The impact of precarious employment on the commitment of registered nurses.

AIM: To investigate the association between precarious employment and commitment among registered nurses. BACKGROUND: The nursing profession faces numerous challenges, and precarious employment (PE) has emerged as a significant issue affecting nurses' well-being and professional status. METHODS: In spring 2023, we conducted a cross-sectional survey involving members of a healthcare workers' trade union in Finland. The study encompassed data from 2,370 registered nurses representing various healthcare sectors nationwide. Regression analysis was used to explore the relationship between PE and nurses' commitment. STROBE guidelines were used to report the study. RESULTS: The modified PE scale demonstrated a good fit. Among the various dimensions of PE, nurses perceived the highest level of precariousness in terms of inadequate training opportunities, followed by unpredictable and nonstandard working hours, low wages, and disempowerment. Vulnerability arising from authoritarian management exhibited the most significant and negative association with nurses' commitment (B = -0.233). DISCUSSION: The findings of this study underscore that PE is a pressing concern within the nursing profession, and it has a detrimental impact on nurses' commitment. While precariousness in nursing is associated with issues related to empowerment and fair leadership, it appears that conventional challenges related to working hours, typical of the nursing profession, do not significantly affect nurses' commitment. IMPLICATIONS FOR NURSING AND NURSING POLICY: To enhance nurses' commitment, healthcare institutions and managers must actively promote leadership practices that empower and support employees. Also, employees' legal work-related rights have to be respected in organizations. Addressing these aspects can contribute to a more resilient and dedicated nursing workforce.

Prioritization decision-making of care in nursing homes: A qualitative study.

BACKGROUND: Prioritization decision-making arises when nurses encounter intricate situations that demand ethically challenging judgments about care. This phenomenon has rarely been studied in nursing homes. Prioritization decision-making may lead to instances where individuals in social and healthcare may not receive all services they need. Making prioritization decisions and awareness of their consequences can increase nurses' workload. AIM: To describe prioritization decision-making regarding unfinished nursing care in nursing homes. RESEARCH DESIGN: A qualitative descriptive study conducted through individual theme interviews. Participants were recruited through social media. The data was analyzed using inductive content analysis. PARTICIPANTS AND RESEARCH CONTEXT: Nurses (n = 23) working in nursing homes for the elderly people in Finland. Data were collected between June 2022 and February 2023. ETHICAL CONSIDERATIONS: Finnish legislation does not mandate an ethical review or research permits, as the participants took part as private individuals. [ask authors to make reference here to informed consent process and anonymity]. FINDINGS: Nurses stated that the need for prioritization decision-making arises from challenges associated with nurses' engagement with person-centered care, the culture of the work community, the burden due to workload and challenges associated with the leadership. Prioritization decision-making was based on the interests of residents, striving for an efficient workflow and nurse's personal interests. Nurses did not receive support for decision-making regarding unfinished care, and protocols for prioritization had not been established in their work communities. Prioritization decision-making and unfinished care were concealed and left unspoken. CONCLUSION: Nursing leaders should address this hidden phenomenon, making it visible through discussions with nurses and by involving them in the development of protocols. The findings can be utilized for developing new approaches to support nurses and reduce their workload and for enhancing the quality and person-centeredness of nursing care in nursing homes.

'I'm a bit of an invisible worker' - Health care and social sector students' experiences of casual and temporary agency work.

OBJECTIVES: In the wake of national and global personnel shortages, it is becoming increasingly common for students to undertake casual and temporary agency work in the health care and social sectors. This phenomenon can have both advantages and disadvantages for these workers. The objective of this study was to describe health care and social sector students' experiences of such work. METHODS: Students currently undertaking casual work in the health care and social sector in Finland were recruited (n = 28). Qualitative semi-structured interviews of these students were conducted in March to May 2021. The data were analysed using inductive content analysis. RESULTS: Respondents reported some positive aspects of casual work. In particular, they liked the freedom to choose the workplace and working times that suited them. However, respondents' experiences were mostly negative. They perceived the induction into work as being insufficient, felt they had too few opportunities to give and receive feedback and believed they were not accepted into the working community. CONCLUSIONS: Students who have bad experiences while undertaking causal work in the health care and social sectors may develop an aversion towards working in those sectors after graduating. In order to ensure the sectors are attractive to graduates, casual student workers' induction and experience of the workplace must be improved.

