The association of vertical and horizontal workplace social capital with employees' job satisfaction, exhaustion and sleep disturbances: a prospective study.

PURPOSE: Workplace social capital (WSC) may be beneficial for employees' health and well-being; however, most studies have analyzed WSC on the individual and not the workplace level. We test whether higher compared to lower levels of vertical WSC (WSC between employees and superiors) and horizontal WSC (WSC between employees), measured at the workplace level, is prospectively associated with higher levels of employees' well-being. METHODS: Using data from an intervention study, we analyzed associations between workplace aggregated vertical and horizontal WSC at baseline with job satisfaction, exhaustion and sleep disturbances at 24-months follow-up. The sample included 606 municipal pre-school employees (71 workplaces). We adjusted for individual and workplace characteristics, baseline scores of outcomes, intervention status, and the interaction of exposure with intervention status. We used the Genmod procedure in SAS with a repeated statement to account for correlation of individuals within workplaces. We repeated analyses using individual-level WSC measurements. RESULTS: Higher levels of vertical and horizontal WSC at baseline predicted a higher level of job satisfaction (0.20, p = 0.01 and 0.24, p = 0.01, respectively) and a lower level of exhaustion (- 0.33, p = 0.04 and - 0.43, p = 0.04) at follow-up in the most adjusted model. Analyses with individual-level measures yielded similar results and further showed an association of a higher level of horizontal WSC with a lower level of sleep disturbances. CONCLUSIONS: Higher levels of vertical and horizontal WSC were prospectively associated with better well-being of employees in municipal pre-schools. Workplaces may thus consider focusing on improving WSC as a means for ensuring or improving employees' well-being.

Effect of a participatory organizational workplace intervention on workplace social capital: post-hoc results from a cluster randomized controlled trial.

BACKGROUND: A high level of workplace social capital (WSC) may contribute to the protection of employees' health. We hypothesized that a participatory workplace intervention would increase the level of WSC defined as vertical WSC (i.e. WSC linking together employees and their leaders) and horizontal WSC (i.e. WSC bonding employees together). METHODS: We conducted a secondary data analysis of a cluster randomized controlled trial that was implemented among all employees in 78 municipal Danish pre-schools (44 intervention and 34 control group schools). The study sample consisted of 606 employees, 386 in the intervention and 220 in the control group. The intervention aimed to improve the psychosocial working environment by using a participatory approach and focusing on core job tasks. Vertical and horizontal WSC was measured by five and four items, respectively, at baseline and at 24-months follow-up. We estimated intervention effect by calculating the interaction of change over time by group assignment (intervention versus control group) and included workplace identification number in a repeated statement to take into account that employees were nested within workplaces. We conducted post-hoc analyses to examine whether intervention effect differed by implementation degree. RESULTS: WSC decreased in both groups. In the main analyses, there was no statistically significant difference between intervention and control group, neither for vertical nor horizontal WSC. However, when we excluded intervention workplaces with a low degree of implementation, we found a statistically significant difference between the intervention and the control group (estimate: 0.25, 95% CI: 0.00 to 0.50, p = 0.049), indicating that vertical WSC decreased in the control group and remained stable in the intervention group. CONCLUSIONS: There was not a statistically significant difference between intervention and control group in the main analysis. Post-hoc analyses, however, suggest that the intervention may have prevented a decrease in vertical WSC among employees in workplaces with a high or a medium degree of implementation. A conference abstract with the key results of this study has been previously presented and published, European Journal of Public Health, Volume 28, Issue suppl_4, November 2018, cky260, https://academic.oup.com/eurpub/article/28/suppl_4/cky260/5187184 . TRIAL REGISTRATION: ISRCTN16271504 , retrospectively registered on November 15, 2016.

The association between team-level social capital and individual-level work engagement: Differences between subtypes of social capital and the impact of intra-team agreement.

The study explored the association between team-level social capital and individual-level work engagement. Questionnaire data were collected from six companies in the dairy industry. Seven hundred seventy-two participants divided into 65 teams were included. In confirmatory factor analyses, we found a superior model fit to a four dimensional model of social capital: bonding social capital, bridging social capital and two types of linking social capital. The results showed a positive association between all subtypes of social capital at the team level and work engagement at the individual level. However, this association only remained significant for linking social capital in relation the workplace as a whole when we adjusted for psychosocial working conditions. The level of intra-team agreement in social capital score did not moderate the association between social capital and work engagement. In conclusion, the results provide further support for previous findings suggesting a positive association between social capital and work engagement. They add to the existing knowledge by suggesting that linking social capital in relation to the workplace is the most important explanatory variable for work engagement, thus emphasizing the need to distinguish between subtypes of social capital in research and practice.

