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2.
Gac. sanit. (Barc., Ed. impr.) ; 33(3): 235-241, mayo-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-183742

RESUMO

Objective: To document the prevalence of poor mental health by gender and social class, and to analyze if poor mental health is associated with the family roles or the employment status inside and outside the household. Method: A cross-sectional study based on a representative sample of the Spanish population was carried out (n = 14,247). Mental health was evaluated using GHQ-12. Employment status, marital status, family roles (main breadwinner and the person who mainly carries out the household work) and educational level were considered as explanatory variables. Multiple logistic regression models stratified by gender and social class were fitted and adjusted odds ratios (aOR) were obtained. Results: Gender and social class differences in the prevalence of poor mental health were observed. Unemployment was associated with higher prevalence. Among men the main breadwinner role was related to poor mental health mainly in those that belong to manual classes (aOR = 1.2). Among women, mainly among nonmanual classes, these problems were associated to marital status: widowed, separated or divorced (aOR = 1.9) and to dealing with the household work by themselves (aOR = 1.9). Conclusions: In Spain, gender and social class differences in mental health still exist. In addition, family roles and working situation, both inside and outside the household, could constitute a source of inequalities in mental health


Objetivo: Conocer la prevalencia de mala salud mental por sexo y clase social, y analizar si la salud mental se relaciona con los roles familiares y la situación laboral fuera y dentro del hogar. Método: Se realizó un diseño transversal basado en una muestra representativa de la población española (n = 14.247). La salud mental se evaluó mediante el GHQ-12. Se consideraron como variables explicativas la situación laboral, el estado civil, el rol familiar (sustentador principal y persona que realiza el trabajo doméstico) y el nivel de estudios. Se ajustaron modelos de regresión logística estratificados por sexo y se obtuvieron las odds ratio ajustadas (ORa). Resultados: Se observaron diferencias en la prevalencia de mala salud mental por sexo y clase social. El desempleo se asoció con mayor prevalencia. En hombres pertenecientes a clases menos favorecidas, el rol de sustentador principal se relacionó con mala salud mental (Ora = 1,2) En mujeres que pertenecían a clases más favorecidas, el estado civil viuda, separada o divorciada (ORa = 1,9) y realizar el trabajo doméstico solas (ORa = 1,9) se relacionaron con mala salud mental. Conclusiones: En España, en salud mental continúa habiendo diferencias de sexo y clase social. Además, el rol familiar y la situación laboral fuera y dentro del ámbito doméstico podrían constituir también una fuente de desigualdad en salud mental


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Transtornos Mentais/epidemiologia , Relações Trabalhistas , Descrição de Cargo , Competência Mental/classificação , Entrevista Psiquiátrica Padronizada/estatística & dados numéricos , Equilíbrio Trabalho-Vida/tendências , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Relações Familiares , Estudos Transversais , Distribuição por Sexo , Fatores Socioeconômicos , Disparidades nos Níveis de Saúde , Fatores de Risco , Inquéritos Epidemiológicos/estatística & dados numéricos , Espanha/epidemiologia
3.
BMC Public Health ; 19(1): 485, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046740

RESUMO

BACKGROUND: Although it is well known that employment conditions exert considerable effects on health and health equity, the association between employment conditions and the use of preventative health services has rarely been studied. We explored whether inequities in the use of preventative services were associated with employment conditions. We used gastric cancer screening as a surrogate for the use of preventative health services. METHODS: The study population was derived from the Korea National Health and Nutrition Survey IV (2007-2009), which included data on 5626 individuals over 40 years of age. Employment conditions were grouped by employment status, work hours, employment contract term, and salary source. Participants who had undergone gastroscopy or an upper gastrointestinal series within the past 2 years were considered to have used cancer screening services according to the National Cancer Screening Program guidelines. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression analysis. As the survey procedure incorporated sample weights, we adjusted our calculations to consider the complex sample design. RESULTS: Self-employed workers were less likely to participate in regular cancer screening than were wage workers (OR = 0.79, 95% CI = 0.68-0.92), and part-time workers were less likely to participate than were full-time workers (OR = 0.81, 95% CI = 0.67-0.99). Among wage workers, temporary workers and daily workers exhibited lower participation rates than did regular workers (OR = 0.81, 95% CI = 0.63-1.05 and OR = 0.58, 95% CI = 0.44-0.76, respectively). Dispatched workers also exhibited lower participation rates (OR = 0.45, 95% CI = 0.25-0.80). CONCLUSIONS: We found obvious inequities in the use of preventative health services associated with various employment conditions. Self-employed, irregular, and dispatched workers were significantly less likely to participate in cancer screening than were other workers. Political efforts should be made to reduce employment insecurity and to improve participation in preventative screening services by vulnerable employees so as to resolve the evident health inequities.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Emprego/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Neoplasias Gástricas/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , República da Coreia , Neoplasias Gástricas/epidemiologia , Inquéritos e Questionários , Local de Trabalho
4.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 828-835, abr.-maio 2019. il
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-987274

