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EN
Objectives: The present study analyzes job stress in terms of education, age and the presence of cardiovascular and endocrine/metabolic diseases. Material and Methods: A total of 411 workers employed by three public organizations completed the Job Content Questionnaire to classify their jobs based on the job strain model. Data about health condition, education and habits was obtained by the use of medical examinations and an interview. Results: The analysis of the completed Job Content Questionnaires indicates that workers with high education have significantly higher decision latitude (DL) than low-educated workers (one-way ANOVA, p < 0.0001). DL was also different between age groups (one-way ANOVA, p < 0.0001) - the highest DL values were observed in the oldest group, while the lowest DL mean was found in the youngest group. Psychological job demands (PJD) and social support (SS) were not significantly different between educational and age groups. The frequency of job stress categories was significantly different between low and highly-educated workers (χ² test, df = 3, p < 0.0001) and also between different age groups (χ² test, df = 6, p < 0.0001). The majority of highly-educated men were exposed to "active" jobs (high PJD and high DL). Most frequently, men older than 45 years experienced jobs with high DL ("active" and "low strain"), men aged 35 to 45 years were exposed to jobs with high PJD ("high strain" and "active") while the majority of men younger than 35 years were exposed to jobs with low DL ("high strain" and "passive"). No association between cardiovascular and endocrine/metabolic disorders and different job stress categories was observed. Conclusion: "High strain" and "passive" jobs were most frequently identified among low-educated and young men. Despite the absence of association between job stress and cardiovascular and endocrine/metabolic diseases, we recommend prevention of work stress, particularly in the case of low-educated workers and workers younger than 45 years exposed to unfavorable job stress categories.
EN
Objectives: The study investigated whether nurses' different working schedules are associated with different levels of job-relatd strain, health symptoms and behavior. No reports have been accessible in the relevant literature on the possible association between shift work and job-related strain in nurses. Materials and Methods: This was a cross-sectional study conducted at a large university hospital in North-East Italy, involving 806 nurses working in selected departments. A multilevel logistic regression was applied to assess the association between work shift conditions and selected outcomes. Results: Night shifts were associated not only with higher odds of having a high Job Demand, but also with lower odds of having a high Decision Authority and consequently with a stronger likelihood of having higher levels of Job Strain (high Job Demand score≥ 38 and Low Decision Authority). The night shift was associated with various symptoms, particularly exhaustion (p = 0.039) and gastric pain (p = 0.020). Nurses' working schedules did not affect their job satisfaction scores. Conclusions: It has been confirmed that night shifts are a risk factor for nurses' health perception and working night shifts carries a considerable degree of strain. This is a condition that hospital nursing managements need to consider carefully to avoid burnout in nursing personnel and prevent an excessive turnover in this profession, which is a recurring problem for health care organizations.
EN
Objective: One of the practical models for assessment of stressful working conditions due to job strain is "job demand and control" or Karasek's job strain model. This model explains how adverse physical and psychological effects including cardiovascular disease risk factors can be established due to high work demand. The aim was to investigate how certain cardiovascular risk factors including body mass index (BMI), heart rate, blood pressure, serum total cholesterol levels, and cigarette smoking are associated with job demand and control in workers. Materials and Methods: In this cohort study, 500 subjects completed "job demand and control" questionnaires. Factor analysis method was used in order to specify the most important "job demand and control" questions. Health check-up records of the workers were applied to extract data about cardiovascular disease risk factors. Ultimately, hypothesis testing, based on Eta, was used to assess the relationship between separated working groups and cardiovascular risk factors (hypertension and serum total cholesterol level). Results: A significant relationship was found between the job demand-control model and cardiovascular risk factors. In terms of chisquared test results, the highest value was assessed for heart rate (Chi² = 145.078). The corresponding results for smoking and BMI were Chi² = 85.652 and Chi² = 30.941, respectively. Subsequently, Eta result for total cholesterol was 0.469, followed by hypertension equaling 0.684. Moreover, there was a significant difference between cardiovascular risk factors and job demand-control profiles among different working groups including the operational group, repairing group and servicing group. Conclusion: Job control and demand are significantly related to heart disease risk factors including hypertension, hyperlipidemia, and cigarette smoking.
