Disability and return to work after a multidisciplinary intervention for (sub)acute low back pain: A systematic review.

OBJECTIVE: This systematic review aimed to examine pain, functional status and return to work after a multidisciplinary intervention, with or without additional workplace intervention, for (sub)acute low back pain among adults. DATA SOURCES: A comprehensive search was completed (November 2022) in six electronic databases (Embase, MEDLINE, Web of Science, Cochrane, CENTRAL and Scopus) and in the reference list of all identified studies. REVIEW METHODS: The search results were screened against predefined eligibility criteria by two independent researchers. Included articles were systematic reviews or randomized controlled trials examining the effect of a multidisciplinary intervention, with or without workplace intervention, in working adults with (sub)acute low back pain. Relevant information was summarized and clustered, and the methodological quality and certainty of evidence were assessed respectively using the RoB 2-tool, the ROBIS tool and the GRADE criteria. RESULTS: The search resulted in a total of 3020 articles. After the screening process, 12 studies remained (11 randomized controlled trials and 1 systematic review), which studied overall 2751 patients, with a follow-up period of at least 12 months. CONCLUSIONS: A multidisciplinary intervention is favorable compared to usual care for pain intensity and functional status but this is less clear for return to work. Comparable work-related effects were found when comparing a multidisciplinary intervention with a less extensive intervention, whereas uncertainties exist regarding outcomes of pain intensity and functional status. Furthermore, adding a workplace intervention to usual care and subdividing patients based on work-related characteristics seems beneficial for return to work.

Exploring Work Absences and Return to Work During Social Transition and Following Gender-Affirming Care, a Mixed-Methods Approach: 'Bridging Support Actors Through Literacy'.

PURPOSE: Research on return to work (RTW) following transition-related gender-affirming care (GAC) is lacking. We aim to study the RTW outcomes and experiences of transgender and gender diverse (TGD) people during social and medical transition to understand their needs better and provide tailored support. METHODS: In this convergent mixed-methods study, the questionnaires of 125 employed TGD people, who took steps in transition (social and GAC), were analyzed for personal- and work characteristics, medical work absences, RTW, support at work, and health literacy. In-depth interviews were held with twenty TGD people to explore perceived facilitators and barriers to RTW. RESULTS: One hundred and nine participants reported an average of 38 sick days after GAC. The majority (90.2%) resumed their job at the same employer. Although TGD workers felt supported, their health literacy (55.1%) was lower compared to the general population. The qualitative data analysis revealed four major themes: (1) the need and access to information; (2) having multidisciplinary TGD allies; (3) the influence of the occupational position; (4) the precarious balance between work, life, and GAC. Especially participants with a low health literacy level experienced RTW barriers by struggling: (1) to find and/or apply information; (2) to navigate (occupational) health and insurance services. CONCLUSION: Our research has shown that RTW for TGD individuals is a multifaceted process, affected by personal factors, work-related elements, and the characteristics of the healthcare and social insurance system. Enhancing support for TGD people at work and their RTW requires a high need for centralized information and promoting health literacy while engaging relevant stakeholders, such as prevention services and employers.

The relation between social capital and burnout: a longitudinal study.

OBJECTIVES: Although social capital approach has showed its merits in predicting well-being and health in the working environment, studies examining the relation between social capital and burnout are scarce and limited to cross-sectional studies in the health care sector. This study aims to explore the longitudinal relationship between workplace social capital and burnout in a Belgian company in the energy sector. An additional aim was to assess whether the relation between workplace social capital and the dimensions of burnout was independent of job characteristics, i.e., the level of decision-making autonomy and task variety, and demographical variables. METHODS: Analyses are conducted on the questionnaire data of 473 workers who participated at the two waves (2013 and 2014) of a longitudinal study. RESULTS: The results showed a negative relation between social capital and distance and a positive relation between social capital and competence, after 1-year follow-up and after adjustments for baseline levels of the respective burnout dimension. In contrast with the literature, no relation between social capital and emotional exhaustion was found after adjustment for baseline level of emotional exhaustion. After additional adjustments were made for the job characteristics 'decision-making autonomy' and 'task variety', the relation between social capital and competence disappeared. CONCLUSIONS: This study delivered evidence for the lagged relation between social capital and distance, even after controlling for demographical and job characteristics. Therefore, the findings suggest that organizations should pay attention to strategies enhancing social interaction, enabling to increase the levels of support, reciprocity, sharing and trust, in the prevention of burnout.

