Impact of Home-Based Work during the COVID-19 Pandemic on Mental and Physical Health in a German Population-Based Sample.

Background: The COVID-19 outbreak necessitated physical distancing, as part of secondary prevention, at a personal and professional level. Working from home (WFH) became increasingly important. In this study, the impact of the COVID-19 pandemic restrictions on physical and mental health is investigated, compared with pre-pandemic data, and with employees who WFH and are on-site. Methods: Data from the German Saxon longitudinal study population were used. Attitudes towards WFH as well as mental and physical health assessments during the COVID-19 pandemic were examined. Comparisons were made with corresponding pre-pandemic scores and between employees WFH and on-site in 2022. Results: In total, 319 participants with equal gender distribution were included. Of those, 86 worked from home stating better organizability of their work, more time for partnership, less stress, and greater work satisfaction. Compared to pre-pandemic data, the D-score, PHQ-4, G-Score, and PHQ-SSS-8 showed a significant increase. No difference in physical or mental health between employees WFH and on-site was observed. Conclusion: In general, COVID-19 restrictions had a negative impact on mental and physical health. Although WFH is well accepted, it did not show significant health benefits.

Influence of Intraoperative Active and Passive Breaks in Simulated Minimally Invasive Procedures on Surgeons' Perceived Discomfort, Performance, and Workload.

Laparoscopic surgeons are at high risk of experiencing musculoskeletal discomfort, which is considered the result of long-lasting static and awkward body postures. We primarily aimed to evaluate whether passive and active work breaks can reduce ratings of perceived discomfort among laparoscopic surgeons compared with no work breaks. We secondarily aimed to examine potential differences in performance and workload across work break conditions and requested the surgeons evaluate working with passive or active work breaks. Following a balanced, randomized cross-over design, laparoscopic surgeons performed three 90 min laparoscopic simulations without and with 2.5 min passive or active work breaks after 30 min work blocks on separate days. The simulation included the following tasks: a hot wire, peg transfer, pick-and-place, pick-and-tighten, pick-and-thread, and pull-and-stick tasks. Ratings of perceived discomfort (CR10 Borg Scale), performance per subtask, and perceived workload (NASA-TLX) were recorded, and the break interventions were evaluated (self-developed questionnaire). Statistical analyses were performed on the rating of perceived discomfort and a selection of the performance outcomes. Twenty-one participants (9F) were included, with a mean age of 36.6 years (SD 9.7) and an average experience in laparoscopies of 8.5 years (SD 5.6). Ratings of perceived musculoskeletal discomfort slightly increased over time from a mean level of 0.1 to 0.9 but did not statistically significantly differ between conditions (p = 0.439). Performance outcomes of the hot wire and peg transfer tasks did not statistically significantly differ between conditions. The overall evaluation by the participants was slightly in favor regarding the duration and content of active breaks and showed a 65% likelihood of implementing them on their own initiative in ≥90 min-lasting laparoscopic surgeries, compared with passive breaks. Both passive and active breaks did not statistically significantly influence ratings of perceived discomfort or perceived workload in a 90 min simulation of laparoscopic surgery, with an overall low mean level of perceived discomfort of 0.9 (SD 1.4). As work breaks do not lead to performance losses, rest breaks should be tested in real-life situations across a complete working shift, where perceived discomfort may differ from this laboratory situation. However, in this respect, it is crucial to investigate the acceptance and practicality of intraoperative work breaks in feasibility studies in advance of assessing their effectiveness in follow-up longitudinal trials.

Impact of digital stress on negative emotions and physical complaints in the home office: a follow up study.