EN
Objectives This study measures the association between hospital staff’s job strain (JS), mental quality of life (MQL) and how they are influenced by the organization models within emergency and critical care units. Material and Methods This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Results Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer’s efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. Conclusions If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented.
EN
Objectives: Days off, on call, night duty, working hours and job stress can affect physicians’ mental health, and support from supervisors and co-workers may have a buffering effect. This study elucidates whether job strain and job factors affect physicians’ mental health, and whether support from supervisors and co-workers has a protective effect on their mental health. Material and Methods: The subjects included 494 physicians. The Brief Job Stress Questionnaire (BJSQ) was used to evaluate job demand, job control and support. High job strain was defined as a combination of high job demand and low job control. Depressive symptoms were assessed using the Patient Health Questionnaire-9. The Maslach Burnout Inventory- General Survey was used to evaluate burnout. Possible confounder adjusted logistic regression analyses were performed to obtain odds ratios for depressive symptoms and burnout. Results: As per the analysis, high job strain had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for depressive symptoms. High job strain and having only 2–4 days off per month (compared to > 8 days off per month) had significantly higher odds ratios, and support from co-workers had significant protective odds ratios for burnout. Conclusions: High job strain was related to depressive symptoms and burnout, and support from co-workers had a buffering effect on depressive symptoms and burnout. An inadequate number of days off was related to burnout. Assessment of job strain may be a good tool to measure physicians’ mental health, and a sufficient number of days off may be needed to prevent burnout.
EN
Introduction Modifications of hearth rate variability (HRV) constitute a marker of the autonomic nervous system (ANS) deregulation, a promising pathway linking job strain (JS) and cardiovascular diseases (CVD). The study objective is to assess whether exposures to recent and prolonged JS reduce time-domain HRV parameters on working days (WD) among CVD-susceptible nurses and whether the association also persists on resting days (RD). Material and methods 313 healthy nurses were investigated twice with one year interval to assess JS based on the demand-control and the effort-reward models. 36, 9 and 16 CVD-susceptible nurses were classified as low JS in both surveys (stable low strain – SLS), recent high JS (high JS at the second screening only-RHS) and prolonged high JS (high strain in both surveys-PHS), respectively. In 9, 7 and 10 of them, free from comorbidities/treatments interfering with HRV, two 24-h ECG recordings were performed on WD and RD. Differences in the time domain HRV metrics among JS categories were assessed using ANCOVA, adjusted for age and smoking. Results In the entire sample (mean age: 39 years, 83% females) the prevalence of high job strain was 38.7% in the second survey. SDNN (standard deviation of all normal RR intervals) on WD significantly declined among JS categories (p = 0.02), with geometric mean values of 169.1, 145.3 and 128.9 ms in SLS, RHS, PHS, respectively. In the PHS group, SDNN remained lower on RD as compared to the low strain subjects (142.4 vs. 171.1 ms, p = 0.02). Similar findings were found for the SDNN_Index, while SDANN (standard deviation of average RR intervals in all 5 min segments of registration) mean values reduced in the PHS group during WD only. Conclusions Our findings suggest that persistent JS lowers HRV time-domain parameters, supporting the hypothesis that the ANS disorders may play an intermediate role in the relationship between work stress and CVD.
