Factors related to burnout and its effects on mental and physical symptoms and daytime dysfunction among female flight attendants.

In this study, risk factors were identified to assess the impact of burnout on the health and daytime function of 412 female flight attendants from an international airline from 2017 to 2018 with convenience sampling. Data were obtained from self-administered questionnaires. Analysis of variance, Pearson's correlation analysis, and independent t-tests were used to assess the relationships between burnout and demographic and work-related factors. A structural equation model analysis was performed to assess the effect of burnout impact factors on mental health using the Brief Symptom Rating Scale, six common physical symptoms, and daytime dysfunction (a subscale of the Athens Insomnia Scale). The results showed a moderate level of burnout, as reported by 19.2 percent of the participants. Personal and work-related characteristics, including marital status and working hours, were not significantly associated with burnout. Smoking behavior was the only significant risk factor (T = -3.64). The impact model of burnout revealed a moderate direct effect of burnout on mental health symptoms (95 percent CI: 0.27, 0.47) and daytime dysfunction (95 percent CI: 0.04, 0.11) and a small direct effect on physical symptoms (95 percent CI: 0.28, 0.47). Our findings increase our understanding of the risk and impact factors related to burnout in female flight attendants.

Examining the Effects of Art Therapy on Reoccurring Tobacco Use in a Taiwanese Youth Population: A Mixed-Method Study.

BACKGROUND: Cigarette smoking is a primary risk factor affecting mental and physical health worldwide. Many chronic diseases are closely related to smoking. Adolescents in Taiwan are increasingly using tobacco, especially in rural areas. OBJECTIVES: This research project used a mixed-method study to examine the effects of art therapy on smoking cessation in rural Taiwanese youth smokers. METHODS: Participants from years 10-11, were drawn from three senior high schools in Taiwan. The experimental group participated in a six-week smoking cessation intervention using art therapy. The comparison group participated in typical courses on smoking cessation. Quantitative measures included need for smoking, nicotine dependence, self-esteem, self-efficacy, and smoking cessation status. Qualitative analysis was based on phenomenology. RESULTS: A total of 66 students (n = 40 experimental group; n = 26 comparison group) were the subjects of quantitative analysis. No differences were noted in baseline characteristics of groups. Generalized estimating equation analyses suggested significant between-group differences in change from pre- to follow-up test scores in the "social domain" (B = -5.12, p < 0.05). Qualitative data (n = 17 experimental group; n = 10 control group) suggested three domains: effects of art therapy on smoking prevention, benefits of art therapy on other outcome measures, and comparison between art therapy and traditional smoking cessation programs. Conclusions/importance: The findings of this study can potentially contribute significantly to existing knowledge regarding the perceptions of art therapy on reoccurring tobacco use in Taiwanese youth.

Alcohol, betel-nut and cigarette consumption are negatively associated with health promoting behaviors in Taiwan: a cross-sectional study.

BACKGROUND: Oral cancer is the 2nd most common cause of death due to cancer in the south-western coastal region of Taiwan; the standardized mortality of oral cancer is higher than elsewhere in the world. According to the evidence, alcohol, betel-nut and cigarette (ABC) consumption cause oral, nasopharyngeal and related cancers. This study describes the relationships between ABC consumers and health promoting behaviors among community adults living around an area with a high prevalence of oral cancer. METHODS: A population-based, cross-sectional study design was conducted in oral cancer epidemic areas in south-western coastal Taiwan in 2010, 6,203 community residents over 20 years of age participated. Demographic data, ABC habits, and health-promoting behaviors were explored. A logistic regression analyses were used to identify factors associated with ABC consumers. RESULTS: A high percentage of participants consumed alcohol, betel-nut and cigarettes. Betel-nut and cigarette consumers took low levels of exercise, adopted a poor diet, and had poor oral hygiene. After adjusting for potential confounders, the logistic regression model indicated that middle aged males of poor education and low economic status, who did not exercise regularly and had poor oral hygiene, were more likely to chew betel quid and smoke cigarettes. CONCLUSIONS: It has identified that BC consumers are negatively associated with health promoting behaviors. Further research is required to understand the reasons why the subjects consume ABC, and explore ways to prevent initiation and enhance cessation of ABC habits in this population.

Insomnia among female flight attendants: Related factors and its association with mental health.

