Methodological issues in assessing job stress and burnout in psychosocial research.

In recent years, researchers identified a "reproducibility crisis" of scientific studies. In assessing job stress and burnout in psychosocial research two biases that prevent the results from being generalized are common: sample bias (included web survey) and common method bias using questionnaires. These issues are commented and remedies are proposed to prevent or contain biases.

[Workplace bullying and sickness absenteeism]. / Rischio mobbing e assenze lavorative per malattia.

AIM: To assess the relationship between workplace bullying and sickness absenteeism in a large sample of Italian workers. DESIGN: A cross-sectional study conducted by means of questionnaires. SETTING AND PARTICIPANTS: In all, 8,992 subjects filled in a questionnaire to detect workplace bullying, the presence of work stress factors and days of sickness absence in the last year. EXPOSURES: Workplace bullying and psychosocial stressor were measured by the means of the CDL 2.0 questionnaire. MAIN OUTCOME MEASURE: Days of sickness absence reported by the subjects. RESULTS: On average, days of sickness absence were 7.4, and 7.2% of the respondents were defined as bullied. Results from logistic regression analyses showed that a workplace bullying was associated with more days of sickness absence after controlling for gender, age, professional qualification, company sector and juridical nature and other psychosocial factors (men: OR =1.62; women: OR =2.15). CONCLUSIONS: The present study confirms that workers exposed to a workplace bullying reported higher sickness absenteeism as compared with non-exposed subjects, also when a potentially highly stressful work environment is considered. The results of the present study support that workplace bullying may be viewed as an extreme stressful condition. Interventions to avoid workplace bullying not only favoure workers' health, but also avoid the company costs associated with workers' sickness absenteeism.

[Work stress, common mental disorders and Work Ability Index among call center workers of an Italian company]. / Stress lavorativo, disturbi psichici minori e indice di capacità di lavoro negli addetti al call center di un'azienda italiana.

AIM: To test three hypotheses in an Italian sample of call center workers: higher levels of perceived work stress are associated with more frequent common mental disorders (GHQ-12) and a lower Work Ability Index; combining the Job Strain (JS) and Effort/Reward Imbalance (ERI) models increases explained variance in health over and above either model when applied separately; compared with outbound operators, inbound call handlers are expected to report a lower health status,which is due to a more intense exposure to task-related work stress factors in the latter. DESIGN: A multi-center cross-sectional study, conducted by means of interviews and self-administered questionnaires. SETTING AND PARTICIPANTS: Call handlers working in the Italian branch of a telecommunication multinational company. In all, 1,106 permanent workers were examined (35.9%of the total target population, 98.9% response rate). The majority were women (76.5%);mean age was 33.3 (SD: 3.9) and company seniority 8.0 (SD: 2.1). Nearly 60% worked as inbound call handlers, about one third as outbound operators. EXPOSURES: Work stress was measured with the well-known JS and ERI models. Three exposure levels (based on tertiles) were identified for each scale. OUTCOMES: Common mental disorders were measured with the GHQ-12 questionnaire. Subjects with a GHQ-12 score 4 were classified as "cases". The Work Ability Index (WAI) was used to evaluate work ability. Being in the "poor" or "moderate" categories of the WAI indicated a low work ability status. Cronbach's alphas were 0.70 for all scales. RESULTS: Multivariate Poisson regressions showed that both models were linked to more frequent common mental disorders and a lower WAI. Moreover, combined models demonstrated an advantage in terms of explained variance in health. Finally, performing inbound call handling was associated with a lower WAI in comparison with engaging in outbound activities. Mediation analyses showed that such association is explained by the higher levels of psychological job demands and Job Strain experienced by inbound operators. CONCLUSIONS: Our results highlight the relevance of work stress as a risk factor for lower psychological health, and especially for a poorer WAI among call center workers. The combined use of the two models increases completeness of work stress assessment in this sector.The higher levels of work stress and the lower WAI observed among inbound operators are due to objectively less favourable task-related characteristics.

[Assessing employees' perceptions of risk factors for job stress using context-specific methods: the case of call-center workers]. / Valutare la percezione dei fattori di rischio da stress lavoro-correlato oro-co rrela to attraverso strumenti adattati al contesto: il caso degli addetti al call-center.

