Work factors and psychological distress in nurses' aides: a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Nurses' aides (assistant nurses), the main providers of practical patient care in many countries, are doing both emotional and heavy physical work, and are exposed to frequent social encounters in their job. There is scarce knowledge, though, of how working conditions are related to psychological distress in this occupational group. The aim of this study was to identify work factors that predict the level of psychological distress in nurses' aides.</p> <p>Methods</p> <p>The sample of this prospective study comprised 5076 Norwegian nurses' aides, not on leave when they completed a mailed questionnaire in 1999. Of these, 4076 (80.3 %) completed a second questionnaire 15 months later. A wide spectrum of physical, psychological, social, and organisational work factors were measured at baseline. Psychological distress (anxiety and depression) was assessed at baseline and follow-up by the SCL-5, a short version of Hopkins Symptom Checklist-25.</p> <p>Results</p> <p>In a linear regression model of the level of psychological distress at follow-up, with baseline level of psychological distress, work factors, and background factors as independent variables, work factors explained 2 % and baseline psychological distress explained 34 % of the variance. Exposures to role conflicts, exposures to threats and violence, working in apartment units for the aged, and changes in the work situation between baseline and follow-up that were reported to result in less support and encouragement were positively associated with the level of psychological distress. Working in psychiatric departments, and changes in the work situation between baseline and follow-up that gave lower work pace were negatively associated with psychological distress.</p> <p>Conclusion</p> <p>The study suggests that work factors explain only a modest part of the psychological distress in nurses' aides. Exposures to role conflicts and threats and violence at work may contribute to psychological distress in nurses' aides. It is important that protective measures against violent patients are implemented, and that occupational health officers offer victims of violence appropriate support or therapy. It is also important that health service organisations focus on reducing role conflicts, and that leaders listen to and consider the views of the staff.</p

Investigating the Bidirectional Associations of Adiposity with Sleep Duration in Older Adults: The English Longitudinal Study of Ageing (ELSA)

Cross-sectional analyses of adiposity and sleep duration in younger adults suggest that increased adiposity is associated with shorter sleep. Prospective studies have yielded mixed findings, and the direction of this association in older adults is unclear. We examined the cross-sectional and potential bi-directional, prospective associations between adiposity and sleep duration (covariates included demographics, health behaviours, and health problems) in 5,015 respondents from the English Longitudinal Study of Ageing (ELSA), at baseline and follow-up. Following adjustment for covariates, we observed no significant cross-sectional relationship between body mass index (BMI) and sleep duration [(unstandardized) B?=??0.28?minutes, (95% Confidence Intervals (CI)?=??0.012; 0.002), p?=?0.190], or waist circumference (WC) and sleep duration [(unstandardized) B?=??0.10?minutes, (95% CI?=??0.004; 0.001), p?=?0.270]. Prospectively, both baseline BMI [B?=??0.42?minutes, (95% CI?=??0.013; ?0.002), p?=?0.013] and WC [B?=??0.18?minutes, (95% CI?=??0.005; ?0.000), p?=?0.016] were associated with decreased sleep duration at follow-up, independently of covariates. There was, however, no association between baseline sleep duration and change in BMI or WC (p?>?0.05). In older adults, our findings suggested that greater adiposity is associated with decreases in sleep duration over time; however the effect was very small

