Multifaceted ORganizational InterventiONs (M-ORION) project for prevention of depression and anxiety among workers: study protocol for a five-arm cluster randomized controlled trial.

BACKGROUND: Depression and anxiety are the most common mental health issues experienced by workers. Although organizational intervention has been extensively evaluated as a primary prevention of depression and anxiety, the corresponding scientific evidence remains limited because of the lack of cluster randomized controlled trials (cRCT) and failure to detect organizational-level effects. Therefore, the present study aims to assess the preventive effects of four types of interventions on depression and anxiety among workers in an open, five-arm, parallel-group cRCT. METHODS: Overall, 140 worksites and 18,200 nested employees will be recruited from September 2023. The eligible worksites will be randomly assigned to each of the five arms, and programs will be offered for 6-12 months. The five arms are 1) psychoeducation for workers, 2) psychoeducation for supervisors, 3) work environment improvement, 4) physical activity promotion, and 5) active control. The primary outcomes of interest are depression and anxiety. We will also assess psychosocial factors at work, work engagement, health-related quality of life, well-being, economic outcomes, physiological outcomes of health checkups, cortisol levels extracted from fingernails, and indices representing the process and implementation outcomes, including program completion rates. Follow-up surveys will be conducted at 6, 12, and 18 months from baseline, and the primary endpoint is set at the 6-month follow-up. Repeated-measures multi-level mixed modeling will be used to evaluate the effect of each intervention compared with the control. ETHICS AND DISSEMINATION: The study protocol was approved by the Research Ethics Committee of the Kitasato University Medical Ethics Organization (C22-082). The results and findings of this study will be published in a scientific journal and disseminated to companies that participate in the study. TRIAL REGISTRATION NUMBER: UMIN000050949.

The effects of pregnancy discrimination on postpartum depressive symptoms: a follow-up study.

BACKGROUND: Pregnancy discrimination in the workplace is prevalent worldwide. However, few studies have examined the effects of pregnancy discrimination on mothers' perinatal mental health. We aimed to investigate the association between pregnancy discrimination and postpartum depressive symptoms, and the mediation effects of prenatal depressive symptoms on this association. METHODS: Our sample consisted of 285 Japanese women employed during pregnancy who completed a baseline online survey in May 2020 and a follow-up mail survey two months postpartum. Pregnancy discrimination was defined as exposure to any of 16 forms of disadvantageous treatment or harassment related to pregnancy, prohibited by national guidelines. Prenatal (assessed at baseline) and postpartum (assessed at follow-up) depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. Multiple linear regression and mediation analyses were performed overall and stratified by regular (permanent) and non-regular (precarious) employees. RESULTS: Overall, 23.9% of participants experienced pregnancy discrimination during pregnancy. After adjusting for potential confounders, pregnancy discrimination was significantly associated with postpartum depressive symptoms (coefficient 1.76, 95% confidence interval [CI] 0.65-2.88). When stratified by employment type, these effects were observable among non-regular employees (coefficient 2.51, 95% CI 0.45-4.57) but not regular employees. Mediation analysis showed that prenatal depressive symptoms mediated 57.1% (95% CI 20.1-94.1%) of the association between pregnancy discrimination and postpartum depressive symptoms among all participants, with a greater effect among non-regular employees (64.1% [95% CI 18.5-109.8%]). CONCLUSIONS: Pregnancy discrimination has adverse effects on postpartum depressive symptoms, partially through prenatal depressive symptoms, especially among non-regular employees. To prevent perinatal depression in female workers, employers should comply with legislation and take preventive measures against pregnancy discrimination, while considering vulnerable employees.

Mothers' nonstandard work schedules and adolescent obesity: a population-based cross-sectional study in the Tokyo metropolitan area.

