Night shift work and cardiovascular diseases among employees in Germany: five-year follow-up of the Gutenberg Health Study.

OBJECTIVE: This study aimed to determine if there is an increased risk of incident cardiovascular diseases (CVD) resulting from cumulative night shift work in the German population-based Gutenberg Health Study (GHS). METHODS: We examined working participants of the GHS at baseline and after five years. Cumulative night shift work in the 10 years before baseline was assessed and categorized as low (1-220 nights ≙ up to 1 year), middle (221-660 nights ≙ 1-3 years), and high (>660 nights ≙ more than 3 years) night shift exposure. Hazard ratios (HR) were estimated for incident "quality-assured CVD events" using Cox proportional hazard models. RESULTS: At baseline, 1092 of 8167 working participants performed night shift work. During the follow-up, 202 incident cardiovascular events occurred. The crude incidence rates for CVD per 1000 person-years were 6.88 [95% confidence interval (CI) 4.80-9.55] for night shift workers and 5.19 (95% CI 4.44-6.04) for day workers. Cumulative incidence curves showed a higher cumulative incidence in workers exposed to night shift work compared to day workers after five years. The adjusted HR for incident CVD events were 1.26 (95% CI 0.68-2.33), 1.37 (95% CI 0.74-2.53) and 1.19 (95% CI 0.67-2.12) for employees in the low, middle and high night shift categories compared to employees without night shift work, respectively. CONCLUSIONS: The observed tendencies indicate that night shift work might be negatively associated with cardiovascular health. We expect the continued follow-up will clarify the long-term impact of night shift work.

Burnout, self-rated general health and life satisfaction among teachers and other academic occupational groups.

Introduction: Teachers work in a job with specific demands that can strain individual coping capabilities and can pose a risk for the development of psychological problems. Prior studies showed that teachers - in comparison with other occupational groups - had high risks of job-related psychological exhaustion. In our study we compared teachers and other occupational groups on burnout, general life satisfaction and self-rated general health. In addition, we analyzed if sociodemographic and job-related factors were relevant predictors of these outcomes. Methods: We analyzed data from a total of 1,500 subjects arising from the Gutenberg Health Study. Binary logistic regression models and descriptive statistics were calculated to determine potential differences between the occupational group membership and the predictive values of sociodemographic and job-related variables. Results: The occupational groups did not differ significantly in terms of burnout, self-rated general health and satisfaction with life. Logistic regression models showed which sociodemographic and job-related variables were associated with the outcomes. Female sex, part-time employment as well as work-privacy conflicts showed particular predictive relevance. Discussion: Job-related interventions for teachers should aim at specific strains, e.g., arising out of work-privacy conflicts where interventions should focus on support of female teachers.

Patient satisfaction in anesthesiology: a narrative review.

PURPOSE OF REVIEW: Healthcare is increasingly expanding its view in outcome discussions to integrate patient-reported outcomes such as patient satisfaction. Involving patients in the evaluation of services and the development of quality improvement strategies is paramount, especially in the service-oriented discipline of anaesthesiology. RECENT FINDINGS: Currently, while the development of validated patient satisfaction questionnaires is well established, the use of rigorously tested scores in research and clinical practice is not standardized. Furthermore, most questionnaires are validated for specific settings, which limits our ability to draw relevant conclusions from them, especially considering the rapidly expanding scope of anaesthesia as a discipline and the addition of same-day surgery. SUMMARY: For this manuscript, we review recent literature regarding patient satisfaction in the inpatient and ambulatory anaesthesia setting. We discuss ongoing controversies and briefly digress to consider management and leadership science regarding 'customer satisfaction'.

Patient satisfaction with divided anesthesia care.

