[Risks and opportunities of digitisation in the professional fields of nursing, care and healing]. / Chancen und Risiken der Digitalisierung in den beruflichen Tätigkeitsfeldern Pflegen, Betreuen und Heilen.

Digitisation is increasingly finding its way into the world of work. Although it is unlikely that human work will be replaced by computers and machines in the near future, it can be assumed that human work will change. These changes are less expected at the sectoral and occupational level and more at the activity level. This article first discusses which requirements are, in general, gaining importance as digitalisation progresses. It is thereby assumed that technological change entails similar requirements as organisational restructuring processes. Subsequently, the requirements employees are increasingly confronted with are presented for the field of nursing, caring and curing. The analyses are based on an employment survey jointly carried out by the German Federal Institute for Vocational Education and Training (BIBB) and the German Federal Institute for Occupational Safety and Health (BAuA), which allows a comparison of the years 2006, 2012 and 2018.The activities are characterised both by a high work intensity and by physically stressful activities. Although it is generally assumed that there will be a decline in physical stress, this has not yet been observed in the activity investigated. Job autonomy, as a psychological resource to cope with different work demands, is also considered in the analyses, with ambiguous results. Altogether, it can be stated that the field of activity of nursing, caring and healing is characterized by comparatively stable work demands. The design of good working conditions in the nursing, care and medical professions should take into account existing challenges as well as new factors that are gaining importance as a result of increasing digitalisation.

Vocational Rehabilitation of Young Adults with Psychological Disabilities.

Objective Vocational rehabilitation measures support youth and young adults with disabilities to obtain vocational training and to enter the labor market. In Germany, a growing number of young people with psychological disabilities in vocational rehabilitation can be observed. The study at hand focuses on this group and examines their (un-)unemployment biographies before vocational rehabilitation, their access to vocational rehabilitation and identifies their individual challenges within the process of vocational rehabilitation. Methods Using a multi-methods approach, we analyze representative administrative data of the German Federal Employment Agency as well as biographical interviews conducted with young rehabilitants. We compare the population of young rehabilitants with psychological disorders to those with other disabilities in terms of vocational rehabilitation and initial labor market entry in order to get a representative picture about their school to work transitions. Since rehabilitants with psychological disabilities tend to be older than the remaining population, analyses are stratified by age groups. In addition, qualitative in-depth interviews provide an additional and deeper understanding of specific employment barriers youth with psychological disorders have to overcome. Furthermore, the individual perspective gives insight on how the crucial transition from school to work is perceived by the population under study. Results The pathway into vocational rehabilitation of youth with psychological disorders is often characterized by obstacles in their transition from school to work. During rehabilitation, it appears essential to provide psychological stabilization along with vocational training. Although their average level of education is higher than those of other rehabilitants, labor market transition after (often company-external) vocational training challenges many young people with psychological disabilities, leaving many of them with comparatively poor labor market prospects. Conclusions Young persons with psychological disabilities, who come from regular schools or dropped out from regular school or university, seem to find their way to vocational rehabilitation more indirectly. Furthermore, vocational rehabilitation itself is often prolonged for those with psychological disabilities possibly due to a corresponding stabilization process. However, vocational rehabilitation can be a core element within the stabilization process of a psychological disease.

Age and gender differences in the impact of labour-market transitions on subjective health in Germany.

AIMS: Applying a gender- and age group-sensitive approach, we investigated the effect of labour-market transitions (job loss and re-employment) on subjective physical and mental health. METHODS: A combination of the difference-in-differences approach and propensity score matching controls for selectivity and initial health differences. This allowed us to analyse the causal effect of job loss and re-employment on subjective health. We made use of data from the German Panel Study Labour Market and Social Security and combined survey information with administrative records of the Federal Employment Agency for employed and unemployed men and women 31-60 years of age ( n = 2213). We controlled for labour-market experiences before the time period under study and for labour-market transitions between the interviews. Subjective health was assessed using the SF-12 health questionnaire, enabling us to differentiate between subjective mental and physical health functioning. RESULTS: We found that physical health was affected mainly in older persons between 45 and 60 years old. Controlling for covariates using propensity score matching, mental health was affected only when living-wage jobs (i.e. jobs that provide sufficient income to achieve a defined minimum standard of living above the social benefit level) are gained or lost. Younger women showed a significant improvement in mental health after re-employment. In contrast, job loss affected only older individuals' mental health, with a particularly negative effect observed for men. CONCLUSIONS: Our results not only showed that women and men are affected differently by job loss and re-employment, but also that age is an important factor. Older men were affected most severely by job loss, whereas re-employment was found to improve mental health only in women aged 31-44 years. It is therefore important to address the health problems of different socio-demographic groups separately, and to apply active labour-market policies with regard to unemployed men and women with health impairments. Based on our results, we suggest the promotion of employment with income levels above the maximum welfare benefit award.