Background: Due to the COVID-19 pandemic many employees perform under increasingly digital conditions. Enabling home office environments became mandatory for companies wherever possible in consideration of the ongoing pandemic. Simultaneously, studies reported on digital stress. The current literature lacks rigorous research into digital stress on psychosomatic outcomes, emotions, and disease. Therefore, we endeavor to understand how digital stress developed over the course of the pandemic and if it predicts differences in negative emotions and physical complaints in the home office setting. Methods: To answer the research question, we conducted an online survey among 441 employees in 2020 and 398 employees in 2022 from three municipal administrations in Germany, who were working from home at least occasionally. We used a cluster analysis to detect digitally stressed employees. Regression analyses were performed on digital stress, negative emotions, and physical complaints. Results: The analysis revealed an increase from 9 to 20% in digital stress, while negative emotions and physical complaints did not show evident differences. In the multivariate model, we observe a change in the proportion of digitally stressed employees between 4 and 17%, while the control variables explain around 9%. Conclusions: Digital stress did not significantly affect either negative emotions or physical complaints. However, digital stress appeared to exert a more substantial predictive influence on negative emotions. The study emphasizes rising digital stress, which contradicts a positive adaption to the digital working conditions within the observed period. The psychosomatic relations are low or lagged. Further research investigating digital stress and countermeasures, especially to understand how to prevent harmful long-term effects such as distress resulting from working from home conditions, is needed.

Work ability among employees 2-10 years beyond breast cancer diagnosis: Late treatment effects and job resources - A longitudinal study.

BACKGROUND: The number of workers who have previously undergone a cancer treatment is increasing, and possible late treatment effects (fatigue, physical and cognitive complaints) may affect work ability. OBJECTIVE: The aim of the study was to investigate the impact of late treatment effects and of job resources (autonomy, supportive leadership style, and colleagues' social support) on the future work ability of employees living 2-10 years beyond a breast cancer diagnosis. METHODS: Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287) among Dutch-speaking workers with a breast cancer diagnosis 2-10 years ago. Longitudinal regression analyses, controlling for years since diagnosis, living with cancer (recurrence or metastasis), other chronic or severe diseases, and work ability at baseline were executed. RESULTS: Higher levels of fatigue and cognitive complaints at baseline predicted lower future work ability. The three job resources did not predict higher future work ability, but did relate cross-sectionally with higher work ability at baseline. Autonomy negatively moderated the association between physical complaints and future work ability. CONCLUSIONS: Fatigue and cognitive complaints among employees 2-10 years past breast cancer diagnosis need awareness and interventions to prevent lower future work ability. Among participants with average or high levels of physical complaints, there was no difference in future work ability between medium and high autonomy. However, future work ability was remarkably lower when autonomy was low.

White blood cell count profile in patients with physical complaints without known causes.

Objectives: The aim of this study was to search for routine blood test biomarkers in patients with physical symptoms but without a diagnosis after comprehensive routine screening diagnostic examinations. Methods: A total of 228 adults aged < 65 years who presented with physical complaints without known causes after comprehensive screening diagnostic examinations and 228 age- and sex-matched healthy controls without physical complaints were enrolled. The blood cell count data at the first hospital visit were compared between these groups. Results: Total white blood cell (p = 0.2143), red blood cell (p = 0.8954), and platelet (p = 0.7716) counts did not differ between the groups. The monocyte count (p = 0.0014) and resultant monocyte-to-lymphocyte ratio (p < 0.0001) were higher in the symptomatic group, while the other white blood cell subtypes did not differ significantly between the two groups. In the symptomatic group, patients with a monocyte-to-lymphocyte ratio > 0.25 were likely to have unexplained nonfocal physical symptoms (p < 0.0001). The characteristic findings included fatigability (p < 0.0001), prolonged slight fever (p = 0.0005), and widespread pain (p < 0.0001). The monocyte-to-lymphocyte ratio level was correlated with the proportion of patients with unexplained nonfocal symptoms. Conclusion: The blood cell count profile was largely the same between healthy individuals and patients with unexplained physical symptoms. However, patients with unexplained nonfocal physical complaints were likely to show an elevated monocyte-to-lymphocyte ratio, typically > 0.25.

Association between Grief and Somatic Complaints in Bereaved University and College Students.

