[Drawing up a Guideline for Handling Information and Communication Technology, Flexibility and Availability in Small and Medium Enterprises]. / Erstellung eines Handlungsleitfadens für einen gesundheitsförderlichen Umgang mit Informations- und Kommunikationstechnologien, Flexibilisierung und Erreichbarkeit in kleinen und mittleren Unternehmen.

BACKGROUND: Within the last decades the world of work has changed enormously. Due to new Information and Communication Technologies (ICT), working at any time from any place has become possible. Flexibility, availability and the dissolution of boundaries between work and private life are the possible results of this development. The spread of this development and possible consequences on the affected employee's health and wellbeing have been examined so far especially in big companies. Small and medium-sized enterprises (SME) are rarely subjects of scientific studies in this context. OBJECTIVE OF THIS PAPER: The aim of this work was to develop a guideline based on experiences and results of a study regarding flexibility in the business world (FlexA), as well as a systematic literature research. The target populations of this guideline are SMEs, focusing on integrating a health promoting way in dealing with ICT, flexibility and availability within the corporate culture. METHODS: In order to delineate the current state in of research in ICT-related work interventions, a systematic review in data bases e. g. PsycINFO, EconLit and Medline was carried out. The search strategy used the key words "work", "intervention", "ICT", "mental strain", "flexibility" and "availability". In addition, grey literature and findings from the FlexA study were used to formulate the current guideline. RESULTS: Based on the exclusion criteria, all studies from the systematic literature search were excluded after title and abstract screening. Within grey literature research, 4 relevant publications could be identified. The measures, developed during the corporate workshops of the FlexA study, e. g. the implementation of collective regulations in the company, were included in the guideline. CONCLUSION: Due to the ongoing development of ICT and flexibility in daily business life, it is getting more and more important to follow this progress. Executives and corporate management are responsible to actively shape this trend in a health-promoting way in their enterprises. The current guideline was made to support the corporate management in this task and it is an important instrument for a health-promoting use of ICT in daily business life taking in to consideration flexibility and availability.

Selection, optimization, and compensation in nursing: exploration of job-specific strategies, scale development, and age-specific associations to work ability.

AIMS: (1) To explore 'successful ageing' strategies in terms of selection, optimization and compensation in nursing; (2) To develop a scale that measures these strategies in nursing; (3) To investigate the association between these strategies in nursing and work ability of nurses and the moderating effects of age on this relationship. BACKGROUND: Studies indicate impaired work ability of older nurses. Research is needed to examine if 'successful ageing' strategies can promote the work ability especially in older nurses. DESIGN: The investigation applied a mixed method design: Study (1) Semi-structured interviews were conducted to explore selection, optimization and compensation in nursing; (Study 2) A cross-sectional survey was used to test the association between selection, optimization and compensation in nursing and work ability. METHODS: Data were collected in 2010 and 2011. Study 1: 17 nurses ≥45 years were interviewed; Study 2: 438 nurses (21-63 years) participated. A selection, optimization and compensation-in-nursing-scale was applied that was developed on the basis of study 1. Work ability was measured with the Work Ability Index (Dimension 1). RESULTS: Study 1, the majority of reported ageing strategies were identified as selection, optimization and compensation in nursing. Study 2, selection, optimization, and compensation in nursing was positively related with work ability. The positive relationship was stronger for older nurses. CONCLUSION: Selection, optimization and compensation in nursing contributes positively to work ability, particularly in older nurses. This finding is relevant for the development of measures that promote work ability of nurses over the course of their professional careers.

Digitally connected work and its consequences for strain - a systematic review.

BACKGROUND: Evolving digitization has an impact not only on the organization of work, but also on the health of employees. Dealing with new technologies, integrating new processes and requirements into work, and restructuring tasks among others are demands that can be stressful and impair health. OBJECTIVES: Our aim was to identify (clusters of) working conditions associated with digitally connected work and to analyze their relations with strain, that is, health and well-being outcomes. METHODS: Between May and October 2019, a search string was used to systematically search six databases (EMBASE, Medline, PSYNDEX, PsycInfo, SocIndex, WISO) for German and English texts according to the PEO scheme. The methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Design. RESULTS: 14 studies were identified. Despite the search string containing latest technologies, we identified mostly studies from the 1980s/90s. To aggregate findings, a categorization of work factors (cognitive demands, social factors, organizational factors, environmental factors) and health factors (motivation/satisfaction, reduced well-being/affective symptoms, physiological parameters/somatic complaints) is introduced. The most frequently identified work factors belong to the category of cognitive demands. For health factors, motivation/satisfaction was identified most often. 475 associations were found in total. CONCLUSIONS: This systematic review provides an overview of work and health factors that have been studied between 1981 and 2019. Recent texts frequently study individualized health factors (e.g., life satisfaction) whereas objective physiological measurement data and objective survey methods such as workplace analysis are not used. This latter approach was predominantly found in the older studies. In order to obtain a comprehensive picture, however, it is worthwhile to use a combination of these subjective and objective approaches for future studies in this field.

