Assessment of the prevalence and associated factors of lower back pain (LBP) among three different professionals in Bangladesh: Findings from a face-to-face survey.

OBJECTIVES: This study aims to evaluate the prevalence and associated factors of lower back pain (LBP) among farmers, rickshaw pullers and office workers in Bangladesh, while also investigating potential contributors within these occupational groups. DESIGN: This cross-sectional study aimed to determine the prevalence of LBP, associated factors and management procedures among farmers, rickshaw pullers and office workers in Bangladesh through face-to-face interviews. SETTING: The study was conducted in different parts of the Bogura district in Bangladesh. PARTICIPANTS: A total of 396 participants were included in the final analysis, all the participants were men and adult in age. MAIN OUTCOME MEASUREMENTS: Data were collected using a semi-structured questionnaire based on previous research. Bivariate and multivariable logistic regression analyses were performed to identify significant associations. RESULTS: The prevalence of LBP was found to be 42.7% among the participants. Farmers and rickshaw pullers had approximately four-times and three-times higher odds of experiencing LBP compared with office workers. Other significant factors associated with LBP included living in a nuclear family, having a normal body weight, lacking professional training, having a chronic disease, having a family history of LBP and experiencing numbness in the legs or feet. The majority of respondents sought medical attention and took medication for their LBP. CONCLUSION: The study underscores occupational differences in LBP prevalence, emphasising the necessity for tailored interventions and occupational health policies. Identifying specific risk factors and management practices in these professions can aid in developing effective prevention strategies and enhancing healthcare services.

Correlation analysis between occupational stress and metabolic syndrome in workers of a petrochemical enterprise: based on two assessment models of occupational stress.

BACKGROUND: Occupational stress is becoming a common phenomenon around the world. Being in a high occupational stress state for a long time may destroy the metabolic balance of the body, thereby increasing the risk of metabolic diseases. There is limited evidence regarding the correlation between occupational stress and metabolic syndrome (MetS), particularly in the petrochemical workers. METHODS: A total of 1683 workers of a petrochemical enterprise in China were included in the survey by cluster sampling method. The occupational stress assessment was carried out by the Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire, and the general demographic characteristics, work characteristics, occupational hazards, lifestyle and health examination data of the participants were collected. Logistic regression and multiple linear regression were used to analyze the correlations and influencing factors between occupational stress and its dimensions with MetS and its components. RESULTS: A total of 1683 questionnaires were sent out, and 1608 were effectively collected, with an effective recovery rate of 95.54%. The detection rates of occupational stress in Job Demand-Control (JDC) and Effort-Reward Imbalance (ERI) models were 28.4% and 27.2%, respectively. In this study, 257 participants (16.0%) were diagnosed with MetS. Compared with the non-MetS group, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG) and fasting blood-glucose (FBG) levels were significantly higher in the MetS group, and high density lipoprotein-cholesterol (HDL-C) levels were significantly lower (P < 0.001). The results of multiple linear regression showed that after adjusting for nation, marital status, education, work system, smoking and drinking, and further adjusting for occupational hazards, the D/C ratio was significantly negatively correlated with SBP in the JDC model. Social support was negatively correlated with WC. In the ERI model, there was a significant positive correlation between over-commitment and FBG. CONCLUSIONS: The detection rates of occupational stress and MetS were high in workers of a petrochemical enterprise. In the JDC model, occupational stress was negatively correlated with SBP, and social support was negatively correlated with WC. In the ERI model, there was a significantly positive correlation between over-commitment and FBG.

Evidence map on burnout syndrome in higher education teachers and its relationship with ergonomic and biopsychosocial factors: a scoping review.

Objectives. This study aimed to map the evidence on burnout syndrome in higher education teachers and its relationship with ergonomic and biopsychosocial factors. Methods. We performed a scoping review of articles published up to 2021, extracting the location, study design, sample characteristics and assessment methods, and investigated ergonomic and biopsychosocial factors. Results. Eighteen studies were found in 12 countries, and most used a cross-sectional design (n = 17/18, 94%). The Maslach burnout inventory was the most used assessment method (n = 9, 50%). There is a consensus that burnout syndrome in higher education teachers requires more attention, as it can be related to physical, mental and social factors. Conclusions. In the professional environment, physical ergonomic characteristics or those related to work organization deserve greater attention, as well as psychosocial factors, as they are strongly associated with burnout syndrome.