BACKGROUND: Up to now, no prospective cohort study using a validated questionnaire has assessed patients' expectation and perception of divided anesthesia care and its influence on patient satisfaction. OBJECTIVE: We assessed patient satisfaction with divided anesthesia care in a district general hospital in Switzerland. We hypothesized that patient expectations, combined with their perceptions of the (un)importance of continuous anesthesia care would influence patient satisfaction. MATERIAL AND METHODS: A total of 484 eligible in-patients receiving anesthesia from October 2019 to February 2020 were included and received preoperative information about divided care via a brochure and face-to-face. The primary outcome was the assessment of patient satisfaction with divided anesthesia care using a validated questionnaire. In group 1 continuity of care was considered important but not performed. In group 2 continuity was ensured. In group 3 continuity was regarded as not important and was not performed. In group 4 patients could not remember or did not answer. A psychometrically developed validated questionnaire was sent to patients at home after discharge. RESULTS: A total of 484 completed questionnaires (response rate 81%) were analyzed. In group 1 (n = 110) the mean total dissatisfaction score was 25% (95% confidence interval [CI] 21.8-28.1), in group 2 (n = 61) 6.8% (95% CI 4.8-8.7), in group 3 (n = 223) 12.1% (95% CI 10.7-13.4), and in group 4 (n = 90) 15% (95% CI 11-18); ANOVA: p < 0.001, η = 0.43. Of the patients 286 (59%) considered continuity of care by the same anesthetist relatively unimportant (34%) or not important at all (25%). The other 40% considered it important (22%) or very important (18%). CONCLUSION: Despite receiving comprehensive preoperative information about divided anesthesia care, 40% of patients still considered continuity of care by the same anesthetist important. We recommend further research evaluating whether and how patient expectations can be modified towards the common practice of divided care and patient satisfaction can be increased.

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.

Assessing the psychosocial work environment in the health care setting: translation and psychometric testing of the French and Italian Copenhagen Psychosocial Questionnaires (COPSOQ) in a large sample of health professionals in Switzerland.

BACKGROUND: Measuring work-related stress in a reliable way is important in the development of appropriate prevention and intervention strategies. Especially in multilingual studies the use of comparable and reliable instruments is crucial. Therefore, the aim of this study was to translate selected scales and single items from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) into French and Italian and psychometrically test them in a sample of health professionals. METHODS: This study used cross-sectional data from health professionals at 163 randomised selected health organisations in Switzerland. Selected COPSOQ items/scales were backwards- and forwards- translated and cross-culturally adapted from German to French and Italian. Reliability was assessed with Cronbach alpha and intraclass correlation coefficients, construct validity with confirmatory factor analysis (CFA) and structural equation modelling as well as comparative fit index. RESULTS: Responses from 12,754 health professionals were included in the analysis. Of the overall 24 scales, 20 in the German version, 19 in the French version and 17 in the Italian version attained sufficient internal consistency with a threshold of 0.7 for Cronbach's alpha. Predominantly high factor loadings on scale level are reported (> 0.35), as well as good and satisfactory fit values with RMSEA below 0.1, SRMR below 0.08 and CFI above 0.95. For 10 out of 15 scales, the test for factor invariance revealed a significant difference regarding the psychological constructs of the scales across the language versions. CONCLUSIONS: The psychometric properties verify the underlying theoretical model of the COPSOQ questionnaire, which is to some extent comparable across the three language versions. Of the 10 scales with significant factor variance, four showed large differences, implying that revision is needed for better comparability. Potential cultural issues as well as regional differences may have led to the factor variance and the different reliability scores per scale across language versions. One known influencing factor for regional differences is culture, which should be considered in scale development. Moreover, emerging topics such as digitization should be considered in further development of the questionnaire.

Determining factors for compensatory movements of the left arm and shoulder in violin playing.