The relation between indicators of low employment quality and attendance behavior in countries of the European Union.

Background: Previous research demonstrated an association between low employment quality and lower sickness absence, which may be explained by presenteeism. Therefore, this study aimed exploring the relation between three indicators of employment quality (long working hours, precarious employment, job insecurity) and attendance behavior. Methods: The association between employment quality and attendance behavior was investigated in 28.999 workers (mean age: 40.0 years, 53% males) of the fifth wave of the European Working Conditions Survey, using multilevel multinomial logistic regression analysis. Attendance behavior was operationalized as different combinations of sickness absence and presenteeism. Results: Those working >48 h/week, had a higher risk to report presenteeism (with or without sickness absence). They had a lower risk to report sickness absence without presenteeism. Workers with a precarious contract had a lower risk to report absenteeism without presenteeism and the combination of both presenteeism and absenteeism. Finally, for workers perceiving job insecurity, the risk for presenteeism without sickness absence was significantly higher. Conclusions: Several indicators of low employment quality were associated with attendance behavior, suggesting a complex behavioral mechanism in workers facing low job quality employment. Therefore, policy makers are recommended to re-establish the indefinite contractual employment as the standard, avoiding long working hours.

Social inequality in adolescents' healthy food intake: the interplay between economic, social and cultural capital.

Background: Current explanations of health inequalities in adolescents focus on behavourial and economic determinants and rarely include more meaningful forms of economic, cultural, and social capital. The aim of the study was to investigate how the interplay between capitals constitutes social inequalities in adolescent healthy food intake. Methods: Data were collected in the 2013/14 Flemish Health Behavior among School-aged Children (HBSC) survey, which is part of the international WHO HBSC survey. The total sample included 7266 adolescents aged 12-18. A comprehensive set of 58 capital indicators was used to measure economic, cultural and social capital and a healthy food index was computed from a 17-item food frequency questionnaire (FFQ) to assess the consumption frequency of healthy food within the overall food intake. Results: The different forms of capital were unequally distributed in accordance with the subdivisions within the education system. Only half of the capital indicators positively related to healthy food intake, and instead 17 interactions were found that both increased or reduced inequalities. Cultural capital was a crucial component for explaining inequalities such that social gradients in healthy food intake increased when adolescents participated in elite cultural practices ( P < 0.05), and were consequently reduced when adolescents reported to have a high number of books at home ( P < 0.05). Conclusion: A combination of selected resources in the form of economic, cultural and social capital may both increase or reduce healthy food intake inequalities in adolescents. Policy action needs to take into account the unequal distribution of these resources within the education system.

The indirect association of job strain with long-term sickness absence through bullying: a mediation analysis using structural equation modeling.

BACKGROUND: In this longitudinal study the complex interplay between both job strain and bullying in relation to sickness absence was investigated. Following the "work environment hypothesis", which establishes several work characteristics as antecedents of bullying, we assumed that job strain, conceptualized by the Job-Demand-Control model, has an indirect relation with long-term sickness absence through bullying. METHODS: The sample consisted of 2983 Belgian workers, aged 30 to 55 years, who participated in the Belstress III study. They completed a survey, including the Job Content Questionnaire and a bullying inventory, at baseline. Their sickness absence figures were registered during 1 year follow-up. Long-term sickness absence was defined as at least 15 consecutive days. A mediation analysis, using structural equation modeling, was performed to examine the indirect association of job strain through bullying with long-term sickness absence. The full structural model was adjusted for several possible confounders: age, gender, occupational group, educational level, company, smoking habits, alcohol use, body mass index, self-rated health, baseline long-term sickness absence and neuroticism. RESULTS: The results support the hypothesis: a significant indirect association of job strain with long-term sickness absence through bullying was observed, suggesting that bullying is an intermediate variable between job strain and long-term sickness absence. No evidence for the reversed pathway of an indirect association of bullying through job strain was found. CONCLUSIONS: Bullying was observed as a mediating variable in the relation between job strain and sickness absence. The results suggest that exposure to job strain may create circumstances in which a worker risks to become a target of bullying. Our findings are generally in line with the work environment hypothesis, which emphasizes the importance of organizational work factors in the origin of bullying. This study highlights that remodeling jobs to reduce job strain may be important in the prevention of bullying and subsequent sickness absence.

