The EMPOWER Occupational e-Mental Health Intervention Implementation Checklist to Foster e-Mental Health Interventions in the Workplace: Development Study.

BACKGROUND: Occupational e-mental health (OeMH) interventions significantly reduce the burden of mental health conditions. The successful implementation of OeMH interventions is influenced by many implementation strategies, barriers, and facilitators across contexts, which, however, are not systematically tracked. One of the reasons is that international consensus on documenting and reporting the implementation of OeMH interventions is lacking. There is a need for practical guidance on the key factors influencing the implementation of interventions that organizations should consider. Stakeholder consultations secure a valuable source of information about these key strategies, barriers, and facilitators that are relevant to successful implementation of OeMH interventions. OBJECTIVE: The objective of this study was to develop a brief checklist to guide the implementation of OeMH interventions. METHODS: Based on the results of a recently published systematic review, we drafted a comprehensive checklist with a wide set of strategies, barriers, and facilitators that were identified as relevant for the implementation of OeMH interventions. We then used a 2-stage stakeholder consultation process to refine the draft checklist to a brief and practical checklist comprising key implementation factors. In the first stage, stakeholders evaluated the relevance and feasibility of items on the draft checklist using a web-based survey. The list of items comprised 12 facilitators presented as statements addressing "elements that positively affect implementation" and 17 barriers presented as statements addressing "concerns toward implementation." If a strategy was deemed relevant, respondents were asked to rate it using a 4-point Likert scale ranging from "very difficult to implement" to "very easy to implement." In the second stage, stakeholders were interviewed to elaborate on the most relevant barriers and facilitators shortlisted from the first stage. The interview mostly focused on the relevance and priority of strategies and factors affecting OeMH intervention implementation. In the interview, the stakeholders' responses to the open survey's questions were further explored. The final checklist included strategies ranked as relevant and feasible and the most relevant facilitators and barriers, which were endorsed during either the survey or the interviews. RESULTS: In total, 26 stakeholders completed the web-based survey (response rate=24.8%) and 4 stakeholders participated in individual interviews. The OeMH intervention implementation checklist comprised 28 items, including 9 (32.1%) strategies, 8 (28.6%) barriers, and 11 (39.3%) facilitators. There was widespread agreement between findings from the survey and interviews, the most outstanding exception being the idea of proposing OeMH interventions as benefits for employees. CONCLUSIONS: Through our 2-stage stakeholder consultation, we developed a brief checklist that provides organizations with a guide for the implementation of OeMH interventions. Future research should empirically validate the effectiveness and usefulness of the checklist.

Strategies for Implementing Occupational eMental Health Interventions: Scoping Review.

BACKGROUND: The implementation of eMental health interventions, especially in the workplace, is a complex process. Therefore, learning from existing implementation strategies is imperative to ensure improvements in the adoption, development, and scalability of occupational eMental health (OeMH) interventions. However, the implementation strategies used for these interventions are often undocumented or inadequately reported and have not been systematically gathered across implementations in a way that can serve as a much-needed guide for researchers. OBJECTIVE: The objective of this scoping review was to identify implementation strategies relevant to the uptake of OeMH interventions that target employees and detail the associated barriers and facilitation measures. METHODS: A scoping review was conducted. The descriptive synthesis was guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework and the Consolidated Framework for Implementation Research. RESULTS: A total of 31 of 32,916 (0.09%) publications reporting the use of the web-, smartphone-, telephone-, and email-based OeMH interventions were included. In all, 98 implementation strategies, 114 barriers, and 131 facilitators were identified. The synthesis of barriers and facilitators produced 19 facilitation measures that provide initial recommendations for improving the implementation of OeMH interventions. CONCLUSIONS: This scoping review represents one of the first steps in a research agenda aimed at improving the implementation of OeMH interventions by systematically selecting, shaping, evaluating, and reporting implementation strategies. There is a dire need for improved reporting of implementation strategies and combining common implementation frameworks with more technology-centric implementation frameworks to fully capture the complexities of eHealth implementation. Future research should investigate a wider range of common implementation outcomes for OeMH interventions that also focus on a wider set of common mental health problems in the workplace. This scoping review's findings can be critically leveraged by discerning decision-makers to improve the reach, effectiveness, adoption, implementation, and maintenance of OeMH interventions.