Introduction: Despite a large number of available ergonomic aids and recommendations regarding instrument positioning, violin players at any proficiency level still display a worrying incidence of task-specific complaints of incompletely understood etiology. Compensatory movement patterns of the left upper extremity form an integral part of violin playing. They are highly variable between players but remain understudied despite their relevance for task-specific health problems. Methods: This study investigated individual position effects of the instrument and pre-existing biomechanical factors likely determining the degree of typical compensatory movements in the left upper extremity: (1) left elbow/upper arm adduction ("Reference Angle α", deviation from the vertical axis), (2) shoulder elevation ("Coord x", in mm), and (3) shoulder protraction ("Coord y", in mm). In a group of healthy music students (N = 30, 15 m, 15 f, mean age = 22.5, SD = 2.6), "Reference Angle α" was measured by 3D motion capture analysis. "Coord x" and "Coord y" were assessed and ranked by a synchronized 2D HD video monitoring while performing a pre-defined 16-s tune under laboratory conditions. These three primary outcome variables were compared between four typical, standardized violin positions varying by their sideward orientation ("LatAx-CSP") and/or inclination ("LoAx-HP") by 30°, as well as the players' usual playing position. Selected biomechanical hand parameter data were analyzed as co-factors according to Wagner's Biomechanical Hand Measurement (BHM). Results: Mean "Reference Angle α" decreased significantly from 24.84 ± 2.67 to 18.61 ± 3.12° (p < 0.001), "Coord x" from 22.54 ± 7.417 to 4.75 ± 3.488 mm (p < 0.001), and "Coord y" from 5.66 ± 3.287 to 1.94 ± 1.901) mm (p < 0.001) when increasing LatAx-CSP and LoAx-HP by 30°. Concerning the biomechanical co-factors, "Reference Angle α", "Coord y", but not "Coord x", were found to be significantly increased overall, with decreasing passive supination range (r = -0.307, p = <0.001 for "Passive Supination 250 g/16Ncm", and r = -0.194, p = <0.001 for "Coord y"). Compensatory movements were larger during tune sections requiring high positioning of the left hand and when using the small finger. Discussion: Results may enable to adapt individually suitable instrument positions to minimize strenuous and potentially unhealthy compensation movements of the left upper extremity.

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.

Correction: Work-life conflict and cardiovascular health: 5-year follow-up of the Gutenberg Health Study.

[This corrects the article DOI: 10.1371/journal.pone.0251260.].

Muscle Activation and Subjectively Perceived Effort in Typical Violin Positions.

Violinists display a high incidence of task-specific musculoskeletal problems. Sources pertaining to violin playing and teaching traditions as well as musicians' medicine research offer only imprecise and contradictory recommendations regarding suitable instrument positions. The aim of this study was to add to a growing scientific base for teaching and medical counseling regarding violin positioning. The study evaluated muscle activation (EMG) and subjectively perceived effort (Borg scale) in four standardized typical violin positions, as well as the violinists' normally used one. The hypothesis, the smaller the angle between the instrument's longitudinal axis (LoAx) and the player's central sagittal plane (CSP) and the angle between its lateral axis (LatAx) and the player's horizontal plane (HP), the more muscle activation and perceived effort in the violinist's left arm, was confirmed: Decreasing the LoAx-CSP angle from 50° to 20° and the LatAx-HP angle from 50° to 20° resulted in a highly significant and independent increase of EMG and Borg scale self-ratings mean values. Results may allow for a first step in decision-making on violin positioning for ergonomic adaptations in teaching as well as prevention and therapy of playing-related health problems at all levels of proficiency.

Work-life conflict and cardiovascular health: 5-year follow-up of the Gutenberg Health Study.