The impact of retirement on age related cognitive decline - a systematic review.

BACKGROUND: Knowledge on factors affecting the rate of cognitive decline and how to maintain cognitive functioning in old age becomes increasingly relevant. The purpose of the current study was to systematically review the evidence for the impact of retirement on cognitive functioning and on age related cognitive decline. METHOD: We conducted a systematic literature review, following the principles of the PRISMA statement, of longitudinal studies on the association between retirement and cognition. RESULTS: Only seven studies fulfilled the inclusion criteria. We found weak evidence that retirement accelerates the rate of cognitive decline in crystallised abilities, but only for individuals retiring from jobs high in complexity with people. The evidence of the impact of retirement on the rate of decline in fluid cognitive abilities is conflicting. CONCLUSION: The review revealed a major knowledge gap in regards to the impact of retirement on cognitive decline. More knowledge on the association between retirement and age related cognitive decline as well as knowledge on the mechanisms behind these associations is needed.

The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses.

BACKGROUND: Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses. METHODS: Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies. DATA EXTRACTION: Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality. DATA SYNTHESIS: We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study's sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries. RESULTS: There was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior. CONCLUSIONS: Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.

Can psychosocial work conditions protect against age-related cognitive decline? Results from a systematic review.

According to the use it or lose it hypothesis, intellectually stimulating activities postpone age-related cognitive decline. A previous systematic review concluded that a high level of mental work demands and job control protected against cognitive decline. However, it did not distinguish between outcomes that were measured as cognitive function at one point in time or as cognitive decline. Our study aimed to systematically review which psychosocial working conditions were prospectively associated with high levels of cognitive function and/or changes in cognitive function over time. Articles were identified by a systematic literature search (MEDLINE, Web of Science (WOS), PsycNET, Occupational Safety and Health (OSH)). We included only studies with longitudinal designs examining the impact of psychosocial work conditions on outcomes defined as cognitive function or changes in cognitive function. Two independent reviewers compared title-abstract screenings, full-text screenings and quality assessment ratings. Eleven studies were included in the final synthesis and showed that high levels of mental work demands, occupational complexity or job control at one point in time were prospectively associated with higher levels of cognitive function in midlife or late life. However, the evidence to clarify whether these psychosocial factors also affected cognitive decline was insufficient, conflicting or weak. It remains speculative whether job control, job demands or occupational complexity can protect against cognitive decline. Future studies using methodological advancements can reveal whether workers gain more cognitive reserve in midlife and late life than the available evidence currently suggests. The public health implications of a previous review should thereby be redefined accordingly.

Effect of physical exercise on workplace social capital: Cluster randomized controlled trial.

AIMS: While workplace health promotion with group-based physical exercise can improve workers' physical health, less is known about potential carry-over effects to psychosocial factors. This study investigates the effect of physical exercise on social capital at work. METHODS: Altogether, 200 female healthcare workers (nurses and nurse's aides) from 18 departments at three hospitals were randomly allocated at the department level to 10 weeks of (1) group-based physical exercise at work during working hours or (2) physical exercise at home during leisure time. At baseline and follow-up, participants replied to a questionnaire concerning workplace social capital: (1) within teams (bonding); (2) between teams (bridging); (3) between teams and nearest leaders (linking A); (4) between teams and distant leaders (linking B). RESULTS: At baseline, bonding, bridging, linking A and linking B social capital were 74 (SD 17), 61 (SD 19), 72 (SD 22) and 70 (SD 18), respectively, on a scale of 0-100 (where 100 is best). A group by time interaction was found for bonding social capital (P=0.02), where physical exercise at work compared with physical exercise during leisure time increased 5.3 (95% confidence interval 2.3- 8.2)(effect size, Cohen's d = 0.31) from baseline to follow-up. For physical exercise at home during leisure time and exercise at work combined, a time effect (P=0.001) was found for linking A social capital, with a decrease of 4.8 (95% confidence interval 1.9-7.6). CONCLUSIONS: Group-based physical exercise at work contributed to building social capital within teams at the workplace. However, the general decrease of social capital between teams and nearest leaders during the intervention period warrants further research.

Depressive symptoms and early retirement intentions among Danish eldercare workers: Cross-sectional and longitudinal analyses.