[Late effects of mass acute phosphine poisoning - Case report]. / Pózne nastepstwa zbiorowego ostrego zatrucia fosfanem ­ opis przypadku.

This paper reports the case of collective acute phosphide (PH3) intoxication among the crew aboard a merchant ship. All the intoxicated individuals were hospitalized 3 months after the accident. The aim of examinations was to identify late health effects of the accident. Laboratory tests and consultations were performed during their stay in the hospital. There were 5 cases of toxic liver damage. other 5 patients were diagnosed with posttraumatic stress disorder and adjustment disorders. The results of the study suggest that in cases of acute phosphide intoxication, the assessment of patients' psychological functioning should be an indispensable part of diagnostic procedure. Med Pr 2018;69(3):337-344.

Endometriosis - The challenge for occupational life of diagnosed women: A review of quantitative studies.

The aim of the article was to summarize the results offered in the research on occupational functioning of women with endometriosis. We followed PRISMA guidelines. Database search was done in November 2017 using EBSCO. In the review were included the articles clearly referring to the relationships between endometriosis and work or any aspect of work (e.g., work productivity, work ability, absenteeism). Eight papers were included in the final review. Seven studies were cross-sectional, 1 retrospective. The majority of researchers used standardized research measures, such as Work Ability Index, Work Productivity and Activity Impairment Questionnaire or Health Related Productivity Questionnaire. Only in 2 studies the reference group was considered, one of them consisted of healthy women. The results clearly indicate that endometriosis is a disease that causes major disturbance in occupational functioning of the suffering women. In the future the researchers should search for individual and organizational correlates of the improvement of occupational functioning in this group of patients. The methodology of the existing studies has been evaluated and the methodological cues for future research has been given. Med Pr 2018;69(6):663-671.

Maternal stress during pregnancy and neurodevelopmental outcomes of children during the first 2 years of life.

AIM: A growing body of literature documents associations between maternal stress in pregnancy and child development, but findings across studies are often inconsistent. The aim of this study was to estimate the association between exposure to different kinds of prenatal stress and child psychomotor development. METHODS: The study population consisted of 372 mother-child pairs from Polish Mother and Child Cohort. The analysis was restricted to the women who worked at least 1 month during pregnancy period. Maternal psychological stress during pregnancy was assessed based on: the Subjective Work Characteristics Questionnaire, Perceived Stress Scale and Social Readjustment Rating Scale. The level of satisfaction with family functioning and support was evaluated by APGAR Family Scale. Child psychomotor development was assessed at the 12th and 24th months of age by Bayley Scales of Infant and Toddler Development. RESULTS: Negative impact on child cognitive development at the age of two was observed for the Perceived Stress Scale (ß = -0.8; P = 0.01) and the Social Readjustment Rating Scale (ß = -0.4; P = 0.03) after adjusting for the variety of confounders. Occupational stress, as well as satisfaction with family functioning, was not significantly associated with child psychomotor development (P > 0.05). CONCLUSIONS: The study supports the findings that prenatal exposure to maternal stress is significantly associated with decreased child cognitive functions. In order to further understand and quantify the effects of prenatal stress on child neurodevelopment further studies are needed. This will be important for developing interventions that provide more assistance to pregnant women, including emotional support or help to manage psychological stress.

Use of work-life balance benefits guaranteed by law in Poland - Do size of the enterprise and gender matter?

BACKGROUND: The paper is aimed at indicating the similarities and differences in use of benefits supporting work-life balance (WLB) between women and men working in Polish small/medium and large enterprises. MATERIAL AND METHODS: The sample included 556 workers (311 women, 245 men), aged 20-68 years old employed on the basis of employment contracts for at least a year in Polish enterprises. The respondents completed a questionnaire on the use of benefits guaranteed by the Polish Labour Code, referring to their current workplaces. RESULTS: Women took maternity leaves and returned to the same work position after using childcare leaves more often than men. Men took leaves on demand more often than women. Our results also showed that in comparison to women working in smaller enterprises, those working in large enterprises were more likely to use almost all the analyzed WLB benefits - paid days off to take care of others, educational leaves, leaves on demand, maternity leaves and return to the same work position after childcare leave, reduction of business trips when pregnant or having young children and breastfeeding breaks. The size of enterprise, however, did not differentiate the take-up of benefits among the studied men. CONCLUSIONS: Our analysis brought unexpected results on the lack of common availability of the WLB benefits guaranteed by the law in the case of employees who worked on the basis of employment contracts. We also found that women used most of child rearing benefits guaranteed by the law more often than men, which might reflect still a traditional division of child care responsibilities in Poland. Med Pr 2017;68(5):575-581.