INTRODUCTION: Work-life conflicts (WLC) may impact health, but few studies prospectively consider the impact of WLC on objective outcomes such as cardiovascular disease. Using data from the Gutenberg Health Study (GHS), we examined if WLC at baseline was associated with an increased five-year incidence of cardiovascular events (myocardial infarct, stroke, atrial fibrillation, peripheral artery disease, coronary artery disease, chronic heart failure, sudden cardiac death). We also considered if WLC was associated with incident hypertension and arterial stiffness and if the effects of WLC on cardiovascular health differ for men and women. METHODS: A working subsample of the 15,010 GHS cohort participants completed the Copenhagen Psychosocial Questionnaire, which included five "work-privacy conflict" questions at baseline and at the five-year follow-up. Relative risks for incident hypertension due to increased WLC at baseline (WLC scores exceeding 60 out of 100) were estimated with Poisson regression in the subgroup of participants without hypertension at baseline (n = 2426). Categories of WLC at baseline and follow-up were also used to examine the risk of hypertension due to chronic/recurrent WLC. In this subgroup, we also examined the association between WLC as a continuous score ranging from 0 to 100 with change to arterial stiffness after five years using linear regression. Hazard ratios were estimated for incident cardiovascular events in a larger subsample of participants without prevalent cardiovascular disease at baseline (n = 3698) using Cox regression. We used various multivariable regression models to adjust for sex, age, socioeconomic status, occupational, household, and cardiovascular risk factors. RESULTS: We found no association between WLC and incident hypertension or increased arterial stiffness. The fully-adjusted relative risk for WLC >60 at baseline and hypertension was 0.93 (95% 0.74-1.17). The risk of hypertension due to chronic/recurrent WLC >60 was increased but not statistically significant (RR = 1.13, 95% CI 0.83-1.54). Overall, hazard ratios for incident cardiovascular events were also not increased. However, stratifying the results by sex resulted in a hazard ratio of 1.47 (95% CI 0.54-3.98) for incident cardiovascular disease among women in the fully adjusted model. CONCLUSIONS: Although our results were not statistically significant, they indicate that WLC is negatively impacting the cardiovascular health of women. While these results need to be confirmed with additional research and a longer follow-up, interventions to prevent WLC will promote health and could be especially beneficial for women.

Self-reported cardiovascular health of teachers: results from the 5-year follow-up of the Gutenberg Health Study cohort.

OBJECTIVES: Following an exploratory approach, we examined cardiovascular disease risk factors at baseline and the 5-year incidence proportion of self-reported doctor-diagnosed cardiovascular diseases (CVD) in teachers and other occupational groups of the Gutenberg Health Study. METHODS: Study participants lived in the region of Mainz, Germany. Data from 6510 working participants without prevalent CVD at baseline (2007-2012) were analyzed. Participants were teachers (n = 215), other professionals from the health, social or educational (HSE) fields (n = 1061) or worked outside the HSE fields (n = 5234). For occupational comparisons, we estimated prevalence ratios (PR) for each CVD risk factor at baseline with robust Poisson regression analyses. We calculated crude CVD incidence rates based on the observed 5-year CVD cumulative incidence at follow-up and estimated age-weighted incidence proportions. All analyses were stratified by sex. RESULTS: Male non-HSE workers showed a higher prevalence of smoking and physical inactivity than male teachers (PR 2.26; 95%-CI: 1.06-4.82/PR 1.89; 95%-CI: 1.24-2.87). In contrast, non-HSE workers and other HSE professionals were less likely to have reported an unhealthy alcohol intake than teachers. Differences were attenuated after SES-adjustment. We did not detect occupational group-specific differences in CVD incidence. However, there were only two cases of CVD among the teachers. CONCLUSION: Particularly male teachers showed a healthier lifestyle regarding physical inactivity and smoking. Nevertheless, occupational-medical care practitioners and researchers need to be aware of the relatively heightened prevalence of unhealthy alcohol intake in female and male teachers, and in absolute terms, the high hypertension prevalence in male teachers.

Comparing perceived psychosocial working conditions of nurses and physicians in two university hospitals in Germany with other German professionals - feasibility of scale conversion between two versions of the German Copenhagen Psychosocial Questionnaire (COPSOQ).