BACKGROUND: Many wage earners in developed countries have irregular shift patterns and work evenings, nights, and weekends. Some studies have demonstrated that the nonstandard work schedules of parents have adverse effects on their children's weight, specifically leading to or worsening obesity. However, no such study has been conducted in adolescents of high school age. This study examined the association between mothers' nonstandard work schedules and adolescent obesity. METHODS: A cross-sectional study of adolescents aged 16-17 years (n = 1743) used paired matches of self-administered questionnaires for adolescents and their mothers from Tokyo, Japan. Obesity was defined by International Obesity Task Force cut-offs. Nonstandard work schedules were defined as working early mornings, nights, overnights, or weekends. Chi-square tests were conducted to examine the association between the mothers' work schedules and their adolescent children's poor lifestyles, overall and stratified by income levels. Then, logistic regression analyses were conducted to examine the association between mothers' work schedules and obesity of their adolescent children, overall and stratified by income levels. RESULTS: Overall, 6.5% of adolescents had obesity. The prevalence of obesity was higher among adolescents from low-middle income groups (8.2%) than that among those from high-income groups (5.9%). No clear patterns were found between mothers' work schedules and adolescents' poor lifestyles when stratified by income levels. Mothers' nonstandard work schedules were significantly associated with adolescent obesity (odds ratio [OR]: 1.56, 95% confidence interval [CI]: 1.02-2.40). However, this association was not significant after adjustment for confounders. After stratification by income levels, mothers' nonstandard work schedules significantly associated with their children's obesity (OR: 2.93, 95% CI: 1.45-5.92) only in high-income groups. This association remained after adjustment of the adolescents' lifestyles and their mothers' working hours. CONCLUSIONS: Our results suggest that mothers' nonstandard work schedules have adverse effects on adolescent obesity only in high-income families. Low-middle income families experienced higher levels of adolescent obesity, regardless of the mothers' work schedules. Policy makers should consider mothers' work schedules as a factor in preventing adolescent obesity.

Associations between work-related stressors and QALY in a general working population in Japan: a cross-sectional study.

OBJECTIVE: To investigate an association between quality-adjusted life years (QALY) and work-related stressors (job strain, effort/reward imbalance, and poor support from supervisor and coworkers), and estimate loss in QALY caused by these stressors. METHODS: A cross-sectional study investigated data from a third-wave survey (in December 2017) of a 2-year prospective cohort study of Japanese workers. At baseline (first-wave survey), 5000 participants were recruited from workers who registered with an internet survey company. A total of 2530 participants responded to the second-wave survey 1 year later. Participants were then further recruited to the third-wave survey. An online questionnaire collected information regarding health-related quality of life (measured by EQ-5D-5L), job strain, supervisor and coworker support (Brief Job Stress Questionnaire), effort/reward imbalance (Effort/reward Imbalance Questionnaire), and demographic variables (age, sex, education, occupation, work contract, smoking, and alcohol drinking). Multiple linear regression analysis of the QALY score calculated from responses to EQ-5D-5L was employed on standardized scores of the work-related stressors and adjusted for demographic variables (SPSS version 26). RESULTS: Data of 1986 participants were analyzed. Job strain (unstandardized coefficient, b = - 0.013, p < 0.01) and effort/reward imbalance (b = - 0.011, p < 0.01) and coworker support (b = 0017, p < 0.01) were significantly associated with QALY score in the fully adjusted model. CONCLUSION: Job strain, effort/reward imbalance, and poor coworker support may be associated with a reduced QALY score among workers. A substantial impairment in QALY associated with the work-related stressors indicates that workplace interventions targeting work-related stressors may be cost-effective.

Effects of Smartphone-Based Stress Management on Improving Work Engagement Among Nurses in Vietnam: Secondary Analysis of a Three-Arm Randomized Controlled Trial.

BACKGROUND: Work engagement is important for employee well-being and work performance. However, no intervention study has investigated the effect of an eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). OBJECTIVE: The aim of the study was to examine the effects of a newly developed smartphone-based stress management program (ABC Stress Management) on improving work engagement among hospital nurses in Vietnam, an LMIC. METHODS: Full-time registered nurses (n=949) were randomly assigned to one of 2 intervention groups or a control group. The intervention groups were a 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills), provided in either free-choice (program A) or fixed order (program B). Work engagement was assessed at baseline and 3-month and 7-month follow-ups in each of the 3 groups. RESULTS: The scores of work engagement in both intervention groups improved from baseline to 3-month follow-up, and then decreased at the 7-month follow-up, while the score steadily increased from baseline to 7-month follow-up in the control group. Program B showed a significant intervention effect on improving work engagement at the 3-month follow-up (P=.049) with a small effect size (Cohen d= 0.16; 95% CI 0.001 to 0.43]). Program A showed nonsignificant trend (d=0.13; 95% CI -0.014 to 0.41; P=.07) toward improved engagement at 3 months. Neither program achieved effectiveness at the 7-month follow-up. CONCLUSIONS: The study demonstrated that a fixed order (program B) delivery of a smartphone-based stress management program was effective in improving work engagement in nurses in Vietnam. However, the effect was small and only temporary. Further improvement of this program is required to achieve a greater effect size and more sustained, longer lasting impact on work engagement. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry UMIN000033139; tinyurl.com/55gxo253. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2018-025138.