The Italian Advisory Committee on work-related stress has outlined a step-by-step approach which considerably limits workers' participation in the first phases of the assessment procedure. Albeit cost-effective, such approach neglects the relevance of employees' perception in correctly identifying likely risk factors for job stress. Results of the present study, considering call center workers, points to the need of adopting subjective instruments for job stress assessment that are context-specific, whereas using generic job stress models only (such as Job Demand-Control and Effort Reward/Imbalance) may not permit the identfication of risk factors that are peculiar to the work settings under investigation.

Shiftwork, work-family conflict among Italian nurses, and prevention efficacy.

Shiftwork may be a demanding situation because it raises problems for reconciling work and nonwork activities; as such, this conflict may be mitigated by designing and implementing effective preventative actions at the workplace. There is a paucity of research directly examining the impact of work schedules and preventative measures at work on work-family conflict. Hence, the authors posed the following questions in their study: What is the impact of different work schedules on work-family conflict? Is a preventative culture associated with less work-family conflict? Is work-family conflict associated with specific health and well-being indicators and if so, how does work-family conflict affect well-being as compared with other potential determinants? A subset of 750 nurses ( approximately 10% of total workforce) were randomly selected from a larger sample. Nurses completed the Italian version of the NEXT questionnaire plus newly developed items to create an index on occupational safety and health prevention at work. Data were explored using two data mining techniques, Random Forests and Bayesian Networks, and modeled using hierarchical linear regression models. In all, 664 (88.5% of sample) nurses answered the questionnaire. The authors found that different work schedules had a differential impact on work-family conflict. In addition, effective risk communication between workers and people in charge of safety and health, and participation in preventative activities, quantitative workload, performing tasks not belonging to the nursing profession, and the number of weekends/month spent at work were all strongly associated with work-family conflict. The variable "time schedules" also acted as an effect modifier in the relationship between effective communication and participation in preventative activities and work-family conflict. In addition, quantitative demands played a role as a mediator (30% of total effect) in the relationship between effective communication and participation in preventative activities and work-family conflict. Work-family conflict was significantly associated with burnout, sleep, and presenteeism; its association with burnout was higher than other precursors. Shift schedules that involved night work implied different workload demands, less effective communication, and participation in preventative activities than the other work schedules considered. The presence of a preventative culture directly reduced work-family conflict and indirectly via reduction of work demands. The authors conclude that the development of a preventative culture among irregular and night shiftworkers can be effective in reducing work-family conflict, while positively increasing well-being and job performance.

Factors affecting work ability in day and shift-working nurses.

Satisfactory work ability is sustained and promoted by good physical and mental health and by favorable working conditions. This study examined whether favorable and rewarding work-related factors increased the work ability among European nurses. The study sample was drawn from the Nurses' Early Exit Study and consisted of 7,516 nursing staff from seven European countries working in state-owned and private hospitals. In all, 10.8% were day, 4.2% were permanent night, 20.9% were shift without night shift, and 64.1% were shift workers with night shifts. Participants were administered a composite questionnaire at baseline (Time 0) and 1 yr later (Time 1). The Work Ability Index (WAI) at Time 1 was used as the outcome measure, while work schedule, sleep, rewards (esteem and career), satisfaction with pay, work involvement and motivation, and satisfaction with working hours at Time 0 were included as potential determinants of work ability. Univariate and multivariate analyses were conducted after adjusting for a number of confounders (i.e., country, age, sex, type of employment, family status, and other job opportunities in the same area). Work schedule was not related to Time 1 changes in WAI. Higher sleep quality and quantity and more favorable psychosocial factors significantly increased work ability levels. Higher sleep quality and quantity did not mediate the effect of work schedule on work ability. No relevant interaction effects on work ability were observed between work schedule and the other factors considered at Time 0. As a whole, sleep and satisfaction with working time were gradually reduced from day work to permanent night work. However, scores on work involvement, motivation, and satisfaction with pay and rewards were the highest in permanent night workers and the lowest in rotating shift workers that included night shifts.