barcelona Health Survey 2000. The working population aged 16-64 years (2322 men and 1836 women) was included. Mental health was measured with the General Health Questionnaire (GHQ-12). Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated by means of multivariate logistic regression models separated by job qualifications and gender. Results: The prevalence of poor mental health ranged from 8% among men working in non-manual occupations to 19% in women working in manual jobs. Women were more likely to report poor mental health status than men, although sex differences were greater among manual workers (aOR = 2.26; 95%CI, 1.68-3.05 for women compared to men in the same group). Differences according to qualifications were found among women only (aOR = 1.58 [95%CI, 1.22-2.05] for women working in manual jobs compared to those working in non-manual jobs), while no differences were found among men according to qualifications. Psychosocial risk factors were associated with mental health: demand was associated in all groups, autonomy only in non-manual occupations, and social support only in the most highly qualified working women. Employment conditions such as working a split shift (working day with a long lunch break) or having a temporary contract were associated with mental health in manual occupations only. Conclusions: Mental health among the working population is related to professional qualifications and gender. Women are at greater risk than men, especially those working in manual occupations. Psychosocial occupational factors are related to mental health status, showing different patterns depending on gender and professional qualifications.     

Social class and ischaemic heart disease: use of the male:female ratio to identify possible occupational hazards.

In England and Wales there has been an increasing excess of ischaemic heart disease death rates among men and women of social classes IV and V compared with those in classes I and II and this excess is greater in young than in old adults. The male excess over women in IHD death rates is much greater in social classes I and II than in classes IV and V. Although men in professional occupations are at low risk for IHD compared with men in other occupations, women married to professional men are at an even lower risk compared with other women. Also, women married to men in unskilled occupations have relatively higher IHD rates than their husbands. These patterns are not seen for "all causes," cerebrovascular disease, chronic bronchitis, or stomach cancer, where the social class mortality gradients are similar in men and women. There may thus be factors associated with professional occupations that increase the risk of IHD despite the relatively low death rates of men engaged in them. In addition there may be factors operating in women in social classes IV and V that put them at a particularly high risk for the development of IHD.     

Engagement in patterns of daily occupations and perceived health among women of working age

The aim of the present cross-sectional study was to examine how subjective experiences of engagement in patterns of daily occupations (gainful employment, domestic work, enjoyable and recreational occupations) were associated with perceived health among women of working age. The sample (n=488) was drawn from a longitudinal cohort study of women of working age in Gothenburg, Sweden. Participants were women 38 (n=202) and 50 (n=286) years of age. They completed a questionnaire including questions about occupational experiences in relation to their patterns of daily occupations, perceived health, and socioeconomic factors. The results of the present study showed that a combination of different experience dimensions of patterns of daily occupations was associated with perceived health among women of working age, even when adjusted for socioeconomic factors and age. The results provided occupational pattern-related health indicators, i.e. manageability, personally meaningful occupations, and occupational balance. To combine these health indicators can be a way for occupational therapists to enable women to develop strategies to promote health and to prevent stress and sick leave.     

Occupational class and exposure to job stressors among employed men and women in Japan

BACKGROUND: The relationship between occupational class and exposure to job stressors among employed men and women in Japan remains unclear. METHODS: Data of 16,444 men and 3,078 women were analyzed. The information was obtained from answers to a questionnaire distributed among employees of nine companies in Japan between 1996 and 1998 (average response rate, 85%). The International Standardized Classification of Occupations was used to classify respondents into eight occupational categories. The Job Content Questionnaire was used to measure job demands, job control, worksite support, and job insecurity. The associations between occupational class and job stressors, as well as job strain, were examined controlling for age, education, marital status, chronic medical condition, and personality traits, such as neuroticism and extraversion. RESULTS: Men and women in high-class occupations (e.g., managers and professionals) had significantly greater job control, while job demands and worksite social support were not greatly different among occupations. A clear occupational class gradient in job insecurity was observed in women. A greater prevalence of high job strain was observed in low-class occupations compared to high-class occupations in both men and women. The occupational class gradient in job strain was greater for women. These patterns did not change after controlling for other covariates. CONCLUSION: The present study suggests an occupational class gradient in job strain for employed men and women in Japan. Japanese women workers may have a greater occupational class gradient in job strain and job insecurity than men.     

