Work-related outcome assessment instruments

Prevention of work disability is a primary goal within treatment of spinal disorders. Work-related outcome measures therefore are essential indices within evidence-based medicine. So far many measures suffer, however, from standardized measurement, standardized terminology, and a lack of theoretical background. This review addresses traditional indicators like work status and sickness absence, and discusses more theory-bound concepts, i.e. work ability, occupational risk factors for recurrence of symptoms and re-injury, work-related attitudes that may become obstacles to recovery, and individual reactions to occupational stressors that increase the risk of maintenance and recurrence of symptoms. The review includes methodological and theoretical considerations and recommendations for the use of work-related outcome measures in future outcome researc

A Smile is Just a Smile: But Only for Men. Sex Differences in Meaning of Faces Scales

This study tests psychometrics of the faces scale that is often used in organizational psychology to assess emotions, attitudes, and well-being. In analyzing 10,584 two-categorical judgments ("sad” versus "happy”) of 11 faces from 72 participants, women judged a face with a horizontal line as mouth ("neutral face”) more often sad than happy and significantly more often sad than men did. Moreover, women adapted their judgments to the range of faces under study in showing a significant contrast effect. In a range of neutral to bright smiling faces a face showing a mild smile was judged to be sad, while in a range of neutral to heavy griming faces a mild grim was judged to be happy. Sex differences in meaning of faces within faces scales and their implications for the use of the faces scale in work and organizational psychology are discusse

Ambulatory Assessment of Skin Conductivity During First Thesis Presentation: Lower Self-Confidence Predicts Prolonged Stress Response

In this field study self-confidence was tested to predict the course of galvanic electrodermal stress response prior, during and after public speaking. Ten graduate students initially rated their self-confidence and afterwards presented their thesis proposals orally in a 10-min presentation to their supervisor and peers. Galvanic skin response level was measured throughout and analysed for 10min prior to, during, and 10min after the presentation. Two major galvanic electrodermal stress response types were observed. Five students showed a ‘healthy response', i.e. an anticipatory increase in electrodermal conductance, followed by a decrease after termination of the presentation. The other five students showed a steady increase of skin conductance during and after their presentation (‘prolonged response'). In line with the allostatic load model the ‘prolonged response' group reported significantly lower self-confidence before presentation than the ‘healthy response' group (p<0.01). Self-confidence is a resource in novices facing an unfamiliar stresso

Getting Used to Academic Public Speaking: Global Self-Esteem Predicts Habituation in Blood Pressure Response to Repeated Thesis Presentations

Global self-esteem was tested to predict quicker cardiovascular adaptation during stressful oral thesis presentation and faster habituation from the first to the second and third thesis presentations. Nineteen graduate students initially rated their global self-esteem and afterwards orally presented their theses proposals in 20-min presentations to their thesis supervisor and peers. A second and third presentation of the revised thesis concepts took place at 4-weeks intervals. Ambulatory blood pressure and heart rate were assessed repeatedly during the presentations. Post-talk self ratings of stressfulness indicated presentations to be a strong public speaking stressor. One hundred and thirty-eight measurements of systolic (SBP), diastolic blood pressure (DBP), and heart rate (HR) showed a significant adaptation (decrease) during presentations. There was an overall mean level decrease from the first to the second, and the second to the third presentations in HR, but not in SBP and DBP. However, habituation in SBP and DBP across three presentations was significantly faster (p<.05) in those participants who initially reported higher levels of global self-esteem. Higher global self-esteem did not foster adaptation within the presentations. Self-esteem is discussed as an important individual resource that allows successful coping with recurring evaluative threat

