Development of the Nurses' Occupational Stressor Scale.

Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses' Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses' stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses' work environments. Nine subscales were included: (1) work demands, (2) work-family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach's α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.

A preliminary evaluation of psychological stress amongst workers in Taiwan: a cross-sectional survey.

BACKGROUND: Stress and psychological disorders have been assigned increasing significance in the field of occupational health. Based on Japan's psychiatric disability occupational disease recognition regulation, Taiwan's Council of Labor Affairs announced "Evaluation Guidelines for psychiatric diseases induced by work-related stress" in 2009. This evaluation tool was designed to assess the source and intensity of work-related and non-work-related mental stress, and references existing Japanese guidelines. However, empirical data from workers in various sectors in Taiwan are still required to validate the utility of the guidelines. METHODS: This study recruited 2319 workers from the manufacturing, service, and public administration sectors to participate in a survey between 2010 and 2011. The survey included questions regarding participants' demographic characteristics, job type or attributes, a life event stress intensity evaluation Table (35 work-related and 23 non-work-related items on a scale of 1-10). The Chinese version of the Copenhagen Burnout Inventory (C-CBI) and Chinese Health Questionnaire (CHQ-12) were also included to explore associations between work-related/non-work-related stress and health outcomes. RESULTS: Analyses of survey results showed events relating to employment security (e.g., "company bankruptcy" and "being fired or forced to retire" scores; mean stress intensity scores both 6.18) were the cause of the highest intensity work-related stress. Within different demographic/job type categories, women had higher stress intensity scores for most items than men (greatest difference in "sexual harassment in the workplace" score). Furthermore, executive class workers generally experienced more psychological stress than blue-collar workers (greatest difference in "serious injury or disease due to work" score). Results from regression analysis supported the observation that employees' burnout and work-related stress was more significant than non-work-related stress. Moreover, work-related/non-work-related stress intensity levels both had significant negative predictive effects on mental health. CONCLUSIONS: Regarding policy, this study provides empirical evidence and practical suggestions for establishing a psychological stress intensity database of workers under specific social contexts in a newly industrialized East Asian country. Such a database can be employed to help identify workers with work-related psychological disorders. Additionally, this study also provides a point of reference for enterprises to prioritize agendas when developing employee stress management and support protocols.

Role ambiguity and economic hardship as the moderators of the relation between abusive supervision and job burnout: An Application of uncertainty management theory.

Based on uncertainty management theory (Lind & Van den Bos, 2002; Van den Bos & Lind, 2002), we explored whether uncertainty in the workplace (role ambiguity) as well as off the workplace (economic hardship) moderates the relationship between abusive supervision and subordinates' job burnout. Using survey method, we obtained 458 valid responses from employees in a transportation company in Taiwan. The results of moderated hierarchical regression showed that both role ambiguity and economic hardship induce the positive relationship between abusive supervision and subordinates' job burnout. Abusive supervision related more strongly to job burnout when subordinates perceived higher role ambiguity (higher uncertainty) or higher economic hardship (higher uncertainty). As predicted, high uncertainty increases subordinates' attentions to the injustice from abusive supervision and thus strengthens the negative psychological consequences of abusive supervision, regardless of whether the source of uncertainty corresponds to the source of (in)justice perception.

Long-term psychological outcome of workers after occupational injury: prevalence and risk factors.

INTRODUCTION: This study aimed to examine the prevalence rates of both post-traumatic stress disorder (PTSD) and major depression at 12 months in workers experiencing different types of occupational injury in Taiwan. Demographic and injury-related risk factors for psychological symptoms were also evaluated. METHODS: Our study candidates were injured workers in Taiwan who were hospitalized for 3 days or longer and received hospitalization benefits from the Labor Insurance program. A two-staged survey study was conducted. A self-reported questionnaire including the Brief Symptom Rating Scale and Post-traumatic Symptom Checklist was sent to workers at 12 months after injury. Those who met the criteria were recruited for the second-stage phone interview with a psychiatrist using the Mini-international Neuropsychiatric Interview (MINI). RESULTS: A total of 1,233 workers completed the questionnaire (response rate 28.0 %). Among them, 167 (13.5 %) fulfilled the criteria for the MINI interview and were invited. A total of 106 (63.5 %) completed the phone interview. The estimated rate of either PTSD/PPTSD or major depression was 5.2 %. The risk factors for psychological symptoms were female gender, lower education level, loss of consciousness after occupational injury, injury affecting physical appearance, occupational injury experience before this event, life experience before and after this injury, length of hospital stay, self-rated injury severity, and percentage of income to the family. CONCLUSIONS: These results showed that occupational injury can cause long-term psychological impact in workers. Key demographic and injury characteristics may enhance the identification of at-risk occupational injured workers who would benefit from targeted screening and early intervention efforts.

