Types of employment and health: analysis of the Second European Survey on Working Conditions

OBJECTIVES: To investigate the relationships among types of employment and several health self-perceived outcomes in a sample of active workers from the 15 state members of the European Union. METHODS: Cross-sectional study with data drawn from the Second European Survey on Working Conditions (n = 15,146 individuals). The predictive variable was the types of employment aggregated in: permanent workers, sole traders, small employers (less than 10 employees) and temporary workers (full-and part-time). Unconditional logistic regression models were adjusted by age, gender and several indications of working conditions. Permanent workers was used as the baseline category. RESULTS: Employees with permanent (69,3%) and temporary (12,5%) contracts notified the highest level of a job absenteeism while temporary employees reported the highest level of job dissatisfaction. On the other hand, sole traders (12,2%) and small employees (6.1%) notified the most frequent level of overall fatigue, backache and muscular pains. Having permanent workers as baseline category, temporary employees was associated with high dissatisfaction (OR = 1.68), and and overall fatigue (OR = 1.16), but with lower frequency of stress (OR = 0.74) and job absenteeism (OR = 0.87). Small employers showed a low frequency of absenteeism (OR = 0.68), but a high stress (OR = 1.77) and overall fatigue (OR = 1.27). Finally, sole traders reported more frequently overall fatigue (OR = 1.40), and stress (OR = 1.33), but less job absenteeism (OR = 0.58). CONCLUSIONS: These findings suggest that types of employment may have an independent effect on several health self-perceive outcomes. Further research is necessary to overcome various shortcoming of this study, and to assess the role either job security or level of income and social protection.     

Precarious employment and migrant workers’ mental health: a systematic review of quantitative and qualitative studies

ObjectivesEvidence suggests that precarious employment can have detrimental effects on workers’ health, including mental health. Migrant workers are discussed to be especially vulnerable to such effects. Thus, we systematically reviewed existing research on the association between precarious employment and migrant workers’ mental health.MethodsThree electronic databases (Web of Science, PsycINFO and PubMed/Medline) were searched for original articles on quantitative and qualitative studies published from January 1970 to February 2022 in English, German, Turkish and Spanish. Multiple dimensions of precarious employment were considered as exposure, with mental health problems as outcomes. Narrative synthesis and thematic analyses were performed to summarize the findings of the included studies along with risk of bias and quality assessment.ResultsThe literature search resulted in 1557 original articles, 66 of which met the inclusion criteria – 43 were of high quality and 22 were of moderate quality. The most common exposure dimensions analyzed in the studies included temporariness, vulnerability, poor interpersonal relationships, disempowerment, lacking workers’ rights and low income. The outcome measures included stress, depression, anxiety and poor general mental health. The prevalence of these outcomes varied between 10–75% among the included quantitative studies. All qualitative studies reported one or more dimensions of precarious employment as an underlying factor of the development of mental health problems among migrants. Of 33 quantitative studies, 23 reported evidence for an association between dimensions of precarious employment and mental health.ConclusionThe results of this review support the hypothesis that precarious employment is associated with migrant workers’ mental health.     

How workers’ emotional dissonance explains the association between customers’ relations,burnout and health in an Italian supermarket chain

Introduction:Dealing with customers has increasingly became a risk factor that organisations should be aware of. Having to deal with difficult customers, pupils, patients it has been found to be the second most frequent reported risk factor in the recent 2019 ESENER survey (61%, up from 58%), just after repetitive hand or arm movements.Objectives:The aim of the present study is to explore the relationship between negative relations with customers and its association with employees’ burnout and general health.Methods:Data were collected using an anonymous, self-report questionnaire employed in an Italian company working in the large-scale retail sector. The sample was composed of 610 employees (70% women) working in 28 supermarkets.Results:Results showed that negative customer relations were associated to higher levels of emotional dissonance (b = .25; p = .000), which in turn was associated with higher levels of burnout (b = .72; p = .017) and consequently to higher levels of poor general health (b = .03; p = .000).Conclusion:This study contributed to the current understanding of how negative relationship with clients could trigger a health impairment process which could lead to higher levels of burnout and poorer general health in employees. Findings suggest that organizations whose employees’ work activities are characterized by a daily contact with customers should implement interventions such as training activities in order to enhance the employees’ skills in dealing with custumers, for example on how to manage emotions at work.     