Predictors of surgical outcome and their assessment

The relatively high rate of failed back surgery has prompted the search for "risk factors” to predict the result of spinal surgery in a given individual. However, the literature reveals few unequivocal predictors and they often explain a relatively low proportion of variance in outcome. This suggests that we have a long way to go before being able to rest easily, having refused someone surgery on the basis of unfavourable baseline characteristics. The best recommendation is to ensure, firstly, that the indication for surgery is absolutely clear-cut (i.e. that surgically remediable pathology exists) and then to consider the various factors that may influence the "typical” outcome. Consistent risk factors for a poor outcome regarding return-to-work include long-term sick leave/receipt of disability benefit. Hence, every effort should be made to keep the individual in the workforce, despite the ongoing symptoms and plans for surgery. In patients with a particularly heavy job, consultation with occupational physicians might later ease the patient's way back into the workplace. Patients with degenerative disorders and/or comorbidity should be counselled that few of them will have complete/lasting pain relief or a complete return to pre-morbid function. Patients with a high level of distress may benefit from psychological treatment, before and/or accompanying the surgical treatment. The opportunity (time), encouragement (education and positive messages), and resources (referral to appropriate support services) to modify risk factors that are indeed modifiable should be offered, and realistic expectations should be discussed with the patient before the decision to operate is mad

Low back pain at school: unique risk deriving from unsatisfactory grade in maths and school-type recommendation

Psychosocial stress and pain may relate to educational selection. At the end of primary school (International Standard Classification of Education: ISCED level 1) children are recommended for one of three performance-based lower secondary level types of school (ISCED level 2). The study examines the association of educational selection and other risk factors with pain in the upper back (UBP), lower back pain (LBP), peripheral (limb) pain (PP), and abdominal pain (AP). Teacher reports of unsatisfactory grades in mathematics, and official school-type recommendation are included as objective psychosocial risk factors. One hundred and ninety-two schoolchildren, aged between 10 and 13 from 11 classes of 7 schools in Switzerland participated in the cross-sectional study. In logistic regression analysis, predictor variables included age, sex, BMI, participation in sport, physical mobility, weight of satchel, hours of daily TV, video, and computer use, pupils' back pain reported by the mother and father, psychosocial strain, unsatisfactory grade in mathematics, and school-type recommendation. Analysis of pain drawings was highly reliable and revealed high prevalence rates of musculoskeletal pain in the last 4weeks (UBP 15.3%, LBP 13:8%, PP 33.9%, AP 20.1%). Psychosocial risk factors were uniquely significant predictors of UBP (psychosocial strain), LBP (psychosocial strain, unsatisfactory grade in mathematics, school-type recommendation), and AP (school-type recommendation). In conclusion, selection in terms of educational school system was uniquely associated with LBP in schoolchildren. Stress caused by educational selection should be addressed in primary prevention of musculoskeletal pain in schoolchildre

When Unnecessary Tasks Weigh Heavily on the Back: A Diary Study on Musculoskeletal Pain

Background: Auxiliary tasks such as administrative work often include tasks that are unnecessary in the view of workers but still have to be done. These tasks can threaten a worker's self-esteem. The purpose of this study was to examine the effects of unnecessary and unreasonable tasks on musculoskeletal pain. Methods: Fifty-five office workers (29 male; mean age = 41.96, SD = 14.2 years) reported their unnecessary and unreasonable tasks at the beginning of the study and kept a diary of their daily musculoskeletal pain over 5 weeks, using a visual analogue scale. Other work-related risk factors (prolonged sitting), job resources (participation in decision-making), and individual risk factors (sex, smoking, exercise, body mass index, maladaptive back beliefs) were controlled for in multilevel regression analysis. Findings: Multilevel regression analysis with 742 reports showed unnecessary tasks (B = 4.27, p = .006)-but not unreasonable tasks (B = 3.05, p = .074)-to predict the daily intensity of musculoskeletal pain, beyond other significant risk factors, such as prolonged sitting (B = 2.06, p = .039), body mass index (B = 1.52, p < .001), and maladaptive back beliefs (B = 3.78, p = .003). Participation in decision-making was not a significant protective factor (B = -1.67, p = .176). Conclusions/application to practice: The higher frequency of unnecessary tasks-compared with unreasonable tasks-could place workers at risk for musculoskeletal pain. Work redesign that reduces unnecessary and unreasonable tasks can make a valuable contribution to worker health and safety among office workers

Pain assessment

Pain usually is the major complaint of patients with problems of the back, thus making pain evaluation a fundamental requisite in the outcome assessment in spinal surgery. Pain intensity, pain-related disability, pain duration and pain affect are the aspects that define pain and its effects. For each of these aspects, different assessment instruments exist and are discussed in terms of advantages and disadvantages. Risk factors for the development of chronic pain have been a major topic in pain research in the past two decades. Now, it has been realised that psychological and psychosocial factors may substantially influence pain perception in patients with chronic pain and thus may influence the surgical outcome. With this background, pain acceptance, pain tolerance and pain-related anxiety as factors influencing coping strategies are discussed. Finally, a recommendation for a minimum as well as for a more comprehensive pain assessment is give

Holacracy, a modern form of organizational governance predictors for person-organization-fit and job satisfaction.

