Systematic review: complementary therapies and employee well-being

Background:- A variety of workplace-based interventions exist to reduce stress and increase productivity. However, the efficacy of these interventions is sometimes unclear. Aims:- To determine whether complementary therapies offered in the workplace improve employee well-being. Methods:- We performed a systematic literature review which involved an electronic search of articles published between January 2000 and July 2015 from the databases Cochrane Central Register of Controlled Trials, PsycINFO, MEDLINE, AMED, CINAHL Plus, EMBASE and PubMed. We also undertook a manual search of all applicable article reference lists to ensure that no relevant studies were missed. We only selected published, full-length, English-language, peer-reviewed journal articles. Articles had to address the research objective using valid and reliable measures. We excluded articles concerning return to work or whose populations had been adversely affected by work resulting in the development of health issues. Results:- We included 10 articles in the review from 131 identified. Mindfulness and meditation-based interventions were most effective in improving workplace health and work performance; the latter demonstrating some evidence of maintaining gains up to 3 months later. The evidence for relaxation interventions was inconclusive. Conclusions:- Mindfulness and meditation interventions may be helpful in improving both psychosocial workplace health and work performance, but long-term efficacy has yet to be fully determined

Co-design, delivery, and evaluation of wellbeing initiatives for NHS staff: the HOW (Healthier Outcomes at Work) NHS project

Stress and mental health are leading causes of sickness absence in the UK, responsible for over 50% of sickness absence across the country. Healthcare sector workers play a vital role in the life of everyone across the country but have among the highest levels of sickness absence of any sector. The aim of this project, therefore, was to work with UK healthcare workers to co-develop, implement, and evaluate a series of mental health and wellbeing interventions delivered via a smartphone app and associated toolkit. A participatory action research methodology, consisting of individual interviews, focus group discussions, and oversight by an expert action learning group, was used to develop primary (i.e., those associated with the workplace) and secondary (improving individual resilience and coping) stress management interventions. Pre-post-intervention analysis demonstrated improvements in work engagement and working conditions, although significant improvements were only found in mean scoring on demands, control, managerial support, and peer support working condition measures. The project therefore demonstrates that co-produced initiatives which focus on improving either the organisation or resilience of the workforce may be useful in supporting employee health and wellbeing. Future studies should build upon these findings through a full RCT to determine utility of the interventions

The influence of work engagement in social workers in England

Background:- Social workers help to maintain and improve the lives of children, their families, and adult service users in the UK. However, while engagement is shown to be an important determinant of both patient and employee outcomes in related healthcare professions, the influence of engagement has not been demonstrated in social workers. Aims:- To investigate the influence of employee engagement on perceived stress, turnover intentions, job satisfaction, and presenteeism. Methods:- A cross-sectional survey of members of one English social work organisation including measures of engagement (Utrecht Work Engagement Scale), the Perceived Stress Scale, and single-item measures of job satisfaction, turnover intentions, and presenteeism. T-tests and Mann-Whitney analyses were conducted to investigate differences in these measures in high and low engagement scores. Results:- A total of 1,049 responses were analysed; social workers with greater engagement had significantly lower stress and turnover intentions, less presenteeism, and greater job satisfaction. Additionally, overall respondents had poor levels of perceived stress, turnover intentions, and presenteeism. Conclusions:- Employee engagement is significantly associated with a number of work-related outcomes in social workers in England. However, social workers seem to have high turnover intentions and presenteeism, and greater than average perceived stress

Working conditions and stress in the English education system

Background:- The UK education sector has among the highest level of stress sickness absence of all occupations. However, investigations of psychosocial working conditions which contribute to stress, including behaviour of students and parents, has not been conducted. Aims:- To investigate the psychosocial working conditions and prevalence of negative parental and student behaviour in a large sample of school teachers and college lecturers based in England. In addition, to assess the influence of working conditions, student behaviour and parental behaviour on perceived stress. Methods:- A cross-sectional survey of teachers in England. Respondents completed the Management Standards Indicator Tool (MSIT), Perceived Stress Scale (PSS-4), Student Behaviour Scale and a two-item measure of parental behaviour. Differences in these measures across different teaching roles were assessed using analysis of variance. Regression analyses were used to evaluate the association of MSIT, student and parental behaviour on PSS outcomes. Results:- Compared to UK benchmark scoring, psychosocial working conditions were at a poor level, with primary teachers in particular exposed to negative parental behaviours, and secondary teachers to poor student behaviour. Demands were consistently associated with perceived stress outcomes across job roles, although management support and relationships with peers also played a part. Conclusions:- Demands faced by teachers in England played an important part in the experience of stress. Interventions to reduce these demands, and the high frequencies of negative pupil and parental behaviours, should be considered

Co-Creating and Evaluating an App-Based Well-Being Intervention: The HOW (Healthier Outcomes at Work) Social Work Project