Associations of understaffing and cardiovascular health of hospital care providers: A multi-source study.

BACKGROUND: Understaffing in hospitals is a serious problem in healthcare work since it jeopardizes efficiency, reliability and quality of care as well as the work life of the healthcare professionals. However, estimates on the associations of understaffing and cardiovascular health in healthcare professionals are lacking. Further shortcomings refer to the problem, that determinant and outcome measures are often assessed via self-reports what increases the risk of spurious estimates due to common source bias. OBJECTIVE: We sought to reliably identify associations between understaffing and cardiovascular health in hospital nurses. METHODS: Multi-source and cross-sectional study. N = 273 nurses of a large academic hospital were surveyed. All filled out a standardized questionnaire to report psychosocial work conditions and underwent a standardized medical examination. Cardiovascular health outcomes were blood pressure and blood cholesterol (total cholesterol level, LDL-cholesterol) as well as the SCORE classification. Logistic regression analyses were applied to calculate risk estimates for the understaffing and cardiovascular health relationship, adjusted for individual and life-style factors (e.g., sex, age, BMI, alcohol consumption, smoking) and work related characteristics (i.e., shift work, leadership position, work load, autonomy, social support at work). RESULTS: Multivariate associations revealed significant relationships of perceived understaffing with increased blood pressure [OR = 1.60, 95% CI: 1.05, 2.43] and increased total cholesterol [OR = 1.42, 95 CI: 1.04, 1.95]. LDL cholesterol level was associated with understaffing. We furthermore observed associations of high autonomy and high cholesterol levels. CONCLUSIONS: Nurses in hospital units with lower staffing ratios had an increased risk for adverse cardiovascular health, irrespective of workload and social support. We discuss implications for future research on potential mechanisms of understaffing and nurses' health outcomes. The associated risks of poor nurse-patient-ratios for provider health need to be addressed through work and organizational design efforts.

Improving well-being at work: A randomized controlled intervention based on selection, optimization, and compensation.

This study aimed to develop, implement, and evaluate an occupational health intervention that is based on the theoretical model of selection, optimization, and compensation (SOC). We conducted a stratified randomized controlled intervention with 70 nurses of a community hospital in Germany (94% women; mean age 43.7 years). Altogether, the training consisted of 6 sessions (16.5 hours) over a period of 9 months. The training took place in groups of 6-8 employees. Participants were familiarized with the SOC model and developed and implemented a personal project based on SOC to cope effectively with 1 important job demand or to activate a job resource. Consistent with our hypotheses, we observed a meaningful trend that the proposed SOC training enhanced mental well-being, particularly in employees with a strong commitment to the intervention. While highly committed training participants reported higher levels of job control at follow-up, the effects were not statistical significant. Additional analyses of moderation effects showed that the training is particularly effective to enhance mental well-being when job control is low. Contrary to our assumptions, perceived work ability was not improved by the training. Our study provides first indications that SOC training might be a promising approach to occupational health and stress prevention. Moreover, it identifies critical success factors of occupational interventions based on SOC. However, additional studies are needed to corroborate the effectiveness of SOC trainings in the occupational contexts.

Association of age and physical job demands with musculoskeletal disorders in nurses.

A cross-sectional study design was applied on 273 nurses to investigate associations of physical job demands, age, and musculoskeletal disorders (MSDs) in nursing. Concurrently, participants reported on various physical job demands with a standardized questionnaire for Hospital Work. As a special contribution, this investigation illustrates findings on MSDs provided by a standardized physical examination to questionnaire data. MSD located in the lower back (8.7%) had the highest frequency, followed by the neck (7.3%), the shoulders (6.9%), and the knees (2.2%). There were significant differences in the frequencies of MSD between the young/middle age-group and the old age-group in most locations, while the only significant difference between the young and the middle age-group was found for shoulder-MSD. Furthermore high levels of physical job demands increased the risk of MSD significantly (OR = 5.7, 1.55-20.96) in all age-groups. The study provides further indication for development of age-adapted preventive measures.

Promoting work ability and well-being in hospital nursing: the interplay of age, job control, and successful ageing strategies.

Previous research shows that work ability of nurses decreases with age. In our study we therefore addressed the following questions: Do successful ageing strategies at work in terms of selection, optimization, and compensation (SOC) support the work ability of nurses? Does SOC mediate the relationship between job control (i.e., decision opportunities at work) and work ability? Does the mediation differ between age-groups? 438 nurses (Age Range 21-63 years) completed a questionnaire in the course of an employee survey. Results show that SOC is positively related with work ability. The positive effect of job control on work ability is significantly mediated by SOC. There are stronger mediating effects for elder nurses than for younger nurses. Results indicate that the interplay of job control and SOC at work helps to maintain the work ability of nurses in nursing care.