The effects of precarious employment and calling on the psychosocial health and work well-being of young and older workers in the care sector: a longitudinal study.

OBJECTIVE: Employment conditions in the care sector are changing, and precarious employment (PE) is becoming more widespread, manifesting as undervaluation, adverse leadership, work overload, and inadequate control over work. This study aimed to examine changes in psychosocial health, work well-being, PE, and calling over time and explore the effects of PE and calling on psychosocial health and work well-being. METHODS: The longitudinal study collected follow-up panel data in the three time points (2020, 2022, and 2023) from care workers (n = 1502), linear mixed effects models. RESULTS: PE decreased (ß = - 0.02), and perceived work well-being increased (ß = 0.04), but there were no change in psychosocial health (ß = - 0.01) and calling (ß = 0.01) during the three-year period. Younger (< 39) care workers perceived higher levels of PE and had poorer psychological health. Moreover, PE had a negative effect on psychosocial health (ß = - 0.63) and work well-being (ß = - 0.68) and calling had a positive effect on psychosocial health (ß = 0.41) and work well-being (ß = 0.49) in multivariate models. CONCLUSION: PE conditions affect work performance and employee well-being and may threaten patient care; therefore, it should be further investigated in the care sector. It is noteworthy that calling still seems to be central in care work. The results deepen the understanding of the current shortage crisis in health and social care workplaces but can also provide keys to resolving the crisis.

Relationships between nursing leadership and organizational, staff and patient outcomes: A systematic review of reviews.

AIM: To assess and describe reviews of nursing leadership styles associated with organizational, staff and patient outcomes. DESIGN: A systematic review of reviews. METHODS: Reviews describing a search strategy and quality assessment. The review followed the PRISMA statement. Nine databases were searched in February 2022. RESULTS: After screening 6992 records, 12 reviews were included reporting 85 outcomes for 17 relational, nine task-oriented, five passive and five destructive leadership styles. Transformational leadership, which is one of the relational styles, was the most studied among all the styles. Of the outcomes, staff outcomes were the most reported, notably job satisfaction, and patient outcomes were less reported. Also, mediating factors between relational leadership styles and staff and patient outcomes were identified. CONCLUSION: Extensive research shows the beneficial impacts of relational leadership; however, destructive leadership research is lacking. Relational leadership styles should be conceptually assessed. More research is needed on how nurse leadership affects patients and organizations.

Unfinished nursing care in nursing homes.

This study aimed to describe unfinished nursing care activities in nursing homes. The study was conducted as a cross-sectional survey and employed the BERNCA-NH-instrument and one open-ended question. The participants were care workers (n=486) in nursing homes. The results showed that an average of 7.3 nursing care activities out of 20 were unfinished. A large share of the unfinished activities were related to residents' social care and the documentation of care. Female gender, age, and the amount of professional experience were found to increase the likelihood of unfinished nursing care. The unfinished care was the result of insufficient resources, residents' characteristics, unexpected situations, non-nursing activities, and challenges in organizing and leading care. The results indicate that all of the necessary care activities are not performed in nursing homes. Unfinished nursing activities might affect residents' quality of life and diminish the visibility of nursing care. Nursing home leaders have a significant role to play in decreasing unfinished care. Future research should address how to reduce and prevent unfinished nursing care.

Values, Health and Well-Being of Young Europeans Not in Employment, Education or Training (NEET).

