bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19-related changes at work and psychosocial work environment: a prospective cohort study
Authors: Airaksinen J , Aalto V , Kivimäki M , Ervasti J
Published: October 2023

Background

Stressful events and uncertain times are known to pose occupational risks. COVID-19 pandemic brought many changes to work, work arrangements, and work environment. Prospective studies are needed to assess the potential effects of these changes on psychosocial work environment.

Methods

We followed a large cohort of Finnish public sector employees using biennial survey data from 2016 to 2022 (n = 22,688). Those who reported a change (over to remote work, other tasks, or team reorganization) in work due to the pandemic in 2020 were compared to those who did not report such a change. Sex-, age, and socioeconomic status -adjusted means for psychosocial factors were calculated in four timepoints separately for the groups of employees with and without changes. Multilevel modelling was applied to examine the change in psychosocial factors accounting for autocorrelation between observations. To examine the potential difference in trends between the groups, time x group interaction was tested.

Results

Transfer to working from home in 2020 (n = 10,587, 47%) was associated with increased work time control (b = 0.07; 95% CI 0.05, 0.08) and social capital (b = 0.03, 95% CI 0.01, 0.05) over time. A transfer to other work tasks in 2020 (n = 1660, 7%) was associated with suboptimal trend in work time control (b= -0.06; 95% CI -0.09, -0.03), and procedural justice (b= -0.05; 95% CI -0.10, 0.00), particularly in 2020 compared to those not exposed to such transfer. Team reorganization in 2020 ((n = 1067, 5%) was associated with suboptimal trend in work time control compared to those not exposed to team reorganization (b= -0.06; 95% CI -0.10, -0.02).

Conclusions

COVID-19 pandemic induced changes at work were associated with mixed changes in the perceived psychosocial work environment.

Key messages

• COVID-19 -induced changes at work may have had unequal impacts on different groups of employees in the public sector.

• Promoting the resilience of the most vulnerable employee groups needs attention in the future.
When a home is no longer the best place – older adults’ use of health and care services in the context of a major healthcare reform
Authors: Aaltonen M , Häsä J , Edgren J
Published: October 2023

This study investigates the association between insufficient home care and the use of health and social care services among older adults. Data was collected from the Resident Assessment Instrument (RAI) home care register linked to registers for health care and primary health care (N = 33,493). The results show that one in six respondents felt that they would be better off living elsewhere than at home with home care, and these respondents used more hospital, emergency, and home care services than those who preferred living at home. The findings suggest that when older adults perceive their home care to be insufficient, they are more likely to utilize a range of health and social care services. Improved service integration could potentially mitigate the increased use of health and social care services by older adults who perceive their home care as inadequate. Furthermore, the ongoing healthcare reform in Finland aims to promote the integration of health and social services, which could lead to improved care outcomes for older adults. The study's findings can inform policymakers and healthcare providers on the importance of identifying and addressing the needs of older home care clients, particularly in the context of the ongoing healthcare reform in Finland.
Influenza's burden: an umbrella review about complications, hospitalizations and mortality
Authors: Properzi S , Santolini G , Bonanno E , Giacchetta I , de Waure C
Published: October 2023

Background

Influenza virus infection is a major cause of morbidity and mortality worldwide, placing high costs to health systems, yet the quantification of its clinical burden remains debated and undervalued. We conducted an umbrella review to provide a summary of current knowledge on the topic.

Methods

We searched PubMed-MEDLINE, Web of Science, and the Cochrane library for both systematic reviews and metanalysis of observational studies reporting quantitative assessment of seasonal influenza clinical burden in terms of complications, hospitalizations, and deaths, published up to 30th April 2022. English records were considered for inclusion. We collated together quantitative measures across different outcomes.

Results

We identified 17 systematic reviews and 10 systematic reviews with meta-analyses published between 2005 and 2022, which included 1321 primary studies conducted from 1918 to 2020 and covering more than 15 million subjects. Of the 27 systematic reviews, 9 (33%) focused on the general population of all ages, 3 (11%) on subjects aged 18 years or older, and 10 (37%) on the paediatric population. Lastly, three reviews (11%) focused on pregnant women, and 2 (7%) on other special populations. Twenty-one (78%) reviews included studies from different countries. Preliminary results show children aged ≤5 years, and adults aged ≥65 mostly contribute to the morbidity and mortality burden of influenza: the hospitalization rate for influenza-related complications is higher in paediatric subjects than in adults (0.27-10% vs 0.02-0.43%) while the highest mortality rate occurs in over65, ranging from 0.12% at community level to 13% among inpatients. Results suggest also a triggering role by influenza for hearth attack in at-cardiovascular risk patients.

Conclusions

Despite variability in estimates, depending on the setting, the geographic area, and the population considered, influenza carries a significant clinical burden, especially - but not only - in fragile groups.

Key messages

• Influenza still poses a significant threat to health systems, which should be addressed with appropriate preventive strategies.