This study compares illegitimate tasks and appreciation in traditional work organisations and holacracy work organisations based in Switzerland and Germany. In addition, the study tests whether the fit between employees and holacracy organisations depends on personality characteristics. Ninety-five employees working in holacratic companies participated in an online survey with standardised questionnaires on illegitimate tasks, Big Five personality dimensions, perceived holacracy satisfaction and person-organisation fit. For the comparison of illegitimate tasks and appreciation, a propensity-matching comparison group of people working in traditional companies was used. The results revealed significantly lower illegitimate tasks t(53) = -2.04, p < 0.05, with a lower level (2.49) in holacracy than in traditional work (2.78). Concerning appreciation, the results showed significantly higher values for holacratic (5.33) than for traditional work [4.14, t(53) = 4.86, p < 0.001]. Multiple linear regression of holacracy satisfaction on personality dimensions showed neuroticism (b = -4.72, p = 0.006) as a significant predictor. Agreeableness showed marginally significant results (b = 2.39, p = 0.06). This indicates that people scoring low on neuroticism and high in agreeableness may thrive better in holacracy organisations. Based on the results, theoretical and practical implications as for example implications for corporates hiring strategy, are discussed. Finally, this study presents numerous directions for future research

Long working hours and exhaustion: A test of rumination as a mediator among mobile-flexible employees in activity-based offices

The present study examines the effect of extended work hours on experienced exhaustion in the evening in mobile-flexible employees who work in activity-flexible offices. In a seven-day diary study, it was anticipated that daily rumination is a mediator, linked to additional daily exhaustion in individuals. In a morning questionnaire, mobile-flexible employees completed daily questions about the link between extended work hours and exhaustion. Thirty-three employees completed daily questions on the extension of working hours, rumination, and exhaustion. Multilevel analyses of up to 238 daily measurements revealed that more intense extension of working hours predicted more rumination as well as exhaustion. Extended work hours and rumination both predicted more exhaustion. A test of the indirect effects showed no mediation from the extension of working hours via rumination to exhaustion. When designing mobile-flexible work models, overtime is a risk. Occupational prevention of exhaustion should promote recovery processes, especially as new work models may lead to increased rumination due to more personal responsibility of employees.El presente estudio examina el efecto de la ampliación de las horas de trabajo sobre el agotamiento experimentado por la tarde en empleados móviles-flexibles que trabajan en oficinas de actividad flexible. En un estudio de diario de siete días, se anticipó que la rumiación diaria es un mediador, vinculado al agotamiento diario adicional en los individuos. En un cuestionario matutino, los empleados con flexibilidad de actividad completaron preguntas diarias sobre la relación entre las horas de trabajo prolongadas y el agotamiento. Treinta y tres empleados completaron preguntas diarias sobre la extensión de las horas de trabajo, la rumiación y el agotamiento. Los análisis multinivel de hasta 238 mediciones diarias revelaron que una extensión más intensa de las horas de trabajo predecía más rumiación, así como agotamiento. Tanto la prolongación de la jornada laboral como la rumiación predecían un mayor agotamiento. Una prueba de los efectos indirectos no mostró ninguna mediación desde la extensión de las horas de trabajo a través de la rumiación hasta el agotamiento. Cuando se diseñan modelos de trabajo móviles y flexibles, las horas extras son un riesgo. La prevención del agotamiento en el trabajo debería promover los procesos de recuperación, especialmente porque los nuevos modelos de trabajo pueden conducir a un aumento de la rumiación debido a una mayor responsabilidad personal de los empleados