Youth unemployment is a problem that undermines young people's health and well-being and is also a concern for their immediate communities and society. Human values predict health-related behaviour; however, this relation is very little studied and not examined earlier among NEET (not in employment, education or training) young people. This study aimed to explore the association between four higher-order human values (conservation, openness to change, self-enhancement, self-transcendence), self-rated health (SRH) and subjective well-being (SW) among NEET young men and women (n = 3842) across European regions. Pooled European Social Survey data from 2010-2018 were used. First, we run linear regression analysis stratified by European socio-cultural regions and gender. Then, multilevel analyses by gender with interactions were performed. The results show expected variation in value profiles across genders and regions and corresponding differences in SRH and SW. Significant associations between values and SRH and SW were found among both genders and across the regions; however, the results did not entirely confirm the expectations about the "healthiness" of specific values. More likely, prevailing values in societies, such as the social norm to work, might shape these associations. This study contributes to a deeper understanding of the factors affecting NEETs' health and well-being.

Occupational well-being of the work community in social and health care education during the COVID-19 pandemic-A cross-sectional study.

AIM: To evaluate factors related to the occupational well-being of social and health care educators' work communities during the COVID-19 pandemic. DESIGN: A cross-sectional study was conducted among social and health care educators in Finland 2020. METHODS: Data (n = 552) were collected through a questionnaire containing continuous, Likert scale and categorical variables. Descriptive, exploratory factor analysis and multiple regression modelling were used for analysing the data. RESULTS: Educators regarded their work as meaningful and experienced collegiality. Age and work experience were related to experiences on work community subscales and community occupational well-being. Personal occupational well-being and activities promoting occupational well-being on the community level were most related to experiences of the work community and its well-being. The activities that promote occupational well-being on the work community level should be emphasized.

Extending ageing nurses' working lives: A mixed-methods systematic review.

AIM(S): To identify, describe and assess research evidence on factors that promote working until and beyond the official retirement age among nurses. DESIGN: A mixed-methods systematic review. PROSPERO ID: CRD42022303890. DATA SOURCES: The CINAHL, PsycINFO, MEDLINE, Scopus, SocINDEX and Web of Science databases were searched in December 2021. REVIEW METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was followed. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals. Data-based convergent synthesis and thematic analysis were used. RESULTS: Eighteen studies were included, most of which were survey-based. Eleven studies were quantitative, six were qualitative and one used mixed methods. Our results reveal that willingness to continue in work increased with age. Six factors promoted working until and beyond the official retirement age among nurses: good health and work ability, the significance of work sufficient income, meaningful relationships and support in the working community, individually tailored work arrangements, and organizational support and recognition. CONCLUSION: To sustain experienced nurses in working life and promote their working beyond retirement age organizations urgently need to apply throughout working lives supporting age management schemes. Interventions should target supportive relations and individual and flexible arrangements at the workplace. Scarce studies investigated factors contributing to an extension of working life among nurses. Most published evidence on this topic is based primarily on nurses' subjective opinions and preferences: no intervention studies or objective evaluations of factors affecting retirement were found. IMPACT: The available evidence suggests the most critical factors for extending nurses' working lives are support and individual and flexible arrangements in the workplace. There is a need to test interventions and evaluate the effectiveness of measures encouraging nurses to extend their working lives. NO PATIENT OR PUBLIC CONTRIBUTION: Systematic review.

Care workers' positive health during the COVID-19 pandemic: Psychometric properties of the Finnish version of the Salutogenic Health Indicator Scale and an 18-month follow-up.