RESUMO

Objective: The study's purpose has been to further understand the health promotion strategies towards nursing professionals. Methods: It is an integrative literature review with a qualitative approach, which is composed of 23 articles that answer the following guiding question: What are the health promotion strategies developed for nursing professionals? Results: The findings were gathered into four strategy groups, as follows: Promoting the Work Planning, which are based on regulating the workload and salary relationship; Promoting Knowledge, which are focused on the professional update through the use of technologies; Promoting Physical Activity, aiming to guarantee the access to physical exercise, both intra and extra the work environment; and, Promoting Integrative and Complementary Practices, indicating music therapy, relaxation techniques and yoga, which together with the other ones might contribute to reduce work stress, musculoskeletal and cardiovascular problems. Conclusion: The work planning can be considered the main strategy of health promotion for nursing professionals, since it is associated with the development of the others


Objetivo: Conhecer as estratégias de promoção à saúde para os trabalhadores de enfermagem. Método: Revisão integrativa composta por 23 artigos que respondem a questão norteadora: Quais as estratégias de promoção à saúde, desenvolvidas para os trabalhadores de enfermagem? Aplicou-se uma abordagem qualitativa. Resultados: As estratégias para Promoção da Organização do Trabalho pautam-se na regulação da relação carga de trabalho e salário. As do Conhecimento, na atualização profissional com uso de tecnologias. Já as da Atividade Física, na garantia do acesso ao exercício físico, intra e extra, ambiente de trabalho. As de Promoção de Práticas Integrativas e Complementares indica a musicoterapia, as técnicas de relaxamento e yoga, que em conjunto com as demais, contribuem para reduzir o estresse laboral e problemas musculoesqueléticos e cardiovasculares. Conclusão: A organização do trabalho pode ser considerada a principal estratégia de promoção à saúde para trabalhadores de enfermagem, pois a ela associa-se o desenvolvimento das demais


Objetivo: Conecer las estrategias de promoción a la salud para los trabajadores de enfermería. Método: Revisión integrativa compuesta por 23 artículos que responden a la cuestión orientadora: ¿Cuáles son las estrategias de promoción a la salud, desarrolladas para los trabajadores de enfermería? Se aplicó un enfoque cualitativo. Resultados: Las estrategias para Promoción de la Organización del Trabajo se basan en la regulación de la relación carga de trabajo y salario. Las del Conocimiento, en la actualización profesional con uso de tecnologías. Las de la Actividad Física, en la garantía del acceso al ejercicio físico, intra y extra, ambiente de trabajo. Las de Promoción de Prácticas Integrativas y Complementarias indica la musicoterapia, las técnicas de relajación y yoga, que en conjunto con las demás, contribuyen para reducir el estrés laboral y problemas musculoesqueléticos y cardiovasculares. Conclusión: La organización del trabajo puede ser considerada la principal estrategia de promoción a la salud para trabajadores de enfermería, pues a ella se asocia el desarrollo de las demás


Assuntos
Humanos , Masculino , Feminino , Serviços de Saúde do Trabalhador/métodos , Serviços de Saúde do Trabalhador/tendências , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Terapias Complementares/estatística & dados numéricos , Saúde do Trabalhador , Promoção da Saúde
5.
BMC Health Serv Res ; 19(1): 130, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30791905

