Flemish critical care nurses' experiences regarding the influence of work-related demands on their health: a descriptive interpretive qualitative study.

BACKGROUND: Critical care nurses (CCNs) around the globe face other health challenges compared to their peers in general hospital nursing. Moreover, the nursing workforce grapples with persistent staffing shortages. In light of these circumstances, developing a sustainable work environment is imperative to retain the current nursing workforce. Consequently, this study aimed to gain insight into the recalled experiences of CCNs in dealing with the physical and psychosocial influences of work-related demands on their health while examining the environments in which they operate. The second aim was to explore the complex social and psychological processes through which CCNs navigate these work-related demands across various CCN wards. METHODS: A qualitative study following Thorne's interpretive descriptive approach was conducted. From October 2022 to April 2023, six focus groups were organised. Data from a diverse sample of 27 Flemish CCNs engaged in physically demanding roles from three CCN wards were collected. The Qualitative Analysis Guide of Leuven was applied to support the constant comparison process. RESULTS: Participants reported being exposed to occupational physical activity, emotional, quantitative, and cognitive work-related demands, adverse patient behaviour, and poor working time quality. Exposure to these work-related demands was perceived as harmful, potentially resulting in physical, mental, and psychosomatic strain, as well as an increased turnover intention. In response to these demands, participants employed various strategies for mitigation, including seeking social support, exerting control over their work, utilising appropriate equipment, recognising rewards, and engaging in leisure-time physical activity. CONCLUSIONS: CCNs' health is challenged by work-related demands that are not entirely covered by the traditional quantitative frameworks used in research on psychologically healthy work. Therefore, future studies should focus on improving such frameworks by exploring the role of psychosocial and organisational factors in more detail. This study has important implications for workplace health promotion with a view on preventing work absenteeism and drop-out in the long run, as it offers strong arguments to promote sufficient risk management strategies, schedule flexibility, uninterrupted off-job recovery time, and positive management, which can prolong the well-being and sustainable careers of the CCN workforce.

The association between day-to-day stress experiences and work-life interference among office workers in academia: an ecological momentary assessment study.

PURPOSE: We investigated relations between day-to-day job demands, job control, job strain, social support at work, and day-to-day work-life interference among office workers in academia. METHODS: This study is based on a 15-working day data collection period using an Ecological Momentary Assessment (EMA) implemented in our self-developed STRAW smartphone application. We recruited office workers from two academic settings in Belgium and Slovenia. Participants were repeatedly asked to complete EMAs including work stressors and work interfering with personal life (WIPL) as well as personal life interfering with work (PLIW). We applied fixed-effect model testing with random intercepts to investigate within- and between-participant levels. RESULTS: We included 55 participants with 2261 analyzed observations in this study. Our data showed that researchers with a PhD reported higher WIPL compared to administrative and technical staff (ß = 0.37, p < 0.05). We found significant positive associations between job demands (ß = 0.53, p < 0.001), job control (ß = 0.19, p < 0.01), and job strain (ß = 0.61, p < 0.001) and WIPL. Furthermore, there was a significant interaction effect between job control and social support at work on WIPL (ß = - 0.24, p < 0.05). Additionally, a significant negative association was found between job control and PLIW (ß = - 0.20, p < 0.05). CONCLUSION: Based on our EMA study, higher job demands and job strain were correlated with higher WIPL. Furthermore, we found associations going in opposite directions; higher job control was correlated with higher WIPL and lower PLIW. Higher job control leading to higher imbalance stands out as a novel result.

Work environment risk factors causing day-to-day stress in occupational settings: a systematic review.

BACKGROUND: While chronic workplace stress is known to be associated with health-related outcomes like mental and cardiovascular diseases, research about day-to-day occupational stress is limited. This systematic review includes studies assessing stress exposures as work environment risk factors and stress outcomes, measured via self-perceived questionnaires and physiological stress detection. These measures needed to be assessed repeatedly or continuously via Ecological Momentary Assessment (EMA) or similar methods carried out in real-world work environments, to be included in this review. The objective was to identify work environment risk factors causing day-to-day stress. METHODS: The search strategies were applied in seven databases resulting in 11833 records after deduplication, of which 41 studies were included in a qualitative synthesis. Associations were evaluated by correlational analyses. RESULTS: The most commonly measured work environment risk factor was work intensity, while stress was most often framed as an affective response. Measures from these two dimensions were also most frequently correlated with each other and most of their correlation coefficients were statistically significant, making work intensity a major risk factor for day-to-day workplace stress. CONCLUSIONS: This review reveals a diversity in methodological approaches in data collection and data analysis. More studies combining self-perceived stress exposures and outcomes with physiological measures are warranted.

