Associations of university student life challenges with mental health and self-rated health:A longitudinal study with 6 months follow-up

BACKGROUND: Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health. METHODS: In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals). RESULTS: Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6). DISCUSSION: Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students

Sleep quality, sleep duration, and sleep disturbances among hospital night workers:a prospective cohort study

Purpose:This study aimed to assess among hospital night workers (i) to what extent sleep quality, sleep duration and sleep disturbances overlap, and (ii) associations between sociodemographic factors, lifestyle factors and work characteristics and sleep components.Methods:Data were used from 467 hospital night workers participating in the Klokwerk + study, a prospective cohort study with two measurements. Sleep quality was measured by the Pittsburgh Sleep Quality Index, sleep duration and sleep disturbances were measured by the Medical Outcomes Study Sleep Scale. The overlap between the three sleep measures was visualized with a Venn diagram and the proportions of overlap was calculated. Associations between independent variables (sociodemographic factors, lifestyle factors and work characteristics) and the three sleep outcomes were estimated using between-within Poisson regression models.Results:About 50% of the hospital night workers had at least one poor sleep outcome. Overlap in poor sleep outcomes was apparent for 36.8% of these workers, while the majority had a poor outcome in one of the sleep components only (63.1%). Former smoking had a significant association with poor sleep quality. For most independent variables no associations with poor sleep outcomes were observed.Conclusion:Our findings suggest that sleep quality, sleep duration and sleep disturbances are separate entities and should be studied separately. Lifestyle factors and work characteristics were generally not associated with poor sleep. Since these factors can have an acute effect on sleep, future research should consider ecological momentary assessment to examine how exposure and outcomes (co)vary within-persons, over time, and across contexts.Trial registration Netherlands Trial Register trial number NL56022.041.1

Influence of changing working conditions on exit from paid employment among workers with a chronic disease

Objectives To investigate the relation between changes in working conditions and exit from paid employment among workers with a chronic disease. Methods Six waves from the longitudinal Study on Transitions in Employment, Ability and Motivation (2010–2016), enriched with tax-based employment information from Statistics Netherlands (2011–2017), were available for 4820 chronically ill workers aged 45–63 years (mean 55.3 years, SD 5.1). A change in working conditions (physical workload, psychological job demands, job autonomy, emotional job demands and social support) was defined as an increase or decrease between two consecutive waves of at least one SD. Discrete-time survival models with repeated measurements were used to estimate the relative risk (RR) of a change in working conditions on exiting paid employment in the following year compared with no change and consecutive favourable working conditions. Results A favourable change in physical workload lowered the risk to exit paid employment (RR 0.46, 95% CI 0.22 to 0.94). An adverse change in psychosocial working conditions, especially a decrease in social support (RR 2.07, 95% CI 1.52 to 2.81), increased the likelihood to exit paid employment. In contrast, a favourable change in psychological job demands increased the risk to exit paid employment (RR 1.57, 95% CI 1.09 to 2.24). Multiple adverse changes increased the risk to exit paid employment up to six times (RR 6.06, 95% CI 2.83 to 12.98). Conclusions Changes in working conditions among workers with chronic diseases influence exit from paid employment. Ensuring that working conditions can be adapted to the needs of workers with a chronic disease may help to extend working life

The influence of unhealthy behaviours on early exit from paid employment among workers with a chronic disease:a prospective study using the Lifelines cohort

OBJECTIVES: This study examined the risk of unhealthy behaviours and the additive effects of multiple unhealthy behaviours on exit from paid employment among workers with a chronic disease and investigated effect modification by gender and educational level. METHODS: Data from the Lifelines cohort, collected between 2006 and 2013, were enriched with registry data from Statistics Netherlands with up to 11 years follow-up. Workers with a chronic disease were selected (n=11,467). The influence of unhealthy behaviours (physical inactivity, smoking, unhealthy diet, high alcohol intake, and obesity) on exit from paid employment (unemployment, disability benefits, early retirement, and economic inactivity) was examined using competing risk models. To examine effect modification by gender and educational level, interaction terms were added. RESULTS: Smoking and low fruit intake increased the risk to exit paid employment through unemployment and disability benefits. Low vegetable intake increased the risk of unemployment, obesity the risk of receiving disability benefits, and high alcohol intake the risk of early retirement. Physical inactivity was not associated with any exit from paid employment. Having multiple unhealthy behaviours increased the risk of both unemployment and of receiving disability. No consistent effect modification for gender or educational level was found. CONCLUSIONS: Unhealthy behaviours increased the risk to exit paid employment through unemployment and disability benefits among workers with a chronic disease, and this risk increased when having multiple unhealthy behaviours. Health promotion to support workers with chronic diseases to make healthier choices may help to extend their working life

How Work Impairments and Reduced Work Ability are Associated with Health Care Use in Workers with Musculoskeletal Disorders, Cardiovascular Disorders or Mental Disorders

__Abstract__ Purpose the aim of this study was to explore how work impairments and work ability are associated with health care use by workers with musculoskeletal disorders (MSD), cardiovascular disorders (CVD), or mental disorders (MD). Methods in this cross-sectional study, subjects with MSD (n = 2,074), CVD (n = 714), and MD (n = 443) were selected among health care workers in 12 Dutch organizations. Using an online questionnaire, data were collected on in