Acceptability and feasibility of potential intervention strategies for influencing sedentary time at work: focus group interviews in executives and employees.

BACKGROUND: Occupational sitting can be the largest contributor to overall daily sitting time in white-collar workers. With adverse health effects in adults, intervention strategies to influence sedentary time on a working day are needed. Therefore, the present aim was to examine employees' and executives' reflections on occupational sitting and to examine the potential acceptability and feasibility of intervention strategies to reduce and interrupt sedentary time on a working day. METHODS: Seven focus groups (four among employees, n = 34; three among executives, n = 21) were conducted in a convenience sample of three different companies in Flanders (Belgium), using a semi-structured questioning route in five themes [personal sitting patterns; intervention strategies during working hours, (lunch) breaks, commuting; and intervention approach]. The audiotaped interviews were verbatim transcribed, followed by a qualitative inductive content analysis in NVivo 10. RESULTS: The majority of participants recognized they spend their working day mostly sitting and associated this mainly with musculoskeletal health problems. Participants suggested a variety of possible strategies, primarily for working hours (standing during phone calls/meetings, PC reminders, increasing bathroom use by drinking more water, active sitting furniture, standing desks, rearranging the office) and (lunch) breaks (physical activity, movement breaks, standing tables). However, several barriers were reported, including productivity concerns, impracticality, awkwardness of standing, and the habitual nature of sitting. Facilitating factors were raising awareness, providing alternatives for simply standing, making some strategies obligatory and workers taking some personal responsibility. CONCLUSIONS: There are some strategies targeting sedentary time on a working day that are perceived to be realistic and useful. However several barriers emerged, which future trials and practical initiatives should take into account.

Evaluation of the presence and zoonotic transmission of Chlamydia suis in a pig slaughterhouse.

BACKGROUND: A significant number of studies on pig farms and wild boars worldwide, demonstrate the endemic presence of Chlamydia suis in pigs. However, the zoonotic potential of this pathogen, phylogenetically closely related to Chlamydia trachomatis, is still uninvestigated. Therefore, this study aims to examine the zoonotic transmission in a Belgian pig abattoir. METHODS: Presence of Chlamydia suis in pigs, contact surfaces, air and employees was assessed using a Chlamydia suis specific real-time PCR and culture. Furthermore, Chlamydia suis isolates were tested for the presence of the tet(C) gene. RESULTS: Chlamydia suis bacteria could be demonstrated in samples from pigs, the air and contact surfaces. Moreover, eye swabs of two employees were positive for Chlamydia suis by both PCR and culture. The tet(C) gene was absent in both human Chlamydia suis isolates and no clinical signs were reported. CONCLUSIONS: These findings suggest the need for further epidemiological and clinical research to elucidate the significance of human ocular Chlamydia suis infections.

Relationships of organizational social capital with the presence of "gossip and slander," "quarrels and conflicts," sick leave, and poor work ability in nursing homes.

PURPOSE: This study aimed to explore the associations of organizational social capital (OSC) with the presence of "gossip and slander," the presence of "conflicts and quarrels," sick leave prevalence, and prevalence of poor work ability in frontline working personnel of nursing homes. METHODS: A total of 239 subjects (81 % participation), working in 11 different nursing homes, took part in a cross-sectional questionnaire study. Following end points were considered, they are as follows: prevalence of "gossip and slander," "conflicts and quarrels," sick leave, and poor work ability. Associations with OSC were explored at individual level (binomial log-linear regression analysis) and on group level (Kendall's tau correlation coefficients). RESULTS: Significant associations were found between OSC and "gossip and slander," sick leave, and poor work ability, both in the individual- and group-level analyses. The associations showed a higher significance level in the group-level analyses, with the strongest association found between mean OSC of the workplace and the prevalence of poor work ability at the workplace (τ = -0.722; p = 0.002). CONCLUSIONS: This study demonstrated significant associations of OSC with three end points that are relevant within the framework of well-being at work in nursing homes. The results are suggestive that OSC should be treated as a characteristic of the entire workplace, rather than as an individually experienced characteristic. The strikingly strong association between OSC and prevalence of poor work ability is suggestive for an important role of OSC within the context of maintaining work ability.