Many emerging adults experience the death of a loved one while they are enrolled as a student in higher education. Bereavement increases the risk of long-term adverse physical and mental health outcomes. Still, as most studies have focused on psychological aspects of grief, little is known about the impact of grief on somatic complaints in students, leaving them vulnerable to health deteriorations. This study aimed to address this gap, and we hypothesized that there is a positive association between grief and somatic complaints in bereaved students. Participants (N = 688) were students enrolled at Flemish universities and colleges in Belgium. Participants filled out an online survey with sociodemographic questions, two scales assessing grief, and somatic grief reactions, and two additional questions inquiring whether participants had experienced other somatic reactions, and whether they had taken any steps to remedy their somatic complaints. Regression analyses revealed that less social support, type of relationship (first-degree relative), and the level of grief were positively associated with somatic complaints, and bereaved students reported various complaints such as feeling pain and strains, thus confirming the hypothesis. As bereaved students may be reluctant to seek support for somatic complaints, the findings indicate that information and psychoeducation for bereaved students and their social environment must address somatic grief reactions and encourage timely help seeking. In addition, staff members at psychosocial and medical services for students should be trained to recognize somatic as well as psychological grief reactions. Appropriately skilled, they can inquire about such complaints and provide adequate support to prevent long-term health ramifications.

Physical Complaints Decrease after Following a Few-Foods Diet in Children with ADHD.

Attention-deficit hyperactivity disorder (ADHD) symptoms may significantly decrease after following a few-foods diet (FFD). The results of a small randomised controlled trial (RCT) showed that co-occurring physical complaints in children with ADHD decreased as well. To further investigate the effect of an FFD on physical complaints, we analysed unpublished data from previously published studies (i.e., 'Impact of Nutrition on Children with ADHD' [INCA], an RCT, and 'Biomarker Research in ADHD: the Impact of Nutrition' [BRAIN], an open-label trial). In both trials, the association between an FFD, ADHD, and 21 individual physical complaints was assessed. Children either followed a 5-week FFD (the INCA FFD group and BRAIN participants) or received healthy food advice (the INCA control group). The ADHD rating scale and a physical complaint questionnaire were filled in at the start and end of the trials. The INCA results showed, for 10 of 21 complaints, a clinically relevant reduction in the FFD group compared to the control group. The open-label BRAIN results confirmed the outcomes of the FFD group. No association was detected between the decrease in physical complaints and the decrease in ADHD symptoms. The results point toward an association between the FFD and a decrease in thermoregulation problems, gastrointestinal complaints, eczema, and sleep problems.

Higher sense of coherence is associated with better mental and physical health in emergency medical services: results from investigations on the revised sense of coherence scale (SOC-R) in rescue workers.

As rescue workers are regularly confronted with potentially traumatising on-duty events, they have an increased risk to develop trauma-related mental and physical health impairments, including post-traumatic, depressive, and somatic symptoms. For this high-risk group, it could be of particular importance to experience their occupational burden as manageable, meaningful, and coherent. This mindset - called sense of coherence - may be a potential resilience factor against the development of mental and physical health problems. In a cross-sectional cohort of 102 rescue workers (Mdn(QD)age = 26.0 (8.5), age range: 18-61), including 36 women, we investigated whether higher values on the Revised Sense of Coherence Scale (SOC-R) predicted lower post-traumatic, depressive, and somatic symptoms. In addition, we evaluated the factor structure of the SOC-R using confirmatory factor analyses. Linear regressions indicated that higher SOC-R, but particularly manageability scores were associated with less post-traumatic (ß = -.31, p = .009), depressive (ß = -.44, p < .001), and somatic symptoms (ß = -.36, p = .002). Furthermore, we found that all symptom scores significantly increased with occupational and private-life trauma exposure. The SOC-R's factor structure was replicated, comprising the three subscales manageability, reflection, and balance. However, the SOC-R's convergent factor validity was rather low in the present sample. Taken together, a high sense of coherence, and in particular a high manageability conviction, was observed as resilience factors for high-risk groups that are frequently exposed to potentially traumatic events. Future studies might investigate whether strengthening the sense of coherence could be one building block in an effective prevention program for maintaining long-term health in risk groups.