Why do employees follow their superiors' instructions? Identification of the reasons to comply with superiors' will in a group of Polish employees.

BACKGROUND: Managers influence the way organization works as well as the functioning of subordinates - in the context of their work life but non-professional functioning as well e.g., attitude towards work-life balance or taking care of health. We focused on the superior-subordinate relation, referring to social power bases theory by Raven. We identified the reasons why subordinates decide to follow their superiors' orders and determined specific styles of compliance with superiors' will. Understanding why employees listen to their superiors may be valuable in the context of supporting healthy organizational climate and atmosphere of co-operation or communicating values - for example, as regards taking care of own health. We discussed the results referring to the issue of influencing employees in the context of their health behavior. MATERIAL AND METHODS: The research involved 100 Polish employees, aged 28 years old on average, who filled in the Interpersonal Power Inventory by Raven et al. for subordinates in a Polish adaptation by Zaleski. The questionnaire includes 11 subscales referring to power bases. RESULTS: Based on the cluster analysis results, we recognized people who complied because of: all kinds of power bases (typical for 46% of the respondents); the respect for superiors' professionalism (34%); and formal/objective reasons (20%). CONCLUSIONS: Employees differ in terms of their styles of compliance. Their motives to comply with superiors' instructions constitute compilations of power bases. The superiors' awareness of the reasons why their employees decide to follow orders is necessary for successful management. It may motivate employees to work but also to take care of their own health.

[Mental health status of drivers--Motor vehicle accidents perpetrators]. / Stan psychiczny kierowców--sprawców wypadków drogowych.

BACKGROUND: This study aimed at exploring the phenomenon of motor vehicle accidents (MVA). The following research questions were addressed: what are the immediate reactions to accidents among MVA perpetrators, do MVA perpetrators develop posttraumatic stress symptoms, and what are the differences between high and low symptomatic signs in terms of socio-demographics and accident features? MATERIAL AND METHODS: Post-traumatic stress disorder (PTSD) questionnaire by Watson et al. in the Polish adaptation was applied to assess PTSD and its subclinical symptoms. The information on the MVA nature, declared MVA causes, drivers' reactions after MVA, as well as on the age, education and history of driving in the study group was collected. The results of psychological examination obtained from 209 MVA perpetrators were analyzed. The examination took place at least 1 month after the accident. RESULTS: In 1/3 of the study group no physiological reactions were observed directly after the accident, while 46% of respondents experienced trembling and shaking and about 30% of subjects were crying or having tears in their eyes. Compassion for the injured and victims, guilt, helplessness and fear were the most common among immediate psychological reactions related to the accident. On the day of psychological examination 11.2% of drivers met diagnostic criteria for PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV). Drivers showing low and high PTSD symptoms did not differ in terms of age, education, and subjective perception of accident cause. Women were significantly overrepresented it the group meeting the diagnostic criteria for PTSD. CONCLUSIONS: The results of the study indicate the need to carry on systematic screening for mental health problems in drivers involved in serious MVA as a part of strategy for improving road safety.

[Employees with mental illness - possibilities and barriers in professional activity]. / Pracownik z choroba psychiczna - mozliwosci i bariery w pracy zawodowej.