The relation between psychosocial risk factors and cause-specific long-term sickness absence.

BACKGROUND: The aim was to study the impact of psychosocial risk factors on long-term sickness absence due to mental health problems (LSA-MH) or musculoskeletal disorders (LSA-MSD) in 2983 Belgian middle-aged workers. METHODS: Data were collected from 1372 male and 1611 female workers in the Belstress III study. Considered psychosocial risk factors were job demands, job control, social support, job strain, efforts, rewards, effort-reward imbalance and bullying. Prospective registered sickness absence data were collected during 12 months follow-up; the causes for long-term sickness absence episodes of at least 15 consecutive days were obtained by contacting the general practitioner of the worker. Multiple logistic regression models were used to investigate the relationship between the psychosocial risk factors and LSA-MH and LSA-MSD. RESULTS: Higher levels of rewards at baseline were independently and significantly associated with a lower risk for LSA-MH. Higher levels of control were associated with a lower risk for LSA-MSD during follow-up. Higher job demands and efforts were significantly related to a lower risk for LSA-MSD. Finally, bullying was significantly and independently related to both LSA-MH and LSA-MSD during the follow-up period. CONCLUSIONS: These results suggest that psychosocial risk factors are related to LSA-MH and LSA-MSD, of which especially bullying seems to be a potent stressor.

Job-related stress and sickness absence among belgian nurses: a prospective study.

PURPOSE: The purpose of this study was to investigate the influence of job stress on sickness absence of nurses and determine the predictive power of the Demand-Control-Support (DCS) model, the Effort-Reward Imbalance-Overcommitment (ERI-OC) model, and a combination of both. DESIGN: A survey was conducted to measure job stress in a sample of 527 Belgian nurses, followed by prospective data collection of sickness absence (long-term, short-term, and multiple episodes). FINDINGS: Perceptions of job strain and ERI increased the odds for long-term (adjusted odds ratio [OR] = 2.26; 99% confidence interval [CI; 1.27-4.04]) and multiple episodes of sickness absence (adjusted OR = 1.64; 95% CI [1.01-2.65]). Iso-strain and ERI-OC increased the odds for long-term (OR = 1.75; 95% CI [0.98-3.11]), multiple episode (adjusted OR = 1.93; 95% CI [1.14-3.26]), and short-term (adjusted OR = 1.69; 95% CI [1.03-2.76]) sickness absence. CONCLUSIONS: The combined model of DCS and ERI-OC predicts the odds for long-term and short-term sickness absence and multiple episodes. CLINICAL RELEVANCE: This study has implications for human resources management in nursing organizations. Nursing administrators are advised to monitor and balance nurses' job demands and efforts. They should recognize the importance of social support, job control, job rewards, and overcommitment in order to reduce the job stress of nurses.

Comparison of two case-based learning conditions with real patients in teaching occupational medicine.

OBJECTIVE: To investigate the impact of three different training formats in occupational medicine (OM) on perceptions and performance of undergraduate students. METHODS: A comparative study which included all fourth-year medical students was conducted over a three-year period. The year group in 2010 (211 students) received paper case studies followed by one small group session. The format used in 2011 actively engaged 188 students in the learning process by adding collaborative work and group discussions to the written information. In 2012, the approach comprised no longer constructed text cases but 212 students encountered real patients. Students' perceptions were obtained by questionnaire. Their learning performance was assessed through review of written reports and score on oral presentations. Statistical differences in ratings were analyzed using Fisher's exact and Kruskal-Wallis tests. RESULTS: All three formats were found to equally achieve the stated learning objectives. The year groups with incorporation of active learning strategies and patient contacts had significant better test performance compared to those receiving only written case studies. Real patient students gave statistically significant higher rates for relevance, authenticity and appropriate difficulty level of the training than did students who discussed written case studies. CONCLUSION: Both approaches with augmented interaction in 2011 and 2012, improved performance and satisfaction among students. However, students valued the use of real patients higher than paper-form cases.