Assessment of occupational stress among certified registered anesthetists in the Greater Accra region.

Background: Work-related stress is a prevailing concern within the community of Certified Registered Anesthetists (CRAs), significantly impacting both the health and professional performance of these individuals. This study aimed to assess work-related stress and its influencing factors among CRAs practicing in the Greater Accra region was examined. Methods: Using convenience sampling techniques, data were gathered from 140 participants via a Google form questionnaire distributed through WhatsApp. Descriptive statistics were employed to analyze the collected data, focusing on frequencies and proportions for categorical variables. For continuous variables, bivariate analysis (Chi-square) and ordinal logistic regression were conducted using STATA 16. A p-value <0.05 was considered significant. Results: Among the 140 CRAs, 20 individuals (14.3%) reported experiencing mild stress levels according to the Weiman Occupational Stress Scale. Approximately 3 out of 4 CRAs (73.6%) reported having moderate stress levels, and 12.1% reported severe stress levels. This indicated that the majority of CRAs experienced moderate levels of stress, which was notably affected by the type of health facility and the use of inadequate or sub-standard equipment in the hospitals. Conclusion: Based on these findings, the study recommends educational programs and counseling for CRAs to heighten awareness of the demanding nature of their job. Additionally, it suggests the provision of proper resources and standard equipment for CRAs. Facility-level motivation for CRAs is also advised to alleviate their stress. Finally, the study proposes further investigations into the factors contributing to work-related stress among CRAs.

Impact of social desirability bias on the CoPsoQ-ISTAS 21 psychosocial risk assessment questionnaire.

BACKGROUND: Self-reported test is one of the main psychosocial risk assessment tools. However, this test it is susceptible to certain sources of error, including social desirability. Since psychosocial risks are emerging, there are not many studies on their assessment. OBJECTIVE: The aim of this work is to analyze the impact of social desirability on the short version of the CopSoq-ISTAS 21 assessment tool. METHOD: A total of 563 workers (45.10% women and 54.90% men) participated in this study. The short version of the CoPsoQ-Istas21 questionnaire with four Likert scale questions as markers, which correspond to the Eysenck Personality Lie Scale Questionnaire Revised (EPQ-r), were used. The sample was divided into two halves, and both a confirmatory analysis and an exploratory analysis were carried out to find out the factorial structure of the scale and, with it, apply the bias filtering method. RESULTS: The results indicate that 10% of the scale is biased due to social desirability, and that there are significant differences between the group with bias clean scores and the group with scores without bias control. CONCLUSIONS: The effects of social desirability on the scale are verified, so it is concluded that in a psychosocial risk assessment is not enough to apply a self-report test and interpret its results, being necessary to minimize the sources of error.

Social inequalities, stressful work and non-fatal cardiovascular disease: follow-up findings from the CONSTANCES Study.

BACKGROUND: Studies show that a disadvantaged socioeconomic position (SEP) and psychosocial stress at work are both independently associated with an increased risk of cardiovascular disease (CVD). But it is not clear if the effect of stress at work on CVD varies by SEP. METHODS: We used baseline and follow-up data from the French population-based cohort study CONSTANCES, including 48 383 employed women and men aged 30-70 years. Three SEP indicators (education, income, occupation), stressful psychosocial work as measured by effort-reward imbalance, pre-existing CVD and confounders were assessed at baseline, and incident non-fatal CVD events reported during annual follow-up (up to five follow-ups) were used as outcomes. The effect modification hypothesis was both investigated on an additive and multiplicative scale. RESULTS: SEP was inversely associated with CVD risk (eg, for low vs high income, OR 1.28 (95% CI 1.12 to 1.46)), and for all three components of stressful work CVD risks were significantly increased (eg, for effort-reward ratio OR 1.26 (95% CI 1.17 to 1.36)). Employees with a disadvantaged SEP showed moderately increased effect sizes of stressful work on CVD. However, no clear evidence of an effect modification was found. CONCLUSIONS: Disadvantaged SEP and stressful work contribute to higher CVD risk in this cohort. Despite moderately increased effect sizes for disadvantaged SEP groups, no evidence was found to support an effect modification hypothesis.

Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships.

