Fatigue in the workforce of National Health Service Trusts: levels of symptomatology and links with minor psychiatric disorder, demographic, occupational and work role factors

A machine learning model to predict privacy fatigued users from social media personalized advertisements

The increasing use of social media platforms as personalized advertising channels is a double-edged sword. A high level of personalization on these platforms increases users' sense of losing control over personal data: This could trigger the privacy fatigue phenomenon manifested in emotional exhaustion and cynicism toward privacy, which leads to a lack of privacy-protective behavior. Machine learning has shown its effectiveness in the early prediction of people's psychological state to avoid such consequences. Therefore, this study aims to classify users with low and medium-to-high levels of privacy fatigue, based on their information privacy awareness and big-five personality traits. A dataset was collected from 538 participants via an online questionnaire. The prediction models were built using the Support Vector Machine, Naïve Bayes, K-Nearest Neighbors, Decision Tree, and Random Forest classifiers, based on the literature. The results showed that awareness and conscientiousness trait have a significant relationship with privacy fatigue. Support Vector Machine and Naïve Bayes classifiers outperformed the other classifiers by attaining a classification accuracy of 78%, F1 of 87%, recall of 100% and 98%, and precision of 78% and 79% respectively, using five-fold cross-validation.

Impression Management on Instagram and Unethical Behavior: The Role of Gender and Social Media Fatigue

Impression management (IM) concerns can lead to significant psychological consequences, potentially engendering unethical behavior. Therefore, adopting the stressor-strain-outcome framework, this study explores the effects of IM concerns on unethical behavior through wellbeing, and whether IM on social media (i.e., Instagram) triggers fatigue and results in unethical behavior at work. The findings of two empirical studies (n = 480 and n = 299) in different settings (Kuwait and the UK) suggest that women experience higher effects from IM concerns compared with men in Kuwait, while no gender differences are found in the UK. The results also confirm that impression management on social media platforms triggers fatigue, in turn increasing unethical behavior at work. This study contributes to the IM literature by capturing the effect of Instagram activities on workplace behavior.

User characteristics, social media use, and fatigue during the coronavirus pandemic: A stressor–strain–outcome framework

Social networking platforms allow people to connect and socialize online, but the extant research suggests that increased social media (SM) use also leads to fatigue, affecting individual well-being. During the coronavirus (COVID-19) pandemic when millions of people were confined to their homes, SM use surged, posing questions about changes in individual SM use behaviors and effects. Guided by the stressor–strain–outcome framework and SM use research, this study examined the relationship among personal factors (gender, caregiving, income), two stressors (SM use intensity and risk concern about COVID-19), and the strain of SM fatigue. Survey data of 192 U.S. adult SM users were collected in late March of 2020. Our quantitative data analysis shows that SM fatigue increased significantly as individual concern about COVID-19 increased. Meanwhile, gender and caregiving responsibilities significantly impacted SM use intensity. Surprisingly, the predicted effect of SM use intensity on SM fatigue was not supported. Additional factor analysis revealed three motives of SM use (entertainment, networking, and collaboration) and quantitative analysis revealed that only the networking use of SM increased SM fatigue significantly. The results highlight the importance of considering individual risk concern and SM use motives when studying individual SM fatigue during crises.

The home environment in a nationwide sample of multi-family buildings in Sweden: associations with ocular, nasal, throat and dermal symptoms, headache, and fatigue among adults