RESUMO

BACKGROUND: Health risk assessment (HRAs) are commonly used by occupational health services (OHS) to aid workplaces in keeping their employees healthy, but for unknown reasons, many employees choose not to participate in the HRAs. The aim of the study was to explore whether demographic, lifestyle and health-related factors in employees are associated with non-participation in initial and repeated HRAs. METHODS: In an OHS-based health project, 2022 municipal employees were asked to participate in three repeated HRAs. Multiple logistic regression analyses were used so as to determine associations between non-participating and demographic, lifestyle and health-related factors (e.g. biomarkers). RESULTS: Among the employees who were asked to participate in the health project, more than half did not participate in any HRA and among those who did, more than one third did not participate in repeated HRAs. Young age, male sex and being employed in the Technical department or Health and Social Care department in comparison with being employed in the department for Childcare and Education were factors significantly associated with non-participation in the initial HRA. These factors, together with being on sick leave and having unhealthy dietary habits, were factors associated with non-participation in repeated HRAs. CONCLUSIONS: Among the non-participators in initial HRAs and in repeated HRAs younger men and those already related to ill-health were overrepresented. This implicates that health care providers to a higher extent should focus on "those most needed" and that employers should be more engaged in results of repeated HRA's. Future studies should focus on modifiable variables that could make the HRAs more attractive and inclusive.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde , Indicadores Básicos de Saúde , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , Engajamento no Trabalho , Adulto , Idoso , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
Clin Obes ; 9(1): e12284, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30248246

RESUMO

The aim of this study is to examine factors associated with long-term retention in a commercial weight-loss programme. We conducted a retrospective analysis of an employer-based, commercial programme from 2013 to 2016. Our dependent variable was 'long-term retention', defined as continuously enrolled participants who actively engaged through coach calls at 6 and 12 months. Independent variables included baseline demographics, programme engagement and weight change. We conducted multivariate logistic regression analyses assessing for differences in long-term retention by several factors, adjusted for employer clustering. Overall, 68.3% were retained at 6% and 45.9% at 12 months. Greater number of coach calls and website logins during the first 3 months significantly increased the odds of long-term retention, while having chronic conditions significantly decreased the odds. Weight-loss success (≥5% loss at 6 months) was significantly associated with increased odds of retention (12-month: odds ratio [OR] 2.80, P < 0.001), while early weight-loss failure (≥0% weight change at 1 month) significantly decreased odds of retention (12-month: OR 0.66, P = 0.008). In an employer-based, commercial weight loss programme, greater early programme engagement was associated with long-term retention. Given these programmes' popularity and potential reach, our results could be used to develop and test strategies designed to improve retention in commercial weight-loss programmes.


Assuntos
Serviços de Saúde do Trabalhador/estatística & dados numéricos , Retenção nos Cuidados/estatística & dados numéricos , Programas de Redução de Peso/estatística & dados numéricos , Adulto , Índice de Massa Corporal , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade , Razão de Chances , Estudos Retrospectivos , Fumar , Perda de Peso , Programas de Redução de Peso/métodos
7.
Int J Occup Med Environ Health ; 32(3): 353-361, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-30356227

RESUMO

OBJECTIVES: In the contemporary Western culture, working population health issues, stressed in various publications, have been perceived as a crucial part of public health. To deal with occupational health issues properly, occupational health services (OHS), aiming at the protection of the workers' health, are organized in many countries. The survey was to find the differences in occupational health systems that the European Economic Area countries use in order to execute prophylactic activities focused on diseases of affluence and how the OHS are used for health promotion actions. MATERIAL AND METHODS: The survey was conducted with the use of an on-line expert questionnaire. No deep statistical analysis was performed as for the designed aims of the study simple statistics were sufficient. RESULTS: All the reviewed countries have organized OHS. The funding mechanisms are based mainly on the financial involvement of employers. In the majority of countries, the main goal of the OHS is certification of the ability to work. Workplace surveillance aiming at the occupational risk assessment and health promotion activities that focus on work-related and/or occupational diseases are the most popular services provided within national systems. CONCLUSIONS: Occupational health professionals are well placed to perform actions directed at health promotion and prophylactics of a wide range of diseases - not only occupational/work-related, but also non-communicable, particularly life-style-related diseases of affluence. The engagement of the occupational medical services (OMS) in prevention of the non-work-related health issues would be valuable. However, it would be inevitable for employers to finance a wider range of services to a greater extent. Int J Occup Med Environ Health. 2019;32(3):353-61.