BACKGROUND: According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately. OBJECTIVE: Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships. DESIGN, SETTING, AND PARTICIPANTS: An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'. METHODS: The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling. RESULTS: The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern. CONCLUSIONS: Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate. TRIAL REGISTRATION NUMBER: DRKS.de (DRKS00015241); August 9, 2018. TWEETABLE ABSTRACT: Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.

Association between burnout syndrome and obesity: A cross-sectional population-based study.

BACKGROUND: Burnout Syndrome (BS) is a response of organism against long-lasting exposure to occupational stressors. Those affected usually have comorbidities, as well as cardiovascular and metabolic problems. OBJECTIVE: Estimating the association between BS and obesity in primary health care nurses of in the state of Bahia, Brazil. METHODS: Population-analytical, cross-confirmatory, integrated and multicenter study, conducted with a random sample of primary health care nursing professionals in 43 municipalities from 07 mesoregions of Bahia, Brazil. This study was funded by the Brazilian Board for Scientific and Technological Development. The independent variable (BS) was evaluated by using the Maslach Burnout Inventory (MBI) scale, and the dependent one (obesity) was based on the Body Mass Index (BMI)≥30. Effect modification and confounding factors were verified by crude, stratified, and multivariate analysis. RESULTS: The prevalence of BS and obesity was 17.7% and 12.7%, respectively. BS was statistically associated with obesity, even after adjustment (RPa: 1.85; CI 95% 1.11-3.06) per gender, age, physical activity, healthy eating, satisfaction with occupation, another job, night shift, primary health care (PHC) time, and working conditions. Effect-modifying variables were not identified. CONCLUSIONS: The specialized literature points out a path to the association identified here. New studies on the subject are relevant and should have more robust methodologies so that the path of causality is better clarified. In addition, occupational health programs become an alternative to control stress and, therefore, its complications, such as burnout and other health aggravations.

Uma revisão sobre instrumentos de avaliação do Burnout na segurança pública / A review of Burnout assessment instruments in public safety / Una revisión de los instrumentos de evaluación del desgaste en la seguridad pública

Objetivou-se mapear os instrumentos utilizados na avaliação da síndrome de Burnout em profissionais da segurança pública, indicando os aspectos psicométricos, amostras e variáveis associadas. Foram selecionados 19 estudos nas bases de dados pesquisadas (PsycINFO, PubMED e Google Scholar). Os resultados indicaram a utilização dos instrumentos MBI-GS, MBI-HSS, BM-S, CBI e CESQT, mas apenas um dos instrumentos apresentou evidência de validade nesse contexto. Constatou-se a associação do Burnout com variáveis pessoais, organizacionais e específicas. A comparação dos estudos e dos índices de Burnout foi limitada devido à falta de padronização. A ausência de evidências de validade e de padronização dos resultados acarreta problemas como a falta de suporte empírico das pontuações e dificuldade na comparação dos estudos. Os dados revelam limitações na avaliação dos níveis de Burnout utilizadas no contexto de segurança pública, uma vez que as medidas não apresentam evidências de validade para esse contexto, indicando a necessidade de pesquisas na área. (AU)

Aimed to map the instruments used in evaluating Burnout syndrome in public security professionals, indicating the psychometric aspects, samples, and associated variables. Nineteen studies were selected from the searched databases (PsycINFO, PubMED and Google Scholar). Results indicated that the instruments MBI-GS, MBI-HSS, BM-S, CBI and CESQT, but only one of the instruments showed evidence of validity in this context. Burnout was associated with personal, organizational, and specific variables. Comparison of studies and Burnout indices was limited due to the lack of standardization. The absence of evidence of validity and standardization of results leads to problems such as the lack of empirical support for the scores and difficulty in comparing studies. The data reveal limitations in the assessment of burnout levels used in the context of public safety, as the measures do not present validity evidence for this context, pointing to the need for research in the area. (AU)

El objetivo fue mapear los instrumentos utilizados en la evaluación del síndrome de Burnout en profesionales de la seguridad pública, indicando los aspectos psicométricos, muestras y variables asociadas. Se seleccionaron diecinueve estudios de las bases de datos buscadas (PsycINFO, PubMED y Google Scholar). Los resultados indicaron el uso de los instrumentos MBI-GS, MBI-HSS, BM-S, CBI y CESQT, pero solo uno de los instrumentos mostró evidencia de validez en este contexto. El Burnout se encuentra asociado con variables personales, organizacionales y específicas. La comparación de estudios e índices fue limitada debido a la falta de estandarización. La ausencia de evidencia de validez y estandarización de resultados conduce a problemas como la falta de soporte empírico para las puntuaciones y la dificultad para comparar estudios. Los datos revelan limitaciones en la evaluación de los niveles de burnout utilizados en el contexto de la seguridad pública, ya que las medidas no presentan evidencia de validez para este contexto, lo que apunta a la necesidad de realizar investigaciones en el área. (AU)