Risk factors at home for ocular, nasal, throat and dermal symptoms, headache, and fatigue were studied in a nationwide questionnaire survey in Sweden, the BETSI study in 2006. Totally, 5775 adults from a stratified random sample of multi-family buildings participated. Associations between home environment factors and weekly symptoms were analyzed by multi-level logistic regression. In total, 8.3% had ocular symptoms; 11.9% nasal symptoms; 7.1% throat symptoms; 11.9% dermal symptoms; 8.5% headache and 23.1% fatigue. Subjects in colder climate zones had more mucosal and throat symptoms but less fatigue and ocular symptoms. Rented apartments had poorer indoor environment than self-owned apartments. Those living in buildings constructed from 1961 to 1985 had most symptoms. Building dampness, mold and mold odor were risk factors, especially headache and ocular symptoms. Lack of mechanical ventilation system was another risk factor, especially for headache. Environmental tobacco smoke (ETS), electric radiators, and crowdedness were other risk factors. Oiled wooden floors, recent indoor painting, and new floor materials were negatively associated with symptoms. In conclusion, building dampness, mold, poor ventilation conditions, crowdedness, ETS, and emissions from electric radiators in apartments in Sweden can increase the risk of ocular, nasal, throat and dermal symptoms, headache, and fatigue.

Work Fatigue in a Hospital Setting: The Experience at Cheng Hsin General Hospital

We aimed to investigate fatigue and its related factors in a medical professional population aged ≥30 years, as appraised by the implementation of an employee health screening program at Cheng Hsin General Hospital in Taipei, Taiwan. The study participants included a total of 2132 (400 males and 1732 females) healthy medical professionals enrolled in a teaching hospital who underwent physical verification in 2019. Demographic characteristics and fatigue information were collected. The overall prevalence of personal- and work-related fatigue in this study population was 41.4% and 39.1%, respectively. The prevalence of a high risk of work- or personal-related fatigue proved to be substantially greater (p-value for chi-square test <0.0001) than it was for a low or moderate risk of personal-related fatigue. Using multinominal logistic regression analysis, seniority and position were statistically significant in relation to a high risk of personal- and work-related fatigue. Personal- and work-related fatigue were found to be prevalent in physicians and nurses. Lower seniority was also related to severe personal- or work-related fatigue. Providing this population with controlled working environments and health improvements is important.

Understanding determinants of social networking service fatigue: an interpretive structural modeling approach

Purpose

The purpose of this paper is to build a comprehensive structural model to demonstrate the interrelationships of factors influencing social networking service (SNS) fatigue and to identify the varying degrees of influence.

Design/methodology/approach

A total of 14 factors influencing SNS fatigue are identified through an extensive literature review. Interpretive structural modeling (ISM) and Matrice d'Impacts Croisés Multiplication Appliqué à un Classement (MICMAC) analysis are employed to build a hierarchical model and classify these factors into four clusters.

Findings

The results revealed that ubiquitous connectivity and immediacy of feedback are key factors contributing to SNS fatigue through their strong influence on other factors. Privacy concern, impression management concern and work–life conflict lead directly to SNS fatigue. In contrast, system feature overload and system pace of change are relatively insignificant in generating SNS fatigue.

Originality/value

This study represents an initial step toward comprehensively understanding the interrelationships among the factors leading to SNS fatigue and reveals how determinants of SNS fatigue are hierarchically organized, thus extending existing research on SNS fatigue. It also provides logical consistency in the ISM-based model for SNS fatigue by grouping identified factors into dependent and independent categories. Moreover, it extends the applicability of the integration of the ISM and MICMAC approaches to the phenomenon of SNS fatigue.

Why people need privacy? The role of privacy fatigue in app users' intention to disclose privacy: based on personality traits

Purpose

Mobile Applications (App) privacy has become a prominent social problem. Compared with privacy concerns, this study examines a relatively novel concept of privacy fatigue and explores its effect on the users’ intention to disclose their personal information via mobile Apps. In addition, the personality traits are proposed as antecedents that will induce the personal perception of privacy fatigue and privacy concerns differently.

Design/methodology/approach

Data were collected from 426 respondents. Structure equation modeling was used to test the hypotheses.

Findings

The findings describe that App users’ intention toward personal information disclosure is determined by privacy fatigue and privacy concerns, but the former has a greater impact. With minor exceptions, the two factors are also influenced by different personality traits. Specifically, neuroticism has positive effects on privacy fatigue, but agreeableness and extraversion have presented the opposite results on the two variables.

Practical implications

This research is very scarce to examine the joint effects of privacy fatigue, privacy concerns and personality traits on App users’ disclosing intention. In doing so, these results will be of benefit to App providers and platform managers and can be the basis for a variety of follow-up studies.