Assuntos
Promoção da Saúde/organização & administração , Doenças Profissionais/prevenção & controle , Serviços de Saúde do Trabalhador/estatística & dados numéricos , União Europeia , Política de Saúde , Humanos , Estilo de Vida , Saúde do Trabalhador/estatística & dados numéricos , Serviços de Saúde do Trabalhador/economia , Serviços de Saúde do Trabalhador/organização & administração , Inquéritos e Questionários , Local de Trabalho
8.
Scand J Public Health ; 47(1): 28-36, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29806549

RESUMO

AIMS: This study characterizes frequent attenders in primary care provided by occupational health services (OHS) in Finland. METHODS: This is a nationwide cross-sectional study using medical record data from an OHS provider in 2015. Frequent attenders were defined as persons who were within the top decile of annual visits to healthcare professionals (frequent attender 10%, FA10) at any of the OHS's 37 stations. FA10s within this study consulted the OHS primary care unit eight or more times during 2015. We used logistic regression to analyse factors associated with frequent attendance in OHS primary care. The independent variables were age, gender, employer size and industry, health professionals visited and diagnoses given during visits to the OHS. The dependent variable was belonging to the FA10 group. RESULTS: Altogether 31,960 patients met the inclusion criteria and were included in the study. The FA10 group included 3617 patients, who conducted 36% of visits to healthcare professionals. The findings indicate that working within the manufacturing industry, health and social services, or public administration, and being employed in medium or large companies, are associated with frequent attendance. Frequent attendance was also associated with being female, diagnoses of the musculoskeletal system, or mental and behavioral disorders. In particular, depressive episodes and anxiety were associated with FA10s. CONCLUSIONS: This research characterized FA10 clients at a Finnish OHS. Illnesses of the musculoskeletal system and mental and behavioral disorders were accentuated among FA10s. The stability of the FA10 group, along with their sickness absences and work disabilities, should be investigated further.


Assuntos
Serviços de Saúde do Trabalhador/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Emprego/estatística & dados numéricos , Feminino , Finlândia , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/terapia , Fatores Sexuais , Adulto Jovem
9.
BMC Public Health ; 18(1): 1291, 2018 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-30477466

RESUMO

BACKGROUND: The aim of the study was to compare occasional and persistent frequent attenders in occupational health (OH) primary care and to identify the diagnoses associated with persisting frequent attendance. METHODS: This is a longitudinal study using electronic medical record data from 2014 to 2016 from an OH service provider. Frequent attenders were defined as patients in the top decile of annual visits to healthcare professionals (frequent attender 10%, FA10). FA10 were categorized to three groups according to the persistence of frequent attendance (1-year-FA, 2 year-FA, and persistent-FA = frequent attenders in all three years). This was used as the dependent variable. We used patient sex, age, employer size, industry and distribution of visits and diagnostic codes to characterize the different frequent attender groups. RESULTS: In total, 66,831 patients were included, of which 592 persistent frequent attenders (0.9% of the study population) consulted the OH unit on average 13 times a year. They made altogether 23,797 visits during the study years. The proportion of women and employees of medium and large employers increased among persistent-FAs when compared to the other groups. Multinomial logistic regression accentuated musculoskeletal disorders and to a lesser extent diseases of the respiratory and nervous system and mental disorders. One in five FA becomes a persistent-FA. CONCLUSIONS: Our results indicate that in the context of a working population the association of musculoskeletal disorders and persistent frequent attendance is emphasized. Persistent frequent attenders also create a substantial demand on physician resources. When planning interventions aimed at working age frequent attenders, subgroups suffering from musculoskeletal disorders should be identified as they are associated with persisting frequent attendance.