THE MULTIDISCIPLINARY BIOPSYCHOSOCIAL REHABILITATION PROGRAMME FOR PATIENTS WITH CHRONIC SPINAL PAIN: OUTCOMES WITH WORK STATUS AS THE PRIMARY FOCUS.

Objective: To assess the efficacy of the multidisciplinary biopsychosocial rehabilitation programme for chronic spinal patients as to work status, physical functioning, pain intensity, health-related quality of life and the psychosocial domain. Design: This is a retrospective, single-centre, observational cohort study. Subjects/Patients: A total of 209 subjects (mean age 41.5 ± 11.4 years) with chronic spinal pain participated in the rehabilitation programme. Methods: Evaluations were conducted through standardized questionnaires at baseline and at the end of the rehabilitation programme. Results: Patients were more likely to be at work. Sick leave and work VAS changed significantly. Patients in blue-collar jobs are less likely to return to work. Pain intensity, physical functioning, health-related quality of life and lumbar and cervical range of motion improved significantly. Conclusion: The multidisciplinary biopsychosocial rehabilitation programme for chronic spinal patients improved the rate of return to work. In daily clinical practice, attention must be given to reducing mobility issues in daily life in order to get patients back to work. The occupational therapist should give patients with blue-collar jobs sufficient attention early in the programme in order to achieve a higher rate of return to work.

Need for recovery after work and associated risk factors in working menopausal women.

OBJECTIVES: To explore relationships between 'need for recovery' (NFR), a strong predictor of burnout, and menopause symptoms and to identify work-related factors that are associated with a high NFR in Belgian menopausal women. STUDY DESIGN: 760 menopausal women took part in a cross-sectional questionnaire study. NFR, presence of menopause symptoms, job type, age category, work activity, physical workload, psychosocial and physical work environment, balance of work and private life and the opportunity to discuss menopause at work were assessed. MAIN OUTCOME MEASURES: Uni- and multivariate logistic regression analyses were used to calculate the odds ratios for the presence of a high NFR. RESULTS: Of menopausal women currently experiencing menopause symptoms, 53.3 % reported problems while performing their work. The overall prevalence of a high NFR in menopausal women was 41.2 %. Women who experienced problems at work had the highest prevalence of a high NFR (61.1 %), and constituted a separate risk group for having a high NFR (OR 3.31 vs. never symptoms; 95%CI 1.72-6.38). The following factors were significantly associated with a high NFR: poor balance of work and private life (OR 7.89; 95%CI 4.32-14.39), physical workload (OR 1.17; 95%CI 1.08-1.28), discomfort from cognitive demands (OR 1.17; 95%CI 1.09-1.26), organizational justice (OR 0.86; 95%CI; 0.78-0.94), and social support from colleagues (OR 0.87; 95%CI 0.79-0.96). CONCLUSIONS: Maintaining a good balance of work and private life, reducing physical workload, addressing discomfort from cognitive work demands and assuring a fair work distribution are measures that require a culture where open and easy discussion about menopause is possible.

Belgian Cross-Sectional Epidemiological Study on Zoonotic Avian Chlamydia spp. in Chickens.