Debido a que los trabajadores de rescate se enfrentan regularmente con eventos laborales potencialmente traumatizantes, presentan un mayor riesgo de desarrollar trastornos mentales y físicos relacionados con el trauma, incluyendo síntomas postraumáticos, depresivos y somáticos. Para este grupo de alto riesgo sería importante el experimentar su trabajo como manejable, significativo y coherente. Esta perspectiva ­llamada sentido de coherencia­ podría ser un factor potencial de resiliencia en contra del desarrollo de problemas mentales y físicos. En una cohorte transversal con 102 trabajadores de rescate (Mdn(QD)edad = 26.0 (8.5), rango de edad: 18-61), de los cuáles 36 eran mujeres, investigamos si los valores más altos en la Escala del Sentido de Coherencia Revisada (SOC-R) predijeron menos síntomas postraumáticos, depresivos y somáticos. Además, evaluamos la estructura factorial del SOC-R mediante análisis factoriales confirmatorios. Las regresiones lineales indicaron que las puntuaciones más altas del SOC-R, pero particularmente la capacidad de menejabilidad, se asociaron con menos síntomas postraumáticos (ß = −.31, p = .009), depresivos (ß = −.44, p <.001) y somáticos (ß = −.36, p = .002). Además, encontramos que a mayor la exposición con traumas laborales y privados los puntajes de estos síntomas aumentaron significativamente. La estructura factorial del SOC-R se replicó con sus tres subescalas manejabilidad, reflexión y equilibrio. Sin embargo, la validez del factor convergente del SOC-R era menor en la presente muestra. En general, se observó que un alto sentido de coherencia y, en particular una alta manejabilidad, funcionan como factores de resiliencia en grupos de alto riesgo que con frecuencia están expuestos a eventos potencialmente traumáticos. Estudios futuros deberían investigar si el fortalecimiento del sentido de coherencia podría ser un componente básico en un programa de prevención eficaz para mantener la salud a largo plazo en grupos de riesgo.

Personality Traits and Physical Complaints in Patients With Acromegaly: A Cross Sectional Multi-Center Study With Analysis of Influencing Factors.

Objective: Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints. We aimed to investigate in more detail these aspects in acromegalic patients, dependent on influencing factors like disease activity, age, sex, chronic medication, surgery, pituitary radiation, pituitary insufficiency and comorbidities. Design: Cross sectional, multicentric. Methods: 129 patients (M/W 65/64, 58.3 ± 12.7 years, 53/76 with active/controlled disease). Acromegalic patients completed the following inventories: NEO-FFI, IIP-D, and the Giessen Complaints List (GBB-24), after written informed consent. Age, sex, IGF-1 concentrations, comorbidities, treatment modalities and pituitary insufficiency were documented. Results: Acromegalic patients or specific patient-subgroups were more agreeable, neurotic, exploitable/permissive, introverted/socially avoidant, non-assertive/insecure, nurturant and less open to experience, cold/denying, domineering, compared to normal values from the healthy population (controls). Multivariable analysis demonstrated that these overall results were due to the specific patient subgroups as patients on chronic medication, with arthrosis and pituitary insufficiency. Disease activity was only associated with the trait nurturant. Higher scores for introversion were associated with arthrosis. Lower domineering was independent of any disease- or treatment related variable or comorbidity. The GBB inventory showed overall higher scores in patients, with higher scores for exhaustion and general complaints being associated with pituitary insufficiency, coronary heart disease and history of malignancy in the multivariable analysis. Joint complaints were independent of any disease- or treatment- related variable. Conclusions: We define new aspects of a distinct neuropsychological profile in patients with acromegaly, which are largely independent of disease activity. Chronic physical complaints are more pronounced in patients than in controls, with exhaustion and general complaints showing no association with disease activity.