The impact of psychological symptoms on return to work in workers after occupational injury.

INTRODUCTION: This study aimed to investigate the impact of psychological symptoms on return to work (RTW) in workers after occupational injuries. METHODS: Our study candidates were injured workers who were hospitalized for 3 days or longer and received hospitalization benefits from the Labor Insurance. A self-reported questionnaire including Brief Symptom Rating Scale (BSRS-50) and RTW was sent to workers at 12 weeks after injury. At 1 year, all participants were contacted again to determine whether or not they had RTW. RESULTS: A total of 2001 workers completed the questionnaire (response rate 45.5 %) at 12 weeks after injury, among them, 1,149 had returned to work. Among the 852 who were unable to return to work at 12 weeks after injury, 225 reportedly returned to work by 1 year. A proportional hazards regression indicated that after adjusting for all possible risk factors, higher scores in BSRS-50 and BSRS-5 at 12 weeks after injury were significant risk factors for not return to work (NRTW) at 1 year after injury. Other risk factors were gender, education level, length of hospitalization, affected physical appearance, and injury type. Among 10 psycho-physiological symptoms of BSRS-50, a proportional hazards regression indicated that high score in phobic-anxiety scale was a risk factor for NRTW. CONCLUSIONS: After considering all other factors, psychological symptoms further predicted poorer probability of returning to work after occupational injury, and phobic-anxiety was the most significant symptom predicting poor RTW. Development of preventive measures among injured workers according to the risk factors identified in this study is warranted.

Psychological outcome of injured workers at 3 months after occupational injury requiring hospitalization in Taiwan.

INTRODUCTION: After a traumatic event, a significant proportion of victims develop psychiatric disorders. Trauma has been an important ailment among workers. This study aimed to determine the prevalence of post-traumatic stress disorder (PTSD) and other psychiatric disorders at three months after occupational injuries. METHODS: Our study candidates were injured workers in Taiwan who were hospitalized for 3 days or longer and received hospitalization benefits from the Labor Insurance program. A two-staged survey study was conducted. A self-reported questionnaire including the Brief Symptom Rating Scale (BSRS-50) and Post-traumatic Symptom Checklist (PTSC) was sent to workers at 3 months after injury. Those who met the criteria were recruited for the second stage phone interview with a psychiatrist using the Mini-international Neuropsychiatrie Interview (MINI). RESULTS: A total of 2001 workers completed the questionnaire (response rate 45.5%). Among them, 357 (17.8%) fulfilled the criteria for the MINI interview and were invited. A total of 148 (41.5%) completed the phone interview. The estimated rates of PTSD, partial PTSD (PPTSD), major depression, comorbid PTSD/PPTSD and major depression, and either PTSD/PPTSD or major depression were 2.7, 4.1, 3.0, 2.3, and 7.5%, respectively. The estimated rates of either PTSD/PPTSD or major depression among workers who suffered from intracranial injury, fracture, burn, crushing injury, and open wound of upper limbs were 10.4, 6.9, 5.9, 5.8 and 0%, respectively. CONCLUSIONS: At three months after occupational injuries, a significant proportion of workers suffered from psychiatric disorders. The rates of psychiatric disorders occurring after intracranial injuries were significantly higher than those occurring after non-intracranial injuries.

Psychometric properties of the Chinese version of Copenhagen burnout inventory among employees in two companies in Taiwan.

This study examined the psychometric properties of two selected scales--'personal burnout' and 'work-related burnout'--from the Chinese version of the Copenhagen Burnout Inventory (C-CBI) in 384 employees from two companies in Taiwan. A self-administered questionnaire was used that included the two C-CBI scales, the scales of mental health, vitality and general health from the Short Form 36 (SF-36), perceived level of job stress, job satisfaction, working hours, as well as measures for psychological job demands, job control, work-related social support, and over-commitment to work. Both the C-CBI personal burnout scale and work-related burnout scale had high internal consistency and were correlated well with other health, job characteristics, and perception of work measures;furthermore, exploratory factor analysis extracted two empirical factors. However, the two C-CBI scales were highly correlated in the present population and appeared to measure overlapping concepts. Some comments and suggestions were raised for further improvement.