Chlamydia psittaci, Chlamydia gallinacea, and Chlamydia abortus are the most common Chlamydia spp. in chickens and have a confirmed or suggested zoonotic potential. No recent data are available on their prevalence and impact in the Belgian chicken industry or in the recreational chicken branch. Therefore, a cross-sectional epidemiological study was executed where samples were collected from both factory-farmed and backyard chickens. More specifically, pharyngeal chicken swabs were obtained from 20 chicken farms, 5 chicken abattoirs, and 38 different backyard locations and were analyzed using species-specific Polymerase Chain Reactions (PCRs) for the presence of the three avian Chlamydia spp. To investigate their zoonotic potential, samples were simultaneously collected from 54 backyard chicken caretakes and 37 professional chicken caretakers or abattoir employees and analyzed using species-specific PCRs as well. This study confirmed the presence of DNA of all three Chlamydia species in both the chicken industry and backyard settings. Chlamydia psittaci was the most prevalent in the industry chickens (11.0%), whereas Chlamydia gallinacea was the dominant species in the backyard chickens (14.5%). Chlamydia abortus infections were more common in the commercial chickens (9.0%) compared to the backyard chickens (2.6%). The DNA of all three species was also detected in humans (3.9% Chlamydia psittaci, 2.9% Chlamydia gallinacea, and 1.0% Chlamydia abortus).

The association between leisure time physical activity and coronary heart disease among men with different physical work demands: a prospective cohort study.

The interplay of occupational and leisure time physical activity (LTPA) in affecting cardiovascular health is subject to debate. This study aimed to examine the independent and interacting associations of leisure time and occupational physical activity (OPA) with the incidence of coronary events within the BELSTRESS cohort. The study included 14,337 middle-aged men free from coronary heart disease at baseline. Standardized questionnaires and clinical examinations were used to assess socio-demographic factors, level of physical activity, job strain and classical coronary risk factors. The incidence of clinical coronary events was monitored during a mean follow-up time of 3.15 years. Results demonstrated overall a beneficial relation of LTPA and an adverse relation of physical work demands with cardiovascular health. However, an interaction effect between both physical activity types was observed, showing that men with high physical job demands who also engaged in physical activity during leisure time had an almost four times increased incidence of coronary events after adjusting for socio-demographic and classical coronary risk factors (HR 3.82; 95% CI 1.41-10.36). Stratified analyses revealed that moderate to high physical activity during leisure time was associated with a 60% reduced incidence rate of coronary events in men with low OPA (age adjusted HR 0.40; 95% CI 0.21-0.76), while this protective association was not observed in workers being exposed to high physical work demands (age adjusted HR 1.67; 95% CI 0.63-4.48). These findings suggest that recommendations regarding LTPA should be tailored according to the level of occupational physical activity.

IMBA-ICF linking by integrating consensus methods: How group consensus of experts can contribute to in-depth linking of instruments to the ICF.

BACKGROUND: A frame of reference is needed to increase the comparability of vocational rehabilitation assessment instruments and the interpretation of their results. The International Classification of Functioning, Disability and Health (ICF) is a relevant framework, and when linking rules are used, items from existing assessment instruments can be linked to the appropriate categories as described in the ICF. OBJECTIVE: To develop an adapted linking methodology in which experts are involved by means of the application of consensus methods and to transfer this result in a step-by-step set of guidelines, supporting researchers and professionals, linking complex instruments to the ICF. METHODS: The main researcher developed the initial linking of the Integration von Menschen mit Behinderungen in die Arbeitswelt (IMBA) to the ICF by rigorously applying the refined ICF linking rules. To validate this linking, the Delphi and nominal group technique was integrated through different steps, and experts were involved in the process. The method section describes the linking process chronologically with focuses on the used approach, the involvement of experts, and the processing of the output. RESULTS: The results are presented in a 7-step set of guidelines describing the chronological process from the initial to the validated linking. These guidelines describe the core elements in the application of the linking rules and consensus methods in a manual for researchers who are interested in linking complex instruments to the ICF by involving experts. CONCLUSIONS: The Delphi and nominal group technique can be successfully integrated in the linking process, making it possible to involve experts in linking complex instruments to the ICF. A homogeneous composition of the expert panel in terms of knowledge, a heterogeneous composition in terms of setting, a rigorous and repeated application of the linking rules, and structured processing of the output are essential to achieve a valid linking.

Neck and shoulder complaints in computer workers and associated easy to assess occupational factors--a large-scale cross-sectional multivariate study.