Andropause symptoms and sickness absence in Japanese male workers: a prospective study.

OBJECTIVE: The purpose of the study was to investigate the association between andropause symptoms and sickness absence in Japanese male workers over 2 years. METHODS: A baseline survey asking about andropause symptoms, along with blood sampling for testosterone level, was conducted in June 2009. A total of 418 men (mean age = 52.4 years, SD = 8.6) participated and were followed through 2011. Hazard ratios (HRs) and 95% confidence intervals (CIs) for sickness absence were calculated using Cox proportional hazard models. RESULTS: During the follow-up period, 31 of 35 participants who took sickness absences had physical illnesses. A higher andropause symptom score was associated with an increased risk of sickness absence. Testosterone deficiency (<350 ng/dL) was not associated with sickness absence. Among the subscales of andropause symptoms, the somatic symptom score was positively associated with sickness absence, whereas testosterone deficiency combined with high sexual symptoms was not associated with sickness absence. Results were similar when limited to sickness absence because of physical illness. No significant interaction between andropause symptoms and testosterone deficiency was found. CONCLUSIONS: Non-specific andropause symptoms unrelated to testosterone deficiency were positively associated with sickness absence.

Psychosocial Work Environment Explains the Association of Job Dissatisfaction With Long-term Sickness Absence: A One-Year Prospect Study of Japanese Employees.

BACKGROUND: Using a 1-year prospective design, we examined the association of job dissatisfaction with long-term sickness absence lasting 1 month or more, before and after adjusting for psychosocial work environment (ie, quantitative job overload, job control, and workplace social support) in Japanese employees. METHODS: We surveyed 14,687 employees (7,343 men and 7,344 women) aged 20-66 years, who had not taken long-term sickness absence in the past 3 years, from a financial service company in Japan. The Brief Job Stress Questionnaire, including scales on job satisfaction and psychosocial work environment, was administered, and information on demographic and occupational characteristics (ie, age, gender, length of service, job type, and employment position) was obtained from the personnel records of the surveyed company at baseline (July-August 2015). Subsequently, information on the start dates of long-term sickness absences was obtained during the follow-up period (until July 2016) from the personnel records. Cox's proportional hazard regression analysis was conducted. RESULTS: After adjusting for demographic and occupational characteristics, those who perceived job dissatisfaction had a significantly higher hazard ratio of long-term sickness absence than those who perceived job satisfaction (hazard ratio 2.91; 95% confidence interval, 1.74-4.87). After additionally adjusting for psychosocial work environment, this association was weakened and no longer significant (hazard ratio 1.55; 95% confidence interval, 0.86-2.80). CONCLUSIONS: Our findings suggest that the association of job dissatisfaction with long-term sickness absence is spurious and explained mainly via psychosocial work environment.

Occupational stress and the risk of turnover: a large prospective cohort study of employees in Japan.

BACKGROUND: Although several studies have examined the association between occupational stress and turnover, these studies relied on cross-sectional designs, subjects' self-report, healthcare workforce, or small sample sizes. This study aimed to confirm whether occupational stress increases the risk of turnover in a large-scale prospective cohort study using actual turnover data from company records. METHODS: The participants were 3892 male and 5765 female employees aged 20-49 years in a financial service company. We followed them from October 2012 until April 1, 2016 and used company records to identify employees who resigned. We identified employees with high and low stress using the Brief Job Stress Questionnaire. Hazard ratios for turnover in high-stress employees were estimated using Cox proportional hazards models, and population attributable risks were calculated separately for men and women. RESULTS: During 11,475,862 person-days, 122 men and 760 women resigned. After adjustment for age, length of service, job type, and position, the hazard ratios (95% confidence intervals) for turnover in high-stress employees were 2.86 (1.74-4.68) for men and 1.52 (1.29-1.78) for women. The corresponding population attributable risks for high stress were 8.2% for men and 8.3% for women. The component scores, i.e., job stressors, psychological/physical stress response, workplace social support, and job strain (the combination of high job demands and low job control) were also significantly associated with turnover (p < 0.05). CONCLUSIONS: Occupational stress increases the risk of actual turnover. Measures to prevent occupational stress may be useful to prevent employee turnover.

Association Between Reported Long Working Hours and History of Stroke in the CONSTANCES Cohort.