EN
ObjectivesWork-related stress (WRS) is significantly associated with health-related quality of life (HRQoL), but the amounts of evidence on differences of effort-reward imbalance (ERI) and job strain index (JSI) remain sparse and have limited generalizability. Therefore, we aimed to assess the association between ERI and JSI with HRQoL and assess the mediation effect of social support (JS) and over-commitment (OC) on this association in Taiwan’s civil servants.Material and MethodsA cross-sectional national survey was given to registered civil servants in Taiwan – 20 046 civil servants from 647 institutions were enrolled using multistage stratified random cluster sampling. A web-questionnaire collected demographic information, job characteristics, and different indexes of ERI and job-control-demand-support (JCDS) models. Structural equation model (SEM) was used to examine the association between ERI and JSI with HRQoL, and the mediation effect of JS and OC on the associations.ResultsIn the ERI model, ERI and OC were consistently negatively associated with the mental component score (MCS) (r = –0.46 and r = –0.37) and physical component score (PCS) (r = –0.45 and r = –0.34), which were higher than job demand (r = –0.28 and r = –0.22) and JSI (r = –0.38 and r = –0.29). Using hierarchical multiple regression analyses, ERI was significantly correlated with MCS and PCS, which was consistently higher than JSI. The ERI and JSI were significantly correlated with MCS (β = –0.170 and β = –0.140) and PCS (β = –0.150 and β = –0.082) using SEM analysis, whereas ERI was considerably higher than in JSI. In addition, OC and JS mediated the association between The ERI and JSI with HRQoL.ConclusionsWe found the ERI index is significantly correlated with HRQoL superior to JSI, in particular among Taiwan civil servants. Further longitudinal studies are needed to determine the causality and spatiotemporal relation of these differences.
Medycyna Pracy
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2017
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vol. 68
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issue 3
375-390
EN
Background The aim of this paper was to examine how temperament might moderate the health impact of psychosocial hazards at work and thus to attempt to identify the temperament risk factor in the judiciary staff. Material and Methods The data were collected from 355 court employees, including judges, judicial assistants, court clerks and service workers from criminal, civil, commercial as well as from labor and social insurance divisions. The psychosocial work environment was measured with the Psychosocial Working Conditions Questionnaire by Cieślak and Widerszal-Bazyl, temperament with Cloninger’s Temperament and Character Inventory adopted by Hornowska and employee health status was screened with Goldberg’s General Health Questionnaire- 28 (GHQ-28) adopted by Makowska and Merecz. The health impact of job strain with moderating effects of temperament traits was estimated with logistic regression (forward stepwise selection based on the likelihood ratio for the model). Results The analyses confirmed the moderating role of temperament in the health consequences of work-related stress. High score in novelty seeking was identified as independent temperament risk factor for mental health disturbances in judiciary staff facing at least medium job demands. The job control was a protective factor while relative risk of negative health outcomes was also elevated due to female gender. Conclusions Temperament may control sensitivity to the environmental exposure to psychosocial hazards at work and its health consequences. Further research is needed to explore and understand better the moderating role of temperament in the relation between job stress (strain) and health in different vocational groups and workplaces. Med Pr 2017;68(3):375–390
PL