Performance-based incentives and community health workers’ outputs,a systematic review

ObjectiveTo review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low- and middle-income countries.MethodsWe conducted a systematic review of intervention studies published before November 2020 that evaluated the impact of financial and non-financial performance-based incentives for CHWs. Outcomes included patient health indicators; quality, utilization or delivery of health-care services; and CHW motivation or satisfaction. We assessed risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on a framework for measuring the performance of CHW programmes, comprising inputs, processes, performance outputs and health outcomes.FindingsTwo reviewers screened 2811 records; we included 12 studies, 11 of which were randomized controlled trials and one a non-randomized trial. We found that non-financial, publicly displayed recognition of CHWs’ efforts was effective in improved service delivery outcomes. While large financial incentives were more effective than small ones in bringing about improved performance, they often resulted in the reallocation of effort away from other, non-incentivized tasks. We found no studies that tested a combined package of financial and non-financial incentives. The rationale for the design of performance-based incentives or explanation of how incentives interacted with contextual factors were rarely reported.ConclusionFinancial performance-based incentives alone can improve CHW service delivery outcomes, but at the risk of unincentivized tasks being neglected. As calls to professionalize CHW programmes gain momentum, research that explores the interactions among different forms of incentives, context and sustainability is needed.     

Public health policies and health-care workers’ response to the COVID-19 pandemic,Thailand

Since January 2020, the coronavirus disease 2019 (COVID-19) pandemic has had a far-reaching impact on global morbidity and mortality. The effects of varying degrees of implementation of public health and social measures between countries is evident in terms of widely differing disease burdens and levels of disruption to public health systems. Despite Thailand being the first country outside China to report a positive case of COVID-19, the subsequent number of cases and deaths has been much lower than in many other countries. As of 7 January 2021, the number of confirmed COVID-19-positive cases in Thailand was 9636 (138 per million population) and the number of deaths was 67 (1 per million population). We describe the nature of the health workforce and function that facilitated the capacity to respond to this pandemic. We also describe the public health policies (laboratory testing, test-and-trace system and mandatory 14-day quarantine of cases) and social interventions (daily briefings, restriction of mobility and social gatherings, and wearing of face masks) that allowed the virus to be successfully contained. To enhance the capacity of health-care workers to respond to the pandemic, the government (i) mobilized staff to meet the required surge capacity; (ii) developed and implemented policies to protect occupational safety; and (iii) initiated packages to support morale and well-being. The results of the policies that we describe are evident in the data: of the 66 countries with more than 100 COVID-19-positive cases in health-care workers as at 8 May 2020, Thailand ranked 65th.     

Rural and metropolitan South Australian mental health workers’ views about nurse prescribing: A thematic analysis

Almost one third of the South Australian population reside in regional locations, which are serviced by just 8% of the State's total psychiatrist workforce. Consequently, access to psychotropic medications in regional South Australia (SA) can be challenging. Granting prescribing rights to mental health nurses (MHNs) located in regional settings presents an opportunity to increase consumer access to psychotropic medications. The aim of the study was to understand the perspectives of mental health workers (MHWs) practising in regional and metropolitan settings towards MHN prescribing. The study adopted a qualitative approach. Seventeen MHWs participated in three focus groups, including two in regional SA and one in a metropolitan site within the State of SA. Participants reported difficulties in accessing medicines in regional areas. The regional focus groups indicated that MHN prescribing may help to release psychiatrists’ time and provide quicker assessment and diagnosis. By contrast, the metropolitan focus group expressed reservations about MHN prescribing. Participants indicated that suitable governance structures supported by appropriate education programmes were a necessary prerequisite for MHN prescribing of psychotropic medications. MHN prescribing may help to mitigate the impact of psychiatrist shortages in regional South Australia and possibly in other areas of the world where recruitment is a challenge. The provision of adequate education and the establishment of a suitable governance and support framework are considered necessary steps to progress MHN prescribing.     