The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male- and female-dominated occupational groups

The associations of work stress, types of work and gender-role orientation with psychological well-being and sickness absence were investigated in a questionnaire survey of 588 male and female nurses and 387 male and female accountants. We hypothesised that health might be impaired among women working in the male-dominated occupation (accountancy), and men in the female-dominated occupation (nursing), but that effects might be moderated by job strain (perceptions of high demand and low control), work and home hassles, and traditional male (instrumentality) and female (expressivity) psychological characteristics. Responses were analysed from 172 female and 61 male nurses, and from 53 female and 81 male commercial accountants. Female accountants were more likely than other groups to have high anxiety scores on the Hospital Anxiety and Depression Scales, while male nurses had the highest rates of sickness absence. Male nurses and female accountants also reported more work-related hassles than did female nurses and male accountants. Men and women in the same occupation did not differ in job strain or job social support, but nurses reported greater job strain than accountants, due to higher ratings of demands and lower skill utilisation. After adjusting for age, sex, occupation, paid work hours and a measure of social desirability bias, risk of elevated anxiety was independently associated with higher job strain, lower job social support, more work hassles, more domestic responsibility, lower instrumentality and higher expressivity. The association between sex and anxiety was no longer significant after instrumentality had been entered into the regression model. Sickness absence of more than three days over the past 12 months was independently associated with higher job strain, more work hassles, lower instrumentality and higher expressivity. The results suggest that when men and women occupy jobs in which they are in the cultural and numerical minority, there may be adverse health effects that are gender-specific. Psychological traits related to socially constructed gender roles may also be relevant, and mediate in part the differences in psychological well-being between men and women.     

Psychosocial changes during the first year of medical school

The goal of this study was to assess psychosocial changes during the first year, on measures thought related to the long-term adjustment of medical students. Measures of self-esteem, health locus of control, hassles, uplifts, mood, and symptoms of stress were administered at the beginning and end of first year to 128 of 181 students. Self-esteem, powerful other locus of control, and uplifts decreased while hassles increased during the year. Positive mood decreased (joy, contentment, vigour, and affection) while negative mood increased (depression and hostility). Hassles at the beginning of the year were positively associated with health outcome at the beginning and end of the year. End-of-the-year first-year students appear to be worse off psychosocially than when they entered. With greater emphasis on health promotion and disease prevention and the adoption of other reforms in medical education, as suggested in the GPEP Report, medical students may learn to cope more effectively with stress as they pursue their medical education.     

Occupation and meaning in the lives of women with chronic pain

The aim of this study was to examine how women experience occupations as they live with chronic pain and more specifically to gain detailed knowledge regarding the meaning of important occupations in their life. The article is based on an analysis of 17 narratives based on an Occupational Performance History Interview. Participants were interviewed as part of their occupational therapy assessment at Orton Rehabilitation. The narratives were analysed in order to identify the experiences of doing occupations in everyday life. When interpreting their problems in and solution for doing occupations women in this study used four basic metaphors: (1) moving forward, (2) slowing down, (3) fighting and (4) standing still. The tone of the narratives varied from hopeful to hopeless and from fearful to frustrated. Each of these four types of narratives differed in: (a) the tone of the narrative, (b) the meaning ascribed to occupation, (c) how others are viewed in relation to one's doing, and (d) how the future is envisioned. The experience of occupation in the lives of women with chronic pain is heterogeneous and depends on the underlying meaning of the narrative used to experience and interpret occupational life.     

Occupation and meaning in the lives of women with chronic pain

The aim of this study was to examine how women experience occupations as they live with chronic pain and more specifically to gain detailed knowledge regarding the meaning of important occupations in their life. The article is based on an analysis of 17 narratives based on an Occupational Performance History Interview. Participants were interviewed as part of their occupational therapy assessment at Orton Rehabilitation. The narratives were analysed in order to identify the experiences of doing occupations in everyday life. When interpreting their problems in and solution for doing occupations women in this study used four basic metaphors: (1) moving forward, (2) slowing down, (3) fighting and (4) standing still. The tone of the narratives varied from hopeful to hopeless and from fearful to frustrated. Each of these four types of narratives differed in: (a) the tone of the narrative, (b) the meaning ascribed to occupation, (c) how others are viewed in relation to one's doing, and (d) how the future is envisioned. The experience of occupation in the lives of women with chronic pain is heterogeneous and depends on the underlying meaning of the narrative used to experience and interpret occupational life.     