BACKGROUND: In 2015, the WorkSafeMed study assessed, amongst others, perceived psychosocial working conditions in nurses (n = 567) and physicians (n = 381) from two German university hospitals using scales from the German standard version of the COPSOQ (Copenhagen Psychosocial Questionnaire). This standard version is based on the international COPSOQ I and II. Since 2017, a further developed version of the German COPSOQ (G-COPSOQ III) has been available and data from this version are stored in the German COPSOQ database. The aim of the present study was to compare scales depicting perceived psychosocial workloads and strain in hospital staff from the WorkSafeMed study with reference data (hospital care nurses, general hospital physicians, reference values across all occupations) from the German COPSOQ database (2012-2017). As preliminary work, we explored whether a conversion of COPSOQ scales based on data from the WorkSafeMed study to the G-COPSOQ III scales was possible. METHODS: We applied a multistep approach for conversion. First, we compared 17 COPSOQ scales used in the WorkSafeMed study with the corresponding scales from the G-COPSOQ III according to content and then decided if a conversion was appropriate. If possible, we converted WorkSafeMed scales - the converted scales comprised the same content and number of items as in G-COPSOQ III. An explorative statistical analysis for each original and converted WorkSafeMed scale followed detecting possible statistical and relevant differences between the scales. We then compared converted WorkSafeMed scales with reference data from the German COPSOQ database. RESULTS: Based on the comparison undertaken according to content, a conversion was possible for 16 scales. Using the data from the WorkSafeMed study, the statistical analysis showed only differences between original and converted COPSOQ scales "control over working time" (mean 40.2 vs. 51.8, dCohen = 0.56) and "social relations" (mean 55.6 vs. 41.8, dCohen = - 0.55). Comparing converted WorkSafeMed scales with reference data revealed higher values for "quantitative demands", "work-privacy-conflict", and "job satisfaction" in the WorkSafeMed sample. CONCLUSIONS: The conversion of WorkSafeMed scales was appropriate, allowed a comparison with three reference values in the German COPSOQ database and revealed some implications for improving psychosocial working conditions of nurses and physicians in university hospitals in Germany.

Cardiovascular health outcomes of mobbing at work: results of the population-based, five-year follow-up of the Gutenberg health study.

BACKGROUND: The aim of this study was to determine if there is an increased risk of incident cardiovascular disease (CVD) resulting from workplace mobbing measured with two mobbing instruments in the Gutenberg Health Study. METHODS: In this prospective study, we examined working persons younger than 65 years for the presence of mobbing at baseline and at a 5-year follow-up using a single-item and a 5-item instrument. We used multivariate models to investigate the association between mobbing and incident CVD, hypertension, and change in arterial stiffness and further stratified the models by sex. RESULTS: After adjustment for confounders, mobbed workers appeared to have a higher risk of incident CVD than those not mobbed (single-item HR = 1.28, 95% CI 0.73-2.24; 5-item HR = 1.57, 95% CI 0.96-2.54). With the 5-item instrument, men who reported mobbing had a higher risk of incident CVD (HR = 1.77, 95% CI 1.01-3.09), while no association was observed for women (HR = 1.05, 95% CI 0.38-2.91). There was no difference in risks between men and women with the single-item instrument. No association between mobbing and incident hypertension and arterial stiffness was seen. CONCLUSIONS: Our results show an indication of an increased risk of incident CVD for those mobbed at baseline when using the whole study population. Differences in risks between men and women when using the five-item instrument may be due to the instrument itself. Still, it is essential to detect or prevent workplace mobbing, and if present, to apply an intervention to halt it in order to minimize its adverse effects on CVD.

Malay Validation of Copenhagen Psychosocial Work Environment Questionnaire in Context of Second Generation Statistical Techniques.

Psychosocial hazards present in workplaces are being actively investigated by researchers from multiple domains. More research and resources are required to investigate the debilitating consequences of these hazards in the developing and underdeveloped countries where this issue remains one of grave concern. This study aims at investigating the psychometric properties of Malaysian version of Copenhagen Psychosocial Questionnaire for reliability and validity purpose. The Malaysian version of COPSOQ is a multidimensional questionnaire; it comprises of 7 major formative constructs and 28 variables with an additional inclusion of two variables which are organizational loyalty and physiological health biomarkers (blood pressure and body mass index) that explicate a reflective construct which has 93 items all catering to assess psychosocial determinants present in workplace environments. Each formative second-order construct is further categorized into different reflective first-order constructs. The focus of this study was only on first-order reflective constructs. Probability sampling was used for data collection from 300 respondents working in industries with a response rate of 100%; structural equation modeling technique was applied for data analysis. All psychometric analysis performed on reflective constructs gave reliable results which demonstrate the validity of Bahasa Melayu (BM-COPSOQ) and its comprehensiveness of including relevant dimensions particularly in context to Asian region. The BM-COPSOQ will fill up the knowledge gap and provide a bridge between researchers, work professionals and practitioners, and many other workplaces for the best understanding of psychosocial work environment.