Treatment-related and health-related quality of life in lipoprotein apheresis patients.

BACKGROUND: There is evidence for beneficial effects of lipoprotein apheresis (LA) in terms of reduction of cardiovascular events and interventions, but quality of life (QOL) in LA patients has only been explored in small samples. OBJECTIVE: In this study, both LA- or treatment-related and health-related QOL (HRQOL) were assessed in 206 LA patients. METHODS: Mental and physical HRQOL of the LA patients was assessed by means of the SF-12 as well as the EQ-5D. Physical complaints were assessed by the Patient Health Questionnaire-15 and LA- or treatment-related QOL by the Apheresis Quality of Life Form, developed for this study. RESULTS: Comparison with general population norms showed that LA patients scored significantly lower on HRQOL and significantly higher on physical complaints. A higher perceived impact of the treatment proved to have a significant negative association with HRQOL and a positive one with physical complaints. CONCLUSION: Previous studies reported higher levels of QOL in LA patients. This study showed that treatment-related QOL contributes to HRQOL and physical complaints in LA patients. While many patients do not experience LA as a real burden and report positive effects of the treatment, there is also an important group of patients for whom this is not the case. Although the impact on QOL of LA patients does most probably not outweigh the cardiovascular benefits of the treatment, it is important to screen treatment-related QOL in LA patients to optimize care in a personalized way. Future research is needed to compare QOL in LA with non-LA patients with similar medical conditions.

Exploration of Patient Characteristics and Quality of Life in Patients with Lipoedema Using a Survey.

INTRODUCTION: Lipoedema is a chronic disorder in which excessive fat distribution occurs predominantly from the waist down, resulting in a disproportion between the lower extremities and upper torso. Lipoedema is often not recognized, while patients experience pain and easy bruising. As a long-term condition, lipoedema has a massive effect on patients' lives and mental health. The aim of this study is to explore patient characteristics, quality of life, physical complaints and comorbidities in patients with lipoedema. METHODS: A survey was conducted by email amongst lipoedema patients, consisting of informed consent and multiple questionnaires. The questionnaires included general patient characteristics, physical complaints, comorbidities, RAND-36 and EQ-5D-3L. Participants who responded to a message on the Dutch Lipoedema Association website were recruited. RESULTS: All lipoedema patients experience physical complaints, with pain (88.3 %) and easy bruising (85.9 %) as primary complaints. The diagnosis was mostly made by a dermatologist after visiting a mean of 2.8 doctors. Furthermore, mean time from onset until diagnosis was 18 years. Quality of life (59.3) was significantly lower than the Dutch female average (74.9; p < 0.001). Additionally, patients with comorbidities had significant lower quality of life (RAND 54.7, p < 0.001). CONCLUSIONS: Lipoedema patients often have severe complaints and experience lower quality of life regarding physical, emotional and social functioning. Additionally, comorbidities have a large impact on quality of life.

Physical symptoms in very young children assessed for sexual abuse: a mixed method analysis from the ASAC study.