PURPOSE: The aim of this study was to identify easy to assess occupational factors that are associated with the presence of neck and shoulder complaints (NSC) in computer workers. METHODS: A total of 5,630 computer workers filled out a standardised questionnaire at the occasion of their periodical health examination. The dependent outcome variable was the one-year prevalence of neck and/or shoulder complaints. Following independent variables were considered in the analyses: age, gender, number of hours of computer work per week (both at work and at home), average time of uninterrupted computer work, screen position, position of documents, computer mouse use, forearm and separate wrist support, user friendly software and occupational psychosocial factors. Stepwise multivariate logistic regression analysis was used to identify those variables that contributed to the presence of NSC. RESULTS: Apart from gender and three psychosocial factors, following occupational factors were associated with NSC in computer workers: 25 h or more computer work per week, working more than 1 h on a computer without interruption, use of the computer mouse during half or more of the working time, reaching far for the computer mouse, insufficient space for the computer mouse, insufficient forearm support (less than 2/3 on table or no support) and the use of a separate wrist support. CONCLUSIONS: The study enabled to identify several easy to assess occupational factors that were associated with NSC, providing clear cut-off points concerning duration of computer work. Use of the computer mouse, both duration and relative position, and forearm support were also important factors.

Comparison between the first and second versions of the Copenhagen Psychosocial Questionnaire: psychosocial risk factors for a high need for recovery after work.

PURPOSE: The Copenhagen Psychosocial Questionnaire (COPSOQ I) was developed as a tool to assess a broad range of psychosocial work environment factors and was recently revised (COPSOQ II). The research question in this study was: Do COPSOQ II-scales predict a high need for recovery (NFR) after work better than COPSOQ I-scales? METHODS: A cross-sectional questionnaire study was conducted in 990 subjects (84.5% response), employed in the public sector. Psychosocial factors were assessed by COPSOQ I and COPSOQ II. Multivariate logistic regression analysis was used to calculate the odds ratios for the presence of a high NFR, controlled for gender, age, physical workload and other relevant occupational and non-occupational factors. Analyses were performed for COPSOQ I and COPSOQ II separately. RESULTS: In both COPSOQ versions, 'quantitative demands' (p < 0.001) and 'job insecurity' (p < 0.005) were significantly associated with a high NFR. Additionally, in the COPSOQ I model, 'demands for hiding emotions' (p < 0.05) and 'degrees of freedom' (p < 0.05), and in the COPSOQ II model 'emotional demands' (p < 0.05) and 'commitment to the workplace' (p < 0.005) were significant as well. 'Degrees of freedom' was omitted by the developers in the revised COPSOQ II. Reintroducing it into the COPSOQ II model did not alter the existing associations, but pointed out 'degrees of freedom' to be an additional important dimension (p < 0.05). The COPSOQ II model with 'degrees of freedom' included also had the best data fit. CONCLUSIONS: The results suggested the COPSOQ II to be better predictive than COPSOQ I for a high NFR, but also indicated that 'degrees of freedom' should be included into the COPSOQ II when studying the NFR as outcome parameter.

Perceived work ability and turnover intentions: a prospective study among Belgian healthcare workers.

AIM: To report a study exploring prospective relations between nurses' perceived work ability and three forms of turnover intentions, respectively, intent to leave the ward, organization and profession. BACKGROUND: Turnover of nursing staff is a major challenge for healthcare settings and for healthcare in general, urging the need to improve retention. DESIGN: Survey. METHODS: Based on the longitudinal data of the Belgian sample from the European Nurses' Early Exit study, a total of 1531 healthcare workers who remained in their job, completed in 2003 and 1 year later a self-administered questionnaire including the Work Ability Index to assess work ability. Multiple logistic regression analysis was performed adjusting for possible confounding variables. RESULTS: In a population with low intent to leave at baseline prospective analyses showed that a poor work ability at baseline increased the risk of high intent to leave the ward and high intent to leave the organization, 1 year later. A substantial deterioration in work ability was a risk factor for developing high turnover intentions 1 year later. Social support had no effect on the relation between work ability and all three types of intent to leave but the relation between work ability and intent to leave the ward was borderline significantly moderated by good interpersonal relations. CONCLUSIONS: Poor work ability was a risk factor for developing turnover intentions. Maintaining good work ability and improving poor work ability becomes increasingly important to retain nurses.