Employment status, working conditions and depressive symptoms among German employees born in 1959 and 1965.

PURPOSE: We investigated whether (1) current employment status (regular full-time, regular part-time and marginal employment) is associated with depressive symptoms and (2) whether these associations are mediated by current working conditions and previous employment history. METHODS: Two cohorts of German employees aged 46 and 52 years were selected from administrative data of the German Federal Employment Agency and answered questions about depressive symptoms (we use an applied version of BDI-V) and their current working conditions. In addition, the participants gave written consent to link register data regarding their employment histories (n = 4,207). Multiple linear regression analyses were conducted. RESULTS: Men experienced elevated depressive symptoms when working regular part-time; women experienced such symptoms when engaged in marginal employment. These associations decreased when we adjusted for job insecurity and rose slightly when we adjusted for leadership quality. Men and women who reported a low level of influence at work showed a higher risk of depressive symptoms. For women, the association between current employment position and depressive symptoms could be partly explained by low levels of influence at work. For men, the association between depressive symptoms and current regular part-time employment decreased when we adjusted for previous part-time employment. Conversely, for women, the association with depressive symptoms increased in current regular part-time and marginal employment when we adjusted for employment history. CONCLUSIONS: In both genders, the observed associations between depressive symptoms and current employment status were mediated by both current psychosocial conditions and employment history. Employees not having a regular full-time job differed from full-time employees with respect to both their current working conditions and their employment history.

Exploring the Relationship Between Techno-Unreliability at Work and Burnout.

OBJECTIVE: With the growing dissemination of digital technologies in the workplace, technologies itself and related factors are increasingly discussed as an additional source of work stress, often referred to as technostress. This article explores whether techno-unreliability as a dimension of technostress is associated with burnout. METHODS: We perform linear regression analyses based on a large representative sample of German employees collected in 2019. We distinguish between information and communication technology users ( n = 4702) and tool users ( n = 1953). Interaction models explore whether individual and workplace-related factors might moderate the relationship. RESULTS: The results indicate that the more frequently employees experience techno-induced interruptions (as an indicator for techno-unreliability), the stronger their burnout symptoms. Interaction models reveal that social support and job autonomy might buffer this association. CONCLUSIONS: Ensuring reliable technology and technical support can reduce employee stress.

A Systematic Analysis of Biological, Sociodemographic, Psychosocial, and Lifestyle Factors Contributing to Work Ability Across the Working Life Span: Cross-sectional Study.