The (cost-)effectiveness of an individually tailored long-term worksite health promotion programme on physical activity and nutrition: design of a pragmatic cluster randomised controlled trial

Cardiovascular disease is the leading cause of disability and mortality in most Western countries. The prevalence of several risk factors, most notably low physical activity and poor nutrition, is very high. Therefore, lifestyle behaviour changes are of great importance. The worksite offers an efficient structure to reach large groups and to make use of a natural social network. This study investigates a worksite health promotion programme with individually tailored advice in physical activity and nutrition and individual counselling to increase compliance with lifestyle recommendations and sustainability of a healthy lifestyle. METHODS: The study is a pragmatic cluster randomised controlled trial with the worksite as the unit of randomisation. All workers will receive a standard worksite health promotion program. Additionally, the intervention group will receive access to an individual Health Portal consisting of four critical features: a computer-tailored advice, a monitoring function, a personal coach, and opportunities to contact professionals at request. Participants are employees working for companies in the Netherlands, being literate enou

The impact of depressive symptoms on exit from paid employment in Europe: a longitudinal study with 4 years follow-up

Background: Mental health problems are a risk factor for loss of paid employment. This study investigates (i) the relation between depressive symptoms and different involuntary pathways of labour force exit and (ii) explores gender and geographical differences in this relation. Methods: The study population consisted of 5263 individuals in paid employment aged between 50 years and the country-specific retirement age from 11 European countries participating in the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE). Self-reported depressive symptoms at baseline were assessed using the EURO-D. Employment status was derived from interviews after 2 and 4 years. Cox proportional hazards regression analyses were used to investigate the association between depressive symptoms and labour force exit via disability benefit and unemployment. Population attributable fractions (PAFs) were calculated to estimate the contribution of depressive symptoms to these pathways of labour force exit. Results: Both men and women with a EURO-D score ≥4 had a >2-fold increased risk of a disability benefit (HR: 2.46, 95%CI 1.68-3.60) after adjustment for demographics and work-related characteristics. Among men depressive symptoms elevated the risk of becoming unemployed at follow-up (HR 1.55; 95%CI: 0.94-2.57). The PAF was 0.18 for disability benefit and 0.04 for unemployment, and varied across European regions. Conclusions: Individuals with depressive symptoms are at increased risk of losing paid employment, which in turn may aggravate their symptoms. Targeting depressive symptoms with public health and occupational policies should be considered to reduce the burden of mental diseases in Europe

Predictors of working days lost due to sickness absence and disability pension

Objective To identify social and health-related predictors of the number of days lost due to sickness absence (SA) and disability pension (DP) among initially 55-year-old public-sector workers. Methods The data from the Finnish Helsinki Health Study included participants aged 55 years at the baseline (in 2000-2002, N = 1630, 81% women), and were enriched with register-based information on SA and DP. The cumulative number of calendar days lost due to SA >= 1 day or DP between ages 55 and 65 was calculated. Negative binomial regression model was used to identify the predictors of days lost. Results The average calendar days lost was 316 days (about 220 working days) during a 10-year follow-up, and 44% were due to SA and 56% due to DP. Smoking [incidence rate ratio (IRR) = 1.19, 95% CI 1.01-1.40 for past and IRR = 1.30, CI 1.07-1.58 for current], binge drinking (IRR = 1.22, CI 1.02-1.46), lifting or pulling/pushing heavy loads (IRR = 1.35, CI 1.10-1.65), awkward working positions (IRR = 1.24, CI 1.01-1.53), long-standing illness limiting work or daily activities (IRR = 2.32, CI 1.93-2.79), common mental disorder (IRR = 1.52, CI 1.30-1.79), and multisite pain (IRR = 1.50, CI 1.23-1.84) increased the number of days lost, while high level of education (IRR = 0.66, CI 0.52-0.82) and moderate level of leisure-time physical activity (IRR = 0.80, CI 0.67-0.94) reduced the number of days lost. Conclusions Modifiable lifestyle risk factors, workload factors, common mental disorder, and multisite pain substantially increase the number of days lost. However, the findings of this study could be generalized to female workers in the public sector. Future research should also consider shorter SA spells in estimating working years lost and working life expectancy.Peer reviewe

The contribution of work engagement to self-perceived health, work ability, and sickness absence beyond health behaviors and work-related factors

Objective: To investigate whether work engagement influences self-perceived health, work ability, and sickness absence beyond health behaviors and work-related characteristics. Methods: Employees of two organizations participated in a 6-month longitudinal study (n = 733). Using questionnaires, information was collected on health behaviors, work-related characteristics, and work engagement at baseline, and self-perceived health, work ability, and sickness absence at 6-month follow-up. Associations between baseline and follow-up variables were studied using multivariate and multinomial logistic regression analyses and changes in R were calculated. RESULTS:: Low work engagement was related with low work ability (odds ratio: 3.68; 95% confidence interval: 2.15 to 6.30) and long-term sickness absence (odds ratio: 1.84; 95% confidence interval: 1.04 to 3.27). Work engagement increased the explained variance in work ability and sickness absence with 4.1% and 0.5%, respectively. Conclusions: Work engagement contributes to work ability beyond known health behaviors and work-related characteristics