Effects of requested, forced and denied shift schedule change on work ability and health of nurses in Europe -results from the European NEXT-Study.

BACKGROUND: Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule. METHODS: Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed. RESULTS: The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p <0.001), lowest general health (t1: 63.9, t2: 59.2, p <0.001) and showed the highest decrease in both outcomes. Shift pattern change in line with the nurses' wishes was associated with improved work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health. CONCLUSIONS: The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and - to somewhat lesser extent - health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable preventive tool to promote nurses' work ability and - to lesser extent - their perceived health, not least in aging nursing work forces.

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.

The impact of effort-reward imbalance and learning motivation on teachers' sickness absence.

The aim of this study was to analyse the impact of the effort-reward imbalance and learning motivation on sickness absence duration and sickness absence frequency among beginning teachers in Flanders (Belgium). A total of 603 teachers, who recently graduated, participated in this study. Effort-reward imbalance and learning motivation were assessed by means of self-administered questionnaires. Prospective data of registered sickness absence during 12 months follow-up were collected. Multivariate logistic regression analyses were performed. An imbalance between high efforts and low rewards (extrinsic hypothesis) was associated with longer sickness absence duration and more frequent absences. A low level of learning motivation (intrinsic hypothesis) was not associated with longer sickness absence duration but was significantly positively associated with sickness absence frequency. No significant results were obtained for the interaction hypothesis between imbalance and learning motivation. Further research is needed to deepen our understanding of the impact of psychosocial work conditions and personal resources on both sickness absence duration and frequency. Specifically, attention could be given to optimizing or reducing efforts spent at work, increasing rewards and stimulating learning motivation to influence sickness absence.

Malnutrition and associated factors in nursing home residents: a cross-sectional, multi-centre study.

BACKGROUND & AIMS: Malnutrition is a common problem in the elderly living in nursing homes. A clear understanding of associated factors is missing. The aim of this study was to evaluate prevalence of malnutrition and to determine factors independently associated with malnutrition in this setting. METHODS: A cross-sectional, multi-centre study was conducted in 23 nursing homes in Flanders, Belgium. The nutritional status was assessed using the Mini Nutritional Assessment (MNA). Data on possible associated factors were collected using validated scales. RESULTS: The study included 1188 elderly residents; 38.7% were at risk for malnutrition and 19.4% were malnourished. The presence of a wound/pressure ulcer, a recent hospitalization (<3 months ago), being involved in a tailored nutritional intervention, and suffering from a lower cognitive state were significantly associated with malnutrition. Receiving additional meals provided by family members was negatively associated with malnutrition. CONCLUSION: Malnutrition is a prevalent problem in nursing homes in Flanders. Systematic screening and well-defined tailored interventions should be further developed and evaluated in this population at risk.