BACKGROUND: As employees age, their physical and mental abilities decline and work ability decreases, enhancing the risk for long-term sick leave or even premature retirement. However, the relative impact of biological and environmental determinants on work ability with increasing age is poorly understood in terms of their complexity. OBJECTIVE: Previous research has shown relationships between work ability and job and individual resources, as well as specific demographic and lifestyle-related variables. However, other potentially important predictors of work ability remain unexplored, such as personality traits and biological determinants, including cardiovascular, metabolic, immunological, and cognitive abilities or psychosocial factors. Our aim was to systematically evaluate a wide range of factors to extract the most crucial predictors of low and high work ability across the working life span. METHODS: As part of the Dortmund Vital Study, 494 participants from different occupational sectors, aged between 20 and 69 years, completed the Work Ability Index (WAI) assessing employee's mental and physical resources. A total of 30 sociodemographic variables were grouped into 4 categories (social relationships, nutrition and stimulants, education and lifestyle, and work related), and 80 biological and environmental variables were grouped into 8 domains (anthropometric, cardiovascular, metabolic, immunologic, personality, cognitive, stress related, and quality of life) and have been related to the WAI. RESULTS: Using the analyses, we extracted important sociodemographic factors influencing work ability, such as education, social activities, or sleep quality, and identified age-dependent and age-independent determinants of work ability. Regression models explained up to 52% of the WAI variance. Negative predictors of work ability were chronological and immunological age, immunological inefficiency, BMI, neuroticism, psychosocial stress, emotional exhaustion, demands from work, daily cognitive failures, subclinical depression, and burnout symptoms. Positive predictors were maximum heart rate during ergometry, normal blood pressure, hemoglobin and monocyte concentration, weekly physical activity, commitment to the company, pressure to succeed, and good quality of life. CONCLUSIONS: The identified biological and environmental risk factors allowed us to evaluate work ability in its complexity. Policy makers, employers, and occupational safety and health personnel should consider the modifiable risk factors we identified to promote healthy aging at work through focused physical, dietary, cognitive, and stress-reduced preventive programs, in addition to well-balanced working conditions. This may also increase the quality of life, commitment to the job, and motivation to succeed, which are important factors to maintain or even enhance work ability in the aging workforce and to prevent early retirement. TRIAL REGISTRATION: ClinicalTrials.gov NCT05155397; https://clinicaltrials.gov/ct2/show/NCT05155397. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/32352.

Employment effects for people with disabilities after participation in vocational training programmes: A cohort analysis using propensity score matching.

BACKGROUND: Vocational rehabilitation (VR) aims to help people with disabilities to return to the labour market. Though, there is not much evidence on its effectiveness. OBJECTIVES: We explore the effect of vocational training programmes in VR and the VR status itself on employment outcomes. METHODS: Using two samples from administrative data by the German Federal Employment Agency, we applied propensity score matching. We followed rehabilitants commencing VR in 2009/2010 (N = 7,905) for four years (comparison I) and general training participants with and without VR status completing training in 2012/2013 (N = 21,020) for one year (comparison II). For harmonisation purposes, we only considered individuals aged between 25 and 40 and excluded those in employment at the beginning of VR or training. RESULTS: Concerning the effect of training in VR (comparison I), we observe a lock-in effect during training (p < 0.001) due to an involvement in VR; after training, participants are more likely to obtain unsubsidised employment (0.05, p < 0.05) than non-participants, but there is no statistically significant income difference after four years. Regarding the effect of the VR status (comparison II), rehabilitants are more likely to take up (un-)subsidised employment (0.04, p < 0.01; 0.02, p < 0.001) after training, exhibit longer employment durations (19 days, p < 0.001) and achieve higher average incomes (2,414 euro/year, p < 0.001) compared to non-rehabilitants. CONCLUSIONS: Training participation helps to improve employment participation of rehabilitants. However, a longer observation period is recommended. Furthermore, the VR status itself leads to more sustainable and better-paid employment. This is due to more comprehensive support and longer-term subsidised employment opportunities.

Digital transformation: The role of computer use in employee health.

This paper studies employee health in the context of digital transformation in Germany. While most studies have focused on mental health, we focus on physical health. Using pooled survey data, we estimate how an increased use of computers in the workplace relates to subjective health and work-related health complaints. We find that employees using the computer frequently report better subjective health and a significantly lower prevalence of back pain and physical exhaustion. After controlling for physical work exposures, the health-promoting effect of computer use is much smaller, suggesting that high computer use is associated with a less physically demanding work environment, which in turn relates to better (physical) health outcomes. While digital transformation seems to foster physical health, there are hints that mental health could deteriorate. Thus, the focus of occupational health is shifting towards the prevention of mental stress.

Criteria and Guidelines for Human-Centered Work Design in a Digitally Transformed World of Work: Findings from a Formal Consensus Process.