Background and Purpose- Long working hours (LWHs) are a potential risk factor for stroke. The aim of this study was to investigate this association in a large general population cohort. Methods- We used the French population-based cohort, CONSTANCES (Cohorte des Consultants des Centres d'Examens de Santé), to retrieve information on age, sex, smoking, and working hours from the baseline, self-administered questionnaire. Other cardiovascular risk factors and previous occurrence of stroke were taken from a parallel medical interview. We defined LWH as working time >10 hours daily for at least 50 days per year. Participants with primarily part-time jobs were excluded as were those with stroke before LWH exposure. We used logistic models to estimate the association between LWH and stroke, stratified by age, sex, and occupation. In additional modeling, we excluded subjects whose stroke occurred within 5 years of the first reported work exposure. Results- Among the 143 592 participants in the analyses, there were 1224 (0.9%) strokes, 42 542 (29.6%) reported LWH, and 14 481 (10.1%) reported LWH for 10 years or more. LWH was associated with an increased risk of stroke: adjusted odds ratio of 1.29 (95% CI, 1.11-1.49). Being exposed to LWH for 10 years or more was more strongly associated with stroke, adjusted odds ratio of 1.45 (95% CI, 1.21-1.74). The association showed no differences between men and women but was stronger in white-collar workers under 50 years of age. Conclusions- This large analysis reveals a significant association between stroke and exposure to LWH for 10 years or more. The findings are relevant for individual and global prevention.

Organizational Justice and Refraining from Seeking Medical Care Among Japanese Employees: A 1-Year Prospective Cohort Study.

BACKGROUND: Using a 1-year prospective design, we examined the association of organizational justice (i.e., procedural justice and interactional justice) with refraining from seeking medical care (RSMC) among Japanese employees. METHODS: We surveyed 2695 employees (1994 men and 701 women) from two factories of a manufacturing company in Japan. A self-administered questionnaire comprising scales for measuring organizational justice (Organizational Justice Questionnaire) and potential confounders (i.e., demographic and socioeconomic characteristics as well as health-related behaviors) was administered at baseline (from April to June 2011). At 1-year follow-up (from April to June 2012), a single-item question was used to measure RSMC during the follow-up period. Multiple logistic regression analysis was conducted by gender. RESULTS: After adjusting for potential confounders, low procedural justice and low interactional justice at baseline were found to be significantly associated with higher odds of RSMC during the 1-year follow-up for male employees (odds ratio = 1.33 [95% confidence interval = 1.16-1.52], p < 0.001 and 1.15 [95% confidence interval = 1.02-1.29], p = 0.019, respectively). Similar patterns were observed for female employees (odds ratio = 1.37 [95% confidence interval = 1.08-1.74], p = 0.009 and 1.23 [95% confidence interval = 1.02-1.50], p = 0.035 for low procedural justice and low interactional justice, respectively). CONCLUSIONS: The present study provided evidence that the lack of organizational justice is positively associated with RSMC among Japanese employees, independently of demographic and socioeconomic characteristics as well as of health-related behaviors.

Interaction effect of job insecurity and role ambiguity on psychological distress in Japanese employees: a cross-sectional study.

PURPOSE: We examined the interaction effect of job insecurity (JI) and role ambiguity (RA) on psychological distress in Japanese employees. METHODS: Overall, 2184 male and 805 female employees from two factories of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales measuring JI (Job Content Questionnaire), RA (National Institute for Occupational Safety and Health Generic Job Stress Questionnaire), psychological distress (K6 scale), and potential confounders (i.e., age, education, family size, occupational class, and work shift). Taking psychological distress as a dependent variable, hierarchical multiple regression analyses were conducted by gender and employment status (i.e., permanent and non-permanent employees). An interaction term of JI × RA was included in the model. RESULTS: After adjusting for potential confounders, the main effects of JI and RA on psychological distress were significant regardless of gender or employment status. Furthermore, the significant interaction effect of JI × RA on psychological distress was observed among permanent male employees (ß = 0.053, p = 0.010). Post hoc simple slope analyses showed that the simple slope of JI was greater at higher levels of RA (i.e., one standard deviation [SD] above the mean) (ß = 0.300, p < 0.001) compared to lower levels of RA (i.e., one SD below the mean) (ß = 0.212, p < 0.001). On the other hand, the interaction effect of JI × RA was not significant among permanent or non-permanent female employees. CONCLUSIONS: The present study suggests that higher levels of RA strengthen the association of JI with psychological distress, at least among Japanese permanent male employees.

