How do employees currently admitted to acute psychiatric inpatient units rate their psychosocial working conditions with the COPSOQ (Copenhagen Psychosocial Questionnaire).

BACKGROUND: In recent years it could be shown that psychosocial working conditions and mental health of employees are closely correlated. One well-established instrument to measure psychosocial stress at work is the COPSOQ (Copenhagen Psychosocial Questionnaire, German Standard Version). It is an 84 item self-rating instrument addressing several domains of psychosocial working conditions and is generally used for risk assessments in companies. AIMS: To examine associations between COPSOQ ratings with clinical features and symptoms of employees who currently suffer from an episode of a mental illness requiring inpatient treatment. METHOD: For 265 inpatients with mental disorders who participated in a cluster randomized trial (RETURN-study) COPSOQ-data were available as part of the baseline data acquisition. These data were compared with the German COPSOQ validation sample of the Freiburg research center for occupational sciences (FFAW; approximately 250,000 participants). For subdomains of the COPSOQ that showed major and significant differences between the two samples regression analyses were done to predict COPSOQ scores within the RETURN-sample. RESULTS: Psychiatric inpatients did not assess their working conditions significantly different compared to the population based FFAW sample. However, with regard to the effects of working conditions (general health, burnout, presenteeism, and intention to leave the job) there were major differences between the two samples with the clinical sample expressing more negative views. In the RETURN sample these were predicted by a greater expression of depressive symptoms. CONCLUSIONS: The linkage between work and mental wellbeing is complex. Mental illness is not necessarily a result of poor working conditions, while good working conditions may not in every case prevent symptoms of bad health, even if such associations exist.

Psychosocial burden in nurses working in nursing homes during the Covid-19 pandemic: a cross-sectional study with quantitative and qualitative data.

BACKGROUND: The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. METHODS: We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch's t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). RESULTS: Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales 'quantitative demands', 'hiding emotions', 'work-privacy conflicts', 'role conflicts', 'quality of leadership', 'support at work', 'recognition', 'physical demands', 'intention to leave profession', 'burnout', 'presenteeism' and 'inability to relax'. The interviews (n = 15) revealed six main themes related to nurses' psychosocial stress: 'overall working conditions', 'concern for residents', 'management of relatives', 'inability to provide terminal care', 'tensions between being infected and infecting others' and 'technicisation of care'. 'Enhanced community cohesion' (interviews), 'meaning of work' and 'quantity of social relations' (COPSOQ III) were identified as positive effects of the pandemic. CONCLUSIONS: Results clearly illustrate an aggravation of geriatric nurses' situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses' strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.

The Gutenberg health study: a five-year prospective analysis of psychosocial working conditions using COPSOQ (Copenhagen psychosocial Questoinnaire) and ERI (effort-reward imbalance).

BACKGROUND: Psychosocial working conditions were previously analyzed using the first recruitment wave of the Gutenberg Health Study (GHS) cohort (n = 5000). We aimed to confirm the initial analysis using the entire GHS population at baseline (N = 15,010) and at the five-year follow-up. We also aimed to determine the effects of psychosocial working conditions at baseline on self-rated outcomes measured at follow-up. METHODS: At baseline, working GHS participants were assessed with either the Effort-Reward-Imbalance questionnaire (ERI) (n = 4358) or with the Copenhagen Psychosocial Questionnaire (COPSOQ) (n = 4322); participants still working after five years received the same questionnaire again (ERI n = 3142; COPSOQ n = 3091). We analyzed the association between working conditions and the outcomes job satisfaction, general health, burnout, and satisfaction with life at baseline, at follow-up and also prospectively from baseline to follow-up using linear regression models. We examined the outcome variance explained by the models (R2) to estimate the predictive performance of the questionnaires. RESULTS: The models' R2 was comparable to the original baseline analyses at both t0 and t1 (R2 range: ERI 0.10-0.43; COPSOQ 0.10-0.56). However, selected scales of the regression models sometimes changed between assessment times. The prospective analysis showed weaker associations between baseline working conditions and outcomes after five years (R2 range: ERI 0.07-0.19; COPSOQ 0.07-0.24). This was particularly true for job satisfaction. After adjusting for the baseline levels of the outcomes, fewer scales still explained some of the variance in the distribution of the outcome variables at follow-up. The models using only data from t0 or t1 confirmed the previous baseline analysis. We observed a loss of explained variance in the prospective analysis models. This loss was greatest for job satisfaction, suggesting that this outcome is most influenced by short-term working conditions. CONCLUSIONS: Both the COPSOQ and ERI instruments show good criterion validity and adequately predict contemporaneously measured self-reported measurements of health and (occupational) well-being. However, the COPSOQ provides a more detailed picture of working conditions and might be preferable for improvment strategies in workplaces. Additional prospective research with shorter follow-up times would be beneficial for estimating dose-response relationships.