Originality/value

While previous research just focuses on privacy concerns, this study explores the critical roles of privacy fatigue and opens up a new avenue of emotion-attitude analysis that can further increase the specificity and richness of users’ privacy research. Additionally, implications for personality traits as antecedents in the impact of App users’ privacy emotions and attitudes are discussed.

Why does work cause fatigue? A real-time investigation of fatigue, and determinants of fatigue in nurses working 12-hour shifts

BACKGROUND

One of the striking regularities of human behavior is that a prolonged physical, cognitive, or emotional activity leads to feelings of fatigue. Fatigue could be due to (1) depletion of a finite resource of physical and/or psychological energy or (2) changes in motivation, attention, and goal-directed effort (e.g. motivational control theory).

PURPOSE

To contrast predictions from these two views in a real-time study of subjective fatigue in nurses while working.

METHODS

One hundred nurses provided 1,453 assessments over two 12-hr shifts. Nurses rated fatigue, demand, control, and reward every 90 min. Physical energy expenditure was measured objectively using Actiheart. Hypotheses were tested using multilevel models to predict fatigue from (a) the accumulated values of physical energy expended, demand, control, and reward over the shift and (b) from distributed lag models of the same variables over the previous 90 min.

RESULTS

Virtually all participants showed increasing fatigue over the work period. This increase was slightly greater when working overnight. Fatigue was not dependent on physical energy expended nor perceived work demands. However, it was related to perceived control over work and perceived reward associated with work.

CONCLUSIONS

Findings provide little support for a resource depletion model; however, the finding that control and reward both predicted fatigue is consistent with a motivational account of fatigue.

Understanding employees' adoption of the Bring-Your-Own-Device (BYOD): the roles of information security-related conflict and fatigue

Purpose

While the bring-your-own-device (BYOD) trend provides benefits for employees, it also poses security risks to organizations. This study explores whether and how employees decide to adopt BYOD practices when they encounter information security–related conflict.

Design/methodology/approach

Using survey data from 235 employees of Chinese enterprises and applying partial least squares based structural equation modeling (PLS-SEM), we test a series of hypotheses.

Findings

The results suggest that information security–related conflict elicits information security fatigue among employees. As their information security fatigue increases, employees become less likely to adopt BYOD practices. In addition, information security–related conflict has an indirect effect on employee's BYOD adoption through the full mediation of information security fatigue.

Practical implications

This study provides practical implications to adopt BYOD in the workplace through conflict management measures and emotion management strategies. Conflict management measures focused on the reducing of four facets of information security–related conflict, such as improve organization's privacy policies and help employees to build security habits. Emotion management strategies highlighted the solutions to reduce fatigue through easing conflict, such as involving employees in the development or update of information security policies to voice their demands of privacy and other rights.

Originality/value

Our study extends knowledge by focusing on the barriers to employees' BYOD adoption when considering information security in the workplace. Specifically, this study takes a conflict perspective and builds a multi-faceted construct of information security–related conflict. Our study also extends information security behavior research by revealing an emotion-based mediation effect, that of information security fatigue, to explore the mechanism underlying the influence of information security–related conflict on employee behavior.

Relationship between Job Stress and Fatigue Based on Job Demand-control-support Model in Hospital Nurses

Background

This study aimed to examine nurses' job stress based on Karasek's demand-control-support model and assess its relationship with different aspects of fatigue.

Methods

This cross-sectional study was conducted on 522 nurses working in educational hospitals. Job stress dimensions and fatigue were measured by the Persian version of Job Content Questionnaire (JCQ) and Multidimensional Fatigue Inventory (MFI), respectively.

Results

The results showed that psychological and physical job demands obtained high scores, but social support and decision latitude got low scores. MFI results indicated that the highest score was related to the general fatigue. Moreover, the results showed a significant positive relationship between psychological job demands and general fatigue, but a significant negative correlation to reduced activity.

