Work and family characteristics as socioeconomic determinants in long sickness absence: the Japanese civil servants study

Long sickness absence is more common among low socioeconomic status (SES) groups than high SES groups. This study aimed to evaluate whether work and family characteristics contribute to SES and sex differences in long sickness absence (7 days or more). The participants were 3080 civil servants working for a local Japanese government. In both sexes, low-grade employees were likely to take long sickness absence, with a statistically significant association for men (age-adjusted OR of lowest-grade employees for long sickness absence: 2.30 (95% Confidence Interval (CI): 1.32–4.02)). After adjusting for all variables, SES differences in long sickness absence in men decreased to OR 1.98 (CI 1.10–3.55) but remained significant; in men, being without a spouse was significantly associated with long sickness absence. Employees working long hours had lower OR for long sickness absence after adjusting for all variables in both sexes. Conversely, poor sleep quality and longstanding illness significantly increased OR for long sickness absence. In conclusion, SES differences in sickness absence were explained partly by work and family characteristics, longstanding illness, and poor sleep quality; however, other factors that were not evaluated in this study may also be associated with SES differences.     

Explaining global job satisfaction by facets of job satisfaction: the Japanese civil servants study

Objectives  

Management of job satisfaction is of growing importance in terms of the maintenance of employees’ health. This study aimed to evaluate which and to what extent facets of job satisfaction contributed to global job satisfaction.     

Socioeconomic and Gender Inequalities in Job Dissatisfaction among Japanese Civil Servants: The Roles of Work,Family and Personality Characteristics

Abstract: This study examines (1) whether there are employment grade and gender differences in job dissatisfaction and (2) whether work, family, and personality characteristics explain grade and gender differences in job dissatisfaction. The participants were 3,812 civil servants, aged 20–65, working at a local government in Japan. In both males and females, low control, low social support, work-to-family conflict, type A behaviour pattern and negative affectivity were significantly associated with job dissatisfaction. In females, high demands, long work hours and being unmarried were also associated with job dissatisfaction. Among males, in comparison with the highest grade employees, the age-adjusted odds ratio (OR) for job dissatisfaction in the lowest grade employees was 1.90 (95% CI: 1.40–2.59). The grade differences reduced to 1.08 (0.76–1.54) after adjustment for work, family and personality characteristics. Among females, similar grade differences were observed, although the differences were not statistically significant. In comparison with males, the age-adjusted OR in females for job dissatisfaction was 1.32 (1.14–1.52). This gender difference was reduced to 0.95 (0.79–1.14) following adjustment for the other factors. The majority of employees belong to low to middle grades, and female employees have increased. Reducing grade and gender differences in work and family characteristics is needed.     

Sex differences in physical and mental functioning of Japanese civil servants: explanations from work and family characteristics

Poor physical and mental functioning are more common among women than men and those with disadvantaged work and family characteristics. This study aims to clarify whether sex differences in health functioning can be explained by sex differences in work and family characteristics. The subjects were 3787 civil servants (2525 men and 1262 women), aged 20-65, working in a local government on the west coast of Japan. A questionnaire survey was conducted in January 2003. Low employment grade, high demands, long work hours, shift work, being unmarried, having no young children, high family-to-work conflict and high work-to-family conflict were more common among women than men and were independently associated with poor physical and mental functioning. The age-adjusted odds ratios (ORs) of women for poor health functioning were 1.80 for poor physical functioning and 1.77 for poor mental functioning. When adjusted for employment grade and work characteristics (control, demand, support, work hours, and shift work), the sex differences in health functioning attenuated. When adjusted for family characteristics (family structure and work-family conflicts), the sex differences in health functioning further attenuated and were no longer statistically significant. Sex differences in family characteristics contributed more to sex difference in mental functioning than sex differences in work characteristics. Japan belongs to conservative welfare regimes. In such countries, men are able to concentrate on their work with relative freedom from their family tasks and responsibilities, whereas women feel difficulties in maintaining their work-life balances. Such sex differences in work- and family-related stresses may contribute to sex difference in health. Longitudinal research is necessary to clarify the causal nature of these associations.     

Examination of the cut-off values for a questionnaire used to evaluate asthma control in Japanese asthma patients

Background

The Japan Asthma Control Survey (JACS) questionnaire, developed as a tool for measuring asthma control levels in Japanese asthma patients, was previously tested for its reliability and validity. However, many of the patients enrolled in the original validation study had mild asthma; thus a re-evaluation including severe cases was required to calculate more reliable cut-off values.

Development of a questionnaire to evaluate asthma control in Japanese asthma patients

Background

The asthma control questionnaires used in Japan are Japanese translations of those developed outside Japan, and have some limitations; a questionnaire designed to optimally evaluate asthma control levels for Japanese may be necessary. The present study was conducted to validate the Japan Asthma Control Survey (JACS) questionnaire in Japanese asthma patients.

A questionnaire validated using local treatment guidelines may better predict future asthma risk: MARGIN study

BackgroundAsthma patients often feel satisfied with their current treatment, even when they have been diagnosed as uncontrolled by physicians. The present study investigated the differences in the evaluation of asthma control levels between patients and physicians, and the prediction of future risks.MethodsAsthma patients receiving inhaled corticosteroid/long-acting beta-2 agonists for 4 weeks or more were enrolled and followed-up for 24 weeks. Asthma control levels were evaluated using the following guidelines: Asthma Prevention and Management Guideline, Japan (JGL) and Global Initiative for Asthma (GINA) by physicians, and the Japan Asthma Control Survey (JACS) and a 6-item Asthma Control Questionnaire (ACQ6) by patients, at weeks 0 and 24. Analysis for predictive factors influencing exacerbation was performed using JGL, GINA, JACS, and ACQ6 at week 0.ResultsA total of 420 patients were enrolled. Comparison of the distribution of asthma control levels assessed by physicians and patients showed no statistically significant difference between JGL and JACS (P = 0.19), suggesting a symmetric distribution, while ACQ6 demonstrated a significant difference versus JGL and GINA (both P < 0.001). The predictive factors for exacerbation were unscheduled visits based on GINA (rate ratio; 0.25, 95% CI; 0.14, 0.44), and the use of oral steroids on 3 consecutive days based on JGL (rate ratio; 0.42, 95% CI 0.22, 0.82) and JACS (rate ratio; 0.22, 95% CI; 0.13, 0,40).ConclusionsOur study suggests that evaluation based on treatment guidelines and the questionnaire validated according to the local treatment guidelines is important for improved assessment of asthma control levels and the reduction of future risk.Clinical trial registration numberUMIN000030419.