Assuntos
Serviços de Saúde do Trabalhador/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Adolescente , Adulto , Idoso , Registros Eletrônicos de Saúde , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/terapia , Adulto Jovem
10.
Work ; 61(2): 189-209, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30373971

RESUMO

BACKGROUND: Green jobs, being in line with the goals of sustainable development, promote "smart, sustainable and inclusive growth", ensure a healthy functioning of Earth's ecosystems and guarantee decent work for all workers and high levels of workers' health. OBJECTIVE: Assessing whether green jobs protect and promote the health of workers and, at the same time, contribute to a reduction of occupational diseases and health damage resulting from accidents at work. METHODS: A core-set of Occupational Health indicators were selected to analyze the "sustainable work" in green employment, based on Annual Report. The indicators were applied to 281,124 establishments and 2,780,686 workers in Portugal. RESULTS: In the green job there is a lower level of organization as regards Occupational Health and Safety Services with a lower coverage of working population, and the incidence and severity of accidents at work is higher, as well as the percentage of workers with a lower level of professional qualification. CONCLUSIONS: Green job is not necessarily translated into safe, healthy and decent work. There is need and urgency to ensure a proper monitoring of green jobs in the context of Occupational Health, a requirement that should not be underestimated, if sustainable development is to be achieved.


Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Desenvolvimento Sustentável , Humanos , Doenças Profissionais/epidemiologia , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Portugal
11.
Sangyo Eiseigaku Zasshi ; 60(6): 180-190, 2018 Dec 05.
Artigo em Japonês | MEDLINE | ID: mdl-30232299

RESUMO

OBJECTIVES: Although both occupational health centers and occupational health service centers (OHSCs) support small-scale enterprises in Japan, the activities of OHSCs are not well detailed. This survey aimed to clarify the activities and subjective evaluation by directors and coordinators of OHSCs, with a focus on improving occupational health services in small-scale enterprises. METHODS: The survey was conducted by mailing questionnaires to 377 directors and 507 coordinators at 344 OHSCs in Japan from September 2016 to January 2017. The survey items comprised questions about director and coordinator characteristics, OHSCs' systems and activities, and subjective evaluations of OHSCs' activities. RESULTS: Responses were obtained from 290 directors (76.9%) and 413 coordinators (81.5%) of OHSCs. Of the directors, 66.2% were occupational health directors of medical associations. The average number of years' experience for coordinators was 5.7 years, and 44.6% were specially qualified, most as health officers. The percentage of OHSC staff who were not coordinators was 22%, and 29.8% of OHSCs had a public health nurse. The Office of Labor Standard's guidance was most often cited as the reason why small-scale enterprises decided to use OHSCs. At least 90% of OHSC directors and coordinators evaluated OHSCs' activities as "good". Directors not consulted by a coordinator evaluated OHSCs' activities as "very good" significantly more often than directors who were consulted by a coordinator (p<.001). Similarly, directors not consulted by occupational health centers' members evaluated OHSCs' activities as "very good" significantly more often than directors who were consulted by occupational health centers' members (p<.006). Coordinators who were in charge of two or more regions medical associations evaluated OHSCs' activities as "very good" significantly more often than those who were in charge of only one regions medical association (p=.014).Coordinators who had qualification of occupational health evaluated OHSCs' activities as "very good" significantly more often than coordinators who had not (p=.007). Coordinators who conducted public relations activities evaluated OHSCs' activities as "very good" significantly more often than those who did not (p=.011). Similarly, coordinators who conducted public relations activities via email and homepage promotions evaluated OHSCs' activities as "very good" significantly more often than those who did not (p<.001). In addition, coordinators who used the consultation record evaluated OHSCs' activities as "very good" significantly more often than those who did not (p<.001), whereas coordinators who consulted with a director evaluated OHSCs' activities as "very good" significantly more often than those who did not (p=.028). Coordinators who thought doctors were fit for the OHSCs' activities had significantly higher percentages of qualifications than those who did not think this way (p=.032). Likewise, coordinators who conducted public relations activities had significantly higher percentages of qualifications than those who did not (p<.001), whereas coordinators who used the consultation record had significantly higher percentages of qualifications than those who did not (p=.006). CONCLUSIONS: This survey clarified OHSCs' activities and suggested that systems and activities are not the same across OHSCs. We found that coordinators need to master knowledge of occupational health and work support. In addition, improving the relationship between directors and coordinators, enhancing public relations activities, and utilizing tools such as a chart improved OHSCs' activities.