BACKGROUND: There is a need to shift from biomedical and pathogenic approaches to salutogenic approach. OBJECTIVE: To validate the Finnish version of the SHIS by testing its psychometric properties in care workers and to assess the SHIS score over time. METHODS: We first conducted a survey in 2020 (T1) and tested the psychometric properties of SHIS among care workers. We repeated the survey in spring 2022 (T2) among the same subjects. We analyzed the changes in SHIS, self-rated health (SRH), work ability (WAS), sickness absence and occupational calling between T1 and T2. Thereafter, we compared changes between health care sectors' and the other sectors' care workers. RESULTS: The results showed an increase in positive health measured with the SHIS and the occupational calling, a decrease in the SRH, and an increase in the number of sickness-related absences among all the care workers between T1 and T2. There was no change in their WAS. The health care workers had a lower SHIS than the other sectors' care workers in both T1 and T2, but the increase in their SHIS was parallel to that of the other workers. CONCLUSION: SHIS is a useful and reliable measure of positive health and can be used in studies when determining subjective health instead of, or in addition to, diagnoses. It was able to detect the health changes caused by the COVID-19 pandemic. SHIS is capable of capturing the underlying salutogenic approach of health promotive resources.

Calling as a resource for health and occupational wellbeing among the care sector workers in Finland.

BACKGROUND: The salutogenic approach in workplace health promotion emphasizes resources to gain and maintain good health and wellbeing. One of these resources could be calling, but its relation to the salutogenic approach is unknown. OBJECTIVE: To explore the associations between salutogenic measures of health and occupational wellbeing and calling among workers from the care and educational sectors. METHODS: A cross-sectional survey was conducted in Autumn 2020 among Finnish public and private sector care workers. A total of 7925 workers responded. Descriptive analyses and analysis of variance were used for the data analysis. RESULTS: Salutogenic measures of health and occupational wellbeing correlated strongly mutually, and both correlated moderately with calling. Workers aged over 55 years, workers acting in the education sector, workers with superior positions and temporary workers had the highest scores on health, occupational wellbeing and calling. When comparing occupational wellbeing dimensions by profession, managers had the highest scores and nurses the lowest. CONCLUSIONS: This study provides knowledge of promotive factors and health and occupational wellbeing resources for workplace health promotion in the care sector. Perceived calling in work can be considered a salutogenic resource for overall health and wellbeing; however, these connections should be further studied.

Nurses' substance use disorder in disciplinary procedures: A retrospective document analysis.

AIM AND OBJECTIVES: To describe nurses with substance use disorder (SUD) in authority disciplinary actions. BACKGROUND: Nurses with SUD risk patient safety. Research evidence on the identification of nurses' SUD and related management procedures is currently sparse. DESIGN: Retrospective document analysis of decisions related to SUD in nurses' disciplinary actions. METHOD: Decisions on nurses (N = 171) made by the Finnish National Supervisory Authority for Welfare and Health in Finland during 2007-2016 were used as data. An electronic extraction sheet was developed for data collection including variables (N = 34), of which 18 were analysed in this study with descriptive statistical methods and chi-squared statistics. The study reported in accordance with the STROBE checklist for cross-sectional studies. RESULTS: The mean age of the nurses was 43 years (SD 8.7). The most mentioned reasons for notifications leading to disciplinary actions were substance abuse with working while intoxicated and drug theft. The most mentioned intoxicants used were medicines and alcohol. On average, the first disciplinary decision was given at 6.4 months (SD 3.9) and the final decision was given at 17.9 months (SD 13.1). The most common decision was restriction of the right to practice. CONCLUSION: The results supported findings from previous decades and different continents, showing similar trends are prevalent globally and continue today. In future studies, countries' registers of nurses with SUD could be used to clarify the profile of nurses and develop appropriate procedures. Qualitative studies could be conducted to investigate to shed light on concealment of the phenomenon. RELEVANCE TO CLINICAL PRACTICE: There is a need for early identification, intervention and referral to treatment as well as effective protocols for reducing nurses' risks of disciplinary actions related to SUD. It is important to be aware of the signs and symptoms of SUD and training for this is needed.

Mental well-being, work engagement, and work-related and personal resources among nurse managers: A structural equation model.

