Psychosocial predictors of actual turnover among Belgian health care workers

Background: Turnover of nursing staff is a major challenge for healthcare settings and for healthcare in general, urging the need to improve retention. Aim: The aim was to explore the prospective relations between personal and psychosocial work-related factors and actual turnover among Belgian healthcare workers. Methods: Predictors of actual turnover were assessed using the longitudinal Belgian data from the Nurses Early Exit Study (NEXT). Two self-administered questionnaires with a time lag of one year were distributed, covering physical and psychosocial work-related factors, private life, turnover intentions and future perspectives. During follow-up, 90 employees who left the organization voluntary (leavers) and who had a complete data set were identified. These subjects were each matched with two stayers based on gender, age and organization type. Multiple logistic analyses were performed. Results: The first model adjusting for education level showed that quantitative job demands, job satisfaction, burnout, work-home interference, commitment to the institution, pay satisfaction, effort-reward imbalance and intent to leave the organization were significantly associated with actual turnover. When additionally adjusting for intent to leave the organization, job satisfaction (OR 0.29; 95% CI 0.13-0.62) and work-home interference (OR 1.35; 95% CI 1.00-1.81) were found to be the most important independent predictors of turnover. Conclusion: To tackle turnover, special attention should be given to turnover intention, work-home interference and job satisfaction because these risk factors were found to be the strongest predictors of actual turnover among nurses and nursing aids

Comparing the effectiveness of two cardiovascular prevention programmes for highly educated professionals in general practice : a randomised clinical trial

Background: Cardiovascular disease is a major cause of mortality and morbidity and its prevalence is set to increase. While the benefits of medical and lifestyle interventions are established, the effectiveness of interventions which seek to improve the way preventive care is delivered in general practice is less so. The aim was to study and to compare the effectiveness of 2 intervention programmes for reducing cardiovascular risk factors within general practice. Methods: A randomised controlled trial was conducted in Belgium between 2007-2010 with 314 highly educated and mainly healthy professionals allocated to a medical (MP) or a medical + lifestyle (MLP) programme. The MP consisted of medical assessments (screening and follow-up) and the MLP added a tailored lifestyle change programme (web-based and individual coaching) to the MP. Primary outcomes were total cholesterol, blood pressure, and body mass index (BMI). The secondary outcomes were smoking status, fitness-score, and total cardiovascular risk. Results: The mean age was 41 years, 95 (32%) participants were female, 7 had a personal cardiovascular event in their medical history and 3 had diabetes. There were no significant differences found between MP and MLP in primary or secondary outcomes. In both study conditions decreases of cholesterol, systolic blood pressure, and diastolic blood pressure were found. Unfavourable increases were found for BMI (p < .05). A significant decrease of the overall cardiovascular risk was reported (p < .001). Conclusions: Both interventions are effective in reducing cardiovascular risk. In our population the combined medical and lifestyle programme was not superior to the medical programme

Does Aerobic Exercise Increase 24-Hour Ambulatory Blood Pressure Among Workers With High Occupational Physical Activity?-A RCT.

ObjectiveHigh occupational physical activity (OPA) increases cardiovascular risk and aerobic exercise has been recommended for reducing this risk. This paper investigates the effects of an aerobic exercise intervention on 24-hour ambulatory blood pressure (ABP) among cleaners with high OPA.MethodsHundred and sixteen cleaners between 18 and 65 years were randomized. During the 4-month intervention period, the aerobic exercise group (AE) (n = 57) performed worksite aerobic exercise (2 × 30 minutes/week), while the reference group (REF) (n = 59) attended lectures. Between-group differences in 4-month ABP changes were evaluated by intention-to-treat analysis using a repeated-measure 2 × 2 multiadjusted mixed-models design.ResultsRelative to REF, 24-hour ABP significantly increased in AE: systolic 3.6 mm Hg (95% confidence interval (CI) 1.6-5.7) and diastolic 2.3 mm Hg (95% CI 0.9-3.8). Cleaners with high aerobic workload exhibited particularly high 24-hour ABP increases: systolic 6.0 mm Hg (95% CI 2.4-9.6), and diastolic 3.8 mm Hg (95% CI 1.3-6.4).ConclusionAerobic exercise increased 24-hour ABP among cleaners. This adverse effect raises questions about the safety and intended benefits of aerobic exercise, especially among workers with high OPA and a demanding aerobic workload. http://www.controlled-trials.com/ISRCTN86682076. Unique identifier ISRCTN86682076.Clinical trial registrationTrial Number ISRCTN86682076