BACKGROUND: Sleep and mental health are very important in the aviation industry. Reports show that gender is one of the risk factors of insomnia, and most Asian flight attendants are female. Therefore, it is necessary to understand insomnia, and the correction to mental health among female flight attendants. OBJECTIVE: To investigate the prevalence of insomnia in female flight attendants and its association with mental health. METHODS: We used a cross-sectional design. We recruited 412 female flight attendants with more than 3 months of working experience. We collected the socio-demographic and work-related data, measured insomnia and mental health by the Athens Insomnia and Brief Symptom Rating Scales. Descriptive statistics, single-factor analysis of variance, Pearson's correlation analysis, and structural equation modeling were performed to analyze the relationships. RESULTS: There are 45.4% of female flight attendants having insomnia, and 24.8% had suspicious insomnia. The most considerable and serious insomnia problem was falling asleep (15.3%, 4.9%). Factors related to insomnia include smoking, drinking, family load (e.g., housekeeping and caring for family), economic stress and late-night/early morning workdays during last month. Also, insomnia had a direct association with mental health (T = 17.11, p < 0.001). CONCLUSION: We found that insomnia is negatively correlated with the above factors and mental health. We recommend that airline industries can run their sleep-education programs and provide relevant mental-health-promotion programs for flight attendants.

Exploring relationships between health-related lifestyle habits and fatigue among flight attendants and trainees.

BACKGROUND: Fatigue in flight attendants is an important issue concerning flight safety and occupational health. It is well known that work-related factors and certain lifestyle habits can cause fatigue. But very few studies have focused on the difference between having work experience flight attendants and no flight experience trainees. OBJECTIVE: The present study was performed to compare and investigate the relationships between fatigue and health-related lifestyle habits among flight attendants and trainees. METHODS: A questionnaire-based cross-sectional study with convenience sampling was conducted. A total of 107 flight attendants and 109 trainees were recruited in an international airline. The research was using a self-developed health-related lifestyle habits questionnaire and the Checklist Individual Strength (CIS) scale. The relationships between health-related lifestyle habits and fatigue were examined by Pearson's chi-square test and Fisher's exact test. Logistic regression was used to identify factors predicting fatigue among flight attendants and trainees. RESULTS: Nearly half of the participants had fatigue and poor health-related lifestyle habits. Logistic regression showed that trainees with sleeping hours less than 7 hours, had a higher probability of fatigue than those who sleep more than 7 hours. In addition, the flight attendants with an irregular sleep pattern, unbalanced diet, sedentary leisure-time, no use relaxation technique, and an exercise frequency below once a week had a higher probability of fatigue. CONCLUSION: The flight attendants' sleep patterns, diet, activity, and relaxation had a more significant impact on fatigue than trainees. Therefore, a healthy lifestyle is important in this population for good workplace performance.

Sleep Quality and Related Factors in Patients with Breast Cancer: A Cross-Sectional Study in Taiwan.

BACKGROUND: Sleep disturbances are common and symptomatic burden in patients with breast cancer, but they are poorly documented and managed in routine clinical practice. This descriptive and cross-sectional study evaluated factors associated with post-treatment sleep disturbances in patients with breast cancer. PATIENTS AND METHODS: Patients with breast cancer who underwent standard treatment were enrolled and surveyed for their basic demographic data and precancerous and cancer treatment-related factors; they were also administered self-report questionnaires including the Family Adaptation, Partnership, Growth, Affection, Resolve questionnaire; Impact of Event Scale; Center for Epidemiologic Studies Depression Scale; and Maudsley Personality Inventory. Their sleep disturbances were evaluated using the Pittsburgh sleep quality index (PSQI). Independent sample t test and chi-square tests were used to compare the variables between patients with or without sleep disturbance, and multivariate logistic regression analyses were conducted to detect the independent factors. RESULTS: In total, 448 patients, including 145 with PSQI ≤ 5 and 303 with PSQI > 5, completed the investigation. Multiple logistic regression analysis revealed that significantly more patients with sleep disturbances demonstrated psychological distress, severe pain, depression, and impact of stress events than patients without sleep disturbances (adjusted odds ratios [95% confidence intervals]: 2.83 [1.135-7.067], P = 0.026; 1.14 [1.023-1.280], P = 0.018; 1.08 [1.036-1.133], P < 0.001; and 1.03 [1.002-1.051], P = 0.037, respectively). CONCLUSION: Patients with breast cancer showed 67.6% prevalence of sleep disturbances after treatment. The patients with sleep disturbances were more likely to have previously experienced psychological disturbances, severe pain, depression within 5 years after diagnosis. After diagnosis for more than 5 years, higher distress caused by traumatic events still associated with sleep disturbances.

Fatigue Management Health Education Intervention Effects on Flight Attendants.