Background: Nurse managers are central to guaranteeing quality healthcare outcomes. However, their position is very demanding and special attention should be paid to their mental well-being. Good mental well-being at work is associated with overall occupational well-being, increasing nurse managers' intention to stay in the profession and their commitment to their organization. However, little is known about nurse managers' personal and work-related resources that support good mental well-being. Objective: To explore work-related and personal resources associated with nurse managers' work engagement and mental well-being. Design: A cross-sectional survey study. Participants: Finnish nurse managers (n = 366) including ward managers (n = 332), chief nurses (n = 24), and administrative head nurses (n = 6). Methods: Nationwide online survey data was collected with a self-administered questionnaire in February 2023 from the members of one health and social care workers' trade union. The relationships between nurse managers' personal (psychological capital and calling) and work-related (job resources and social support) resources, work engagement and mental well-being were analysed using structural equation modeling. Nurse managers were also divided into two groups based on their mental well-being score: those with and without depression. The study is reported following the guidelines for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: Nurse managers who had depression (27%) were associated with less personal and work-related resources compared to managers without depression. Work engagement correlated strongly with mental well-being. A structural equation model that indicated positive significant total effects of work engagement (ß = 0.38), social support (ß = 0.26), job resources (ß = 0.19), and psychological capital ß = 0.28) and calling (ß = 0.13) with mental well-being had an excellent fit. Conclusion: Nurse managers' mental well-being can be supported by organisational strategies and national policies that enhance leadership skills and increase work-related resources, which, in turn, can manifest as psychological and professional capital and a sense of meaningfulness in work.Globally, the healthcare sector needs resilient and healthy nurse managers to respond to current and future challenges. They are key players in safeguarding the well-being and commitment of nursing staff and thereby improving the quality of care.

Registered nurses' perceptions of their career-An interview study.

AIM: We aim to explore registered nurses' perceptions of their career. BACKGROUND: Career development options have been found to increase attraction to nursing and support nurses' engagement with their organization and profession. METHODS: We collected qualitative individual interviews with 23 registered nurses; data were analysed with thematic analysis and reported according to the consolidated criteria for reporting qualitative research (COREQ) criteria. RESULTS: Three themes emerged: career choices, career engagement and career development. Participants had chosen a nursing career because they perceived it as humane, people oriented, meaningful, diverse and secure work. Participants' engagement in their career was connected to the content of the work, in which direct patient care was central. Nurses connected career development with high competency, independence, influence and meaningful working life experience. However, they perceived career development opportunities as minute within direct patient care. CONCLUSIONS: Career development opportunities for nurses in direct patient care are needed to foster their career engagement and the attractiveness of the nursing profession. Further research is needed on the career planning and development of nurses working in patient care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers must play a central role in engaging nurses in their careers and promoting their competency and career planning and development in organizations.

Registered nurses' perceptions of having a calling to nursing: A mixed-method study.

AIM: To explore how nurses perceived having a calling to nursing. DESIGN: A mixed-method study. METHODS: Survey data collected in autumn 2020 and semi-structured individual interview data collected in spring 2021. The 7925 survey respondents were care professionals and 414 of them were registered nurses. The 23 interview participants were registered nurses who responded to the survey. We examined the survey results using analysis of variance and t-tests and the interview data with qualitative thematic analysis. RESULTS: Registered nurses had a lower calling than other care professionals. Based on the interviews, having a calling to nursing produce four key findings. Nurses with a calling experienced their work as meaningful. They also adopted a humane and holistic approach to their work. However, their calling could change during their professional career. Due to its historical roots, having a calling was seen as a risk for the nursing profession, as it meant nurses had an oppressed position in society and nurses associated it with poor working conditions and low pay. CONCLUSION: Our study showed that having a calling to nursing had multidimensional benefits for the individual nurse, their patient, colleagues, organization and society, but showed strong association between calling and nurses' poor working conditions and low pay. IMPACT: We found that nurses had a lower calling than other care professionals. Calling still exists, but it can produce tension in modern nursing. Organizations and society need to focus on how calling can be seen as a more positive attribute of nursing and improve nurses' working conditions and pay.