BACKGROUND: Depression increases the risk of disability pension and represents a health related strain that pushes people out of the labour market. Although early voluntary retirement is an important alternative to disability pension, few studies have examined whether depressive symptoms incur early voluntary retirement. This study examined whether depressive symptoms and changes in depressive symptoms over time were associated with early retirement intentions. METHODS: We used a cross-sectional (n = 4041) and a prospective (n = 2444) population from a longitudinal study on employees of the Danish eldercare sector. Depressive symptoms were measured by the Major Depression Inventory and the impact of different levels of depressive symptoms (severe, moderately severe, moderate, mild and none) and changes in depressive symptoms (worsened, improved, unaffected) on early retirement intentions were analysed with multinomial logistic regression. RESULTS: In the cross-sectional analysis all levels of depressive symptoms were significantly associated with retirement intentions before the age of 62 years. Similar associations were found prospectively. Depressive symptoms and worsened depressive symptoms in the two year period from baseline to follow-up were also significantly associated with early retirement intentions before age 62. The prospective associations lost statistical significance when controlling for early retirement intentions at baseline. CONCLUSIONS: The whole spectrum of depressive symptoms represents a health related strain that can incur intentions to retire early by early voluntary retirement. In order to change the intentions to retire early, the work related consequences of depressive symptoms should be addressed as early in the treatment process as possible.

Do psychosocial work conditions predict risk of disability pensioning? An analysis of register-based outcomes using pooled data on 40,554 observations.

AIMS: To investigate whether high psychosocial job demands (quantitative demands and work pace) and low psychosocial job resources (influence at work and quality of leadership) predicted risk of disability pensioning among employees in four occupational groups--employees working with customers, employees working with clients, office workers and manual workers--in line with the propositions of the Job Demands-Resources (JD-R) model. METHODS: Survey data from 40,554 individuals were fitted to the DREAM register containing information on payments of disability pension. Using multi-adjusted Cox regression, observations were followed in the DREAM-register to assess risk of disability pensioning. Average follow-up time was 5.9 years (SD=3.0). RESULTS: Low levels of influence at work predicted an increased risk of disability pensioning and medium levels of quantitative demands predicted a decreased risk of disability pensioning in the study population. We found significant interaction effects between job demands and job resources as combinations low quality of leadership and high job demands predicted the highest rate of disability pensioning. Further analyses showed some, but no statistically significant, differences between the four occupational groups in the associations between job demands, job resources and risk of disability pensioning. CONCLUSIONS: The study showed that psychosocial job demands and job resources predicted risk of disability pensioning. The direction of some of the observed associations countered the expectations of the JD-R model and the findings of the present study therefore imply that associations between job demands, job resources and adverse labour market outcomes are more complex than conceptualised in the JD-R model.

Do psychosocial job demands and job resources predict long-term sickness absence? An analysis of register-based outcomes using pooled data on 39,408 individuals in four occupational groups.

PURPOSE: To investigate whether psychosocial job demands (work pace and quantitative demands) and job resources (influence at work and quality of leadership) predict long-term sickness absence (LTSA) for more than three consecutive weeks in four occupational groups. METHODS: Survey data pooling 39,408 respondents were fitted to a national register containing information on payments of sickness absence compensation. Using multi-adjusted Cox regression, respondents were followed for an 18-month follow-up period to assess risk of LTSA. RESULTS: In the entire study population, low and medium levels of influence at work and low quality of leadership predicted a significantly increased risk of LTSA, whereas medium levels of quantitative demands predicted a significantly reduced risk of LTSA. For employees working with clients and for office workers, low and medium influence at work associated with a significantly increased risk of LTSA. For employees working with clients, low quality of leadership predicted a significantly increased risk of LTSA. For manual workers, low influence at work predicted a significantly increased risk of LTSA and medium quantitative demands were associated with a significantly reduced risk of LTSA. For employees working with customers, medium quantitative demands predicted a significantly reduced risk of LTSA. Finally, in predicting LTSA, we found significant interaction effects between job demands and job resources. CONCLUSIONS: The study indicates that a lack of job resources--particularly influence at work--are more important predictors of LTSA than high job demands.

Does affective organizational commitment and experience of meaning at work predict risk of disability pensioning? An analysis of register-based outcomes using pooled data on 40,554 observations in four occupational groups.

