Active job, healthy job? Occupational stress and depression among hospital physicians in Taiwan

This study assessed the levels and association of occupational stress and depression rate among physicians, and to compare physicians' occupational stress with that of Taiwanese employees in other occupations. The subjects were physicians employed at 14 participating regional hospitals in the Around Taiwan Health Care Alliance. Self-administered questionnaires capturing data on demographics, occupational characteristics, occupational stress measured using Job Content Questionnaire (C-JCQ), and health status measured using Taiwanese Depression Questionnaire (TDQ) were sent to eligible physicians. Results revealed that the depression rate (13.3%) was higher than that found in the general population (3.7%) of Taiwan. The mean scores of the JCQ dimensions "work demands" and "job control" were both much higher than those in most occupations in Taiwan. Higher depression scores were found in subjects with higher work demands, 8-10 d of being on duty per month, and more frequent alcohol consumption, while lower depression scores were found in subjects working in the east Taiwan area, with higher job control and with greater workplace social support. On the other hand, gender, smoking, and working hour were not independently correlated with depression, but the interaction of gender and job control also had an independent effect on depression. This study suggests that job stress plays an important role in depression in physicians; it is necessary to pay attention to physicians at high risk of depression, as well as their work environments, for early detection and intervention.     

Health complaints and satisfied with the job? A cross-sectional study on work environment, job satisfaction, and subjective health complaints

OBJECTIVE: The aim of this study was to examine the prevalence of subjective health complaints (SHCs) among satisfied and dissatisfied workers. The second aim was to evaluate whether any SHC differences were attributable directly to the work environment or mediated by the individual perception of the environment (satisfactory or not). METHOD: In a cross-sectional study of 458 employees (56% women) in 5 different organizations, work environment, job satisfaction, and SHC were measured. RESULTS: Satisfied workers reported an average of five to six subjective health complaints that correspond to the prevalence found in a Norwegian general population. Work environment explained 43% of the variance for job satisfaction and 9% of the variance in SHCs. CONCLUSION: SHCs are common among satisfied workers. Work environment has only a limited influence on this validated health indicator.     

Combining job and family demands and being healthy: what are the differences between men and women?

BACKGROUND: The objective of this study is to analyse gender inequalities in the combination of job and family life and their effect on health status and use of health care services. METHODS: The data come from the Navarra Survey of Working Conditions (Spain, 1997) carried out on a sample of 2185 workers. The analysis was restricted to 881 men and 400 women, aged 25-64 years, who were married or cohabiting. Dependent variables were self-perceived health status, psychosomatic symptoms, and medical visits, all of them dichotomized. Independent variables were family demands and number of hours of paid work a week. The analysis was adjusted for age and occupational social class. Multivariate logistic regression models, separated by sex, were fitted in order to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: Family demands were not associated with men's health whereas married women who lived in family units of more than three members had a higher risk of poor self-perceived health status (aOR=4.16; 95% CI: 1.37-12.65) and of psychosomatic symptoms (aOR=2.05; 95% CI: 1.12-3.75). Among women, working more than 40 hours a week was also associated with both health indicators and, additionally, with a higher probability of medical visits. CONCLUSION: In order to fully understand social determinants of workers' health, besides social class, gender inequalities in the distribution of family responsibilities should be considered.     

Is any job better than no job at all? Studying the relations between employment types,unemployment and subjective health in Belgium

Background

This study focuses on the health impact of the labour market position, since recent research indicates that exposure to both unemployment and precarious employment causes serious harm to people’s health and well-being. An overview of general and mental health associations of different labour market positions in Belgium is provided. A distinction is made between employment and unemployment and in addition between different types of jobs among the employed, taking into account the quality of employment. Given the fact that precarious labour market positions tend to coincide with a precarious social environment, the latter is taken into consideration by including the composition and material living conditions of the household and the presence of social support.

Methods

Belgian data from the 1st Generations and Gender Survey are used. A Latent Class Cluster Analysis is performed to construct a typology of labour market positions that includes four different types of waged employment: standard jobs, instrumental jobs, precarious jobs and portfolio jobs, as well as self-employment and unemployment. Then, binary logistic regression analyses are performed in order to relate this typology to health, controlling for household situation and social support. Two health outcomes are included: self-perceived general health (good versus fair/bad) and self-rated mental health (good versus bad, based on 7 items from the Center for Epidemiologic Studies Depression Scale).

Results

Two labour market positions are consistently related to poor general and mental health in Belgium: unemployment and the precarious job type. The rather small gap in general and mental health between both labour market positions emphasises the importance of employment quality for the health and well-being of individuals in waged employment. Controlling for the household level context and social support illustrates that part of the reported health associations can be explained by the precarious social environment of individuals in unfavourable labour market positions.

Conclusions

The results from this study confirm that the labour market position and social environment of individuals are important health determinants in Belgium.

     

Combining a job and children: contrasting the health of married and divorced women in the Netherlands?

