A systematic review of literature on occupational health and safety interventions for older workers.

As the global population ages there is an imperative to enhance labour participation of older workers in ways that support good physical and psychological health. However, there is limited guidance for organisations on how to do this effectively. This systematic review examined literature identified through four databases and a targeted web-search, yielding 39 PRISMA records (32 scholarly, seven grey literature) reporting workplace interventions aimed at improving the injury outcomes of older workers. The review revealed that organisational and composite interventions may be most effective, although an absence of robust research in this area and a scarcity of empirical evidence-based interventions known to improve injury outcomes for older workers was noted. Responding to these shortcomings, this article presents 'A future research agenda for older worker health, safety and well-being interventions.' This systems-based approach has a dual focus on organisational and composite interventions combined with robust research design.Practitioner summary: We conducted a systematic literature review of studies focussed on workplace interventions to improve the physical and psychological safety of older workers. Within the existing literature, evidence for effective interventions and guidance for organisations is weak. We present a future research agenda with a systems approach to address these gaps.

Discrepancies between proxy estimates and patient reported, health related, quality of life: minding the gap between patient and clinician perceptions in heart failure.

PURPOSE: Health related quality of life (HRQoL) is rarely routinely measured in the clinical setting. In the absence of patient reported data, clinicians rely on proxy and informal estimates to support clinical decisions. This study compares clinician estimates (proxy) with patient reported HRQoL in patients with advanced heart failure and examines factors influencing discrepancies. METHODS: Seventy-five patients with heart failure, (22 females, 53 males) completed the EQ-5D-5L questionnaire. Thirty-nine clinicians (11 medical, 23 nursing, 5 allied health) completed the proxy version (V1) producing 194 dyads. Correlation was assessed using Spearman's rank tests, systematic bias was examined with Bland-Altman analyses. Inter-rater agreement at the domain level, was investigated using linear weighted Kappa statistics while factors influencing the IRG were explored using independent student t-tests, analysis of variance and regression. RESULTS: There was a moderate positive correlation between clinician HRQoL estimates and patient reported utility (r = 0.38; p < .0005). Mean clinician estimates were higher than patient reported utility (0.60 vs 0.54; p = 0.008), with significant underestimation of reported problems apparent in three of the five EQ-5D-5L domains. Patient sex (female), depressed mood and frailty were all associated with an increased inter-rater gap. CONCLUSION: Clinicians in this sample overestimated HRQoL. Factors affecting the inter-rater gap, including sex and depression, support formal HRQoL screening to enhance clinical conversations and decision making. The discrepancy also supports regulatory restriction on the use of expert opinion in the development of QALYs in health economic analysis.

Nurse safety outcomes: old problem, new solution - the differentiating roles of nurses' psychological capital and managerial support.

AIM: The aim of this study was to examine the impacts of nurses' psychological capital and managerial support, plus specific safety interventions (managerial safety priorities, safety training satisfaction), on nurses' in-role safety performance. BACKGROUND: Most hospitals in industrialized countries have adopted selective (often the least costly) aspects of safety, usually related to safety policies. However, patient safety remains a challenge in many countries. Research shows that training can be used to upskill employees in psychological capital, with statistically significant organizational and employee benefits, but this area is under-researched in nursing. DESIGN: Data were collected using a survey-based, self-report strategy. The emerging patterns of data were then compared with the findings of previous research. METHODS: Quantitative survey data were collected during 2014 from 242 nurses working in six Australian hospitals. Two models were tested and analysed using covariance-based Structural Equation Modelling. RESULTS: Psychological capital and safety training satisfaction were important predictors of nurses' in-role safety performance and as predictors of nurses' perceptions of whether management implements what it espouses about safety ('managerial safety priorities'). Managerial support accounted for just under a third of psychological capital and together, psychological capital and managerial support, plus satisfaction with safety training, were important to nurses' perceptions of in-role safety performance. CONCLUSION: Organizations are likely to benefit from upskilling nurses and their managers to increase nurses' psychological capital and managerial support, which then will enhance nurses' satisfaction with training and in-role safety performance perceptions.

Older Worker-Orientated Human Resource Practices, Wellbeing and Leave Intentions: A Conservation of Resources Approach for Ageing Workforces.

At a time where there are ageing populations, global shortages of skilled labour, and migration pathways impacted by the COVID-19 pandemic, retaining older workers presents as a vital strategic initiative for organizations globally. This study examines the role of Human Resource Practices (HRPs), which are oriented towards accommodating the needs of an ageing workforce in mitigating psychological distress and turnover intentions. The study collected self-reported survey data from 300 Australian employees over the age of 45, over two time points. Using structural equation modelling, the study analyzed the extent to which Older Worker-oriented Human Resources Practices (OW-HRPs) translate into employee psychological health and retention within organizations, through the mediation of ageism and work-life conflict. The results support our hypothesis that OW-HRPs are associated with lower ageism, better work-life balance; and in combination these reduce psychological distress and help retain older workers in the workforce. We conclude that OW-HRPs can foster work environments conducive to older worker wellbeing, supporting the retention of talent and maintaining effectiveness, in the face of substantial labour supply challenges brought on by the COVID-19 pandemic and an ageing population.

A systems model for the design of occupational health and safety management systems inclusive of work-from-home arrangements.

The study addressed an important knowledge gap in the literature by co-designing a model for OHS management systems inclusive of workers who work-from-home, with a focus on psychosocial risks. This qualitative research study utilised a series of co-design focus groups involving Australian regulators, health and safety managers and practitioners, senior managers, middle managers and workers who work-from-home, to better understand the types of measures that organisations can apply to improve their health and safety management systems. Using a systems approach, consideration was given to the organisation of the remote working system, the home-work interface for remote workers, the competencies of managers and employees in regard to their occupation health and safety (OHS) responsibilities, and the complexity of identifying, reporting and monitoring psychosocial hazards for employees working from home. The study identified a need for tools designed to support both managers and workers in promoting psychologically safe working from home.