BACKGROUND: This study explored the impact of a fatigue management health education intervention (FMI) on flight attendants fatigue management knowledge, attitudes, behavioral intention, self-efficacy, and fatigue intensity.METHODS: A quasi-experimental pretest-posttest design was used. The sample included 70 flight attendants of an international airline company in Taiwan. The experimental group (N 34) received an FMI, while the control group (N 36) had no intervention. Fatigue management knowledge, attitude, behavior intention, self-efficacy, and fatigue intensity were assessed at baseline and 1 wk later. Single-factor analysis of covariance and Jensen Neman methods were used to assess the differences in outcomes between the two groups.RESULTS: Attitude and self-efficacy in the experimental group were significantly improved after the FMI [standardized mean difference (SMD), 0.96; 1.98]. The intervention also reduced their fatigue intensity (SMD 6.05) and both knowledge and behavioral intention scores were increased in more than 80% of subjects in the experimental group.DISCUSSION: FMI can effectively improve fatigue management knowledge, attitudes, behavioral intention, and self-efficacy and reduce fatigue intensity in flight attendants.Hu CJ, Lee FP, Hong RM. Fatigue management health education intervention effects on flight attendants. Aerosp Med Hum Perform. 2020; 91(12):911917.

Insomnia, Work-Related Burnout, and Eating Habits Affecting the Work Ability of Flight Attendants.

BACKGROUND: Work ability is an important component of occupational health assessments and reflects how a persons' physical and mental health affect their ability to perform their job. However, little is known about factors relating to the work ability status of flight attendants. The aim of this study was to investigate the physical, mental, and work-related factors that affect flight attendants' work ability.METHODS: A questionnaire-based cross-sectional study and simple random sampling was conducted with participants employed at a Taiwan-based airline for longer than 1 yr. Analysis of variance and Pearson correlation tests were carried out to analyze work ability according to the flight attendants' social demographics, physical and mental health, and work-related factors. Multiple regression analysis was used to predict the flight attendants' work abilities.RESULTS: A total of 472 flight attendants were recruited and the response rate was 78.67%. The work ability of the flight attendants ranged from 'moderate' to 'excellent' (WAI score, 34.1 ± 1.8 to 45.1 ± 1.5). In a regression analysis, work ability was positively associated with gender, age, and good eating habits; in contrast, insomnia and work-related burnout were negatively associated with work ability (R² = 32.4%).DISCUSSION: Insomnia, work-related burnout, and eating habits had a significant impact on flight attendants' work abilities. Hence, it is important to address insomnia and high workloads and maintain a healthy lifestyle in the workplace.Hu C-J, Hong R-M, Yeh G-L, Hsieh I-C. Insomnia, work-related burnout, and eating habits affecting the work ability of flight attendants. Aerosp Med Hum Perform. 2019; 90(7):601-605.

The Experiences of Tobacco Use among South-Western Taiwanese Adolescent Males.

Most smokers start young. Initiation of cigarette smoking at an earlier age leads to more life-years for tobacco use, makes quitting harder, and increases the risk of serious health consequences. Despite these challenges, research focusing on smoking behavior among adolescent boys in Taiwan is rare. Although the Taiwanese government enacted the Tobacco Hazards Prevention Act in 2009, aimed at prevention and reducing the rate of smoking, the percentage of high school students who smoke has continued to increase. In 2006, 7.5% of adolescent boys engaged in smoking. By 2012 the rate had increased to 24.6%. This paper explores the experiences that contribute to adolescent Taiwanese boys making the decision to smoke. A phenomenological approach to inquiry was used as the philosophical foundations for this study with twelve adolescent boys who engaged in smoking behaviors. Data was gathered through two face-to-face semi-structured interviews and a focus group. Data analysis was performed using Colaizzi's analysis method. Findings indicated that decisions to begin smoking were motivated by curiosity and as a means of establishing friendships while decisions to continue smoking were linked to the addictive nature of smoking and as a means of coping with stress and passing the time. The findings can be used to inform the prevention of tobacco use and to reduce the high smoking rates among adolescent boys.

The lived experiences of single Taiwanese mothers being resilient after divorce.

The lived experiences of being resilient as described by 13 single Taiwanese mothers after divorce was the focus of this study. A descriptive phenomenological approach to inquiry was the theoretical framework underpinning the study. Information was gathered through two in-depth face-to-face digitally recorded interviews with each participant. Each of the participants had suffered from depression. For the analysis of the participants' transcripts of interview the authors used Colaizzi's method. Four themes emerged from the analysis process: having faith in God, bending with the ebb and flow of daily life, finding strength in the support and friendship of others, and new found freedom and hope for the future. Findings of this study have the potential to enhance understanding of the mental health needs of single mothers and their children in the provision of holistic health care delivery.