BACKGROUND: The aim of this study is to investigate whether experience of meaning at work (MAW) and affective organizational commitment (AOC) predict risk of disability pensioning in four occupational groups. METHODS: Survey data from 40,554 individuals were fitted to a national register (DREAM) containing information on payments of disability pension. Using multi-adjusted Cox-regression, observations were followed in the DREAM-register to assess risk of disability pensioning. RESULTS: Low levels of MAW significantly increased risk of disability pensioning during follow-up referencing high levels of MAW. Respondents with medium levels of AOC had a significantly reduced risk of disability pensioning, when compared to respondents with high levels of AOC. Furthermore, results indicate an interaction effect between AOC and MAW in predicting risk of disability pension. CONCLUSIONS: AOC and MAW are significantly associated with risk of disability pensioning. Promoting MAW and managing AOC in contemporary workplaces may contribute towards reducing risk of disability pensioning.

Why are they leaving? Causes of actual turnover in the Danish eldercare services.

AIM: To investigate reasons for actual turnover among eldercare staff and to investigate changes in job design that could prevent turnover. BACKGROUND: Many Western countries have difficulties in recruiting healthcare staff to provide care for an ageing population. Knowledge on the causes of turnover among healthcare staff is therefore important. METHOD: In a prospective cohort study (n = 7025) baseline characteristics were compared for employees who respectively quit, retired and worked in eldercare at follow-up. Additionally, a survey was conducted among those employees who left their jobs during follow-up. RESULTS: Employees who quit their jobs (n = 461) primarily stated that psychosocial work conditions caused them to quit, whereas retirees (n = 265) primarily stated reasons related to health and physical job demands. Improvements in the time available for the contact with the elderly, increased skill discretion and improved social relations could prompt employees to reconsider quitting or retiring. CONCLUSION: Work in eldercare has some 'core' aspects that appear desirable to employees who quit or retired. Building on those aspects offers a strategy for enhanced recruitment potential. IMPACT FOR NURSING MANAGEMENT: To reduce turnover managers should improve psychosocial work conditions in eldercare and ensure that physical demands do not exceed the capacities of employees.

To what extent do single symptoms from a depression rating scale predict risk of long-term sickness absence among employees who are free of clinical depression?

PURPOSE: Depression rating scales have predicted long-term sickness absence (LTSA) in previous studies. With this study, we investigated to what extent single symptoms from a depression rating scale predicted LTSA among employees who were free of clinical depression. METHODS: We studied 6,670 female employees in the Danish eldercare sector. Frequency of 12 depressive symptoms over the last 2 weeks was assessed with the Major Depression Inventory. A symptom was considered as elevated if it was present at least "slightly more than half of the time." Data were linked to a national register on LTSA (≥3 weeks). We calculated hazard ratios (HR) from Cox's proportional hazard models to analyze whether a symptom predicted time to onset of LTSA during a 1-year follow-up. Analyses were adjusted for age, family status, health behaviors, occupational group, and previous LTSA. RESULTS: Of the 12 symptoms, three predicted LTSA after adjustment for covariates: "felt low in spirits and sad" (HR = 1.41, 95 % CI = 1.05-1.89), "felt lacking in energy and strength" (HR = 1.33, 95 % CI = 1.08-1.64), and "had trouble sleeping at night" (HR = 1.38, 95 % CI = 1.09-1.74). CONCLUSION: Among female eldercare workers free of clinical depression, feelings of low spirits and sadness, feelings of lack of energy and strength, and sleep disturbances predict risk of LTSA. Interventions that decrease the prevalence of these symptoms might contribute to a reduction in LTSA in this population.

Psychosocial work environment factors and weight change: a prospective study among Danish health care workers.

BACKGROUND: Lifestyle variables may serve as important intermediate factors between psychosocial work environment and health outcomes. Previous studies, focussing on work stress models have shown mixed and weak results in relation to weight change. This study aims to investigate psychosocial factors outside the classical work stress models as potential predictors of change in body mass index (BMI) in a population of health care workers. METHODS: A cohort study, with three years follow-up, was conducted among Danish health care workers (3982 women and 152 men). Logistic regression analyses examined change in BMI (more than +/- 2 kg/m(2)) as predicted by baseline psychosocial work factors (work pace, workload, quality of leadership, influence at work, meaning of work, predictability, commitment, role clarity, and role conflicts) and five covariates (age, cohabitation, physical work demands, type of work position and seniority). RESULTS: Among women, high role conflicts predicted weight gain, while high role clarity predicted both weight gain and weight loss. Living alone also predicted weight gain among women, while older age decreased the odds of weight gain. High leadership quality predicted weight loss among men. Associations were generally weak, with the exception of quality of leadership, age, and cohabitation. CONCLUSION: This study of a single occupational group suggested a few new risk factors for weight change outside the traditional work stress models.