Association Between Cortisol to DHEA-s Ratio and Sickness Absence in Japanese Male Workers.

PURPOSE: This study aimed to investigate the association between serum levels of cortisol and dehydroepiandrosterone sulfate (DHEA-s) and sickness absence over 2 years in Japanese male workers. METHOD: A baseline survey including questions about health behavior, along with blood sampling for cortisol and DHEA-s, was conducted in 2009. In total, 429 men (mean ± SD age, 52.9 ± 8.6 years) from whom blood samples were collected at baseline were followed until December 31, 2011. The hazard ratios (HR) and 95% confidence intervals (CI) for sickness absence were calculated using a Cox proportional hazard model, adjusted for potential confounders. RESULTS: Among 35 workers who took sickness absences, 31 had physical illness. A high cortisol to DHEA-s ratio increased the risk of sickness absence (crude HR = 2.68, 95% CI 1.12-6.41; adjusted HR = 3.33, 95% CI 1.35-8.20). The cortisol to DHEA-s ratio was linearly associated with an increased risk of sickness absence (p for trend < .050). Single effects of cortisol and DHEA-s levels were not associated with sickness absences. This trend did not change when limited to absences resulting from physical illness. CONCLUSION: Hormonal conditions related to the hypothalamus-pituitary-adrenocortical axis and adrenal function should be considered when predicting sickness absence. The cortisol to DHEA-s ratio may be more informative than single effects of cortisol and DHEA-s levels.

Feelings about Nursing Assistants that Enhance the Work Motivation of Japanese Registered Nurses and Licensed Practical Nurses.

Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.

Effort-reward imbalance, cortisol secretion, and inflammatory activity in police officers with 24-h work shifts.

PURPOSE: Accumulating evidence shows that effort-reward imbalance (ERI) at work can cause various health problems. However, few studies have investigated the biological pathways linking ERI and health outcomes, and their findings have been inconsistent. In this study, we investigated the associations between ERI, the hypothalamic-pituitary-adrenocortical axis, and inflammation in a sample of police officers. METHODS: One hundred forty-two male police officers that were engaged in a working system of 24-h shifts were followed up during the work shift as well as during the two subsequent work-free days. Throughout this period, the participants provided two saliva samples each day for the 3-day period, and we measured the concentrations of cortisol and C-reactive protein (CRP) in the saliva. The police officers also completed the Japanese short version of the Effort-Reward Imbalance Questionnaire. RESULTS: The results of linear mixed model analyses controlled for possible confounding variables indicated that higher effort scores (p = 0.031) as well as effort-reward ratio (p = 0.080) were associated with lower cortisol levels, and the effect of effort was strengthened in the younger police officers (p = 0.017). Furthermore, higher effort scores were associated with higher CRP levels in younger police officers (p = 0.037). CONCLUSIONS: Our results indicate that effort, a component of ERI, has physiological effects in younger police officers, which possibly contribute to the development of stress-related diseases.

Modifying effect of cigarette smoking on the association of organizational justice with serious psychological distress in Japanese employees: a cross-sectional study.

PURPOSE: We examined the modifying effect of cigarette smoking (i.e., smokers vs. non-smokers) on the association of organizational justice (i.e., procedural justice and interactional justice) with serious psychological distress (SPD) in Japanese employees. METHODS: Overall, 2838 participants from two factories of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales on organizational justice (Organizational Justice Questionnaire), smoking status, psychological distress (K6 scale), demographic and occupational characteristics (i.e., gender, age, education, family size, history of depression, chronic physical conditions, occupation, and work form), and other health-related behaviors (i.e., drinking habit and physical activity). Multiple logistic regression analyses were conducted. In a series of analyses, interaction term of procedural justice or interactional justice with smoking status was included in the model. RESULTS: After adjusting for demographic and occupational characteristics as well as other health-related behaviors, low procedural justice and low interactional justice were significantly associated with SPD (defined as K6 ≥ 13). Furthermore, marginally significant interaction effect of procedural justice with smoking status was observed. Specifically, the association of low procedural justice with SPD was greater among smokers [prevalence odds ratio 7.13 (95 % confidence interval 3.25-15.7) for low vs. high procedural justice subgroup] than among non-smokers [prevalence odds ratio 2.34 (95 % confidence interval 1.52-3.60) for low vs. high procedural justice subgroup]. On the other hand, interaction effect of interactional justice with smoking status was not significant. CONCLUSIONS: Cigarette smoking seems to have a harmful effect on the association of the lack of procedural justice with SPD in Japanese employees.