A Personal Decision Support System for Heart Failure Management (HeartMan): study protocol of the HeartMan randomized controlled trial.

BACKGROUND: Heart failure (HF) is a highly prevalent chronic disease, for which there is no cure available. Therefore, improving disease management is crucial, with mobile health (mHealth) being a promising technology. The aim of the HeartMan study is to evaluate the effect of a personal mHealth system on top of standard care on disease management and health-related quality of life (HRQoL) in HF. METHODS: HeartMan is a randomized controlled 1:2 (control:intervention) proof-of-concept trial, which will enrol 120 stable ambulatory HF patients with reduced ejection fraction across two European countries. Participants in the intervention group are equipped with a multi-monitoring health platform with the HeartMan wristband sensor as the main component. HeartMan provides guidance through a decision support system on four domains of disease management (exercise, nutrition, medication adherence and mental support), adapted to the patient's medical and psychological profile. The primary endpoint of the study is improvement in self-care and HRQoL after a six-months intervention. Secondary endpoints are the effects of HeartMan on: behavioural outcomes, illness perception, clinical outcomes and mental state. DISCUSSION: HeartMan is technologically the most innovative HF self-management support system to date. This trial will provide evidence whether modern mHealth technology, when used to its full extent, can improve HRQoL in HF. TRIAL REGISTRATION: This trial has been registered on https://clinicaltrials.gov/ct2/show/NCT03497871 , on April 13 2018 with registration number NCT03497871.

How does day-to-day stress appraisal relate to coping among office workers in academia? An ecological momentary assessment study.

Existing literature indicates that academic staff experience increasing levels of work stress. This study investigated associations between day-to-day threat and challenge appraisal and day-to-day problem-focused coping, emotion-focused coping, and seeking social support among academic office workers. This study is based on an Ecological Momentary Assessment (EMA) design with a 15-working day data collection period utilising our self-developed STRAW smartphone application. A total of 55 office workers from academic institutions in Belgium (n = 29) and Slovenia (n = 26) were included and 3665 item measurements were analysed. Participants were asked approximately every 90 min about their appraisal of stressful events (experienced during the working day) and their coping styles. For data analysis, we used an unstructured covariance matrix in our linear mixed models. Challenge appraisal predicted problem-focused coping and threat appraisal predicted emotion-focused coping. Our findings suggest an association between threat appraisal as well as challenge appraisal and seeking social support. Younger and female workers chose social support more often as a coping style. While working from home, participants were less likely to seek social support. The findings of our EMA study confirm previous research on the relationship between stress appraisal and coping with stress. Participants reported seeking social support less while working from home compared to working at the office, making the work location an aspect that deserves further research.

The association between day-to-day stress experiences, recovery, and work engagement among office workers in academia-An Ecological Momentary Assessment study.

OBJECTIVES: This study aimed to investigate the associations between day-to-day work-related stress exposures (i.e., job demands and lack of job control), job strain, and next-day work engagement among office workers in academic settings. Additionally, we assessed the influence of psychological detachment and relaxation on next-day work engagement and tested for interaction effects of these recovery variables on the relationship between work-related stressors and next-day work engagement. METHODS: Office workers from two academic settings in Belgium and Slovenia were recruited. This study is based on an Ecological Momentary Assessment (EMA) with a 15-working day data collection period using our self-developed STRAW smartphone application. Participants were asked repeatedly about their work-related stressors, work engagement, and recovery experiences. Fixed-effect model testing using random intercepts was applied to investigate within- and between-participant levels. RESULTS: Our sample consisted of 55 participants and 2710 item measurements were analysed. A significant positive association was found between job control and next-day work engagement (ß = 0.28, p < 0.001). Further, a significant negative association was found between job strain and next-day work engagement (ß = -0.32, p = 0.05). Furthermore, relaxation was negatively associated with work engagement (ß = -0.08, p = 0.03). CONCLUSIONS: This study confirmed previous results, such as higher job control being associated with higher work engagement and higher job strain predicting lower work engagement. An interesting result was the association of higher relaxation after the working day with a lower next-day work engagement. Further research investigating fluctuations in work-related stressors, work engagement, and recovery experiences is required.