Are environmental characteristics in the municipal eldercare, more closely associated with frequent short sick leave spells among employees than with total sick leave: a cross-sectional study.

BACKGROUND: It has been suggested that frequent-, short-term sick leave is associated with work environment factors, whereas long-term sick leave is associated mainly with health factors. However, studies of the hypothesis of an association between a poor working environment and frequent short spells of sick leave are few and results are inconsistent. Therefore, we aimed to explore associations between self-reported psychosocial work factors and workplace-registered frequency and length of sick leave in the eldercare sector. METHODS: Employees from the municipal eldercare in Aarhus (N = 2,534) were included. In 2005, they responded to a work environment questionnaire. Sick leave records from 2005 were dichotomised into total sick leave days (0-14 and above 14 days) and into spell patterns (0-2 short, 3-9 short, and mixed spells and 1-3 long spells). Logistic regression models were used to analyse associations; adjusted for age, gender, occupation, and number of spells or sick leave length. RESULTS: The response rate was 76%; 96% of the respondents were women. Unfavourable mean scores in work pace, demands for hiding emotions, poor quality of leadership and bullying were best indicated by more than 14 sick leave days compared with 0-14 sick leave days. For work pace, the best indicator was a long-term sick leave pattern compared with a non-frequent short-term pattern. A frequent short-term sick leave pattern was a better indicator of emotional demands (1.62; 95% CI: 1.1-2.5) and role conflict (1.50; 95% CI: 1.2-1.9) than a short-term non-frequent pattern.Age (= < 40 / >40 years) statistically significantly modified the association between the 1-3 long-term sick leave spell pattern and commitment to the workplace compared with the 3-9 frequent short-term pattern. CONCLUSIONS: Total sick leave length and a long-term sick leave spell pattern were just as good or even better indicators of unfavourable work factor scores than a frequent short-term sick leave pattern. Scores in commitment to the workplace and quality of leadership varied with sick leave pattern and age. Thus, different sick leave measures seem to be associated with different work environment factors. Further studies on these associations may inform interventions to improve occupational health care.

Work-related factors and early retirement intention: a study of the Danish eldercare sector.

BACKGROUND: Western countries are experiencing an ageing and shrinking workforce in the eldercare sector. This study investigated whether 12 different work-related factors are associated with early retirement intentions of employees in the Danish eldercare sector. We tested whether three hypotheses explained the increase of early retirement intention: (i) high job demands (four factors) and low resources (four factors); (ii) low job attitude (three factors); and (iii) high physical strain (one factor). METHODS: We included 2444 employees (aged 45-57 years) from two waves (T1 and T2) from a prospective study. Multinomial logistic regression models showed whether 12 work-related factors (T1) were associated with early retirement intention (T2); very early retirement intention and early retirement intention vs. normal retirement intention. RESULTS: Only 14% of the participants wished to retire at the normal retirement age (65 years or older). High physical strain [hypothesis (iii)] and low and normal affective organizational commitment [hypothesis (ii)] were associated with very early retirement intention. None of the other work-related factors associated with early retirement intention. CONCLUSIONS: Future interventions should focus on reducing physical strain and increase or maintain affective organizational commitment among employees in the eldercare sector to postpone retirement.

Do psychosocial working conditions modify the effect of depressive symptoms on long-term sickness absence?

BACKGROUND: The objective of this study was to investigate whether work unit-levels of psychosocial working conditions modify the effect of depressive symptoms on risk of long-term sickness absence (LTSA). METHODS: A total of 5,416 Danish female eldercare workers from 309 work units were surveyed using questionnaires assessing depressive symptoms and psychosocial working conditions. LTSA was derived from a national register. We aggregated scores of psychosocial working conditions to the work unit-level and conducted multi-level Poisson regression analyses. RESULTS: Depressive symptoms, but not psychosocial working conditions, predicted LTSA. Psychosocial working conditions did not statistically significantly modify the effect of depressive symptoms on LTSA. CONCLUSIONS: Psychosocial working conditions did not modify the effect of depressive symptoms on LTSA. The results, however, need to be interpreted with caution, as we cannot rule out lack of exposure contrast and non-differential misclassification of the exposure.

Does psychological well-being mediate the association between experiences of acts of offensive behaviour and turnover among care workers? A longitudinal analysis.