• The best preventive strategy to reduce the flu burden is vaccination, especially in at-risk groups.
Can ChatGPT follow an algorithm for ethical decision-making in public health?
Authors: Anov A , Statev K , Stateva A , Seizov A , Aleksandrova-Yankulovska S
Published: October 2023

Background

With the rapid development of AI, especially chat bots based on Large Language Models like OpenAI ChatGPT and Google Bard, the question of the day is can AI replace (partially or entirely) experts in certain fields - for example in Medical Ethics. The aim of this work is to test the application of ChatGPT to public health ethics (PHE) cases.

Methods

ChatGPT was given the task to analyse Ebola quarantine case in Sierra Leone by applying methodology for ethical analysis of its own choice and by applying a 4-step model for ethical analysis developed in Medical University - Pleven. The tests were done with simple and detailed tasks. No additional plugins to ChatGPT were included.

Results

Given a simple task ChatGPT applied 4-step model to the case - Facts, Stakeholders, Ethical principles (Autonomy, Non-maleficence, Beneficence, Justice), Potential consequences. A brief argumentation was provided for each point. ChatGPT identified key ethical concepts for the case (limiting autonomy and freedom, limiting access to resources). When asked to analyse the case with the principles of PHE as defined in The Cambridge Textbook of Bioethics, ChatGPT still used Beauchamp and Childress principles of bioethics. When introduced to PHE principles ChatGPT identified limiting access to resources, creating social and economic hardship for those affected by quarantine as key issues. ChatGPT managed to apply the 4-step model for ethical analysis developed in Medical University - Pleven to some degree. It produced detailed discussion but didn't use any ethical standards, patient's rights or public health policies that could help with decision-making. Individual autonomy was disregarded by ChatGPT in the most detailed analysis.

Conclusions

ChatGPT has basic knowledge of methodologies for ethical case analysis. With proper guidance and detailed instructions, it could follow complex methodologies and produce a decision.

Key messages

• AI will continue to develop and its inclusion in medicine and public health practice and teaching is inevitable.

• Public health professionals should always be critical of AI decisions and double check the information that was provided by AI.
Multimethod study on patient-reported measures for routine assessment of primary care
Authors: Drexler S , Kiss N , Harrison H L , Bilger M
Published: October 2023

Objectives

Health systems across the Organization for Economic Cooperation and Development (OECD) spend around 9% of their GDP on health, but we know surprisingly little about whether health systems are truly delivering the care people need. One solution is the routine collection of patient reported outcome measures (PROMs) and patient reported experience measures (PREMs), i.e. patients’ subjective health status and experiences of care. The aim of this study is to evaluate whether validated generic PROMs and PREMs measure criteria relevant to routine performance assessment of and monitoring in primary care.

Methods

This is a multimethod study. First, we collected qualitative data using the nominal group technique to identify the roles and tasks of primary care from the perspective of patients, providers, and decision-makers in healthcare. Second, we conducted a systematic literature search in EMBASE supplemented by a grey literature search to identify self-administered, validated, and generic PREMs and PROMs for adults used in primary care.

Results

The role of primary care is not limited to improving health, but also includes, for example, patient empowerment and support in navigating the healthcare system. Experiences of care and the supportive structure of primary care were rated as more important than health outcomes. Six of 14 questionnaires identified in the literature review address both PREMs and PROMs. PREMs largely focused on experiences with healthcare providers. Comparison of both data sources revealed a lack of PREMs addressing experiences with care structures.

Conclusions

The results suggest that care experiences are an outcome in their own right in primary care and should thus be considered in routine evaluation of primary healthcare services, which additionally allows pointing to quality improvements. Future questionnaires should address experiences with care structures and the relationship between care experience and health outcomes.

Key messages

• Alongside health outcomes, care experiences are a primary care outcome in their own right and should thus be considered in routine assessment.

• Future routine assessment tools should address experiences with care structures and the relationship between care experiences and health outcomes.
Investigating the longitudinal impacts of frontline work on healthcare workers family functioning
Authors: Sheen J , Lee BEC , Clancy E M , Considine J , Dwyer A , Tchernegovski P , Reupert A , Taylor N , Herrick C A , Boyd L
Published: October 2023

Background

At a time when many families were sheltering at home, frontline healthcare workers (FHWs) worldwide continued to work in the community, often under significant stress. While it has been well documented that frontline work during the COVID-19 pandemic has had impacts on healthcare workers’ mental and physical health, the impacts on their family functioning remain unclear. This study investigates the longitudinal impact of frontline work on family functioning amongst Australian healthcare workers.

Methods

Semi-structured interviews were conducted with Australian FHWs working in high-risk areas such as Emergency Departments, Intensive Care Units, COVID wards, Hospital in the Home, and Aged Care. Interviews occurred across three timepoints (Dec 2020=39 participants, June 2021=34 participants, Jan 2022=31 participants). Transcripts from each timepoint were analysed separately using reflexive thematic analysis, then whole group comparisons were made between timepoints to identify changes and the nature of the changes.