Modification Effects of Changes in Job Demands on Associations Between Changes in Testosterone Levels and Andropause Symptoms: 2-Year Follow-up Study in Male Middle-Aged Japanese Workers.

PURPOSE: The purpose of this longitudinal study was to ascertain if changes in job demands modify associations between changes in testosterone levels and andropause symptoms in male Japanese workers. METHOD: A baseline survey including job demands and the Aging Males' Symptoms scale, lifestyle factors, and blood levels of testosterone was conducted in 2007. Among 192 men (mean age ± SD 52.2 ± 7.6 years) who completed all relevant questionnaires and provided blood at baseline, 104 men (50.9 ± 7.2 years) were followed up in 2009. Changes of variables in 2 years were calculated (data of follow-up minus those of baseline). RESULTS: Testosterone levels were increased significantly, whereas job demands and somatic symptoms were reduced significantly, at follow-up. Changes in testosterone levels were negatively associated with changes in total andropause symptoms, psychological symptoms, and sexual symptoms (standardized ß = -0.27, -0.24, and, -0.29, p < 0.05, respectively), after adjustment for confounders. Changes in job demands were positively associated with changes in somatic symptoms (standardized ß = 0.21, p < 0.05). Significant interactions of changes in testosterone levels and job demands were noted for changes in psychological symptoms (standardized ß = 0.26, p < 0.05). For men with a 1-SD reduction in job demands, negative associations between changes in testosterone levels and psychological symptoms were intensified, but not for men with a 1-SD increase in job demands. CONCLUSION: Andropause symptoms may be affected by changes in testosterone levels and job demands. Change in job demands may modify associations between changes in testosterone levels and andropause symptoms.

Source-specific workplace social support and high-sensitivity C-reactive protein levels among Japanese workers: A 1-year prospective cohort study.

BACKGROUND: This study investigated the prospective association between source-specific workplace social support and high-sensitivity C-reactive protein (hs-CRP) levels in workers in Japan. METHODS: We conducted a 1-year prospective cohort study with 1,487 men and 533 women aged 18-65 years. Participants worked at two manufacturing worksites in Japan and were free of major illness. We used multivariable linear regression analyses to evaluate the prospective association between supervisor and coworker support at baseline, and hs-CRP levels at follow-up. We conducted the analyses separately for men and women. RESULTS: For women, high supervisor support at baseline was significantly associated with lower hs-CRP levels at follow-up (ß = -0.109, P < 0.01), whereas coworker support at baseline was not significantly associated with hs-CRP levels at follow-up. Associations between supervisor and coworker support and hs-CRP levels were not significant for men. CONCLUSIONS: Supervisor support may have beneficial effects on inflammatory markers in working women. Am. J. Ind. Med. 59:676-684, 2016. © 2016 Wiley Periodicals, Inc.

Predictors of a Desire to be Helpful to Professional Nurses Among Japanese Nursing Assistants in Small- to Medium-Sized Hospitals.

Registered nurses and licensed practical nurses have been educated as professional nurses. Professional nurses can concentrate on their jobs requiring a high degree of expertise with help they get from nursing assistants.If professional nurses have improper attitudes toward nursing assistants, it is most likely that the nursing assistants will not help them to the best of their ability. We investigated nursing assistants' impressions regarding professional nurses' attitudes, and what effects nursing assistants' impressions have on their "desire to be helpful to professional nurses." The study design was a cross sectional study. Twenty-five small- to medium-sized hospitals with 55 to 458 beds were included in this study. The analyzed subjects were 642 nursing assistants (96 males, 546 females). Factor analyses were conducted to extract the factors of nursing assistants' impressions regarding professional nurses' attitudes. Multiple linear regression analysis was conducted to investigate the predictors of "desire to be helpful to professional nurses." We discovered 5 factors: 1. professional nurses' model behavior, 2. manner dealing with nursing assistants, 3. respect for nursing assistants' passion for their work, 4. respect for nursing assistants' work, and 5. enhancing the ability of nursing assistants to do their work. The "desire to be helpful to professional nurses" was significantly associated with "professional nurses' model behavior," "manner dealing with nursing assistants" and "respect for nursing assistants' passion for their work." Factors 1 to 3 are fundamental principles when people establish appropriate relationships. Professional nurses must consider these fundamentals in their daily work in order to get complete cooperation from nursing assistants.