COPSOQ III in Germany: validation of a standard instrument to measure psychosocial factors at work.

BACKGROUND: Over the last almost 20 years COPSOQ (Copenhagen Psychosocial Questionnaire) has become a well-established instrument to measure psychosocial stress at work. In Germany, a first validated version of COPSOQ was introduced in 2005. After the COPSOQ international network took over responsibility for the development of COPSOQ, a new version was published in 2019 (COPSOQ III). The German version of this questionnaire is now to be validated. METHODS: Measurement qualities of German COPSOQ III are explored in adherence to the to the usual requirements of a validation study as defined by DIN EN ISO 10075-3. A sample of observations from more than 250,000 participants surveyed with the COPSOQ in Germany is used for univariate and multivariate statistical analysis. RESULTS: With its 84 items the German COPSOQ III includes all psychosocial work factors that are internationally obligatory and is still compatible with almost 70% of the content in the 2005 German version. Typical psychometric properties of the questionnaire (e. g., validity and reliability) are either good or very good for most of the 84 items and 31 scales. Beyond basic results, congruences with widely used theoretical approaches like the Demand-Control(-Support) model or the Job Demands-Resources model are generally satisfactory. CONCLUSIONS: With the launch of COPSOQ III in Germany, new workplace psychosocial aspects could be explored. Like the preceding version, the questionnaire is a highly useful instrument for research as well as for risk assessment in enterprises. COSPQO III covers a multitude of theoretical approaches and gives comprehensive information on psychosocial working conditions to deduce actions for their improvement.

The Third Version of the Copenhagen Psychosocial Questionnaire.

INTRODUCTION: A new third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) has been developed in response to trends in working life, theoretical concepts, and international experience. A key component of the COPSOQ III is a defined set of mandatory core items to be included in national short, middle, and long versions of the questionnaire. The aim of the present article is to present and test the reliability of the new international middle version of the COPSOQ III. METHODS: The questionnaire was tested among 23,361 employees during 2016-2017 in Canada, Spain, France, Germany, Sweden, and Turkey. A total of 26 dimensions (measured through scales or single items) of the middle version and two from the long version were tested. Psychometric properties of the dimensions were assessed regarding reliability (Cronbach α), ceiling and floor effects (fractions with extreme answers), and distinctiveness (correlations with other dimensions). RESULTS: Most international middle dimensions had satisfactory reliability in most countries, though some ceiling and floor effects were present. Dimensions with missing values were rare. Most dimensions had low to medium intercorrelations. CONCLUSIONS: The COPSOQ III offers reliable and distinct measures of a wide range of psychosocial dimensions of modern working life in different countries; although a few measures could be improved. Future testing should focus on validation of the COPSOQ items and dimensions using both qualitative and quantitative approaches. Such investigations would enhance the basis for recommendations using the COPSOQ III.

Preferences for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD): a discrete choice experiment.