Results

Flexibility and the need for constant adaptation were consistent themes across the three timepoints, as FHWs struggled to balance the demands of workplace changes alongside lockdown and COVID-19 related changes in their personal lives. In the early stages of the pandemic, families with pre-existing vulnerabilities reported significant challenges whereas others reflected on family resilience and growth. Two years on, even those families that articulated resilience and growth have observed declines associated with the persistent demands of their healthcare roles.

Conclusions

While healthcare organisations globally have made efforts to support their staff, these challenges observed by participants highlights the need for more targeted workplace and public health strategies within healthcare systems, particularly with respect to family support.

Key messages

• Healthcare workers have faced considerable challenges through the course of the COVID-19 pandemic, with declines in mental health and family functioning observed.

• Beyond resilience and wellbeing interventions, healthcare workers need workplaces that acknowledge and support their family lives.
The “Cristo Re” hospital experience on telerehabilitation for treatment post thyroidectomy neck pain
Authors: Nasi G , Princi P , Galeoto G , Brandimarte G , D'Avino A , La Penna M L , Nigro C , Lombardi C P , Tempera S E , Brandimarte G
Published: October 2023

Background

Thyroidectomies are one of the most frequently performed endocrine surgical procedures and are mostly consequent to thyroid cancers with about 80% of patients develop neck pain and stiffness. For better management in a public health setting, Cristo Re Hospital in Rome has designed specific physiotherapy based on selective stretching and strengthening of neck muscles combined with breathing.

Methods

The study enrolled 26 patients with a mean age of 51.2 years: 20 were treated with total thyroidectomy and 6 with thyroid lobectomy. Follow-up was performed at 1 day, 1 week and 1 month after surgery. We used for assessment: Visual Analog Scale (VAS), Neck Pain and Disability Scale-I (NPDS-I), Short Form-12 (SF12), Disability of the Arm, Shoulder and Hand (DASH), Neck Disability Index Questionnaire (NDI). The patients performed 10 therapeutic sessions: the first in the hospital on the first post-surgery day, the others in telerehabilitation 3 times a week (40 min. each) for 3 weeks. A nonparametric Friedmann test was analyzed the differences between the scale averages at T0/T1 and T2. Using case-control analysis the effects of treatment duration (90 min.) were assessed with the U-Mann-Whitney test.

Results

A statistically significant improvement was shown in the Physical Component Summary- SF12 at 1 week and 1 month after treatment (+3 pts at T1, +13.2 at T2 p < 0.001), while no significant changes in the Mental Component Summary. The averages of NPDS-I, NDI and DASH also decreased at T1 and T2 demonstrating the effectiveness of the protocol (-37.7 median points,-18.3 mp,-34.5 mp,-35 mp, respectively p < 0.001). No significant change in VAS scale at T1 and T2 and in patients treated for more or less than 90 minutes.

Conclusions

This protocol is useful for reducing neck pain and improving quality of life and can be recommended as a therapy after thyroidectomy with a strong reduction in cost and morbidity, being able to treat patients even in telerehabilitation.

Key messages

• Therapy after thyroidectomy that, by being able to treat patients even in telerehabilitation, reduces hospitalization rates, costs, and morbidity due to neck pain, with increased quality of life.

• New low-cost methodology for neck physiotherapy after thyroidectomy, also performed in telerehabilitation, which improves quality of life and ability of movement while greatly reducing pain.
Predictive model for patient blood management in elective cardiac surgery: blood bag saving 2013-2020
Authors: Limaj S , Cartocci A , Simeone F , Cevenini G , Messina G , Nante N
Published: October 2023

Background

Blood shortage is a worldwide persistent emergency: it is a relevant topic in scientific research and policy making. There are several research topics about blood management strategies, but there is not much evidence on the quantity of blood bags needed for an elective cardiac surgery. Once they are unfrozen and prepared, they can't be stored anymore even if unused. This study aims to show how many blood bags are saved with the usage of a model, developed by Siena University researchers, that estimates the need for each elective cardiac surgery.

Methods

Data about the number of blood bags predicted by the model for patients that underwent elective cardiac surgery in University Hospital of Siena from 2013 to 2020 were retrospectively collected. Surgeries for aortic dissection, heart transplants and artificial heart implant were excluded. Before developing the model, the general policy of the hospital was to use about 10 blood bags for each patient. The algorithm establishes the number of blood bags based on HCT, therapy, combined and/or a redo operation, Euroscore2 threshold, comorbidities, and type of operation. 4 extra bags were added to every prediction as safety buffer.

Results

This study included 2307 surgical interventions. The sum of all the bags calculated by the model and, thus, prepared for the surgeries, with 4 extra bags as safety buffer per operation, was 13044, compared to the 23070 calculated with the previous criteria. Euroscore 2 score had the closest algorithm prediction to real usage and a mean of 5,4 bags per operation for Euroscore2 <6% and 6,6 for Euroscore2 >6%. Roughly 1.814.706 euros were saved, considering only the rough price of the single blood bag (181€ each).