Cost-effectiveness calculators for health, well-being and safety promotion: a systematic review.

BACKGROUND: The health, well-being and safety of the general population are important goals for society, but forecasting outcomes and weighing up the costs and benefits of effective promotional programmes is challenging. This study aimed to identify and describe the cost-effectiveness calculators that analyze interventions that promote health, well-being and safety. METHODS: Our systematic review used the CINAHL, PsycINFO, SocINDEX, EconLit, PubMed and Scopus databases to identify peer-reviewed studies published in English between January 2010 and April 2020. The data were analyzed with narrative synthesis. RESULTS: The searches identified 6880 papers and nine met our eligibility and quality criteria. All nine calculators focussed on interventions that promoted health and well-being, but no safety promotion tools were identified. Five calculators were targeted at group-level initiatives, two at regional levels and two at national levels. The calculators combined different data sources, in addition to data inputted by users. This included empirical research and previous literature. The calculators created baseline estimates and assessed the cost-effectiveness of the interventions before or after they were implemented. The calculators were heterogeneous in terms of outcomes, the interventions they evaluated and the data and methods used. CONCLUSION: This review identified nine calculators that assessed the cost-effectiveness of health and well-being interventions and supported decision-making and resource allocations at local, regional and national levels, but none focussed on safety. Producing calculators that work accurately in different contexts might be challenging. Further research should identify how to assess sustainable evaluation of health, well-being and safety strategies.

Health-improving interventions for obtaining employment in unemployed job seekers.

BACKGROUND: Unemployment is associated with decreased health which may be a reason or a consequence of becoming unemployed. Decreased health can inhibit re-employment. OBJECTIVES: To assess the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. SEARCH METHODS: We searched (3 May 2018, updated 13 August 2019) the Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, PsycINFO, CINAHL, SocINDEX, OSH Update, ClinicalTrials.gov, the WHO trials portal, and also reference lists of included studies and selected reviews. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. The primary outcome was re-employment reported as the number or percentage of participants who obtained employment. Our secondary outcomes were health and work ability. DATA COLLECTION AND ANALYSIS: Two authors independently screened studies, extracted outcome data, and assessed risk of bias. We pooled study results with random-effect models and reported risk ratios (RRs) with 95% confidence intervals (CIs) and assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS: We included 15 randomised controlled trials (16 interventions) with a total of 6397 unemployed participants. Eight studies evaluated therapeutic interventions such as cognitive behavioural therapy, physical exercise, and health-related advice and counselling and, in seven studies, interventions were combined using therapeutic methods and job-search training. Therapeutic interventions Therapeutic interventions compared to no intervention may increase employment at an average of 11 months follow-up but the evidence is very uncertain (RR = 1.41, 95% CI 1.07 to 1.87, n = 1142, 8 studies with 9 interventions, I² = 52%, very low-quality evidence). There is probably no difference in the effects of therapeutic interventions compared to no intervention on mental health (SMD 0.12, 95% CI -0.06 to 0.29, n = 530, 2 studies, low-quality evidence) and on general health (SMD 0.19, 95% CI -0.04 to 0.41, n = 318, 1 study, moderate-quality evidence). Combined interventions Combined interventions probably increase employment slightly compared to no intervention at an average of 10 months follow-up (RR 1.12, 95% CI 1.06 to 1.20, n = 4101, 6 studies, I² = 7%). There were no studies that measured work-ability, adverse events, or cost-effectiveness. AUTHORS' CONCLUSIONS: Interventions combining therapeutic methods and job-search training probably have a small beneficial effect in increasing employment. Therapeutic interventions may have an effect on re-employment, but we are very uncertain. Therapeutic interventions may not improve health in unemployed job seekers. Large high-quality RCTs targeting short-term or long-term unemployed people are needed to increase the quality of the evidence. A cost-effectiveness assessment is needed of the small beneficial effects.