Burnout Syndrome Assessment Scale in Public Safety: Psychometric Parameters / Escala de Avaliação da Síndrome de Burnout na Segurança Pública: Parâmetros Psicométricos

ABSTRACT The burnout variable has been studied in different professions; however, it presents challenges in its measurement. The present study provides evidence of validity based on the internal structure of the Burnout Syndrome Assessment Scale in Public Security Workers (EASB-SP) and presents the estimation of item parameters through the Item Response Theory (IRT). A total of 10,885 public security agents from all states of Brazil participated in the study. The analyses indicated a three-factor structure, with adequate reliability indices and discrimination of the items. The Professional Fulfillment factor presented a lower theta value to be endorsed. The instrument was shown to be an adequate measure, with evidence of validity for the context of Brazilian public security.

RESUMO O Burnout tem sido uma variável estudada em diferentes profissões, embora com desafios em sua medida. O presente estudo apresenta evidências de validade baseada na estrutura interna da Escala de Avaliação da Síndrome de Burnout (EASB-SP) para a segurança pública, além de apresentar a estimativa dos parâmetros dos itens por meio da Teoria de Resposta ao Item (TRI). Participaram do estudo 10.885 agentes da segurança pública de todas as unidades federativas do Brasil. As análises indicaram uma estrutura tri-fatorial, com índices de fidedignidade e discriminação dos itens adequados. O fator de realização profissional indicou menor theta para ser endossado. O instrumento em questão apresenta-se como uma medida adequada e com evidências de validade para o contexto de segurança pública brasileira.

Workplace Assessment Scale: Pilot Validation Study.

First responders, such as police officers, paramedics, and firefighters are at an increased risk of experiencing negative mental health outcomes compared to the general population. This predisposition can partially be attributed to common occupational stressors, which may provoke strong feelings of betrayal and humiliation. The Workplace Assessment Scale (WAS) was developed as there is currently no appropriate measure to assess such feelings in the first responder population. Initial development of the WAS included a Betrayal Subscale and the Humiliation Subscale, each comprised of 5 Likert scale questions which ask participants to report the frequency at which they experience specific feelings associated with their workplace. This pilot validation study was conducted to determine if there is preliminary evidence to support a large-scale validation study. To determine this, we assessed the internal structure and the convergent, concurrent, and predictive validity of the WAS. Based on 21/22 (95%) participant responses, a factor analysis did not support the two-factor model we anticipated, with only one factor and seven items retained from the original version of the scale. However, the internal consistency of the remaining items was strong. The validity analysis found moderate convergent validity and weak predictive validity based on correlations between the WAS and other psychometric scales. Minimal concurrent validity was noted. Additional research is needed for further analysis and validation of the WAS.

ICOH Statement on Protecting the Occupational Safety and Health of Migrant Workers.

Globally, it is estimated that the number of people living outside of their country of origin reached 281 million in 2020. The primary drive of those migrants when migrating voluntarily is work to increase their income and provide for their families left behind in their home countries. Those who migrate immediately seek means of income to sustain themselves through a perilous process as currently evidenced in the war in Ukraine and not too long ago in Syria and Venezuela. Unfortunately, migrant workers are globally known to predominantly be working in "4-D jobs"- dirty, dangerous, and difficult and discriminatory; the fourth D was recently added to acknowledge the discriminatory aspect and other social determinants of health migrant workers face in their host country while exposed to precarious work. Consequently, migrant workers are at considerable risk of work-related illnesses and injury but their health needs are critically overlooked in research and policy. Recognizing the UN Universal Declaration of Human Rights "Everyone has the right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment", we cannot consider any human life - thus, the life of migrant workers - as dispensable through a structural discriminatory process that undervalues their occupational safety and health, livelihood and the contribution these workers bring to their host countries. This was seen during the preparation for the upcoming world cup in Qatar where migrant workers were exposed to a multiplicity of serious hazards including deadly heat hazards.