Conclusions

Machine-learning odels like the one used in this study can improve patient blood management by predicting how many blood bags a patient needs for elective cardiac surgery.

Key messages

• An algorithm can improve patient blood management by predicting how many blood bags a patient needs for elective cardiac surgery.

• Euroscore2, among other criteria such as therapy, comorbidities, and type of operation, improves the accuracy of this algorithm.
Swiss cohort of healthcare professionals & informal caregivers (SCOHPICA): baseline survey's results
Authors: Jolidon V J , Jubin J J , Gilles I G , Escasain L E , Zuercher E Z , Roth L R , Oulevey Bachmann AOB , Peytremann-Bridevaux IPB
Published: October 2023

Background

Worldwide, health systems face workforce problems such as personnel shortages, low job satisfaction and burnout. In Switzerland, data is insufficient to address this health system crisis. Hence, the Swiss COhort of Healthcare Professionals and Informal Caregivers (SCOHPICA) aims to study healthcare professionals (HCPs) and informal caregivers’ experiences, well-being, and career/personal trajectories. Results of the baseline survey on HCPs (completed in January 2023) are reported.

Methods

SCOHPICA is an open prospective cohort. Any HCP working with patients in any healthcare setting in Switzerland was eligible. The data was collected with a self-reported electronic questionnaire. Outcome variables are intents to stay in the job/profession/health sector and well-being; we also explored organizational, psychosocial, psychological and occupational factors, as well as sociodemographic and socioprofessional variables.

Results

The baseline sample included 1707 HCPs, with 32% registered nurses, 12% physicians and 9% physiotherapists among others. In the next few months, 20% of HCPs “not really/not at all intended to stay in their job”, 13% “in their profession” and 11% “in the health sector”; “not intending to stay in the profession” was highest among healthcare assistants (HCAs), nurses and pharmacists. Well-being was also low for these HCPs. Across other factors, pharmacists, physicians, and nurses showed worse scores than other HCPs, especially for workload and work-life balance. HCAs, pharmacists, and nurses reported more burnout and worse self-rated health.

Conclusions

Results revealed that some categories of HCPs had a lower intent to stay in their profession, and worse working conditions and experiences, such as nurses and pharmacists, compared to other HCPs. Future data collections, findings and data dissemination through a data repository will support decision-makers and public health policies with first-hand evidence.

Key messages

• SCOHPICA is the first cohort study to examine the working conditions, intents to leave/stay in the profession, well-being and trajectories of all types of healthcare professional across Switzerland.

• At baseline, 13% of healthcare professionals did not intend to stay in their profession; pharmacists and nurses reported worse working conditions and experiences than other healthcare professionals.
Is workplace mental health stigma associated with managers’ prevention of employee’s sick-leave?
Authors: Schuller S , de Rijk A , Corin L , Bertilsson M
Published: October 2023

Common Mental Disorders (CMDs) are a common cause for sick-leave. CMDs carry stigma and it has been argued that stigma impairs support in the workplace. Earlier research has investigated managers’ personal stigma towards CMDs, but insight into contextual stigma at work, and its importance for sick-leave prevention is lacking. We investigated personal stigma and three layers of contextual stigma (employee, collegial, organizational) and its association with managers’ possibility to take different types of actions to prevent sick-leave. 2,769 Swedish managers from the private sector partook in a survey. Personal stigma was measured with an established scale that was supplemented with four additional items capturing contextual stigma. The managers’ possibility to prevent sick-leave regarding 20 possible preventive actions was assessed using a video vignette design. Principal component analysis revealed three types of actions: ‘Actions to adapt tasks and setting', ‘Actions to involve experts', and ‘Social support actions'. Multiple linear regression analyses were done with the layers of stigma as independent variables for each of the three types of actions, adjusted for co-variates. Personal stigma was significantly associated with the possibility for all types of actions (p<.001). Collegial and organizational stigma was associated with the possibility for ‘Actions to adapt tasks and setting’ (p<.001). Collegial stigma was associated with the possibility for ‘Actions to involve experts’ (p<.001). All contextual stigma variables were associated with the possibility for ‘Social support actions’ (p<.01). More workplace stigma was associated to lower possibility to take action. Personal and contextual stigma were associated with less possibilities for managers to prevent sick-leave in relation to the vignette case. This calls for greater awareness for mental health stigma in workplaces and how stigma can impair sick-leave prevention.

Key messages

• Workplace mental health stigma consists of personal, employee, collegial, and organizational stigma. Managers can take three types of actions: adapt tasks and settings, involve experts, and support.