Assuntos
Centros Comunitários de Saúde/estatística & dados numéricos , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Saúde do Trabalhador , Encaminhamento e Consulta/estatística & dados numéricos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
12.
Artigo em Inglês | MEDLINE | ID: mdl-30257476

RESUMO

Evidence on the effectiveness of workplace mental health promotion for people with disabilities is limited. This study aimed to evaluate the effectiveness of a brief mental health promotion intervention in social enterprises. It had a non-blinded cluster randomized controlled trial design with follow-up one and four months after the intervention. In total 196 employees agreed to participate (86 intervention and 110 control). Empowerment was the main outcome; secondary outcomes were resilience, palliative behavior, determinants of four coping strategies of mental health, quality of life, and life satisfaction. A brief participant satisfaction survey was conducted after the intervention. No significant intervention effect on empowerment was found. However, at one month follow-up, significant favorable effects were found on perceived social support for coping strategies for mental health and on palliative behavior. At four months follow-up, favorable intervention effects were found on quality of life, but unfavorable effects were found on unjustified worrying. In addition, the intervention was well received by the employees. This brief intervention might be a promising first step to improve mental health in people with disabilities working in social enterprises. Nevertheless, additional monitoring by professionals and managers working in the organizations might be needed to maintain these effects.


Assuntos
Pessoas com Deficiência/psicologia , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Saúde do Trabalhador/educação , Saúde do Trabalhador/estatística & dados numéricos , Setor Privado , Local de Trabalho/psicologia , Adulto , Bélgica , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Adulto Jovem
13.
Occup Med (Lond) ; 68(6): 378-383, 2018 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-29917123

RESUMO

Background: Staff well-being is vital to the functioning of the UK National Health Service (NHS). Mental health nurses (MHNs) with personal experience of mental illness can offer a professionally and personally informed insight into the occupational health (OH) service offered by their employer. Aims: To investigate MHNs' views of OH provision in the NHS, based on their personal experience. Methods: A qualitative interview study using a purposive sample of MHNs with personal experience of mental illness. Results: Twenty-seven MHNs met the inclusion criteria. Thematic analysis identified three themes: comparisons of 'relative expertise' between the mental health nurse and the OH clinician; concerns about 'being treated' by a service at their work; and 'returning to work'. Conclusions: OH provision in mental health settings must take account of the expertise of its staff. Further research, looking at NHS OH provision from the provider perspective is warranted.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Serviços de Saúde do Trabalhador/tendências , Enfermagem Psiquiátrica , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Pesquisa Qualitativa
14.
J Occup Environ Med ; 60(8): e397-e405, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29851732

RESUMO

OBJECTIVE: The aim of this study was to examine the impact of worksite clinics on health care utilization and cost, self-reported health status, and student achievement growth in a public school district. METHODS: We used insurance claims, health risk assessment, and student achievement growth data for active teachers during 2007 to 2015. A difference-in-differences approach was applied to measure the impact of worksite clinics. RESULTS: Compared with using a community-based clinic as the usual source of primary care, using a worksite clinic was associated with significantly lower inpatient admissions (53 vs 31 per 1000 teacher years), annual health care cost ($5043 vs $4298 in 2016 US dollars, a difference of $62 per teacher per month), and annual absent work hours (63 vs 61). No significant differences were detected in self-reported health status or student achievement growth. CONCLUSION: Worksite clinics reduce teacher health care cost and absenteeism.


Assuntos
Docentes/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Setor Público , Absenteísmo , Sucesso Acadêmico , Adulto , Feminino , Nível de Saúde , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Instituições Acadêmicas , Estudantes , Local de Trabalho , Adulto Jovem
15.
Br Med Bull ; 126(1): 113-121, 2018 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-29684103

RESUMO

Background: Governments and employers' organizations have sustained focus on common mental disorders (CMD), how they impact a person's ability to gain or continue work, the costs of sickness absence, presenteeism and job loss, and the positive impact of work on wellbeing. Sources of data: Scientific literature, mainly systematic reviews and grey literature, i.e. publications not accessible through medical databases. Areas of agreement: CMD are a major cause of disability, unemployment and dependency on welfare benefits. Good and healthy work is important for maintaining mental health and for promoting recovery from mental disorders. Areas of controversy: Evidence is limited with respect to the effectiveness of workplace interventions to prevent CMD and especially with respect to work outcomes and work reintegration of those who have been off sick. Growing points: There is growing interest in, and an increasing number of, best practice guidelines for employers, that could be improved and shared more actively. Areas timely for developing research: There is need for high-quality studies of interventions that examine work outcomes in patients who have been unable to obtain or continue work because of CMD.