Abordagem multifatorial do absenteísmo por doença em trabalhadores de enfermagem

OBJETIVO: Analisar fatores associados ao absenteísmo por doença autorreferido em trabalhadores de enfermagem. MÉTODOS: Estudo transversal com 1.509 trabalhadores de três hospitais públicos no município do Rio de Janeiro, RJ, em 2006. O absenteísmo foi classificado em três níveis: nenhum dia, poucos dias (um a nove dias) e muitos dias (>; 10 dias), a partir da resposta a uma pergunta do questionário de avaliação do índice de capacidade para o trabalho. As análises de regressão logística levaram em conta um modelo conceitual com base em determinantes distais (condições socioeconômicas), de níveis intermediários I (características ocupacionais) e II (características do estilo de vida), e proximais (doenças e condições de saúde). RESULTADOS: As frequências de absenteísmo por doença foram de 20,3% e 16,6% para poucos e muitos dias, respectivamente. Aqueles que referiram mais de um emprego, doenças osteomusculares e avaliaram sua saúde como ruim ou regular apresentaram chances mais elevadas de absenteísmo. Comparados aos enfermeiros, os auxiliares tiveram menor chance de referir poucos dias e os técnicos, maiores chances de apresentar muitos dias de ausência. Chances mais elevadas de referir muitos dias de ausência foram observadas entre os servidores públicos em relação aos contratados (OR = 3,12; IC95% 1,86;5,22) e entre os casados (OR = 1,73; IC95% 1,14;2,63) e separados, divorciados e viúvos (OR = 2,06; IC95% 1,27;3,35), comparados aos solteiros. CONCLUSÕES: Diferentes variáveis foram associadas às duas modalidades de absenteísmo, o que sugere sua determinação múltipla e complexa, relacionada a fatores de diversos níveis que não podem ser explicados apenas por problemas de saúde.OBJETIVO: Analizar factores asociados al ausentismo por enfermedad auto referida en trabajadores de enfermería. MÉTODOS: Estudio transversal con 1.509 trabajadores de tres hospitales públicos en Rio de Janeiro, Sureste de Brasil, en 2006. El ausentismo fue clasificado en tres niveles: ningún día, pocos días (uno a nueve días) y muchos días (>;10 días), a partir de la respuesta a una pregunta de cuestionario de evaluación del índice de capacidad para el trabajo. Los análisis de regresión logística tomaron en cuenta un modelo conceptual con base en determinantes distales (condiciones socioeconómicas), de nivel intermedio I (características ocupacionales) y II (características de estilo de vida) y, proximales (enfermedades y condiciones de salud). RESULTADOS: Las frecuencias de ausentismo por enfermedad fueron de 20,3% y 16,6% para pocos y muchos días, respectivamente. Aquellos que mencionaron más de un empleo, enfermedades osteomusculares y evaluaron su salud como mala o regular presentaron chances más elevados de ausentismo. En comparación con los enfermeros, los auxiliares tuvieron menor chance de relatar pocos días y los técnicos, mayores chances de presentar muchos días de ausencia. Chances mas elevados de mencionar muchos días de ausencia fueron observados entre los servidores públicos con relación a los contratados (OR=3,12; IC95% 1,86;5,22) y entre los casados (OR= 1,73; IC95% 1,14;2,63) y separados, divorciados y viudos (OR= 2,06; IC95% 1,27;3,35), en comparación con los solteros. CONCLUSIONES: Diferentes variables fueron asociadas con las dos modalidades de ausentismo, lo que sugiere su determinación múltiple y compleja, relacionada con factores de diversos niveles que no pueden ser explicados sólo por problemas de salud.OBJECTIVE: To analyze factors associated with self-reported sickness absenteeism among nursing workers. METHODS: Cross-sectional study with 1,509 workers from three public hospitals in the city of Rio de Janeiro (Southeastern Brazil) in 2006. Absenteeism was classified in three levels: no day, a few days (1-9 days) and many days (>; 10 days), based on the answer to a question of the work ability index questionnaire. The logistic regression analysis considered a conceptual model based on distal (socioeconomic status), intermediate I (occupational characteristics), intermediate II (lifestyle characteristics), and proximal (diseases and health conditions) determinants. RESULTS: The frequencies of sickness absenteeism were 20.3% and 16.6% for a few days and many days, respectively. Those who reported more than one job, musculoskeletal diseases and rated their health as poor or regular had higher odds of absenteeism. Compared to nurses, nursing assistants were less likely to mention a few days, and technicians were more likely to have many days of absence. Higher odds of mentioning many days of absence were observed among public servants, compared to contract workers (OR = 3.12; 95%CI 1.86;5.22), and among married (OR = 1.73; 95%CI 1.14;2.63) and separated, divorced and widowed individuals (OR = 2.06, 95%CI 1.27;3.35), compared to singles. CONCLUSIONS: Different variables were associated with the two forms of absenteeism, which suggests its multiple and complex determination related to factors from different levels that cannot be exclusively explained by health problems

Effects of workplace-based dietary and/or physical activity interventions for weight management targeting healthcare professionals : a systematic review of randomised controlled trials

BACKGROUND: The prevalence of overweight and obesity is high amongst healthcare professionals and there is growing interest in delivering weight loss interventions in the workplace. We conducted a systematic review to (i) examine the effectiveness of workplace-based diet and/or physical activity interventions aimed at healthcare professionals and to (ii) identify and describe key components of effective interventions. Seven electronic databases were systematically searched. RESULTS: Thirteen randomised controlled trials met the inclusion criteria, of which seven had data available for meta-analysis. Where meta-analysis was possible, studies were grouped according to length of follow-up (<12 months and ≥12 months) and behavioural target (diet only, physical activity only or diet and physical activity), with outcome data pooled using a weighted random effects model. Nine studies reported statistically significant (between-group) differences. Four studies reported being informed by a behaviour change theory. Meta-analysis of all trials reporting weight data demonstrated healthcare professionals allocated to dietary and physical activity interventions lost significantly more body weight (-3.95 Kg, [95% CI -4.96 to- 2.95 Kg]) than controls up to 12 months follow up. CONCLUSIONS: Workplace diet and/or physical activity interventions targeting healthcare professionals are limited in number and are heterogeneous. To improve the evidence base, we recommend additional evaluations of theory-based interventions and adequate reporting of intervention content.Peer reviewedFinal Published versio

"Sleep disparity" in the population: poor sleep quality is strongly associated with poverty and ethnicity

<p>Abstract</p> <p>Background</p> <p>Little is known about the social determinants of sleep attainment. This study examines the relationship of race/ethnicity, socio-economic status (SES) and other factors upon sleep quality.</p> <p>Methods</p> <p>A cross-sectional survey of 9,714 randomly selected subjects was used to explore sleep quality obtained by self-report, in relation to socioeconomic factors including poverty, employment status, and education level. The primary outcome was poor sleep quality. Data were collected by the Philadelphia Health Management Corporation.</p> <p>Results</p> <p>Significant differences were observed in the outcome for race/ethnicity (African-American and Latino versus White: unadjusted OR = 1.59, 95% CI 1.24-2.05 and OR = 1.65, 95% CI 1.37-1.98, respectively) and income (below poverty threshold, unadjusted OR = 2.84, 95%CI 2.41-3.35). In multivariable modeling, health indicators significantly influenced sleep quality most prominently in poor individuals. After adjusting for socioeconomic factors (education, employment) and health indicators, the association of income and poor sleep quality diminished, but still persisted in poor Whites while it was no longer significant in poor African-Americans (adjusted OR = 1.95, 95% CI 1.47-2.58 versus OR = 1.16, 95% CI 0.87-1.54, respectively). Post-college education (adjusted OR = 0.47, 95% CI 0.31-0.71) protected against poor sleep.</p> <p>Conclusions</p> <p>A "sleep disparity" exists in the study population: poor sleep quality is strongly associated with poverty and race. Factors such as employment, education and health status, amongst others, significantly mediated this effect only in poor subjects, suggesting a differential vulnerability to these factors in poor relative to non-poor individuals in the context of sleep quality. Consideration of this could help optimize targeted interventions in certain groups and subsequently reduce the adverse societal effects of poor sleep.</p