• More workplace mental health stigma is associated to lower possibility for managers to take action to prevent sick-leave.
Sleep quality, sleep quantity, and sleep disturbances among hospital night workers
Authors: van Elk F , Loef B , Proper K I , Burdorf A , Oude Hengel K M , Robroek SJW
Published: October 2023

Background

Night work impacts sleep and is unavoidable in healthcare. Different sleep components have been studied, such as quality, duration and disturbances, which need to be considered different fundamental components of sleep. In the general population sociodemographic, lifestyle and work factors are associated with these sleep components, but less is known among night workers. Therefore, this study assessed among hospital night workers i) to what extent sleep quality, sleep duration and sleep disturbances overlap, and ii) associations between sociodemographic, lifestyle and work factors and these sleep components.

Methods

Data were used from 467 hospital night workers from the Klokwerk+ study, a prospective cohort study with two measurements. Sleep quality was measured by the Pittsburgh Sleep Quality Index, sleep duration and disturbances were measured by the Medical Outcomes Study Sleep Scale. The proportions of overlap between the three sleep measures were calculated and visualized with a Venn diagram. Associations of sociodemographic, lifestyle, and work factors with the three sleep outcomes were estimated using between-within Poisson regression models.

Results

About 50% of the hospital night workers had at least one poor sleep outcome. Overlap in poor sleep outcomes was apparent for 36.8% of these workers, while the majority had a poor outcome in only one sleep component (63.1%). Former smoking had a significant association with poor sleep quality. For most independent variables no associations with poor sleep outcomes were observed.

Conclusions

Our findings suggest that sleep quality, duration and disturbances are separate entities and should be studied separately. Lifestyle and work factors were generally not associated with poor sleep. Since these factors can have acute effects on sleep, future research should consider ecological momentary assessment to examine how exposure and outcomes (co)vary within-persons, over time, and across contexts.

Key messages

• Sleep quality, sleep duration and sleep disturbances are separate entities of sleep and should be studied as such.

• Lifestyle factors and work characteristics were generally not associated with poor sleep among hospital night workers.
Managerś attitudes towards common mental health problems differ across sectors: a Swedish study
Authors: Bertilsson M , Staland-Nyman C , Hahn M , de Rijk A
Published: October 2023

Background

The stigma around common mental health problems (CMHP) is a problem both in the society and in working life. Workplaces are characterized by prevailing norms and values, with impact on their employees’ attitudes. Population-based studies show highly educated and females to stigmatize CMPH less than others. Still, we lack knowledge if attitudes towards CMHP differ across work sectors. Our aim was to investigate if attitudes to CMHP of managers differ between blue, white and pink collar work sectors.

Methods

A version of the MSED scale, measuring managers’ stigma to employees with CMHP, was answered by Swedish managers (n = 2710) in the private sector in a web-survey in 2021. The participants were grouped into blue collar sector (working with things), white collar sector (working with symbols), pink collar sector (working with people) and others, based on industry affiliation. Multivariable logistic regression was used for calculating probabilities (ORs with 95% CI) for negative attitudes towards CMHP among white, pink and others using blue sector as reference category, adjusted for several organizational and individual factors.

Results

Compared to managers in the blue sector, managers in other sectors were less likely to have negative attitudes towards CMHP. For managers in the white sector the OR was 0.71 (CI 0.56-0.91), in the pink sector the OR was 0.76 (CI 0.58-0.99) and for managers in the other sector the OR was 0.64 (CI 0.47-0.86).

Discussions

The result confirmed that managers in the blue sector, which is characterized by more male employees and a lower educational level, were more likely to report stigmatizing attitudes to CMHP. Interventions to decrease stigma in workplaces need to be tailored differently depending on work sector.

Key messages

• Managers working in the private blue-collar sector in Sweden report a more negative attitude towards mental health problems than managers in other private sectors.

• The private blue-collar sector needs more awareness regarding reducing stigma around mental health problems than other private sectors.
Distress among healthcare professionals during the first two years of COVID-19 pandemic in Portugal
Authors: Costa A , Fialho M , Rasga C , Martiniano H , Santos O , Virgolino A , Moura Vicente A , Heitor M J
Published: October 2023

Background

The COVID-19 pandemic increased existing psychosocial risk factors among healthcare professionals (HCPs). Integrated into a wider project, the main objective of this study was to characterize Portuguese HCPs mental health (MH), estimate the percentage of symptoms of anxiety, depression, post-traumatic stress disorder (PTSD), and burnout, and identify risk and protective factors.

Methods

A cross-sectional online survey and a longitudinal assessment were conducted in 2020 (T0) and 2021 (T1). Sociodemographic and occupational variables, as well as protection behaviors and pandemic-context data were collected from a large non-probabilistic sample of HCPs in Portugal. MH outcomes were assessed using instruments with sound psychometric properties. Risk and protective factors were evaluated through simple and multiple logistic regression models.