In Poland patients with psychiatric problems form a large group; in 2010 there were almost 1.5 million people for whom outpatient psychiatric care was provided, whereas approximately 200 thousand ill individuals were treated in 24-h psychiatric wards. Only 17% of the mentally disabled are professionally active. The results of many researches show that despite the detrimental influence of mental disorders on the employment (e.g., lower productivity, absenteeism, presenteism, increased risk of accidents at the workplace), professional activity can play a key role in the7stabilization of the mental state, it can also help in disease recovery. People with mental disorders are a social group that is at the higher risk of exclusion from the job market. The opinion prevailing among employers is that mentally ill individuals have decreased ability to conduct professional activity, and social attitudes towards them tend to be based on marking and stigmatizing. This review tackles the advantages of working during the illness, barriers which people with mental disorders face on the job market when they want to either start or continue work, and professional functioning of people with diagnosed depression (e.g., affective disorders) and schizophrenia (representing psychotic disorders). The analysis of existing data show that to improve the situation of mentally ill people present on the job market close cooperation between the representatives of various medical specializations is necessary, as well as their active participation in the process of social and professional rehabilitation of people affected by mental disorders.

[The characteristics of psychosocial risks in the banking sector: a brief report]. / Charakterystyka zagrozen psychospolecznych w sektorze bankowym--komunikat z badan.

BACKGROUND: Psychosocial risks in workplace are common phenomenon, stressing even for so-called white collar workers. The aim of the study was to indicate the most important threats in terms of banking sector employees. MATERIAL AND METHODS: The studied subjects were 484 employees employed in 26 companies. The Scale of Psychosocial Risk (SPR) was used as a research tool. RESULTS: The most frequent and the most stressful categories of threats were: lack of control over workload and lack of career development chances. Banking sector employees are obliged to follow strict procedures of customer service and they regard their promotion chances as low. Employees's appraisal system is another strongly stressful factor. Work in a banking sector involves a great mental strain and the high risk of dismissal. Interpersonal relationships at work turned out to be the least stressful work facet in the banking sector. CONCLUSIONS: Given the most serious sources of psychosocial risks, the authors suggested to take the following actions: changes in work and work control system, education of employees and managerial staff and regular monitoring of occurring threats.

[Occupational stress and psychosocial risk among journalists]. / Stres zawodowy a ryzyko psychospoleczne w grupie dziennikarzy.

BACKGROUND: Traumatic stress symptoms in journalists are well known but chronic occupational stress in this professional group is still to be elucidated. This study aimed at answering the following questions: (1) which of psychosocial risks (PRs) are most frequently reported as stressogenic in journalists, (2) are there any differences in exposure to PRs and their stressfulness between journalists and other professional groups, (3) what relationships occur between PR categories of stressfulness and their consequences for employees' functioning in the job, and (4) what is the risk of negative consequences of stress (health deterioration and worse job performance). MATERIAL AND METHODS: The Psychosocial Risk Scale was used to investigate general and specific PRs at work and the stressfulness of particular PRs. A group of 211 journalists working in Polish newspapers, radio and TV editorial offices participated in the study. RESULTS: The journalists experienced occupational stress at an average level, but at significantly lower than other professional groups. The study revealed the risk of health self-assessment deterioration, depending on specific risks (OR = 1.849, 95% CI: 1.068-3.203), risk of work organization dissatisfaction due to the impact of stress arising from the contextual job characteristics (OR = 1.942, 95% CI: 1.125-3.352) and dissatisfaction with relationships with co-workers due to the stressfulness of pathologies occurring in the workplace (OR = 2.012, 95% CI: 1.184-3.419). CONCLUSIONS: The study results evidence that occupational stress experienced by journalists determine the risk of health self-assessment, satisfaction with work organization and interpersonal relationships. The presented outcomes indicate that regardless of the experienced stress level it is necessary to assess the psychosocial risk because even an average level of stressfulness could be associated with the risk of adverse consequences for employees in terms of their job performance.

[The occupational, family and health conditions of Polish workers living in urban areas]. / Kondycja zawodowa, rodzinna i zdrowotna pracujacych polaków, mieszkanców miast.