Improving employment opportunities of the unemployed by health and work ability promotion in Finland.

The study explored the impact of self-rated health (SRH) and work ability on employment, and examined the effects of meaningfulness, social networks and physical activity on health and work ability with a population-based cross-sectional survey data (n = 12 729) of full-time employed and unemployed workers. SRH, perceived work ability and levels of perceived meaningfulness, social networks and physical activity were all significantly better among employed workers compared to unemployed people. The results showed that work ability mediated the effect of health on employment and predicted employment. Meaningfulness, social networks and physical activity had direct positive effects on health and work ability, and also on employment. The results indicated that good health is a substantial element of good work ability, which in turn is needed to maintain or to get a job. Our findings suggested that perceiving one's life as meaningful, having a strong social network and being physically active are important predictors of good health as well as of good work ability. These could be contributing factors to re-employment among unemployed people.

Association between good work ability and health behaviours among unemployed: A cross-sectional survey.

BACKGROUND: There has been relatively little research on the possible factors promoting good work ability among unemployed people. Consequently, the role of health behaviours in good work ability among the unemployed is unknown. PURPOSE: To explore the work ability and health behaviours of unemployed people through sociodemographic factors and examine the association between good work ability and health behaviours. DESIGN: A cross-sectional survey. METHODS: The study is based on the Finnish nationwide Regional Health and Well-being Study using mailed and online questionnaires in 2014-2015. A total of 1973 unemployed or laid-off people between the ages of 20 and 65 responded to the survey. The associations of work ability with sociodemographic factors - gender, age, marital status, minors (i.e. under-18s) living in the household, education, living environment, and duration of unemployment - and health behaviours with sociodemographic factors were first explored using cross-tabulations. Health behaviours included body mass index, daily smoking, alcohol consumption, vegetable consumption, health promotion groups, physical exercise, and sitting in one's leisure time. Health behaviours were then examined using logistic regression analyses, in association with good work ability; the latter was measured with the Work Ability Score. RESULTS: Being aged below 45, being married or cohabiting, having a high level of education, and short-term unemployment were associated with good work ability. A quarter of participants were daily smokers. A proportion of women with risk level alcohol use (79%) was higher than that of men (59.9%). A third of unemployed people participated in high-intensity physical activity. In regression analyses, high-intensity physical activity (OR 2.25, 95% CI 1.06-4.78) was associated with good work ability. CONCLUSIONS: Unemployed women and men widely exhibited unhealthy behaviours such as daily smoking and a risk level use of alcohol. Health promotion actions for enhancing a healthy lifestyle and good work ability among unemployed people, particularly in emphasizing the importance of physical activity, are highly recommended.

Good work ability among unemployed individuals: Association of sociodemographic, work-related and well-being factors.

AIMS: The aims of this study were to describe the perceived work ability of unemployed individuals and to explore the association between perceived good work ability and sociodemographic, work-related and well-being factors. METHODS: The data were derived from the Finnish Regional Health and Well-being Study (ATH) collected by postal and Internet-based questionnaires in 2014-2015. The random sample was selected from the Finnish National Population Register. The present study includes data from unemployed or laid-off respondents ( n=1975) aged 20-65 years. Logistic regression was used in the statistical analysis. Perceived work ability was measured with the Work Ability Score. RESULTS: Factors significantly associated with good work ability were having young children living in the household, short-term unemployment, low or moderate physical strain in most recent job, moderate mental strain in most recent job, satisfaction with most recent job, good self-rated health and good quality of life. Good self-rated health (odds ratio=10.53, 95% confidence interval 5.90-18.80) was the most substantial factor in the multivariate model. CONCLUSIONS: The findings provide further evidence on the factors related to good work ability of the unemployed. These factors should be considered when designing interventions for promoting work ability and to minimise the harmful effects of long-term unemployment.