Experiences, impacts and service needs of injured and ill workers in the WSIB process: evidence from Thunder Bay and District (Ontario, Canada). / Expériences, besoins en services et répercussions des processus de la Commission de la sécurité professionnelle et de l'assurance contre les accidents du travail (WSIB) chez les travailleurs blessés et malades : données probantes de la ville et du district de Thunder Bay (Ontario, Canada).

INTRODUCTION: Individuals experience negative physical, social and psychological ramifications when they are hurt or become ill at work. Ontario's Workplace Safety and Insurance Board (WSIB) is intended to mitigate these effects, yet the WSIB process can be difficult. Supports for injured workers can be fragmented and scarce, especially in underserved areas. We describe the experiences and mental health needs of injured and ill Northwestern Ontario workers in the WSIB process, in order to promote system improvements. METHODS: Community-recruited injured and ill workers (n = 40) from Thunder Bay and District completed an online survey about their mental health, social service and legal system needs while involved with WSIB. Additional Northwestern Ontario injured and ill workers (n = 16) and community service providers experienced with WSIB processes (n = 8) completed interviews addressing similar themes. RESULTS: Northwestern Ontario workers described the impacts of workplace injury and illness on their professional, family, financial and social functioning, and on their physical and mental health. Many also reported incremental negative impacts of the WSIB processes themselves, including regional issues such as "small town" privacy concerns and the cost burden of travel required by the WSIB, especially during COVID-19. Workers and service providers suggested streamlining and explicating WSIB processes, increasing WSIB continuity of care, and region-specific actions such as improving access to regional support services through arm's-length navigators. CONCLUSION: Northwestern Ontario workers experienced negative effects from workplace injuries and illness and the WSIB process itself. Stakeholders can use these findings to improve processes and outcomes for injured and ill workers, with special considerations for the North.

Burnout Assessment Among Surgeons and Surgical Trainees During the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: The objective of the current study was to summarize current research on burnout among surgical trainees and surgeons during the COVID-19 pandemic. METHODS: PubMed, SCOPUS, Embase, and Psych INFO were systematically searched for studies that evaluated burnout during the COVID-19 pandemic among surgical trainees and surgeons. RESULTS: A total of 29 articles met inclusion criteria, most of which originated from the United States (n = 18, 62.1%). Rates of burnout ranged from 6.0% to 86.0%. Personal factors responsible for burnout were fear of contracting/transmitting COVID-19 (8 studies, 27.6%), female gender (8, 27.6%), and younger age (5, 17.2%). Professional factors contributing to burnout included increased COVID-19 patient clinical load (6, 20.7%), limited work experience (6, 20.7%), reduction in operative cases (5, 17.2%) and redeployment to COVID-19 wards (4, 13.8%). The COVID-19 pandemic negatively impacted surgical education due to reduced number of operative cases (11, 37.9%), decreased hands-on experience (4, 13.8%), and not being able to complete case requirements (3, 10.34%). The shift of didactics to virtual formats (3, 10.3%), increased use of telemedicine (2, 6.9%), and improved camaraderie among residents (1, 3.4%) were viewed as positive consequences. CONCLUSION: COVID-19 related burnout was reported in as many as 1 in 2 surgical trainees and attending surgeons. Intrinsic- (i.e., gender, age), family- (i.e., family/being married/having children or being single/not having children), as well as work-related extrinsic- (i.e., work-force deployment, risk of infection/spread, changes in educational format) factors were strongly associated with risk of burnout. These factors should be considered when designing interventions to ameliorate burnout among surgical trainees and surgeons.

Stressful work in primary health care and mental health: The role of gender inequities in Brazil.

BACKGROUND: This study aims to analyze the association between occupational stressors, evaluated by the Effort-Reward Imbalance Model (ERI), and the occurrence of common mental disorders (CMD) among healthcare workers (HCW), additionally considering mediation by over-commitment from work (OW) and mediation of gender effects by work stressors. METHODS: Cross-sectional study, including a random sample of 3343 HCWs, from six municipalities of Bahia, Brazil. The ERI scale measured the occupational stressors (main exposure), and the Self-Reporting Questionnaire (SRQ-20) was used to screen for CMD. Data analysis used Structural Equation Modeling techniques to understand the relationships between gender, occupational stressors, and the occurrence of CMD. RESULTS: ERI and OW were associated with CMD. OW mediated the negative effect of ERI on the mental health of HCW. Female workers had higher levels of ERI, OW, and CMD prevalence; the total gender effect on CMD prevalence was mediated by ERI and OW. CONCLUSIONS: The findings highlight the association of work psychosocial stressors and CMD among HCW, including partial mediation by OW. Gender inequalities persisted among HCW, with women most exposed to occupational stressors and CMD. ERI and OW partially mediated the effect of gender on CMD.