Results

A total of 2027 HCPs participated in the survey in T0; 1843 in T1. Despite the percentage of moderate to severe symptoms had decreased from T0 to T1: 26.1% and 23.3% for anxiety (T0 and T1, respectively; p = 0.028), 25.3% and 23.7% for depression, 22.7% and 19.1% for PTSD (p = 0.003), and 29.8% to 29.5% for burnout, a considerable proportion of HCPs reported symptoms of distress in both years. Being a woman, working in a COVID-19-treatment frontline position and the perception of work-life imbalance increased the odds of distress (in both T0 and T1), whilst high resilience, good social/family support, and hobbies/lifestyle maintenance were found to be MH protective factors.

Conclusions

The longitudinal approach of our study allowed following-up changes in HCPs mental health and show that performing as an HCP during the pandemic may result in long-term effects on MH. Our results also provide evidence to support interventions targeting gender and professional sub-groups. Further studies are needed to understand the potential long-lasting psychological burden related to COVID-19 among HCPs.

Key messages

• Our findings are crucial to understand the psychological burden of Portuguese HCPs during the pandemic and to advocate the need of tailored interventions targeting gender and professional sub-groups.

• Protecting HCPs mental health by mitigating risks factors and reducing the possibility of long-lasting psychiatric morbidity is paramount to ensure the provision of sustainable healthcare services.
Barriers, facilitators and needs for self-direction in return-to-work: a multi-perspective study
Authors: de Mul B P , de Vries H J , van Ooijen R , Roelen CAM , Brouwer S
Published: October 2023

Background

Long-term sickness absence is not only an organizational, but also a societal public health problem. Many sick-listed workers experience challenges in self-directing their return-to-work (RTW), where RTW is considered as a gradual process in which work hours and tasks are gradually increased. This view of RTW as a process is common in several European countries, such as The Netherlands, Sweden, Denmark, Norway, Austria, Germany and Switzerland. Self-direction in RTW can reduce long-term sickness absence. The aim of this study is to provide a multi-perspective view on the experiences and needs regarding workers’ self-direction in RTW.

Methods

We conducted semi-structured interviews with (previously) sick-listed workers (n = 7) and focus groups with occupational physicians and labour experts (n = 10), case managers and job coaches (n = 6) and organizational representatives (n = 8). The interviews and focus groups were recorded, transcribed and coded thematically by two independent researchers.

Preliminary results

All stakeholders considered (self-directing) RTW as a learning process. Barriers to self-direct RTW were lack of sufficient support from employers and involved RTW professionals, lack of knowledge about the RTW process and responsibilities among both workers and their supervisors, and employers complying with legal requirements rather than applying a person-centered approach. Workers and the involved professionals emphasized the need to gain insight into long-term employability perspectives and scenarios to maintain work.

Conclusions

This qualitative study shows that there is a need for knowledge among workers and person centered support in RTW. The findings can be used in policy and practice to improve self-direction of sick-listed workers during RTW.

Key messages

• (Self-directing) RTW is a learning process for sick-listed workers.

• Sick-listed workers need knowledge and person-centered support from employers and professionals to self-direct RTW.
The role of gender composition in workplace sexual harassment
Authors: Larsson N P , Craven L , Madsen IEH
Published: October 2023

Background

Workplace sexual harassment is associated with adverse mental health consequences and research suggests that gender minority status may be a risk factor. We analysed the prevalence of workplace sexual harassment in male and female-dominated-occupations to elucidate the role of gender minority status.

Methods

We analysed data from a survey (n = 9,012) on sexual harassment from a random sample representative of the Danish workforce. We measured sexual harassment by 21 items covering three domains: (1) unwanted sexual attention, (2) gender harassment and (3) sexual coercion. We focused on sexual harassment conducted by other employees at the workplace. We categorized the gender-ratio for male- or female-dominated occupations into: low (under 25%), medium (25% - 75%), and high (more than 75%).

Results

We found an increased risk of sexual harassment in both male and female dominated occupations. Women in male dominated occupations had higher risk, with prevalences of 25.3% (95%CI 19.5; 31.1) for high, 21.8% (95%CI 19.1; 24.3) for medium, and 10.4% (95%CI: 8.1; 12.8) for low proportion of men. We found similar patterns across all three domains of harassing behaviours. For men, the pattern in relation to female-dominated occupations was slightly different. We found that men had the lowest risk of sexual harassment in gender-balanced occupations. The prevalence for men in occupations with medium proportion of women was 14.0% (95%CI: 11.9; 16.1), whereas the prevalence for men in occupations with high proportion of women was 21.1% (95%CI: 13.3; 28.8), and it was 16.1% (95%CI: 12.7; 19.5) in occupations with low proportion of women. We saw similar patterns in all domains except gender harassment.

Conclusions

Both men and women were most likely to report sexual harassment in occupations where they were a gender minority. The results highlight the role of gender composition in workplace sexual harassment and calls for further attention on prevention in high risk groups.

Key messages

• Both men and women reported more often sexual harassment when they were a gender minority in their occupation.