With the increasing digital transformation, work tasks are changing-in some cases, significantly. Our study addresses the question of whether the established criteria for work design are still sufficient or if they should get updated and additional criteria become necessary in the context of digitalization. In a multistage consensus process involving interdisciplinary groups of experts, we have identified specific criteria for the humane design of work in a world increasingly permeated by digitalized work tools. Starting with an expert workshop using a combined nominal group/focus group technique, followed by a real-time Delphi study, a content analysis and a five-stage peer comment process, we detected 13 criteria and 38 design guidelines for human-centered work in digital transformation. Mapping these with established criteria, it became apparent that some established criteria have experienced a new dynamic because of the digital transformation. For other criteria, a need for digitization-sensitive design is discernible. In addition, criteria have emerged whose necessity is rooted in the digital transformation. A diffusion and stronger interconnection of the various levels of the work system in connection with the digital transformation of work is apparent.

Social jetlag and sleep debts are altered in different rosters of night shift work.

BACKGROUND: Night and shift work are suspected to cause various adverse effects on health and sleep. Sleep deprivation through shift work is assumed to be compensated on free days. So far it is not clear how different shift systems and shift lengths affect sleep structure on work and free days. Especially working night shifts disrupts the circadian rhythm but also extended working hours (12h) might affect sleep characteristics. Hitherto, the magnitude of sleep debt, social jetlag, and Locomotor Inactivity During Sleep (LIDS) in different shift systems is unknown. METHODS: Here, we investigated the impact of five different shift rosters on sleep in 129 industrial workers from Germany. Permanent night work with multiple shift systems with and without night shifts and with different shift lengths were compared. Wrist-activity was monitored over 28 days revealing sleep on- and offsets as well as LIDS as proxy for sleep quality. Overall, 3,865 sleep bouts comprising 22,310 hours of sleep were examined. RESULTS: The mean daily age-adjusted sleep duration (including naps) was 6:43h and did not differ between shift workers of different rosters. However, sleep duration on workdays was particularly low in rotational shift systems with 12h-shifts (5:00h), while overall sleep debt was highest. Shift workers showed a median absolute social jetlag of 3:03h, which differed considerably between shift types and rosters (p<0.0001). Permanent night workers had the highest social jetlag (5:08h) and latest mid-sleeps on workdays and free days. Sleep quality was reduced in permanent night shift workers compared with shift workers in other rosters and differed between daytime and nighttime sleep. CONCLUSIONS: Shift work leads to partial sleep deprivation, which particularly affects workers in 12h-shifts and permanent night shifts. Working these shifts resulted in higher sleep debts and larger absolute social jetlag whereas sleep quality was especially reduced in permanent night shift workers compared with shift workers of other rosters.

Investigating the influence of shift work rosters on stress measured as cortisol in hair during the SARS-CoV-2 pandemic.

The COVID-19 pandemic has increased the workload and has affected physical and mental health of many employees. Hair cortisol concentration (HCC) has proven useful as a marker for retrospective assessment of stress in epidemiological studies and was measured here in non-healthcare night-shift workers with standard shifts (8-h shifts) and extended shifts (12-h shifts) before and during the first wave of the COVID-19 pandemic in Germany. Results showed a twofold increase in HCC among shift workers during the first wave of the COVID-19 pandemic compared with previous measurements. Subjectively reported measures of psychosomatic stress were not found to be reliable predictors of HCC. No statistically significant HCC differences were found between rosters. Working 12-h shifts does not appear to be an additional stressor in the already demanding COVID-19 pandemic.

Firms' contribution to the internal and external employability of older employees: evidence from Germany.

In the examination of older employees' employability, one can distinguish between internal and external employability. Internal employability can be measured by individual employment stability, and external employability occurs when employees replace one employment relationship with another. Most studies focus on the personal skills and characteristics that are necessary to maintain employability. However, external factors also contribute to individual employability. Therefore, this study examines which organisational attributes of firms contribute to older employees' employability in Germany. Taking firm and individual characteristics into account, the results of discrete-time survival models show that in specific organisational structures, older employees have higher internal employability. Accordingly, older employees are more likely to maintain employment in the service sector and in recruiting organisations facing (skilled) labour shortages. However, the results also indicate that financially investing organisations facilitate early labour market exits. With regard to older employees' external employability, the results show only little evidence indicating an association between organisational attributes of firms and the likelihood of job change.