Chronic stress, behavioral tendencies, and determinants of health behaviors in nurses: a mixed-methods approach.

BACKGROUND: Nurses experience high, and often chronic, levels of occupational stress. As high-quality care requires a healthy workforce, individualized stress-alleviating interventions for nurses are needed. This study explored barriers and resources associated with health behaviors in nurses with different stress levels and work-related behavioral tendencies and identified health behavior determinants based on the Health Action Process Approach (HAPA) model. METHODS: Applying a mixed methods transformative triangulation design, n = 43 nurses filled out chronic stress (SSCS) and work-related behavior and experience patterns (German acronym AVEM) questionnaires, and participated in semi-structured interviews. With content analysis, categories of health behavior-related barriers and resources emerged. Behavior determinants (self-efficacy, outcome expectancies), health behavior, and barriers and resources were quantified via frequency and magnitude coding and interrelated with SSCS and AVEM scores to link level of health behavior with potential influencing factors. Nonparametric tests explored differences in quantified variables for SSCS and AVEM scores and 4-step-hierarchical regression analysis identified predictors for health behavior. RESULTS: Eighty-four percent of the nurses were chronically stressed while 49% exhibited unhealthy behavioral tendencies at the workplace. 16 personal and organizational themes (six resources, ten barriers) influenced health behaviors. Stress was associated with resource frequency (p = .027) and current health behaviors (p = .07). Self-efficacy significantly explained variance in health behaviors (p = .003). CONCLUSION: Health promotion related barriers and resources should be considered in designing nurse health promotion campaigns. Practitioners need to individualize and tailor interventions toward stress and behavioral experiences for sustainable effects on adherence and health.

Psychological peer support for staff: implementing the Trauma Risk Management model in a hospital setting.

One of the many consequences of the coronavirus disease 2019 (COVID-19) pandemic is that the psychological well-being of nurses and other healthcare staff has received greater attention. The Supporting Our Staff (SOS) service, set up in 2017 at Northampton General Hospital NHS Trust, provides psychological peer support to staff using the Trauma Risk Management (TRiM) model. TRiM is a psychological risk assessment and peer support model designed to mitigate the risks associated with exposure to traumatic events. It was initially developed and used in the UK armed forces but has started to be used in healthcare organisations. This article describes the development and expansion of the SOS service, the implementation of the TRiM model by the SOS team, and the significant part the service has played in the trust's response to the increased psychological support needs of its staff during the COVID-19 pandemic.

Economic Precarity, Financial Strain, and Job-Related Stress Among Philadelphia's Public Mental Health Clinicians.

OBJECTIVE: Efforts to improve mental health treatment delivery come at a time of rising inequality and cuts or insufficient increases to mental health funding. Public mental health clinicians face increased demands, experience economic stress, and treat underresourced patients disproportionately burdened by trauma. The authors sought to understand clinicians' current economic and psychological conditions and the relationship of these conditions to the delivery of an evidence-based intervention (EBI) designed to treat posttraumatic stress disorder among youths. METHODS: In July 2020, 49 public mental health clinicians from 16 Philadelphia clinics who were trained in an EBI, trauma-focused cognitive-behavioral therapy (TF-CBT), were surveyed by e-mail. Respondents reported on their economic precarity, financial strain, burnout, secondary traumatic stress (i.e., the stress response associated with caring for people exposed to trauma), and TF-CBT use. Associations between clinicians' job-related stressors and their use of TF-CBT were examined with mixed models. Content coding was used to organize clinicians' open-ended responses to questions regarding financial strain related to the COVID-19 pandemic. RESULTS: Clinicians' economic precarity, financial strain, and job-related stress were high; 37% of clinicians were independent contractors, 44% of whom wanted a salaried position. Of 37 clinicians with education debt, 38% reported owing ≥$100,000. In the past year, 29% of clinicians reported lack of personal mental health care because of cost, and 22% met the cutoff for experiencing secondary traumatic stress symptoms. Education debt was negatively associated with use of TF-CBT (p<0.001). CONCLUSIONS: The stress of providing care in underresourced clinical settings may interfere with efforts to integrate scientific evidence into mental health care.