Stress and mental health at work are the leading causes of long-term sickness absence in the UK, with chronically poor working conditions impacting employee physiological and psychological health. Social workers play a significant part in the fabric of UK society, but have one of the most stressful occupations in the country. The aim of this project was to work with UK social workers to co-develop, implement, and evaluate a series of smartphone-based mental health initiatives. A Participatory Action Research (PAR) approach, consisting of semi-structured interviews and focus group and steering group discussions, was utilized to design the mental health and well-being interventions. Study efficacy was evaluated via a pre- and post-intervention survey and post-intervention semi-structured interviews. Interventions developed were psycho-educational, improved top-down and bottom-up communication, and provided access to a Vocational Rehabilitation Assistant for those struggling and at risk of sickness absence. Six months following dissemination, surveys demonstrated significant improvements in communication, and mean score improvements in four other working conditions. This project, therefore, demonstrates that co-developed initiatives can be positively impactful, despite post-intervention data collection being impacted by COVID-19. Future studies should build upon these findings and broaden the PAR approach nationally while taking a robust approach to evaluation

Appreciative inquiry for stress management

Purpose: The purpose of this paper is to demonstrate the innovative application of an Appreciative Inquiry (AI) approach for the design and implementation of organizational stress management interventions, alongside a case study of the successful design and implementation of the approach. By utilizing the AI methodology to develop a “local stress theory” for the participating organization, the authors propose a model which can be utilized in other similar organizations. Design/methodology/approach: Stage 1: 35 participants completed up to ten daily logs by answering four positively framed questions regarding their working day. Stage 2: semi-structured interviews (n=13). The interview schedule was designed to further elaborate log findings, and begin looking into feasible organizational changes for improvement of stress. Stage 3: two focus groups (Stage 3, total 13 employees) verified interventions from logs and interviews and discuss how these can be implemented. Findings: The log phase identified two key themes for improvement: managerial/organizational support and communication. From these, interviews and focus groups led to workable proposals for simple but likely effective changes. The authors reported findings to management, emphasizing organizational change implementation, and these were subsequently implemented. Research limitations/implications: The study demonstrated the effectiveness of AI to identify and implement relatively simple but meaningful changes. The AI cycle was completed but allocating lengthy follow-up time for evaluation of outcomes was not possible, although initial responses were favorable. There are also issues of generalizability of the findings. Originality/value: This is the among first studies to utilize an AI approach for the design of stress management interventions

Return to work interventions for chronic pain: a systematic review

Background:- Chronic pain (CP) remains the second commonest reason for being off work. Tertiary return to work (RTW) interventions aim to improve psychological and physical capacity amongst workers already off sick. Their effectiveness for workers with CP is unclear. Aims:- To explore which tertiary interventions effectively promote RTW for CP sufferers. Methods:- We searched eight databases for randomised controlled trials evaluating the effectiveness of tertiary RTW interventions for CP sufferers. We employed the Cochrane Risk of Bias (ROB) and methodological quality assessment tools for all included papers. We synthesised findings narratively. Meta-analysis was not possible due to heterogeneity of study characteristics. Results:- We included 16 papers pertaining to 13 trials. The types, delivery format and follow-up schedules of RTW interventions varied greatly. Most treatments were multidisciplinary, comprising psychological, physical and workplace elements. Five trials reported that tertiary interventions with multidisciplinary elements promoted RTW for workers with CP compared to controls. We gave a high ROB rating for one or more assessment criteria to three out of the five successful intervention trials. Two had medium and low risk elements across all categories. One compared different intensity multidisciplinary treatment and one comprised work-hardening with a job-coach. Seven trials found treatment effects for secondary outcomes but no RTW improvement. Conclusions:- There is no conclusive evidence to support any specific tertiary RTW intervention for workers with CP, but multidisciplinary efforts should be considered. Workers’ compensation is an important area for RTW policymakers to consider

BJP ASM Poster Abstracts 2018 - Tertiary return to work interventions for chronic pain: a systematic literature review

An abstract presented at British Journal of Pain's Annual Scientific Meeting. Five of the best abstracts submitted to the journal were presented during Plenary Session 7 on 2 May 2018 and also published in the journal

Working conditions and wellbeing in UK social workers

Summary:- UK social workers are exposed to chronically poor working conditions and experience extremely high levels of sickness absence. The aim of this study was to gain an in-depth understanding of working conditions and wellbeing of social workers. Seven UK social work employers sent a survey of working conditions, wellbeing, and turnover intentions to all child and family social workers, followed by a series of individual semi-structured interviews with respondents. Data were collected between January and May 2019. Six hundred and seventy-six (41% response rate) completed surveys were returned and 19 interviews undertaken. Findings:- Quantitative findings demonstrated that working conditions scored better than previous studies, with positive scores on autonomy, peer, and managerial support. However, the four remaining conditions (demands, relationships, role, and change) each scored worse than 75–90% of respondents in UK-wide benchmarks of individuals from various occupations. Regression outcomes demonstrated that demands, control, change, relationships, and peer support each significantly impacted employee wellbeing. Furthermore, over 20% of respondents suggested that they were frequently exposed to poor service user behaviour. Thematic analysis of interviews suggested that workload (demands), relationships with peers, management, and services users, and the way in which change was communicated were the main difficulties cited. Applications:- It is clear that work is needed to support social worker stress and wellbeing at work. Management should support individuals in terms of developing peer and managerial support, and adopting best practice in reflective supervision. Furthermore, a more robust system of caseload allocation would support and improve significant workload pressures