BACKGROUND: This article presents the diagnosis of the socio-economic status and health condition of Polish workers living in urban areas. MATERIAL AND METHODS: The study was conducted in the nationwide group of occupationally active people aged 19-65 years. The interview questionnaire comprised an extensive socio-demographic part and a psychometric part, containing questionnaires measuring the status of mental health, work ability, work satisfaction and family functioning. RESULTS: Slightly more than half of the respondents (54%) worked in occupations related to their profession. The majority (88%) worked full-time, 8 h a day (65%) being employed by 1 employer (92%). Most respondents were satisfied with their job (apart from the financial aspect) and family life; 59% of employees were stressed by their job, including 15% of those who experienced strong stress. The family situation was emphasized by 31% of the respondents. At least one health disorder was diagnosed in 42% of the respondents. Musculoskeletal disorders (19%), cardiovascular diseases (13%) and respiratory disorders (11%) were most frequently reported. At the same time 76% of respondents assessed their health as rather good and good. The mental health index fell within the average values, but 12% of patients reached the score indicating the risk of serious mental health problems. Most of employees assessed their work ability as rather good and good. CONCLUSIONS: The data presented show the direction of the activities that need to be undertaken in the workplace, namely prevention of occupational stress, musculo-skeletal, cardiovascular and respiratory disorders, which significantly limit work ability. It is also necessary to implement educational programs in the workplace. Such activities, if organized on a regular basis, bring the best results.

[Organizational and individual determinants of using initiatives conducive to successful work-life balance]. / Organizacyjne i indywidualne uwarunkowania korzystania z rozwiazan sprzyjajacych równowazeniu zycia zawodowego i prywatnego.

Appropriate distribution of time and energy between work and personal life poses a challenge to many working people. Unfortunately, many professionally active people experience work-family conflict. In order to minimize it, employees are offered various solutions aimed at reconciling professional and private spheres (work-life balance (WLB) initiatives). The authors attempt to answer what makes employees use WLB initiatives and what influences the decision to reject the available options. The review is based on the articles published after 2000, searched by Google Scholar and Web of Knowledge with use of the key words: work-life balance, work-family conflict, work-life balance initiatives, work-life balance initiatives use, use of WLB solutions. We focused on organizational and individual determinants of WLB initiatives use, such as organizational culture, stereotypes and values prevailing in the work environment that may result in stigmatization of workers - flexibility stigma. We discuss the reasons why supervisors and co-workers stigmatize their colleagues, and what are the consequences of experiencing such stigmatization. Among the individual determinants of WLB initiatives use, we have inter alia focused on the preference for integration vs. separation of the spheres of life. The presented material shows that social factors - cultural norms prevailing in a society, relationships in the workplace and individual factors, such as the level of self-control - are of equal importance for decisions of using WLB initiatives as their existence. Our conclusion is that little attention has been paid to the research on determinants of WLB initiatives use, especially to individual ones.

[Psychosocial risks and the job activity of banking sector employees]. / Zagrozenia psychospoleczne a funkcjonowanie zawodowe pracowników sektora bankowego.

BACKGROUND: Psychosocial risks, via stress mechanism, may negatively influence employees' health and work activity. Both the scale and the type of these risks depend on job specificity in particular occupation or sector. The aim of the study was to characterize the categories of stressors occurring in the banking sector and their effects on employees' performance. MATERIAL AND METHODS: The studied subjects were 484 employees tested with the questionnaire method. The Scale of Psychosocial Risk was used as a research tool. RESULTS: The more the employees are exposed to threats connected with work content, work context, pathologies and specific factor, the less satisfied they are and the more frequently they declare turnover intention. However, rarely does it change their engagement or absence. The subjects felt the effects of risks, regardless of their stressfulness. It turns out that individual's well-being is rather related to work context, e.g. relations with co-workers or salary, than to the character of tasks. It was observed, that with age, employees are less resistant to work context related to threats, which results in frequent absence. CONCLUSIONS: Most of the results comply with the literature data. The work environment diagnosis may be based only on the occurrence of psychosocial risks, regardless of the subjectively experienced stress. The conclusions can be used by both employers and specialists in occupational stress prevention.

[Cardiovascular risk factors and life and occupational stress among policemen]. / Czynniki ryzyka chorób ukladu krazenia (CVD) a stres zyciowy i zawodowy u policjantów.