Risk and resilience: health inequalities,working conditions and sickness benefit arrangements: an analysis of the 2010 European Working Conditions survey

In this article we ask whether the level of sickness benefit provision protects the health of employees, particularly those who are most exposed to hazardous working conditions or who have a little education. The study uses the European Working Condition Survey that includes information on 20,626 individuals from 28 countries. Health was measured by self‐reported mental wellbeing and self‐rated general health. Country‐level sickness benefit provision was constructed using spending data from Eurostat. Group‐specific associations were fitted using cross‐level interaction terms between sickness benefit provision and physical and psychosocial working conditions respectively, as well as those with little education. The mental wellbeing of employees exposed to psychosocial job strain and physical hazards, or who had little education, was better in countries that offer more generous sickness benefit. These results were found in both men and women and were robust to the inclusion of GDP and country fixed effects. In the analyses of self‐reported general health, few group‐specific associations were found. This article concludes that generous sickness benefit provision may strengthen employee's resilience against mental health risks at work and risks associated with little education. Consequently, in countries with a generous provision of sickness benefit, social inequalities in mental health are smaller.     

Working conditions and mental health: Results from the CARESUN study

The authors conducted a work-related stress surveillance study in 2013 on 6,558 public-sector employees in Italy, examining how they perceived their jobs, via the Job Content Questionnaire, and their mental health status, via the General Health Questionnaire 12 (GHQ-12). Of the 2,094 employees completing the questionnaires, 60% were male, 52% had a medium-level education, and 76% had a medium-level job. Three hundred and eighty-five employees (18%) had a GHQ-12 score >3 and were classified as GHQ-12 cases: these were more often female (54%), medium-to-highly educated (54%), and had more often reported health problems over the previous year (51%). Thus, GHQ-12 cases represented a significant percentage of the examined population, indicating that work-related stress surveillance programs are needed for the planning of psychosocial interventions aimed at the reintegration of individuals with mental health problems.     

Canadian community mental health workers’ perceived priorities for supportive housing services in northern and rural contexts

A relationship between mental health and supportive housing has been established, yet there exist enduring challenges in meeting the supportive housing needs of people with severe mental health problems. Furthermore, not all stakeholder viewpoints of supportive housing services are well documented in the research literature, and research has tended to focus on supportive housing provision in large, urban centres. Potentially, distinct challenges and opportunities associated with the provision of supportive housing services in smaller urban and rural communities that define the greater geographical terrain of Canada and other jurisdictions are less developed. This study describes community mental health service workers’ priorities for supportive housing services. Using Q methodology, 39 statements about supportive housing services, developed from a mixed‐methods parent study, were sorted by 58 service providers working in four communities in northern Ontario, Canada. Data used in this study were collected in 2010. Q analysis was used to identify correlations between service workers who held similar and different viewpoints concerning service priorities. The results yielded four discrete viewpoints about priorities for delivery of supportive housing services including: a functional system, service efficiency, individualised services and promotion of social inclusion. Common across these viewpoints was the need for concrete deliverables inclusive of financial supports and timely access to adequate housing. These findings have the potential to inform the development of housing policy in regions of low population density which address both system and individual variables.     

Manitoba First Nation peoples’ use of hospital-based mental health services: trends and solutions

ObjectivesThe objective of this article is to document patterns and trends of in-hospital mental health service use by First Nations (FN) living in rural and remote communities in the province of Manitoba.MethodsOur sample included all Manitoba residents eligible under the Manitoba Health Services Insurance Plan living on FN reserves and those living in rural and remote communities from 1986 to 2014. Using administrative claims data, we developed multi-level models that describe hospitalization for mental health conditions shown responsive to primary healthcare interventions. We aggregated the results by First Nation Tribal Councils and remoteness to derive rates of hospitalization episodes, length of stay and readmission rates.ResultsRates of hospitalization for mental health are increasing for FN males and females. This is particularly evident for those affiliated with the Island Lake and Keewatin Tribal Councils. The length of stay has increased. Changes in rates of readmissions were not statistically significant. FNs are admitted for mental health conditions at a younger age when compared with other Manitobans, and trends show that the FNs’ average age at admission is decreasing.ConclusionsOur results raise serious concerns about the responsiveness of community-based mental health services for FNs in Manitoba, because of both increasing rates of episodes of hospitalization and decreasing age of admission. Given the documented lack of mental health services accessible on-reserve, levels of social distress associated with a history of oppressive policies, and continued lack of infrastructure, current trends are alarming.     