• For women, prevalence of sexual harassment was lowest in occupations with a low proportion of men, whereas for men, prevalence of sexual harassment was lowest in occupations with gender-balance.
Work participation of elderly construction workers. A systematic review and qualitative analysis
Authors: Schultz Petersen K , Hansen C H , Fonager K , Bøggild H
Published: October 2023

Background

Trends towards longer labor market participation are seen in international policies. In the EU countries, labor force participation rate for those past 60 years of age, has been raised extensively for the past decade. In 2035 Danish workers are expected to work till 69 years of age. The aim of the study was twofold, firstly to identify and synthesize findings from former studies of factors of importance in construction workers (age 55+) work participation and secondly to understand and explore how construction workers experience their work participation.

Methods

A systematic review and integrative thematic synthesis of qualitative and quantitative studies aiming to identify factors of importance in construction workers work participation were carried out followed by individual interview 20 Danish construction workers and thematic analysis.

Results

Four themes illustrating factors influencing construction workers work participation were identified in the review. Theme 1 Socioeconomical and cultural factors, Theme 2 Legislation and policy, Theme 3 Workplace factors and Theme 4 Individual factors. The identified themes helped structure the interview guide. Preliminary results of the individual interviews provide a deeper understanding of how both individual, social and workplace factors interacts and how it is possible for construction workers to compensate from the experienced age-related physical limitations. Elderly construction workers adjust and compensate for demanding work tasks by receiving support from co-workers and having less demanding work tasks during their workday. Both physical and psychosocial work environment and employers’ attitudes towards elderly workers seems to be significant for their ability for working late in life.

Conclusions

The interplay between individual, psychosocial, and work environmental factors are affecting elderly construction workers work participation which have an impact on their work retention late in life.

Key messages

• Elderly construction workers work participation depends on the physical and the psychosocial work environment and possibilities for adjustment and compensation for performing demanding work tasks.

• individual, social and workplace factors interacts and how it is possible for construction workers to compensate from the experienced age-related physical limitations.
The consequences of informal employment on workers’ health and family well-being in Europe
Authors: Aronsson A
Published: October 2023

Introduction

Informal employment, characterized by unregistered and unprotected employment arrangements, can be detrimental to the health and well-being of workers and their families. Because non-standard work with ambiguous employment arrangements is growing more common across Europe, informal employment is becoming a health risk for an increasing number of people. The aim of this study is to explore the link between informal employment and health, focusing on the effect of employment precariousness and accounting for macrostructural contextual factors.

Methods

A sample of workers aged 15-64 in Europe from the latest European Working Conditions Survey of 2021, will be used. Using logistic regression models, with standard employment as the reference, the consequences of informal employment on physical health, psychosocial health, and family well-being will be assessed. The effects of precarious conditions (employment insecurity, low material rewards, lack of rights and opportunities, and disempowerment) on the relationship will be tested.

Results

Based on existing theory, the results should reveal that informal employment is associated with adverse outcomes. Precarious employment conditions should have a stronger effect for informal workers and their families as opposed to workers in standard employment. The results will be analyzed in relation to country-based structural factors such as welfare state policies and labour market trends.

Conclusions

The study will have implications for both research and policy. It will fill a critical research gap of the underexplored association between informal employment, workers’ health, and family well-being. Since non-standard work is growing in the European countries, the results should also demonstrate the importance of targeted policies to reduce the negative effect of this type of work to protect the health of not only workers, but the well-being of their families.

Key messages

• Informal employment is associated with adverse outcomes among workers and their families.

• Employment precariousness is key to explaining how informality determines health and should therefore be at the core when adapting policies to the current labour market transformations.
Sick at work and future sickness absence - a prospective study of two measures of sickness presence
Authors: Hansen C D , Dalgaard L , Winding T N , Andersen J H
Published: October 2023

Background

Sickness presence (SP), or going to work despite being ill, is a common way of practicing sickness absence (SA). However, its consequences for long-term SA are poorly understood, and there is no consensus on how to measure SP. This study aims to examine the consequences of SP on long-term sickness absence (>14 days) using two different measures.

Methods

Data from a Danish public human service organization were analyzed, with approximately 2400 employees answering questionnaires in November 2019, yielding a response rate of 50%. Information on SA, work environment, self-reported health, SP episodes, and sociodemographic information were included in negative binomial regression models. The outcome variable was prospective episodes of SA (>14 days) taken from the SA register of the organization. Two different ways of measuring SP were used: a traditional measure of overall SP frequency and a measure of going to work with specific symptoms (fever, cold, headache, musculoskeletal pain).

Results

Participants who reported SP frequency of more than 10 times during the last 6 months had a two-fold risk of long-term SA (IRR: 2.19 (95%CI 1.09-4.58)) in the follow-up period. This risk remained significant even after adjusting for work environment factors, sociodemographic factors, self-rated health, and spells of sickness absence in the previous year. Going to work with fever (IR: 1.43) or cold (IR: 1.48) was also associated with long-term SA in the follow-up period.