Wstęp Celem pracy była eksploracja temperamentu jako moderatora konsekwencji zdrowotnych narażenia pracowników sądownictwa na zagrożenia psychospołeczne w pracy oraz próba wyodrębnienia temperamentalnego czynnika ryzyka. Materiał i metody W badaniu uwzględniono dane zebrane od 355 pracowników sądownictwa powszechnego: sędziów, asystentów, urzędników i pracowników obsługi z wydziałów cywilnych, karnych, gospodarczych oraz pracy i ubezpieczeń społecznych. Do pomiaru wykorzystano: Kwestionariusz Psychospołeczne Warunki Pracy autorstwa Cieślaka i Widerszal-Bazyl, Kwestionariusz Temperamentu i Charakteru (Temperament and Character Inventory – TCI) Cloningera w adaptacji Hornowskiej oraz Kwestionariusz Ogólnego Stanu Zdrowia Goldberga (General Health Questionnaire-28 – GHQ-28) w adaptacji Makowskiej i Merecz. Analizy prowadzono w modelu regresji logistycznej metodą selekcji postępującej w oparciu o iloraz wiarygodności dla modelu. Wyniki Uzyskane rezultaty potwierdzają moderujący wpływ temperamentu na skutki zdrowotne stresu związanego z pracą. Ujawniono, że wysoki poziom poszukiwania nowości stanowi niezależny temperamentalny czynnik ryzyka wystąpienia zaburzeń zdrowia psychicznego wśród pracowników sądownictwa w sytuacji ekspozycji na umiarkowane lub wysokie wymagania w pracy. Istotnym czynnikiem ochronnym okazała się kontrola nad pracą. Płeć żeńska zwiększała ryzyko szkód zdrowotnych. Wnioski Temperament może być czynnikiem kontrolującym wpływ zagrożeń psychospołecznych na zdrowie pracowników. Konieczne są dalsze badania w celu lepszego poznania moderującej roli temperamentu w występowaniu konsekwencji zdrowotnych stresu związanego z pracą, z uwzględnieniem specyfiki różnych grup zawodowych i środowisk pracy. Med. Pr. 2017;68(3):375–390
EN
The classification of an acute vascular episode, both heart infarct and stroke, as an accident at work poses difficulties not only for post accidental teams, but also to occupational health professionals, experts and judges at labor and social insurance courts. This article presents the case of a 41-year-old office worker, whose job involved client services. While attending a very aggressive customer she developed solid stress that resulted in symptoms of the central nervous system (headache, speech disturbances). During her hospitalisation at the neurological unit ischemic stroke with transient mixed type aphasia was diagnosed. Magnetic resonance imaging (MRI) scan of the head revealed subacute ischemia. After an analysis of the accident circumstances, the employer’s post accidental team decided that ischemic stroke had been an accident at work, because it was a sudden incident due to an external cause inducing work-related traumatic stroke. As a primary cause tough stress and emotional strain due to the situation developed while attending the customer were acknowledged. During control medical check up after 5 months the patient was found to be fit for work, so she could return to work. However, it should be noted that such a check up examination of subjects returning to work after stroke must be holistic, including the evaluation of job predispositions and health education aimed at secondary prevention of heart and vascular diseases with special reference to their risk factors. Med Pr 2015;66(4):595–599
PL
Zakwalifikowanie ostrego incydentu naczyniowego, zarówno zawału serca, jak i udaru mózgu, jako wypadku przy pracy, stwarza trudności nie tylko zespołom powypadkowym, ale także konsultującym zdarzenie lekarzom sprawującym opiekę profilaktyczną nad pracownikami, biegłym wydającym opinie sądowo-lekarskie czy w końcu sądom pracy i ubezpieczeń społecznych. W artykule przedstawiono przypadek 41-letniej pracownicy administracyjno-biurowej, która w zakresie czynności zawodowych miała obsługę klientów i przyjmując agresywnego interesanta, doznała silnego stresu. W jego konsekwencji pojawiły się objawy ze strony ośrodkowego układu nerwowego (ból głowy, zaburzenia mowy), a w trakcie hospitalizacji rozpoznano niedokrwienny udar mózgu z ustępującą afazją mieszaną. W badaniu rezonansu magnetycznego głowy uwidoczniono podostre zmiany niedokrwienne. Zespół powypadkowy pracodawcy ustalił okoliczności wypadku przy pracy i w konsekwencji uznał, że zawał mózgu wywołany przez zator tętnic mózgowych był wypadkiem przy pracy, ponieważ było to nagłe zdarzenie wywołane przyczyną zewnętrzną powodującą uraz (udar), które miało związek z pracą. Jako jego przyczynę wskazano silny stres i napięcie nerwowe spowodowane zaistniałą sytuacją podczas obsługi klienta. Po 5 miesiącach, podczas badań kontrolnych pacjentka uzyskała orzeczenie o braku przeciwwskazań do pracy na swoim stanowisku, dzięki czemu mogła wrócić do pracy. Należy zwrócić uwagę, że badania kontrolne u osób powracających do pracy po udarze mózgu powinny obejmować: po pierwsze, holistyczną ocenę predyspozycji zdrowotnych do wykonywania dotychczasowych obowiązków zawodowych, a po drugie, edukację zdrowotną w miejscu pracy, ukierunkowaną na prewencję wtórną dotyczącą ograniczania czynników ryzyka powikłań chorób sercowo-naczyniowych. Med. Pr. 2015;66(4):595–599
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