应用Kessler10量表对白领心理健康状况的调查研究

目的利用Kessler10量表调查了解白领心理健康状况及其影响因素。方法对2009年15月在福田区第二人民医院体检门诊进行健康体检的白领人员利用自制调查问卷和凯斯勒量表（Kesslerl0,K10）对其心理健康状况进行访谈式调查,采用SPSS16．0软件进行统计分析。结果共调查白领人员共278人,其K10分值总体分布为（14．88±5．47）,67．6％的白领心理健康状况相对较好（Kesslsler10量表评分在10～15分）;文化程度低和高两端、有健康问题或症状、自觉健康状况较差、自觉有心理问题、有自杀念头、缺乏体育锻炼、睡眠不足、无业余爱好、遭遇重大挫折、有心理疾病家族史的白领K10得分较高。结论白领的心理健康状况受文化程度、健康状况、生活行为方式等因素的影响。     

Epidemiology and prevention of occupational health hazards within the European Community

Since 1978 the European Community has had an action programme on safety and health at work covering all 120 million workers in the Community. On the basis of this programme, directives (instruments of Community legislations) have been adopted by the Council of Ministers and new directives are being drafted. The aim of these directives is to improve safety at work and to protect the health of workers from mechanical, physical, chemical and biological hazards. The drafting of proposals by the Commission for presentation to the Council necessitates detailed and critical examination of the scientific data available, such as epidemiological studies, statistical data and the results of experiments. Epidemiological studies of cases of mesothelioma have led us to propose more stringent limit values for crocidolite than for other asbestos fibres in the air at the place of work. At present, in order to gain a clearer idea of the carcinogenicity of the various compounds of nickel, efforts are being made to collate and update all the epidemiological studies conducted on this subject throughout the world. Finally, particular attention is being paid to the opportunities provided by the anti-poison centres for developing clinical toxicology and epidemiology.     

Exploring a Dutch paradox: an ethnographic investigation of gay men's mental health

Despite the Netherlands' reputation as a world leader with respect to gay rights, homosexual Dutch men have much higher rates of mood disorders, anxiety disorders and suicide attempts than heterosexual Dutch men. Epidemiologists report similar disparities elsewhere in Western Europe and North America. These findings have been the focus of a blossoming psychological literature, inspired by minority stress theory and deploying quantitative methods. Our investigation aims to complement this body of work by adopting an ethnographic approach. Drawing from fieldwork conducted in the Netherlands from 2009 to 2010, we explore sociocultural and contextual factors that have received relatively little attention with respect to gay mental health. In the Netherlands – considered a model for gay equality – how can one understand high rates of psychiatric disorders among gay men? This study points to heteronormativity, complex dynamics involving long-term relationships and processes within gay subcultures as key issues. Notwithstanding their putative socioeconomic, legal and political equality, gay men struggled – at various stages of the life cycle – with internalised norms that they found difficult to fulfil. The desire to embody these ideals, and structural constraints in meeting them, could be potent sources of disappointment and distress.     

Low sensitivity of rapid tests detecting anti-CoV-2 IgG and IgM in health care workers’ serum for COVID-19 screening

Background: the sensitivity and specificity of a rapid antibody test were investigated for the screening of healthcare workers. Methods: the serum of 389 health care workers exposed to COVID-19 patients or with symptoms, were analysed. All workers underwent monthly the screening for SARS-CoV-2 with detection of viral RNA in nasopharyngeal swabs by RT-PCR. IgG antibody detection in serum was performed by Chemiluminescence Immunoassay (CLIA) and by the Rapid test (KHB diagnostic kit for SARS CoV-2 IgM/IgG antibody after a median of 7.6 weeks (25°-75° percentiles 6.6-11.5). Results: the rapid test resulted positive in 31/132 (23.5%), 16/135 (11.8%) and 0/122 cases in COVID-19 positive individuals, in those with only SARS-CoV-2 IgG antibodies and in those negative for both tests, respectively. Sensitivity was 17.6% (CI95% 13.2-22.7) and 23.5% (CI95% 16.5-31.6), and specificity was 100% (CI95% 97-100) and 100% (CI95% 97-100) considering Rapid test vs CLIA IgG or Rapid test vs SARS-CoV-2 positive RNA detection, respectively. Conclusion: the KHB Rapid test is not suitable for the screening of workers with previous COVID-19 infection.     

Work process in mental health and the psychosocial area

We present a theoretical reflection about determinants and constitutive elements of the nursing work process in the psychiatric and psychosocial areas, in the context of the Brazilian Psychiatric Reform. The aim is to offer theoretical and conceptual guidance with a view to mental health workers' reflexive action, particularly in nursing. The purpose of this article is to preserve the memory of nursing practice in psychiatry and to go beyond, with a view to constructing the psychosocial area, supporting teaching in all fields of health knowledge.