BACKGROUND: Several studies have shown an association between work-related stress and risk factors for cardiovascular disease. ever, only a few studies concerned the police. The aim of this study was to assess the relationship between the general and work-related stress, and the functioning of the circulatory system in the police staff. MATERIAL AND METHODS: The study group consisted of 126 policemen (aged 37.8 +/- 7.3 years), with average employment duration of 14.4 +/- 7 years. The study comprised the assessment of health status based on the medical examination and medical history of identified diseases, cardiovascular risk factors and symptoms, dietary habits, physical activity, intake of drugs, data on the family history, determinations of serum total cholesterol, HDL and LDL fractions, triglycerides, and fasting glycemia . The stress level was assessed using the Questionnaire for the Subjective Assessment of Work and Perceived Stress Scale. RESULTS: On medical examination hypertension was found in 36% of the people under study. Chest discomfort was reported by 60% of the subjects. Average body mass index (BMI), serum cholesterol and LDI, were elevated (22.7 +/- 4.1, 222.6 +/- 41.7 mg/dl and 142.7 +/- 39.7 mg/dl, respectively). Mean triglyceride, HDL fraction and fasting glucose levels were normal in the whole group. The levels of general and occupational stress were 34.914.8 and 128.0+33.3, respectively, being higher than in other occupational groups. In the group with the highest level of stress, there were significantly more people with circulatory problems (81%), drinking strong alcohol at least once a week (27%), working in a 3-shift system (40.5%) and working overtime (44%). CONCLUSIONS: The results show that the police are a group at high risk of developing cardiovascular diseases due to work-related stress.

Design and development of a digital intervention for workplace stress and mental health (EMPOWER).

Purpose: We describe the design and development of the European Platform to Promote health and wellbeing in the workplace (EMPOWER) digital intervention that provides an integrative user programme meeting the needs of employees and employers in addressing work stress. Results: A user-centred design process was followed from January 2020 until November 2021. A tailored algorithm was developed to provide support at the individual employee level and the company level. Each element of the digital intervention was developed in English and then translated in Spanish, English, Polish and Finnish. The digital intervention consists of a website and a mobile application (app) that provides algorithm-based personalised content after assessing a user's somatic and psychological symptoms, work functioning, and psychosocial risk factors for work stress. It has a public section and an employer portal that provides recommendations to reduce psychosocial risks in their company based upon clustered input from employees. Usability testing was conducted and showed high ease of use and completion of tasks by participants. Conclusion: The EMPOWER digital intervention is a tailored multimodal intervention addressing wellbeing, work stress, mental and physical health problems, and work productivity. This will be used in a planned RCT in four countries to evaluate its effectiveness.

Effectiveness of tailored digital health interventions for mental health at the workplace: A systematic review of randomised controlled trials.

Mental health problems in the workplace are common and have a considerable impact on employee wellbeing and productivity. Mental ill-health costs employers between £33 billion and £42 billion a year. According to a 2020 HSE report, roughly 2,440 per 100,000 workers in the UK were affected by work-related stress, depression, or anxiety, resulting in an estimated 17.9 million working days lost. We performed a systematic review of randomised controlled trials (RCTs) to assess the effect of tailored digital health interventions provided in the workplace aiming to improve mental health, presenteeism and absenteeism of employees. We searched several databases for RCTs published from 2000 onwards. Data were extracted into a standardised data extraction form. The quality of the included studies was assessed using the Cochrane Risk of Bias tool. Due to the heterogeneity of outcome measures, narrative synthesis was used to summarise the findings. Seven RCTs (eight publications) were included that evaluated tailored digital interventions versus waiting list control or usual care to improve physical and mental health outcomes and work productivity. The results are promising to the advantage of tailored digital interventions regarding presenteeism, sleep, stress levels, and physical symptoms related to somatisation; but less for addressing depression, anxiety, and absenteeism. Even though tailored digital interventions did not reduce anxiety and depression in the general working population, they significantly reduced depression and anxiety in employees with higher levels of psychological distress. Tailored digital interventions seem more effective in employees with higher levels of distress, presenteeism or absenteeism than in the general working population. There was high heterogeneity in outcome measures, especially for work productivity; this should be a focus of attention in future studies.

Study protocol of EMPOWER: A cluster randomized trial of a multimodal eHealth intervention for promoting mental health in the workplace following a stepped wedge trial design.