Sources of Occupational Stress among Office Workers-A Focus Group Study.

Workplace stress remains a major interest of occupational health research, usually based on theoretical models and quantitative large-scale studies. Office workers are especially exposed to stressors such as high workload and time pressure. The aim of this qualitative research was to follow a phenomenological approach to identify work stressors as they are perceived by office workers. Six focus groups with office workers of different occupations were conducted in Belgium and Slovenia. A total of 39 participants were included in the study. We used the RQDA software for data processing and analysis and the seven job-quality indices of the European Working Conditions Survey (EWCS) to structure our findings. The results show that work intensity and social environment proved to be main stress categories, followed by skills and discretion, prospects, and working time quality. The physical environment and earnings were not covered in our results. We created organisational (structural/process-oriented and financial) stressors and office workers' physical health as two additional categories since these topics did not fit into the EWCS. While our findings mainly confirm data from existing occupational stress literature and emphasise the multi-level complexity of work stress experiences, this paper suggests that there are relevant stressors experienced by office workers beyond existing quantitative frameworks.

Protocol of the STRess at Work (STRAW) Project: How to Disentangle Day-to-Day Occupational Stress among Academics Based on EMA, Physiological Data, and Smartphone Sensor and Usage Data.

Several studies have reported on increasing psychosocial stress in academia due to work environment risk factors like job insecurity, work-family conflict, research grant applications, and high workload. The STRAW project adds novel aspects to occupational stress research among academic staff by measuring day-to-day stress in their real-world work environments over 15 working days. Work environment risk factors, stress outcomes, health-related behaviors, and work activities were measured repeatedly via an ecological momentary assessment (EMA), specially developed for this project. These results were combined with continuously tracked physiological stress responses using wearable devices and smartphone sensor and usage data. These data provide information on workplace context using our self-developed Android smartphone app. The data were analyzed using two approaches: 1) multilevel statistical modelling for repeated data to analyze relations between work environment risk factors and stress outcomes on a within- and between-person level, based on EMA results and a baseline screening, and 2) machine-learning focusing on building prediction models to develop and evaluate acute stress detection models, based on physiological data and smartphone sensor and usage data. Linking these data collection and analysis approaches enabled us to disentangle and model sources, outcomes, and contexts of occupational stress in academia.

From Opioid Pain Management to Opioid Crisis in the USA: How Can Public-Private Partnerships Help?

The current opioid crisis in the USA arose from (at first) successful opioid pain management in three waves, starting in the'90s. Today, USA patients consume opioid drugs on a massive scale. Considering their potential for tolerance, as well as their potential for lethality in relatively small overdose, the overuse of opioids form an urgent threat to public health in the USA. Since the opioid crisis is a complex phenomenon, several stakeholders are needed to tackle the problem. Both public and private stakeholders should collaborate, e.g., in Public-Private Partnerships. Those collaborations should focus on different aspects related to the opioid crisis such as medical and societal (e.g., pain management process, including addressing opioid use disorders), as well as economical and regulatory issues (e.g., incentivizing the search for alternative non-addictive pain medication and banning aggressive marketing tactics used by the pharmaceutical industry). Additionally, collaborations should cover interdisciplinary education and training of various healthcare actors involved. In conclusion, interdisciplinary collaboration on the various opioid abuse-related aspects is urgently needed to tackle the opioid crisis in the USA.

The tragedy of becoming tired of living: Youth and young adults' suicide in Greenland and Denmark.

BACKGROUND: Suicide is a tremendous public health issue and worldwide the second leading cause of death among young people. In 2015, Greenland had the highest burden of disease due to self-harm with loss of 2,952.97 disability-adjusted life years per 100,000 inhabitants, more than six times as many as Denmark. AIMS: What are possible reasons for Greenland's higher youth suicide rate compared to Denmark, despite being one kingdom of Denmark? METHOD: Mixed methods in the form of qualitative, semi-structured interviews, the analysis of available data for 2003-2016 and a literature review were conducted with the aim to answer this question. RESULTS: Several exposures cause this difference, most significantly adverse effects of the colonial past, such as social issues and experienced traumas in Greenland compared to its former coloniser Denmark. CONCLUSION: The ongoing burden of youth suicide in Greenland requires enhanced actions of all stakeholders involved in suicide prevention, intervention and postvention.