Connotations of psychological and physiological health in the psychosocial work environment: An industrial context.

BACKGROUND: Psychological conditions are experiences of the conscious and unconscious elements of the work context, which revolve around workers' perceptions of feeling either engaged or disengaged with the assigned tasks. In the psychosocial work environment of hazardous industries like petrochemicals where production lasts twenty-four hours a day and continues seven-days-a-week, a psychologically available worker is extremely important. Psychological availability refers to when workers who are physically, emotionally and psychologically engaged at the moment of performing tasks. OBJECTIVE: The broad objective of this study was to investigate the direct and indirect effects of behavioral factors on the psychological and physiological health of workers. METHODS: The latest, second generation technique, which is structural equation modeling, is used to identify the relationships between behavioral antecedents and health outcomes. A total of 277 technical workers participated, aged between 20 and 49 and were healthy in all aspects. RESULTS: The study results showed quantitative demands, emotional demands, work-family conflict, and job insecurity were significantly associated with both psychological (stress) and physiological (Body Mass Index) factors. The social support of colleagues produced mixed findings with direct and indirect paths. Stress also significantly mediates the psychosocial factors and burnout of the workers. CONCLUSION: The study concluded that workers were physically available, but they experienced distractions as members of social systems, affecting their physiological and psychological health.

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.

Does Psychosocial Work Environment Factors Predict Stress and Mean Arterial Pressure in the Malaysian Industry Workers?

Psychosocial risks are considered as a burning issue in the Asia-Pacific region. The aim of this study was to investigate the impact of psychosocial work environment factors on health of petrochemical industry workers of Malaysia. In lieu to job demands-resources theory, significant positive associations were found between quantitative demands, work-family conflict, and job insecurity with stress, while a significant negative association of role clarity as a resource factor with stress was detected. We also found that quantitative demands were significantly associated with the mean arterial pressure (MAP). Multistage sampling procedure was used to collect study sample. Structural Equation Modeling was used to identify relationship between the endogenous and exogenous variables. Finally, the empirically tested psychosocial work environment model will further help in providing a better risk assessment in different industries and enterprises.

The Portuguese long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) - a validation study.

BACKGROUND: Psychosocial risks are now widely recognised as one of the biggest challenges for occupational safety and health (OSH) and a major public health concern. The aim of this paper is to investigate the Portuguese long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II), in order to analyse the psychometric properties of the instrument and to validate it. METHODS: The Portuguese COPSOQ II was issued to a total of 745 Portuguese employees from both private and public organisations across several economic sectors at a baseline and then 2 weeks later. Methodological quality appraisal was based on COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations. An analysis of the psychometric properties of the long version of COPSOQ II (internal consistency, intraclass correlation coefficient, floor and ceiling effects, response rate, missing values, mean and standard deviation, exploratory factor analysis) was performed to determine the validity and reliability of the instrument. RESULTS: The COPSOQ II had a response rate of 60.6% (test) and a follow-up response rate of 59.5% (retest). In general, a Cronbach's alpha of the COPSOQ scales (test and retest) was above the conventional threshold of 0.70. The test-retest reliability estimated by the intraclass correlation coefficient (ICC) showed a higher reliability for most of the scales, above the conventional 0.7, except for eight scales. The proportion of the missing values was less than 1.3%, except for two scales. The average scores and standard deviations showed similar results to the original Danish study, except for eight scales. All of the scales had low floor and ceiling effects, with one exception. Overall, the exploratory factor analysis presented good results in 27 scales assuming a reflective measurement model. The hypothesized factor structure under a reflective model was not supported in 14 scales and for some but not all of these scales the explanation may be a formative measurement model. CONCLUSION: The Portuguese long version of COPSOQ II is a reliable and valid instrument for assessing psychosocial risks in the workplace. Although the results are good for most of the scales, there are those that should be evaluated in greater depth in future studies. This instrument may contribute to the promotion of a healthy working environment and workforce, providing clear benefits for companies and employees.