Conclusions

SP may negatively impact employees’ health status and increase long-term sickness absence. Health professionals should be aware of the negative consequences of focusing solely on reducing short-term sickness absence especially if they inadvertently encourage employees to substitute sickness presence for sickness absence.

Key messages

• Going to work despite having ill health is common but may have adverse health consequences and lead to long-term sickness absence.

• Focusing narrowly on reducing short-term sickness absence might be a bad idea for public health. Employees might feel encouraged to go ill to work which could increase future sick leave.
Introducing outdoor office work to reduce stress among office workers in Sweden
Authors: Javan Abraham F , Andreasson P , King A , Bälter K , Toivanen S
Published: October 2023

Background

Office workplace stress is concerning as it leads to adverse and chronic health outcomes. Outdoor office work (OOW), an innovative practice may address these challenges as being outdoors has potential benefits. This study aims to assess stress among office workers that are working in their normal indoor office compared to practicing OOW and identifying facilitators and barriers for doing OOW.

Methods

In a feasibility study, 9 office workers were asked to work indoors the 1st week and OOW for at least 30 minutes per day during the 2nd week. They wore a heart rate variability (HRV) monitor (FirstBeat BG3) for 2 weeks while at work to assess objective stress. Subjective stress was assessed via daily surveys using a scale of 1 to 10 from “not stressed at all” to “very stressed”. They were instructed to use the app “Our Voice Discovery Tool” to take photos of facilitators or barriers to practicing OOW.

Subjective stress data was analysed using paired sample t-test in SPSS 28. Photos were categorised into themes. Analysis of HRV time and frequency parameters is underway.

Results

Preliminary findings show statistically significant decrease in stress scores between week 1 (M = 4.42, SD = 1.43) and week 2 (M = 3.74, SD = 1.31) t(7)=1.91, p=.049 (one-tailed), mean decrease in self-rated stress was .68 with a 95% confidence interval ranging from -.12 to 1.43. The Cohen's d (.67) indicated a medium effect size. Picture analysis revealed themes related to “convenience/comfort”, equipment/facilities”, and “weather” as barriers. Out of 76 pictures, most themed “nature”, both indoor and outdoor, were marked as positive experiences.

Conclusions

Reduction in subjective stress from week 1 to week 2 suggests OOW's potential as useful method to reduce work-related stress. Picture analysis suggests, to ensure a healthier milieu for office workers, conditions conducive to OOW such as outdoor work facilities and green spaces in offices’ vicinity may need to be facilitated by employers.

Key messages

• Outdoor office work (OOW) may reduce workplace stress, potentially improving employee health, well-being, and productivity.

• Employers should facilitate outdoor workspaces and green areas to promote healthier office environments.
Identification and evaluation of cases of polypharmacy and irrational pharmacotherapy in Georgia
Authors: Gabunia L , Ratiani L , Gorgaslidze N , Sanikidze T , Gvishiani M , Gumbaridze L , Rukhadze L , Rtveladze T , Iosebidze T , Varazi G
Published: October 2023

Background

Medical practice sometimes involves the prescription of multiple medications (5 or more) at once, known as polypharmacy. Most frequently it occurs when a patient receives care from multiple doctors as a result of poly morbidity. The study aimed to identify polypharmacy cases (prescribing 5 or more than 5 medications) and irrational pharmacotherapy.

Methods

Polypharmacy and irrational pharmacotherapy cases in Georgia from 1 July to 30 September 2021 were evaluated using an electronic prescription system. The total number of polypharmacy was 7665, where 5 or more medications were prescribed. Out of 7665 cases, 612 (8%) were irrational pharmacotherapy that was assessed according to Beers criteria (American Geriatrics Association, 2015) and STOP/START criteria (recommendations of the Great Britain National Health Organization, NHS, 2014).

Results

Out of 612 cases 95 (15.6%) indicated irrational prescription (2 or more drugs) containing the same active ingredient under different trade names, which represented 1.2% of the total number of prescriptions; out of 612 cases 72% (440) and 5.9% out of a total number of cases the simultaneous appointment of drugs of the same and/or similar pharmacological group was detected. In 9.4% of cases (57) non-rational pharmacotherapy (an incompatibility of drugs) was revealed that was 0.8% of the total cases; out of 612 cases 20, or 3%, and 0.3% of the total cases showed that the prescription contained more than 2 antibiotics.

Conclusions

Medical polypharmacy is widespread in Georgia, especially in co-morbid elderly patients, which further increases their morbidity and mortality rates. The obtained results could be used to increase the efficiency of treatment, improve the population's health and reduce treatment costs.

Key messages

• The selection drug or combination of drugs is a complex process and requires justification of the appropriateness of the prescription for a particular patient.

• A major goal of the best clinical practice is to optimize the use of medical preparations, improve quality of life and reduce expenses on drugs.