So far, a recognizable pattern of clinical symptoms for child sexual abuse (CSA), especially in young male children, is lacking. To improve early recognition of CSA, we reviewed physical complaints, physical examination, and tests on sexually transmitted infections (STIs) in confirmed victims (predominantly preschool boys) of CSA from the Amsterdam sexual abuse case (ASAC). We retrospectively analyzed the outcomes of the primary assessment using mixed methods: descriptive analysis of physical complaints, physical exams, and STI tests from medical files and a qualitative analysis on expert's interpretations of physical complaints and children's behavior during physical examination. We included 54 confirmed CSA victims, median age 3.2 (0-6) years, 43 boys (80%), and 11 girls (20%). Physical complaints were reported in 50%, of which gastrointestinal and anogenital complaints were most common. None of the children showed CSA-specific genital signs at physical examination. Most prominent finding during physical examination was a deviant behavioral response (anxiety, withdrawal, too outgoing) in 15 children (28%), especially in children who experienced anal/vaginal penetration. Testing for STIs was negative. CONCLUSION: Physical complaints and physical signs at examinations were non-specific for CSA. Deviant behavioral reactions during physical examination were the most prominent finding. Precise observation of a child's behavior during physical examination is needed. What is known • Child sexual abuse (CSA) affects many children on both the short and the long term but remains unrecognized in most cases. • So far, there is a lack of studies on symptom patterns of CSA in male, preschool children. What is new • None of the children showed CSA-specific findings at physical and anogenital examination; STIs were not found in the confirmed victims of CSA. • The most prominent finding was the deviant behavioral response of the children examined, especially in children who experienced anal/vaginal penetration; therefore, precise observation of a child's behavior during physical examination is a crucial part of the evaluation of suspected CSA.

Age and Gender Differences in Prevalence of Screen Based Behaviour, Physical Activity and Health Complaints among Slovak School-aged Children.

AIM: The aim of this study was to assess age and gender differences in prevalence of screen based behaviour, physical activity and health complaints among Slovak school-aged children. METHODS: Data from the cross-sectional Health Behaviour of School-aged Children study collected in 2010 among Slovak children (age 11-15 years, N=8,042) was used. Logistic regression models adjusted to age and gender were used to analyse the associations between watching TV, working with a computer or playing computer games and physical activity and headache, backache, sleep difficulties, feeling low, irritability, and feeling nervous. RESULTS: Around one-quarter of adolescents is spending more than three hours a day with screen-based activities. While the age was significantly associated with watching TV and computer use, gender was significantly associated only with excessive computer use. As for physical activity only 25% of adolescents reported being physically active every day as recommended, and this number decreases with increasing age. Boys used to be more often active in comparison with girls. A sizeable number of adolescents suffer with selected health complaints every week. Moreover, the prevalence of health complaints increases with age and is significantly higher among girls. CONCLUSIONS: The prevalence of screen-based activities as well as insufficient physical activity and health complaints among adolescents is relatively high and it increases with age. Gender differences are also significant, except for watching TV.

Physical complaints in girls with major depression--a controlled study.

Major depression is a frequent affective disorder in young adolescents. Patients do not only suffer from severe psychological but also from physical impairments. Aim of the present study is a description of physical complaints in girls with major depression. Seventy-three patients fulfilling DSM-IV criteria for major depression were compared to 72 controls. Physical complaints were assessed by a standardised and validated German questionnaire (Giessen Scale of Physical Complaints in Children and Adolescents). Patients reported significantly more complaints, in particular exhaustion and circulation problems. Physical problems are more likely to be a consequence rather than a cause of depression. Treatment of adolescents׳ depression should consider coping with body dysfunction during depressive episodes.

S3 Guideline "Management of Patients with Non-Specific, Functional and Somatoform Physical Complaints" - What is Important for Gynaecological Practice?

When the guideline was compiled, the available evidence was heterogeneous; the evidence varied depending on the subject addressed and was often of only moderate quality. Nevertheless, a strong consensus was reached on almost all subjects. It is recommended that physicians develop a collaborative working relationship with the patient, focus on symptoms and coping strategies and avoid making stigmatising comments. A biopsychosocial diagnostic evaluation with a sensitive discussion of the signs of psychosocial stress allows problems of this type and co-morbid conditions to be recognised early on and reduces the risk of iatrogenic somatisation. In uncomplicated cases, establishing a biopsychosocial explanatory model and physical/social activation are recommended. More serious cases call for collaborative, coordinated management with regular appointments (as opposed to ad-hoc appointments when the patient feels worse), gradual activation and psychotherapy. The comprehensive treatment plan can be multimodal and can potentially include physical management strategies, relaxation techniques and antidepressants.