Assuntos
Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Saúde do Trabalhador , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Humanos , Transtornos Mentais/economia , Serviços de Saúde Mental/economia , Serviços de Saúde do Trabalhador/economia , Retorno ao Trabalho/economia , Licença Médica/economia , Local de Trabalho
16.
J Gen Intern Med ; 33(5): 705-709, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29508257

RESUMO

BACKGROUND: Burnout and depression are prevalent among resident physicians, though the supportive role of the program director (PD) is not well defined. OBJECTIVE: To understand the residents' view of the residency program director's role in assessing and promoting resident wellness. METHODS: A single institution survey of all house staff was conducted in 2017. Rates of burnout and depression were identified via the 2-item Maslach Burnout Inventory (MBI) and the Patient Health Questionaire-2 (PHQ-2), respectively. Residents then qualified their preferences for various assistance services and for the role of their program directors in assisting them. RESULTS: One-hundred sixty-one of 202 (79.7%) residents completed the survey. The rate of depression was 28%. Rates of emotional exhaustion and depersonalization (2-item MBI) were 44 and 62%, respectively. Only 4% of respondents had used the Employee Assistance Program (EAP) in the prior 12 months. Eighty-two percent of residents were in favor of PDs inquiring about wellness regardless of their job performance and only 1% of residents stated the PD should not inquire about wellness at all. Thirty-three percent of residents reported that they would be likely to contact EAP on their own if they felt unwell. Significantly more residents (62%) reported being more likely to contact EAP if recommended by their PD (33 vs 62%, p < 0.001%). Important perceived barriers to seeking assistance were lack of time (65%), lack of knowledge of how to contact EAP (41%), and concerns about appearing weak (35%). CONCLUSIONS: Despite a high prevalence of burnout and depression, residents are unlikely to seek help on their own. Program directors have an important role in assessing and promoting the wellness of their residents. The majority of residents wants their PD to inquire about wellness and may be more likely to seek and receive help if recommended and facilitated by their PD.


Assuntos
Esgotamento Profissional/terapia , Comportamento de Busca de Ajuda , Internato e Residência , Liderança , Médicos/psicologia , Adulto , Esgotamento Profissional/epidemiologia , Estudos Transversais , Despersonalização/diagnóstico , Despersonalização/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Inquéritos e Questionários
17.
Can J Diabetes ; 42(5): 493-499.e1, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29555342

RESUMO

OBJECTIVES: There is a lack of Canadian data concerning the effectiveness of diabetes interventions in the workplace. The objective of this study was to evaluate the effectiveness of Motivaction, a diabetes screening and education pilot program, in the workplace. METHODS: The Motivaction program involves a voluntary web-based diabetes health-risk assessment, the Canadian Diabetes Risk Questionnaire (CANRISK), combined with an opportunity for those eligible (i.e. having diabetes or having a CANRISK score ≥21) to attend 2 on-site biometric screening meetings with a registered nurse and 4 educational sessions by telephone with a certified diabetes educator. Biometric data, as well as information about self-efficacy, lifestyle changes, productivity, well-being, mental health and program satisfaction, were collected at baseline and at 6 months. RESULTS: Attendance at the initial and 6-month clinical visits included 293 people. At baseline, 21% were identified as having prediabetes (13%) or having diabetes (8%). Statistically significant reductions in glycated hemoglobin levels from baseline to the study's end were observed in those with prediabetes or diabetes. No statistically significant changes in glycated hemoglobin levels were observed in individuals with normal levels or in those at risk for diabetes at baseline. No statistical differences were observed in terms of productivity or mental health for the full population or across diabetes-risk categories. More than 90% of employees would recommend the Motivaction program to other employers. CONCLUSIONS: This study provides a framework for future diabetes interventions in the workplace and demonstrates that workplace interventions may reduce employees' diabetes risk levels and are valued by employees.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Programas de Rastreamento , Local de Trabalho/estatística & dados numéricos , Adulto , Canadá/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Estilo de Vida , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Satisfação Pessoal , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-29385714