Smoking, social support, and hassles in an urban African-American community.

BACKGROUND. Despite public health efforts, the prevalence of smoking among African Americans remains high. The determinants of smoking behavior in this population must be elucidated so that interventions can be better targeted and more effective. METHODS. As part of a prospective community intervention trial to reduce cancer mortality, we conducted a random household survey of 1137 African-American adults in San Francisco and Oakland between November 1985 and July 1986. The survey instrument included questions about social network characteristics, instrumental and emotional aspects of social support, smoking behavior, and stressors. RESULTS. The overall prevalence of smoking (41.9%) was higher than that reported in national surveys. Logistic models revealed that persons reporting high levels of stress, represented by an abbreviated hassles index, were more likely to smoke than those reporting less stress. Women with poor social networks were more likely to smoke (odds ratio = 3.1) than women with optimal networks; however, this relationship did not hold among men. Indeed, men lacking emotional support from friends or family were less likely to smoke (odds ratio = 0.5) than men receiving such support. No interaction between social support and hassles was observed. CONCLUSIONS. Stressful environments may contribute to high-risk smoking behavior among urban African Americans.     

Sexual risk behaviour for women working in recreational venues in Mwanza,Tanzania: considerations for the acceptability and use of vaginal microbicide gels

Qualitative research was conducted to explore the social context of sexual-risk behaviour among women working in recreational occupations, during a feasibility study in preparation for the Phase III clinical trial of vaginal microbicides in Mwanza, Tanzania. Participant observation was conducted in 68 recreational venues. Six focus group discussions were conducted with women working in recreational occupations and two with male customers at these venues. Findings revealed that these women are at risk of HIV due their dependence on sexual transactions to improve their economic circumstances, which take place in environments and relationships where condom use is difficult. However, the findings revealed that, in spite of constraints, women did take actions to prevent HIV by negotiating for condom use or avoiding perceived risky practices or partnerships, in particular moving to more casual partnerships where condom negotiation is more acceptable. This indicates that, given their perception of their own risk, women working in recreational occupations will welcome an effective microbicide. However, sustained use will depend on how formulations overcome the difficulties women currently experience with condom negotiation and the specific environments and relationships in which they engage in sex.     

Smoking patterns by occupation and duration of employment

Lifetime patterns of smoking and occupation based on personal interviews were examined among 3,627 white men and 1,200 white women who were randomly selected from ten areas in the United States during the period 1977-1978. These individuals participated in the control series of the National Bladder Cancer Study. We estimated, based on Axelson's method, the extent to which smoking habits for given occupational groups would confound the estimated relative risk for lung cancer for 62 occupations among men and 18 occupations among women. Among men, confounding by smoking resulted in a 30% or greater increased risk of lung cancer in only three occupational groups--namely, stationary engineers and power station operators (relative risk (RR) = 1.6), printers (RR = 1.3), and fishermen and sailors (RR = 1.3). A decrease in lung cancer risk of 0.8 or less due to smoking habits was observed among the clergy (RR = 0.5) and chemical workers (RR = 0.7). Among women, a 30% increase or greater in the risk of lung cancer based on smoking habits alone was found for food service workers (RR = 1.5), building managers and administrators (RR = 1.3), telephone and telegraph operators (RR = 1.3), and operatives (RR = 1.3). A risk ratio of 0.8 or less was observed for those women employed as farmers (RR = 0.5) and teachers (RR = 0.8). Smoking habits by duration of employment were also examined for 38 occupations among men. The largest increase in the risk of lung cancer based on the smoking habits among long-term workers was only 1.3 and was observed for those men employed 20 or more years as painters and as electricians. These findings suggest that the smoking patterns, in only a few occupational groups that we evaluated, confound estimates of the relative risk by more than 30%, and for most occupational groups under investigation in this study, confounding by smoking alone did not produce trends in relative risks by duration of employment.