BACKGROUND: While there is an increasing emphasis on patient empowerment and shared decision-making, subjective values for attributes associated with their treatment still need to be measured and considered. This contribution seeks to define properties of an ideal drug treatment of individuals concerned with Attention-Deficit/Hyperactivity Disorder (ADHD). Because of the lack of information on patient needs in the decision-makers assessment of health services, the individuals' preferences often play a subordinate role at present. Discrete Choice Experiments offer strategies for eliciting subjective values and making them accessible for physicians and other health care professionals. METHODS: The evidence comes from a Discrete Choice Experiments (DCE) performed in 2007. After reviewing the literature about preferences of ADHS we conducted a qualitative study with four focus groups consisting of five to eleven ADHS-patients each. In order to achieve content validity, we aimed at collecting all relevant factors for an ideal ADHS treatment. In a subsequent quantitative study phase (n = 219), data was collected in an online or paper-pencil self-completed questionnaire. It included sociodemographic data, health status and patients' preferences of therapy characteristics using direct measurement (23 items on a five-point Likert-scale) as well as a Discrete-Choice-Experiment (DCE, six factors in a fold-over design). RESULTS: Those concerned were capable of clearly defining success criteria and expectations. In the direct assessment and the DCE, respondents attached special significance to the improvement of their social situation and emotional state (relative importance 40%). Another essential factor was the desire for drugs with a long-lasting effect over the day (relative importance 18%). Other criteria, such as flexibility and discretion, were less important to the respondents (6% and 9%, respectively). CONCLUSION: Results point out that ADHD patients and their family members have clear ideas of their needs. This is especially important against the backdrop of present discussions in the healthcare sector on the relevance of patient reported outcomes (PROs) and shared decision-making. The combination of the methods used in this study offer promising strategies to elicit subjective values and making them accessible for health care professionals in a manner that drives health choices.

Evaluating patients' preferences for multiple myeloma therapy, a Discrete-Choice-Experiment.

BACKGROUND: While there is an increasing emphasis on patient empowerment and shared decision making, patients' preferences for attributes associated with their treatment still need to be measured and considered. In the present study, patients' preferences regarding treatment of multiple myeloma (MM) were explored using direct assessment and a Discrete-Choice-Experiment (DCE). PATIENTS AND METHODS: After reviewing the literature about preferences of myeloma patients we conducted a qualitative study with three focus groups consisting of six to eight MM-patients each. In order to achieve content validity, we aimed at collecting all relevant factors for an ideal MM-treatment. In a subsequent quantitative study phase, data was collected in an online or paper-pencil self-completed questionnaire. It included sociodemographic data, self-rated health (SF12v2 variation) and patients preferences of therapy characteristics using direct measurement (16 items on a five-point Likert-scale) as well as a Discrete-Choice-Experiment (DCE, eight pairs with eight characteristics). RESULTS: 282 patients answered the questionnaire; 46% female, age: mean 62 yrs (SD=10 years), duration of MM: 5 yrs (SD=3.8 years). Direct measurement showed effectiveness aspects (i.e. high effectiveness, long lasting effects, max. prolonged life expectancy) and further treatment options in the first places, followed by maximal prolonged life expectancy, minor side effects and therapy-free-intervals. In the DCE, alternatives with further treatment options, longer life expectancy, "not always think of the disease" and therapy-free-intervals were more likely to be chosen, giving thus similar results. CONCLUSION: Besides prolongation of life expectancy and effectiveness of treatment, further treatment options are of foremost importance to multiple myeloma patients. In addition, therapy-free intervals as well as an improved emotional quality of life ("Not always think of the disease") are valued as very important. The combination of direct assessment of importance and DCE is a valid combined survey technique for eliciting preferences of patients with multiple myeloma. The former ensures content validity (the possibility to measure a longer list of potentially important aspects), the latter has the advantage to combine positive and negative therapy characteristics and to avoid the problem of ceiling effects and "all-is-important" results.