Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors

Background: Recurrent reports from national and international studies show a persistent high prevalence of sickness presence among hospital physicians. Despite the negative consequences reported, we do not know a lot about the reasons why physicians choose to work when ill, and whether there may be some positive correlates of this behaviour that in turn may lead to the design of appropriate interventions. The aim of this study is to explore the perception and experience with sickness presenteeism among hospital physicians, and to explore possible positive and negative foundations and consequences associated with sickness presence. Methods: Semi-structured interviews of 21 Norwegian university hospital physicians. Results: Positive and negative dimensions associated with 1) evaluation of illness, 2) organizational structure, 3) organizational culture, and 4) individual factors simultaneously contributed to presenteeism. Conclusions: The study underlines the inherent complexity of the causal chain of events affecting sickness presenteeism, something that also inhibits intervention. It appears that sufficient staffing, predictability in employment, adequate communication of formal policies and senior physicians adopting the position of a positive role model are particularly important

Additional file 3: Table S2. of Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors

Themes and sample quotes. (DOCX 28 kb

Additional file 1: Table S1. of Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors

Participant characteristics. (DOCX 21 kb

The Norwegian version of the Copenhagen Psychosocial Questionnaire (COPSOQ III): Initial validation study using a national sample of registered nurses.

BackgroundEmployers are legally obligated to ensure the safety and health of employees, including the organizational and psychosocial working environment. The Copenhagen Psychosocial Questionnaire (COPSOQ III) covers multiple dimensions of the work environment. COPSOQ III has three parts: a) work environment b) conflicts and offensive behaviours and c) health and welfare. We translated all three parts into Norwegian and evaluated the statistical properties of the 28 work environment dimensions in part a), using a sample of registered nurses.MethodsThe original English version was translated into Norwegian and back translated into English; the two versions were compared, and adjustments made. In total, 86 of 99 items from the translated version were included in a survey to which 8804 registered nurses responded. Item response theory models designed for ordinal manifest variables were used to evaluate construct validity and identify potential redundant items. A standard confirmatory factor analysis was performed to verify the latent dimensionality established in the original version, and a more exploratory factor analysis without restrictions is included to determine dependency between items and to identify separable dimensions.ResultsThe measure of sampling adequacy shows that the data are well suited for factor analyses. The latent dimensionality in the original version is confirmed in the Norwegian translated version and the scale reliability is high for all dimensions except 'Demands for Hiding Emotions'. In this homogenous sample, eight of the 28 dimensions are found not to be separate dimensions as items covering these dimensions loaded onto the same factor. Moreover, little information is provided at the low and high ends of exposure for some dimensions in this sample. Of the 86 items included, 14 are found to be potential candidates for removal to obtain a shorter Norwegian version.ConclusionThe established Norwegian translation of COPSOQ III can be used in further research about working environment factors and health and wellbeing in Norway. The extended use of the instrument internationally enables comparative studies, which can increase the knowledge and understanding of similarities and differences between labour markets in different countries. This first validation study shows that the Norwegian version has strong statistical properties like the original, and can be used to assess work environment factors, including relational and emotional risk factors and resources available at the workplace

Registered nurses’ exposure to workplace aggression in Norway : 12-month prevalence rates, perpetrators, and current turnover intention

Background Identifying occupational health hazards among Registered Nurses (RNs) and other health personneland implementing effective preventive measures are crucial to the long-term sustainability of health services. Theobjectives of this study were (1) to assess the 12-month prevalence rates of exposure to workplace aggression,including physical violence, threats of violence, sexual harassment, and bullying; (2) to identify whether theperpetrators were colleagues, managers, subordinates, or patients and their relatives; (3) to determine whetherprevious exposure to these hazards was associated with RNs’ current turnover intention; and (4) to frame workplaceaggression from an occupational health and safety perspective.Methods The third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was used to assess RNs’exposure to workplace aggression and turnover intention. A national sample of 8,800 RNs in Norway, representative ofthe entire population of registered nurses in terms of gender and geography, was analysed. Binary and ordinal logisticregression analyses were conducted, and odds for exposure and intention to leave are presented, with and withoutcontrols for RNs’ gender, age, and the type of health service they work in.Results The 12-month prevalence rates for exposure were 17.0% for physical violence, 32.5% for threats of violence,12.6% for sexual harassment, and 10.5% for bullying. In total, 42.6% of the RNs had experienced at least one of thesetypes of exposure during the past 12 months, and exposure to more than one of these hazards was common.Most perpetrators who committed physical acts and sexual harassment were patients, while bullying was usuallycommitted by colleagues. There was a strong statistical association between exposure to all types of workplaceaggression and RNs’ intention to leave. The strongest association was for bullying, which greatly increased the odds oflooking for work elsewhere.Conclusions Efforts to prevent exposure to workplace aggression should be emphasised to retain health personneland to secure the supply of skilled healthcare workers. The results indicate a need for improvements. To ensure thesustainability of health services, labour and health authorities should join forces to develop effective workplace