AIM: To investigate whether the psychological well-being of care workers in the Danish eldercare services mediated the association between experiences of acts of offensive behaviour and actual turnover. BACKGROUND: Research suggests that experiences of acts of offensive behaviour are associated with risk of turnover. However, little is known about the longitudinal associations between experiences of different types of offensive behaviour (threats, violence, bullying, and unwanted sexual attention) and risk of actual turnover. DESIGN: A prospective cohort study. METHODS: The study was conducted among employees in the eldercare services in Denmark. Employees aged 55 or more and non-care staff were excluded from the study. Employees who were working in eldercare at baseline (2005) and no longer worked in eldercare at follow-up (2006) were interviewed through questionnaires. Respondents to this questionnaire were coded as cases of turnover (N = 608) and were compared with employees who had not changed jobs during follow-up (N = 4330). Data on experiences of acts of offensive behaviour and well-being were measured at baseline. Data were analysed using logistic regression analysis. RESULTS: Frequent and occasional experiences of bullying and threats and occasional experiences of unwanted sexual attention at baseline entailed a significantly increased risk of turnover at follow-up. Further analyses showed that psychological well-being significantly reduced the risk of turnover and that well-being partially mediated the association between bullying and turnover and fully mediated the association between threats, unwanted sexual attention, and turnover. CONCLUSION: Prevention of threats, unwanted sexual attention and - especially - bullying may contribute towards improving well-being and reducing turnover among eldercare staff.

The Predictive Validity of the Danish Psychosocial Work Environment Questionnaire With Regard to Onset of Depressive Disorders and Long-Term Sickness Absence.

OBJECTIVES: To investigate the predictive validity of 32 measures of the Danish Psychosocial Work Environment Questionnaire (DPQ) against two criteria variables: onset of depressive disorders and long-term sickness absence (LTSA). METHODS: The DPQ was sent to 8958 employed individuals in 14 job groups of which 4340 responded (response rate: 48.4%). Depressive disorders were measured by self-report with a 6-month follow-up. LTSA was measured with a 1-year follow-up in a national register. We analyzed onset of depressive disorders at follow-up using logistic regression models, adjusted for age, sex, and job group, while excluding respondents with depressive disorders at baseline. We analyzed onset of LTSA with Cox regression models, adjusted for age, sex, and job group, while excluding respondents with previous LTSA. RESULTS: The general pattern of the results followed our hypotheses as high job demands, poorly organized working conditions, poor relations to colleagues and superiors, and negative reactions to the work situation predicted onset of depressive disorders at follow-up and onset of LTSA during follow-up. Analyzing onset of depressive disorders and onset of LTSA, we found risk estimates that deviated from unity in most of the investigated associations. Overall, we found higher risk estimates when analyzing onset of depressive disorders compared with onset of LTSA. CONCLUSIONS: The analyses provide support for the predictive validity of most DPQ-measures. Results suggest that the DPQ constitutes a useful tool for identifying risk factors for depression and LTSA in the psychosocial work environment.

Acts of offensive behaviour and risk of long-term sickness absence in the Danish elder-care services: a prospective analysis of register-based outcomes.

PURPOSE: To investigate associations between acts of offensive behaviour (threats, violence, bullying, and unwanted sexual attention) and risk of long-term sickness absence for eight or more consecutive weeks among female staff in the Danish elder-care services. METHODS: These associations were investigated using Cox regression analysis. Data consisted of a merger between Danish survey data collected among 9,520 female employees in the Danish elder-care services and register data on sickness absence compensation. RESULTS: Compared to unexposed employees, employees frequently exposed to threats (HR = 1.52, 95% CI:1.11-2.07), violence (HR = 1.54, 95% CI:1.06-2.25), and bullying (HR = 2.33, 95% CI:1.55-3.51) had significantly increased risk of long-term sickness absence when adjusting for age, job function, tenure, BMI, smoking status, and psychosocial work conditions. When mutually adjusting for the four types of offensive behaviours, only bullying remained significantly associated with risk of long-term sickness absence (HR = 2.26, 95% CI: 1.50-3.42). No significant associations were found between unwanted sexual attention and risk for long-term sickness absence. CONCLUSIONS: Results indicate that prevention of threats, violence, and bullying may contribute to reduced sickness absence among elder-care staff. The results furthermore suggest that work organizations must be attentive on how to handle and prevent acts of offensive behaviour and support targets of offensive behaviours.