Objective: This article describes the EMPOWER study, a controlled trial aiming to determine the effectiveness and cost-effectiveness of an eHealth intervention to prevent common health problems and reduce presenteeism and absenteeism in the workplace. Intervention: The EMPOWER intervention spans universal, secondary and tertiary prevention and consists of an eHealth platform delivered via a website and a smartphone app designed to guide employees throughout different modules according to their specific profiles. Design: A stepped-wedge cluster randomized trial will be implemented in four countries (Finland, Poland, Spain and UK) with employees from small and medium enterprises (SMEs) and public agencies. Companies will be randomly allocated in one of three groups with different times at which the intervention is implemented. The intervention will last 7 weeks. Employees will answer several questionnaires at baseline, pre- and post-intervention and follow-up. Outcome measures: The main outcome is presenteeism. Secondary outcomes include depression, anxiety, insomnia, stress levels, wellbeing and absenteeism. Analyses will be conducted at the individual level using the intention-to-treat approach and mixed models. Additional analyses will evaluate the intervention effects according to gender, country or type of company. Cost-effectiveness and cost-utility analyses [based on the use of quality-adjusted life-years (QALYS)] will consider a societal, employers' and employees' perspective.

Predictors of illness acceptance in women with endometriosis.

BACKGROUND: The study aimed to identify significant predictors of illness acceptance in women with endometriosis. As potential predictive factors, variables related to the disease (pain frequency, co-morbid infertility, diagnostic delay, years of living with the diagnosis), demographic variables (age, place of residence, education, income, the fact of having children) and psychological variables (pain coping strategies) were taken into account. PARTICIPANTS AND PROCEDURE: The study participants - 247 women with endometriosis - were recruited in Poland in medical facilities from 6 large voivodship cities and through a patients' association. The participants filled in the following questionnaires: the Acceptance of Illness Scale (AIS), Endometriosis Health Profile-30 (EHP-30), and the Coping Strategies Questionnaire (CSQ). The data were analysed with the method of stepwise hierarchical regression. RESULTS: The final significant model explained 24% of the variance of the AIS score. The model consisted of the following variables: pain frequency, reinterpreting pain sensations, pain catastrophizing and praying/hoping. Only two variables were significant predictors in this model: pain frequency and pain catastrophizing. Years with diagnosis, age, diagnostic delay, place of residence, education, income, and the fact of having children were not significant. CONCLUSIONS: The interventions addressed to patients should support their acceptance of chronic pain and help them to develop adaptive pain coping strategies. Due to the co-morbidity of endometriosis-related pain and depression the inclusion of antidepressant pharmacotherapy and psychotherapy based on cognitive techniques is recommended.

[Aggravating factors in teachers' work and fatigue]. / Czynniki obciazajace w pracy nauczycieli a zmeczenie.

BACKGROUND: Teachers are a occupational group in which, due to the type and specificity of work, it can be expected that the feeling of fatigue will be very intense. However, there has been little research into this problem. The aim of the research was to assess the level of fatigue after work and chronic fatigue in teachers, and to determine whether and to what extent it depends on occupational and non-occupational loads. MATERIAL AND METHODS: The stratified sampling model was used to select the sample, where the layers were the type of school and its location (size of a town/city). All teachers from selected schools were invited to participate. Overall, 650 questionnaires were distributed and 403 teachers returned completed questionnaires. Fatigue after work was assessed on the basis of answers to the following question: "Do you feel tired after work?" and chronic fatigue using the Fatigue Assessment Scale. A special questionnaire was developed to assess other factors that might affect the level of fatigue. The Subjective Stress Assessment at Work Questionnaire, Cohen's Perceived Stress Scale, a part of the Questionnaire of Professional Loads of the Teacher and a list of additional factors disturbing the work were used. RESULTS: The study involved 70 men aged 35-63 years and 333 women (24-64 years). The groups did not differ significantly in terms of mean age. The level of fatigue, regardless of gender, was mostly influenced by time pressure, rush, mismanagement of the pace of work to individual abilities, increasing workload, an excess of responsible tasks, a lack of support from superiors, a low prestige of the profession, a lack of pedagogical successes, a sense of the lack of meaning in work, and the negative impact of work on family life, as well as non-occupational loads and insufficient rest. CONCLUSIONS: The conducted study allowed for determining the profile and frequency of occupational and non-occupational factors affecting the level of fatigue in teachers. Med Pr. 2021;72(3):283-303.