RESUMO

In previous studies, it was found that patients treated at a psychosomatic outpatient clinic (PSOC) for common mental disorders showed more severe symptoms than those who used a psychotherapeutic consultation service at the workplace (PSIW). This study examines whether the higher symptom severity of the PSOC patients in comparison to their PSIW counterparts is also related to higher levels of occupational stress as measured by the demand-control-support model (DCS). N = 253 participants (PSIW n = 100; PSOC n = 153) provided self-reported data on demands, decision latitude, social support, and health before consultation. The association between mental health care setting, symptom level and demands, decision latitude, and social support was assessed by means of a path model. Results of the path model indicated that the higher level of depression in PSOC patients was related to higher levels of demands and lower levels of social support. Demands and social support were found to be indirectly associated with treatment setting. No interaction effect between demands, decision latitude, social support, and depression was found. Results of this study reveal that the working conditions influenced the pathway to care process via symptom severity.


Assuntos
Assistência Ambulatorial , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Psicoterapia , Encaminhamento e Consulta , Local de Trabalho , Adolescente , Adulto , Depressão/terapia , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador/métodos , Estresse Psicológico/prevenção & controle , Adulto Jovem
19.
Scand J Public Health ; 46(3): 347-357, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-28673125

RESUMO

AIMS: While workplace wellness services are proactively established to improve well-being and reduce sickness absence, knowledge of reasons for using these services remains sparse. This study investigates which factors determine use of an in-house wellness service at a large organization (the Danish Police) with several departments in different geographical locations. METHODS: All potential users of the Wellness service ( n = 15,284) were invited to respond to a cross-sectional questionnaire. Of 6060 eligible respondents, 58% had used the service at least once (any use) and 17% had used the service at least three times (frequent users). Two items assessed the frequency of statements of justifications for using or not using the Wellness service. Associations between 32 demographic and psychosocial variables and use of the Wellness service were evaluated with unadjusted bivariate logistic regression analyses. RESULTS: The two primary justifications for using the Wellness service were: to get a blood pressure assessment (37%) and to rehabilitate injury (26%). The two most common justifications for not using the Wellness service were: no perceived need (44%) and already physically active (34%). Of the 32 demographical and psychosocial variables included, 28 were associated with any use and 24 with frequent use. CONCLUSIONS: Use of the Wellness service appears to be driven by a complex configuration of factors that resist easy translation into practical advice. Non-participation was accounted for in terms of both positive and negative barriers. Use of the service for purposes of primary prevention and health promotion was, relatively speaking, lagging behind.


Assuntos
Serviços de Saúde do Trabalhador/estatística & dados numéricos , Polícia/psicologia , Adulto , Estudos Transversais , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polícia/estatística & dados numéricos , Inquéritos e Questionários
20.
Ann Glob Health ; 84(3): 465-469, 2018 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-30835383

RESUMO

The agricultural sector has by far the world's largest labour force, there are more than one billion workers in this industry worldwide, which contains half of the total world labour force. On the other hand, agriculture is one of the most hazardous occupations, and many workers suffer occupational accidents and ill health each year. Farming and animal breeding are associated with exposure to a wide variety of risk factors, including zoonotic agents, dust, elements of the thermal environment, noise, vibration and chemicals. Although half of the world's population are economically active and spend at least one third of their time in the workplace, only 15% of the workers have access to basic occupational health services. According to a WHO report, Iran has a well-structured health care system through which basic health care services are available to the entire population, and health indicators in Iran have consistently improved. The agricultural health program in Iran is being carried out in the cities and rural areas, and occupational health services are mainly integrated into the health network. This paper aims to describe the health care system and basic occupational health services (BOHs) available to 5,300 agricultural enterprises with 8,380 employees in the cities of Abadan, Khorramshahr and Shadegan in the Abadan region (Abadan, Khoramshahr and Shadegan districts), in the south of Iran.


Assuntos
Fazendeiros/estatística & dados numéricos , Programas Nacionais de Saúde/organização & administração , Serviços de Saúde do Trabalhador/organização & administração , Saúde do Trabalhador/estatística & dados numéricos , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Irã (Geográfico) , Programas Nacionais de Saúde/estatística & dados numéricos , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/normas , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador/normas , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Traumatismos Ocupacionais/prevenção & controle
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