Stress perception among employees in a French University Hospital

Background Nantes University Hospital comprises 20 activity sectors.Aims To investigate the role of the work environment at the individual level, as well as the workplace level, in explaining the variability in employees’ perception of stress. Methods A self-administered enhanced Karasek Job Content Questionnaire was sent to employees. The main variables were the psychological job demand (PJD) score and the job decision latitude (JDL) score. Univariate and multivariate logistic regression analyses were conducted to estimate crude odds ratio (OR) and adjusted OR. Results One thousand eight hundred and sixty-eight workers were included. Nursing managers (25.9 ± 3.4), non-specialized nurses (25.6 ± 3.5) and physicians (25.3 ± 3.4) had the highest PJD. Cleaning staff (61.4 ± 11.4) and nurse aides (63.6 ± 8.8) had the lowest JDL. Items correlated with high PJD are: unacceptable work schedule, adjusted OR 2.16 (95% CI = 1.3–3.5); unsatisfactory workstation accessibility, OR 1.92 (95% CI = 1.1–3.2); getting from A to B, OR 1.67 (95% CI = 1.2–2.4); and heavy manual handling, OR 1.62 (95% CI = 1.1–2.3). Sleeping tablet use was linked to high PJD (P < 0.01), extra workload (P < 0.05) and tiredness (P < 0.05). Use of painkillers was correlated with musculoskeletal disorders (P < 0.05). Conclusions Our study highlighted women >40 years old, nurse managers, physicians, permanent and/or full-time workers having a high PJD. Nursing aides, medical secretary and nurses presented with high strain. Better control measures should be implemented for those socioprofessional categories to improve prevention measures. This study should be repeated in the future with a multi-centre approach to determine the generalizability of the findings

Epidemiological surveillance of lumbar disc surgery in the general population: a pilot study in a French region.

OBJECTIVES: Disc-related sciatica (DRS) is a significant and costly health problem in the working population. The aim of this pilot study was to assess the feasibility of a surveillance system for DRS using hospital databases for lumbar disc surgery (LDS). METHODS: A total of 272 inpatients (119 men and 153 women) living in a French region and discharged in 2002-2003 from a spine center of a large University Hospital following LDS were compared with demographic and socioeconomic data on the population of the same region. Medical and occupational histories were gathered using a mailed questionnaire. The age-adjusted relative risks and population attributable fraction of risk (PAF) were calculated in relation to occupations and industries. RESULTS: Information on employment was available for the 75 women and 71 men. The risk of LDS varied according to occupations and industries. PAFs ranged between 30% (12-48) for male blue collar workers and 22% (4-40) for female lower white collar workers. PAFs ranged between 7 and 17% in the economic sectors at high risk. CONCLUSION: The surveillance of LDS can identify occupations and industries at risk

Population attributable risk of lumbar disc surgery according to occupation: a study in a French general population

Aims: Disc-related sciatica represents one of the most significant and costly health problems occurring in the working population. The aim of this study was to assess the work-related population attributable fraction (PAF) of lumbar disc surgery (LDS) for disc-related sciatica in occupational categories at high risk in the general population. Methods: Patients living in a French region in 2003 and discharged from a large University Hospital following LDS were compared with demographic and socioeconomic data from the population census. Medical and occupational histories from 75 women and 71 men were gathered using a mailed questionnaire. The ageadjusted relative risks and PAF of CTS were calculated according to occupational categories. Results: The PAFs of lumbar disc surgery was 37% [19-54] for the male blue-collar workers suggesting that about 37% of the cases occurring in this category of workers could be avoided if the excess risk of LDS could be eliminated. The PAF value for male and female lower-grade white collar workers and female intermediate occupations were 18%, 33% and 13%, respectively. Conclusion: The study suggested that 13–37% of LDS for disc-related sciatica might be avoided in the whole population if totally effective intervention programs were implemented in specific occupational categories or industries. However, these preliminary findings must be confirmed by a larger study conducted in the whole region to assess more accurately the proportion of avoidable cases of LDS in the population

Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study.

BACKGROUND: International studies on occupational risks in public hospitals are infrequent and only few researchers have focused on psychosocial stress in Moroccan Health Care Workers (HCWs). The aim of this study was to present and analyze Moroccan HCWs occupational risk perception. Across nine public hospitals from three Moroccan regions (northern, central and southern), a 49 item French questionnaire with 4 occupational risks subscales, was distributed to 4746 HCWs. This questionnaire was based on the Job Content Questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis were used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. RESULTS: 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % of Moroccan HCWs were at high strain. High strain was strongly associated with two occupational categories: midwives (2.33 OR; CI 1.41-3.85), full-time employment (1.65 OR; CI 1.24-2.19), hypnotics and sedatives use (1.41 OR; CI 1.11-1.79), analgesics use (1.37 OR; CI 1.13-1.66). CONCLUSION: Moroccan HCWs, physicians included, perceive their job as high strain. Moroccan HCWs use of hypnotics, sedatives and analgesics is high. Risk prevention plan implementation is highly recommended

Patient-physician interaction in general practice and health inequalities in a multidisciplinary study: design, methods and feasibility in the French INTERMEDE study

<p>Abstract</p> <p>Background</p> <p>The way in which patients and their doctors interact is a potentially important factor in optimal communication during consultations as well as treatment, compliance and follow-up care. The aim of this multidisciplinary study is to use both qualitative and quantitative methods to explore the 'black box' that is the interaction between the two parties during a general practice consultation, and to identify factors therein that may contribute to producing health inequalities. This paper outlines the original multidisciplinary methodology used, and the feasibility of this type of study.</p> <p>Methods and design</p> <p>The study design combines methodologies on two separate samples in two phases. Firstly, a qualitative phase collected ethnographical and sociological data during consultation, followed by in-depth interviews with both patients and doctors independently. Secondly, a quantitative phase on a different sample of patients and physicians collected data via several questionnaires given to patients and doctors consisting of specific 'mirrored' questions asked post-consultation, as well as collecting information on patient and physician characteristics.</p> <p>Discussion</p> <p>The design and methodology used in this study were both successfully implemented, and readily accepted by doctors and patients alike. This type of multidisciplinary study shows great potential in providing further knowledge into the role of patient/physician interaction and its influence on maintaining or producing health inequalities. The next challenge in this study will be implementing the multidisciplinary approach during the data analysis.</p