The research question of this paper is whether the combination of paid employment and taking care of children promotes or damages the health of married and divorced women in the Netherlands. To answer this question, data are used from 936 women aged 30-54 years who were either living with a partner (N = 431) or divorced and living alone 505). The findings show that combining a job outside the home and childcare does not harm women's health, irrespective of the length of the working week and the age of the children. In fact, some work-childcare combinations are associated with better health. This is true for both married and divorced women and especially holds true in the case of a part-time job and having older children. Two effects are responsible for the findings: enjoying good health enables mothers to work outside the home (selection effect) and working outside the home promotes mothers' health (health effect).     

General self-efficacy and the effect of hospital workplace violence on doctors’ stress and job satisfaction in China

Objectives

This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors’ work-related attitudes.

Material and Methods

In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors’ experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses.

Results

Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p < 0.001) and with job satisfaction (β = ?0.35 and ?0.34, respectively; p < 0.05). However, it did not modify the relationships between both experiencing and witnessing workplace violence with job initiative (p > 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased.

Conclusions

The findings suggest that GSE can modify effects of workplace violence on health care workers’ stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers’ recovery from workplace violence, and thereby improving their work-related attitudes.     

Does the job demand-control model correspond to externally assessed demands and control for both women and men?

AIMS: To explore externally assessed demands and control for both women and men in each of the groups of the job demand-control (JDC) model, which itself was based on self-reported data. A specific aim was to better understand why health conditions among women with active jobs were as bad as those among women with high-strain jobs in some earlier studies. METHODS: Expert assessments were made through direct observation and interviews concerning time pressure, hindrances, influence, and creative work tasks. The sample consisted of 203 men and women in 85 occupations. The four groups of the JDC model (high strain, low strain, active, and passive) were constructed from self-reported data. RESULTS: Most comparative analyses of the JDC groups showed that external assessments corresponded to self-reports in the expected direction for both women and men, although not always statistically significant. However, in the active job situation, external assessments deviated from self-reports in different directions for women and men. Women had more hindrances and less influence over their work, while the situation was reversed for men. Women in active jobs worked more often than men in an organization with mostly female staff and in a predominantly female occupation. CONCLUSIONS: Associations between self-reported working conditions and health might be underestimated among women reporting an active job situation. Our findings contribute to the discussion on why the results in some studies show that active jobs among women are as hazardous for health as high-strain jobs.     

Immunisation of refugee and migrant young people: can schools do the job?

OBJECTIVES: To assess immunisation needs, primary health care (PHC) use and trial a school-based immunisation service for refugee and migrant young people attending an Intensive English Centre (IEC) high school in Western Sydney. METHODS: We surveyed students attending an IEC in Western Sydney, assessing self-reported immunisation status and use of PHC services via questionnaires translated in six languages. Those students who were not immunised for hepatitis B and measles-mumps-rubella (MMR) were provided the first and second dose of a three-dose hepatitis B immunisation schedule and a single dose of MMR vaccine. We compared the immunisation requirements for MMR and hepatitis B with utilisation of PHC. RESULTS: One-hundred and sixty-five students (85%) returned the questionnaire. Forty-nine students (30%) reported previous immunisation with MMR and 29 (18%) with hepatitis B. As part of the school immunisation program, 142 (74%) received MMR vaccine, 151 (78%) received the first dose of hepatitis B vaccine, 144 (95%) received the second dose of hepatitis B, and 34 (23%) received the third hepatitis B dose elsewhere. Sixty-six students (40%) reported seeing a doctor in the past year. Students who had not seen a doctor in the previous year were significantly more likely to request immunisation (p < 0.01). CONCLUSIONS AND IMPLICATIONS: Refugee and migrant young people attending an IEC in Western Sydney report low immunisation rates. Our study highlights the urgent need for education and health to work together to provide specialised immunisation services for refugee and migrant young people.     

Downsizing-initiated job transfer of hospital nurses: how do the job transferees fare?

In this longitudinal panel study, the authors compared the reactions to hospital amalgamation of 66 nurses who had been transferred to a different unit for a downsizing-related reason (bumped/displaced, unit closed, redundancy) with the reactions of 181 nurses who remained on their same unit. Prior to any job transfers, the two groups perceived comparable levels of support and held similar attitudes towards their job and the hospital. Two years later, after job transfers had taken place, transferred nurses perceived significantly lower coworker support. They also reported a significantly greater decrease in organizational commitment than nurses who were not transferred. However, both groups reported a significant decrease between time a and time 2 in perceived organizational support, satisfaction with amount of work and career future, hospital identification, and organization trust. Overall, the results indicate that the downsizing associated with the amalgamation of the hospitals had a highly negative effects not only on those nurses who were transferred because of the downsizing but also on those nurses who remained on their original unit.     

Does job insecurity deteriorate health?