Acidente de Trabalho com Exposição a Material Biológico: percepções dos residentes de medicina / Accident at Work with Exposure to Biological Material: perceptions of medical residents

RESUMO Trata-se de um estudo de abordagem qualitativa, realizado em um complexo hospitalar universitário, com o objetivo de descrever as percepções dos residentes de medicina que sofreram um Acidente de Trabalho com Exposição a Material Biológico quanto aos fatores pessoais, institucionais e sociais associados à ocorrência do acidente. As informações foram coletadas por meio das fichas de notificação dos acidentes e de entrevistas com uma questão aberta norteadora. Foi utilizada a análise de conteúdo de Bardin e o fechamento amostral por saturação. Foram entrevistados vinte e um residentes de medicina e identificados dois eixos temáticos: condições de trabalho e estado emocional do residente médico. Os resultados revelaram que a sobrecarga de trabalho, o acúmulo de atividades, a equipe de saúde reduzida, a ausência de supervisão por um preceptor médico e a imperícia do profissional contribuíram para ocorrência do acidente. Além disso, foram relatados fatores como cansaço, fadiga, privação do sono, desatenção e, sobretudo, estresse emocional. São poucos os estudos sobre o tema, porém, as percepções dos residentes médicos evidenciaram um cenário em que o processo de trabalho interfere no bem-estar físico e psíquico dos profissionais, contribuindo para a ocorrência dos acidentes.

ABSTRACT This was a qualitative study carried out in a university hospital complex, with the objective of describing the perceptions of medical residents who suffered an Accident at Work with Exposure to Biological Material regarding the personal, institutional and social factors associated with the occurrence of the accident. Information was collected using accident notification forms and interviews with an open guiding question. Bardin content analysis and saturation sampling were used. Twenty-one medical residents were interviewed and two thematic axes were identified: working conditions and emotional state of the medical resident. The work overload, the accumulation of activities, the reduced health team, the absence of supervision by a medical preceptor, and the professional incompetence contributed to the occurrence of the accident. In addition, factors such as tiredness, fatigue, sleep deprivation, inattention, and especially emotional stress were reported. There are few studies on the subject, but perceptions of medical residents showed a scenario in which the work process interferes with the physical and psychological well-being of professionals, contributing to the occurrence of accidents.

The objective structured clinical examination as an assessment strategy for clinical competence in novice nursing practitioners in Taiwan.

BACKGROUND: The conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. This work was aimed to develop an Objective Structured Clinical Exam (OSCE) to evaluate novice nursing practitioners' clinical competency, work stress, professional confidence, and career satisfaction. METHODS: A Quasi-experimental study (pre-post). Fifty-five novice nursing practitioners received the OSCE three-months following their graduation, which consisted of four stations: history taking, physical examination, problem-directed management, interpersonal communication, and the required techniques of related procedures. The examiners had to complete an assessment checklist, and the participants had to complete a pre-post questionnaire (modified from a Nursing Competency Questionnaire, a Stress scale, and Satisfaction with Learning scale). RESULTS: Among the novice nursing practitioners, 41 of them (74.5 %) passed the exam with a mean score of 61.38 ± 8.34. There was a significantly higher passing rate among nurses who were working in medical-surgical wards (85.7 %) and the intensive care unit-emergency department (77.8 %) compared to novice nursing practitioners working in other units. All the novice nursing practitioners at Station A had poor performance in assessing patients with a fever. OSCE performance was more associated with educational attainment and work unit, rather than the gender. Finally, the participants showed statistically significant increases in their clinical competency, confidence in their professional competence, satisfaction with the clinical practice, and decreased work stress after the OSCE. CONCLUSIONS: We found that the OSCE process had a positive educational effect, in providing a meaningful and accurate assessment of the competence of novice nursing practitioners. An appropriate OSCE program is vital for novice nursing practitioners, educators, and administrators. The effective application of OSCEs can help novice nursing practitioners gain confidence in their clinical skills.