Effectiveness of e-learning in continuing medical education for occupational physicians.

BACKGROUND: Within a clinical context e-learning is comparable to traditional approaches of continuing medical education (CME). However, the occupational health context differs and until now the effect of postgraduate e-learning among occupational physicians (OPs) has not been evaluated. AIM: To evaluate the effect of e-learning on knowledge on mental health issues as compared to lecture-based learning in a CME programme for OPs. METHODS: Within the context of a postgraduate meeting for 74 OPs, a randomized controlled trial was conducted. Test assessments of knowledge were made before and immediately after an educational session with either e-learning or lecture-based learning. RESULTS: In both groups, a significant gain in knowledge on mental health care was found (P < 0.05). However, there was no significant difference between the two educational approaches. CONCLUSION: The effect of e-learning on OPs' mental health care knowledge is comparable to a lecture-based approach. Therefore, e-learning can be beneficial for the CME of OPs.

Need for recovery after work predicts sickness absence: a 2-year prospective cohort study in truck drivers.

BACKGROUND: Incomplete recovery from work-related fatigue after work (i.e., sustained activation) is assumed to mediate the relation between the exposure to stressful working conditions and the development of health problems. The need for recovery after work scale reflects the extent to which workers have difficulties to recover adequately from work-related fatigue after a working day. OBJECTIVES: The aim of this study was to establish if need for recovery after work in truck drivers (1). predicts future sickness absence (>14 working days) and (2). mediates the prospective relation between stressful working conditions (low control, high job demands) and sickness absence. METHODS: Self-administered questionnaires, providing information about need for recovery after work, sickness absence, job control, and job demands (psychological, physical, and supervisor job demands), were sent to a random sample of 2000 drivers in 1998. Of the 1123 responders, 820 returned a completed questionnaire 2 years later (response 72%). This study was restricted to the 526 participants who still worked at follow-up as a truck driver at the same company. RESULTS: High baseline need for recovery after work was associated with an increased risk for subsequent sickness absence (odds ratio [OR] 2.19, 95% confidence interval [CI] 1.13-4.24) after adjustment for age, previous sickness absence, marital status, educational level, and company size. Additional adjustment for baseline stressful working conditions led to a marginally reduction of the excess risk for sickness absence. CONCLUSIONS: High need for recovery after work increases the risk of subsequent sickness absence that is not explained by relevant (non-) work-related factors. However, the results did not testify that need for recovery after work mediates between the exposure to stressful working conditions, and the subsequent occurrence of sickness absence. Practically, the results indicate that monitoring recovery complaints in truck drivers may assist practitioners to take efficient preventive measures at the appropriate time.

Stressful work, psychological job strain, and turnover: a 2-year prospective cohort study of truck drivers.

Based on a model that combines existing organizational stress theory and job transition theory, this 2-year longitudinal study examined antecedents and consequences of turnover among Dutch truck drivers. For this purpose, self-reported data on stressful work (job demands and control), psychological strain (need for recovery after work and fatigue), and turnover were obtained from 820 drivers in 1998 and 2000. In agreement with the model, the results showed that strain mediates the influence of stressful work on voluntary turnover. Also in conformity with the model, job movement to any job outside the trucking industry (i.e., interoccupational turnover) resulted in a larger strain reduction as compared to job movement within the trucking industry (intraoccupational turnover). Finally, strain was found to stimulate interoccupational turnover more strongly than it stimulated intraoccupational turnover. These findings provide a thorough validation of existing turnover theory and give new insights into the turnover (decision) process.

Information technology and road transport industry: how does IT affect the lorry driver?

A quasi-experimental design was used to study the effect of on board computer-systems (OBC-systems) on the Dutch lorry drivers' psychosocial work environment (i.e., control and demands) and coinciding mental health (i.e., need for recovery after work) and job attitudes (i.e., organisational commitment). The intervention group (n = 26) started working with an OBC-system between 1998 and 2000 and was compared with two matched reference groups (n = 26 in both groups). All participants were from a cohort of 650 drivers who participated in a prospective study on occupational stress and health. All outcome variables were quantified by standardised and validated questionnaires. Results showed that the application of OBC-systems negatively affected the drivers' job control and organisational commitment. However, OBC-systems did not influence the drivers' psychological job demands and need for recovery after work. Accordingly, it is concluded that the application of OBC-systems negatively affects the lorry driver's psychosocial work environment and job attitudes.

The effect of office concepts on worker health and performance: a systematic review of the literature.

Conventional and innovative office concepts can be described according to three dimensions: (1) the office location (e.g. telework office versus conventional office); (2) the office lay-out (e.g. open lay-out versus cellular office); and (3) the office use (e.g. fixed versus shared workplaces). This review examined how these three office dimensions affect the office worker's job demands, job resources, short- and long-term reactions. Using search terms related to the office concept (dimensions), a systematic literature search starting from 1972 was conducted in seven databases. Subsequently, based on the quality of the studies and the consistency of the findings, the level of evidence for the observed findings was assessed. Out of 1091 hits 49 relevant studies were identified. Results provide strong evidence that working in open workplaces reduces privacy and job satisfaction. Limited evidence is available that working in open workplaces intensifies cognitive workload and worsens interpersonal relations; close distance between workstations intensifies cognitive workload and reduces privacy; and desk-sharing improves communication. Due to a lack of studies no evidence was obtained for an effect of the three office dimensions on long-term reactions. The results suggest that ergonomists involved in office innovation could play a meaningful role in safeguarding the worker's job demands, job resources and well-being. Attention should be paid, in particular, to effects of workplace openness by providing acoustic and visual protection.

Occupation-specific screening for future sickness absence: criterion validity of the trucker strain monitor (TSM).

BACKGROUND: Monitoring psychological job strain may help occupational physicians to take preventive action at the appropriate time. For this purpose, the 10-item trucker strain monitor (TSM) assessing work-related fatigue and sleeping problems in truck drivers was developed. OBJECTIVES: This study examined (1) test-retest reliability, (2) criterion validity of the TSM with respect to future sickness absence due to psychological health complaints and (3) usefulness of the TSM two-scales structure. METHODS: The TSM and self-administered questionnaires, providing information about stressful working conditions (job control and job demands) and sickness absence, were sent to a random sample of 2000 drivers in 1998. Of the 1123 responders, 820 returned a completed questionnaire 2 years later (response: 72%). RESULTS: The TSM work-related fatigue scale, the TSM sleeping problems scale and the TSM composite scale showed satisfactory 2-year test-retest reliability (coefficient r=0.62, 0.66 and 0.67, respectively). The work-related fatigue, sleeping problems scale and composite scale had sensitivities of 61, 65 and 61%, respectively in identifying drivers with future sickness absence due to psychological health complaints. The specificity and positive predictive value of the TSM composite scale were 77 and 11%, respectively. The work-related fatigue scale and the sleeping problems scale were moderately strong correlated (r=0.62). However, stressful working conditions were differentially associated with the two scales. CONCLUSIONS: The results support the test-retest reliability, criterion validity and two-factor structure of the TSM. In general, the results suggest that the use of occupation-specific psychological job strain questionnaires is fruitful.