This paper estimates the causal effect of perceived job insecurity – that is, the fear of involuntary job loss – on health in a sample of men from 22 European countries. We rely on an original instrumental variable approach on the basis of the idea that workers perceive greater job security in countries where employment is strongly protected by the law and more so if employed in industries where employment protection legislation is more binding; that is, in induastries with a higher natural rate of dismissals. Using cross‐country data from the 2010 European Working Conditions Survey, we show that, when the potential endogeneity of job insecurity is not accounted for, the latter appears to deteriorate almost all health outcomes. When tackling the endogeneity issue by estimating an instrumental variable model and dealing with potential weak‐instrument issues, the health‐damaging effect of job insecurity is confirmed for a limited subgroup of health outcomes; namely, suffering from headaches or eyestrain and skin problems. As for other health variables, the impact of job insecurity appears to be insignificant at conventional levels. Copyright © 2014 John Wiley & Sons, Ltd.     

Can high psychological job demands,low decision latitude,and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers

Objectives

The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period.

Methods

We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register.

Results

Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04–2.0) and 1.7 in women (95 % CI, 1.3–2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women.

Conclusions

High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.

     

GP job satisfaction in 1987, 1990 and 1998: lessons for the future?

BACKGROUND: Job satisfaction is an important determinant of physician retention and turnover, and may also affect performance. Objective. Our aim was to investigate changes in GP job satisfaction from 1987 to 1998, covering a period of major change in the organization of British general practice. METHODS: Postal surveys of random national samples of GPs were carried out by separate groups of investigators in 1987, 1990 and 1998. In each survey, the questionnaire contained a standardized job satisfaction scale and a list of 14 job stressors. The final samples consisted of 1817 GPs in 1987 (response rate 45%), 917 GPs in 1990 (response rate 61%) and 1828 GPs in 1998 (response rate 49%). RESULTS: For both men and women, overall job satisfaction declined from 1987 to 1990 and then improved from 1990 to 1998, although satisfaction in 1998 remained below that in 1987. Women tended to report higher levels of satisfaction than men in all 3 years. Satisfaction with nine specific aspects of work showed dissimilar patterns of change over time. From 1987 to 1990, reported levels of stress increased for eight of 14 job stressors. Of these, three subsequently declined in 1998, two remained unchanged and three continued to increase. Of the six job stressors which showed no change from 1987 to 1990, five subsequently increased as sources of stress. Men and women differed in their sources of stress, but the differences were not consistent over time. CONCLUSIONS: The results suggest that GP job satisfaction has improved significantly from the low point reached following the introduction of the 1990/1991 NHS reforms, although reported levels of stress in relation to many aspects of work have continued to increase. The changes are discussed within the context of wider research into the determinants of GP job satisfaction in order to anticipate the likely effects on GPs of future organizational reforms.     

Can labour contract differences in health and work-related attitudes be explained by quality of working life and job insecurity?

Study aim

We hypothesise that due to a lower quality of working life and higher job insecurity, the health and work-related attitudes of temporary workers may be less positive compared to permanent workers. Therefore, we aimed to (1) examine differences between contract groups (i.e. permanent contract, temporary contract with prospect of permanent work, fixed-term contract, temporary agency contract and on-call contract) in the quality of working life, job insecurity, health and work-related attitudes and (2) investigate whether these latter contract group differences in health and work-related attitudes can be explained by differences in the quality of working life and/or job insecurity.

Methods

Data were collected from the Netherlands Working Conditions Survey 2008 (N?=?21,639), and Hypotheses were tested using analysis of variance and cross-table analysis.

Results

Temporary work was associated with fewer task demands and lower autonomy and was more often passive or high-strain work, while permanent work was more often active work. Except for on-call work, temporary work was more insecure and associated with worse health and work-related attitude scores than permanent work. Finally, the quality of working life and job insecurity partly accounted for most contract differences in work-related attitudes but not in health.

Conclusions

Especially agency workers have a lower health status and worse work-related attitudes. Job redesign measures regarding their quality of working life and job insecurity are recommended.     

Do psychosocial job demands and job resources predict long-term sickness absence? An analysis of register-based outcomes using pooled data on 39,408 individuals in four occupational groups

Purpose

To investigate whether psychosocial job demands (work pace and quantitative demands) and job resources (influence at work and quality of leadership) predict long-term sickness absence (LTSA) for more than three consecutive weeks in four occupational groups.

Methods

Survey data pooling 39,408 respondents were fitted to a national register containing information on payments of sickness absence compensation. Using multi-adjusted Cox regression, respondents were followed for an 18-month follow-up period to assess risk of LTSA.

Results

In the entire study population, low and medium levels of influence at work and low quality of leadership predicted a significantly increased risk of LTSA, whereas medium levels of quantitative demands predicted a significantly reduced risk of LTSA. For employees working with clients and for office workers, low and medium influence at work associated with a significantly increased risk of LTSA. For employees working with clients, low quality of leadership predicted a significantly increased risk of LTSA. For manual workers, low influence at work predicted a significantly increased risk of LTSA and medium quantitative demands were associated with a significantly reduced risk of LTSA. For employees working with customers, medium quantitative demands predicted a significantly reduced risk of LTSA. Finally, in predicting LTSA, we found significant interaction effects between job demands and job resources.

Conclusions

The study indicates that a lack of job resources—particularly influence at work—are more important predictors of LTSA than high job demands.