Conclusions

Considering the effects of job stress on nurses' fatigue, it is necessary to develop a suitable interventional program for nurses in healthcare centers, especially hospitals, to decrease job stress and improve working conditions.

An empirical investigation of the continuance intention using the bullet curtain

Purpose

In accordance with Bagozzi’s self-regulation theory, the aim of this paper is to explore the enablers and inhibitors of continuance intention from the perspective of bullet curtain, a new form of commentary on online video websites.

Design/methodology/approach

A total of 350 questionnaires were collected for the final analysis (covering 101 questionnaires for the pilot test) from China’s bullet curtain website. To analyze the model, the authors adopted SmartPLS 3.2, a structural equation modeling software.

Findings

As the results suggest, there is a positive correlation between satisfaction and continuance intention and a negative association between social network fatigue and continuance intention. In addition, synchronicity between the comments and video content, a dimension of synchronicity proposed in this study, improves the satisfaction. Furthermore, information overload significantly intensify social network fatigue.

Practical implications

The results help bullet curtain providers offer better interactive environment and improve websites’ functions to stimulate users.

Originality/value

By combining positive effect and negative effect of commentary, this study investigates Bagozzi’s theory in a context of bullet curtain. Besides, combinations of these factors help to gain insights in how the bullet curtain works in online video websites. These offer useful guidelines for managers to optimize a better system.

Social network fatigue affecting continuance intention of social networking services

Purpose

The purpose of this paper is to explore how social network fatigue affects continuance intention of social networking services (SNSs) from a more comprehensive perspective.

Design/methodology/approach

A research model was proposed by integrating uses and gratification theory (UGT), social network fatigue and continuance intention. The relationships between the three dimensions of UGT and continuance intention were examined, as well as the direct and moderating effects of social network fatigue. To collect data, an online survey was adopted, and 227 valid responses were analyzed by structural equation modeling.

Findings

The empirical findings demonstrate that utilitarian gratification (information seeking), social gratification (social interaction) and hedonic gratification (perceived enjoyment) are positively associated with SNS users’ continuance intention. Meanwhile, social network fatigue can directly and negatively affect continuance intention. Furthermore, the relationships between the two dimensions of UGT (information seeking, perceived enjoyment) and continuance intention are also negatively moderated by social network fatigue.

Originality/value

This study contributes to the understanding about the relationship between continuance intention and social network fatigue. The authors indicate that social network fatigue will not only directly weaken SNS users’ continuance intention, but also negatively influence the formation process of the continuance intention. Some other theoretical and practical implications are also provided.

Healing ourselves: ethical issues in the care of sick doctors

In this paper I review some of the ethical dilemmas that arise when psychiatrists are involved in the assessment and treatment of medical colleagues. Special attention needs to be paid to the context of the relationship between the psychiatrist and the doctor-patient, and to the extent to which the patient is seeking help voluntarily or at the request of a third party. Psychiatrists may find themselves uncertain about how to meet the ethical demands of their duties to the patient and their duties to the public, when these conflict.

A comparison of stress levels, coping styles and psychological morbidity between graduate-entry and traditional undergraduate medical students during the first 2 years at a UK medical school

BACKGROUND

Stress levels and psychological morbidity are high among undergraduate medical students (UGs), but there is a lack of research into the psychological health of UK graduate-entry medical students (GEs). GEs are likely to experience different (perhaps more severe) stressors and to cope with stress differently. We compared stress levels, psychological morbidity and coping styles in GE versus UG medical students studying at the same UK medical school in the same academic year. A cross-sectional self-rated questionnaire study of all first- and second-year GE and UG medical students was conducted. Perceived stress, psychological morbidity, recent adverse life events, stress-related personality traits and coping styles were assessed using standard questionnaires.

RESULTS

75% GEs and 46% UGs responded to the questionnaire. Both groups reported equally high levels, and similar profiles of, perceived stress and psychological morbidity. Levels of recent adverse life events and stress-related personality traits were similar in both groups. Compared to UGs, GEs were more likely to use active coping (p = 0.02) and positive reframing (p = 0.03), but were also more likely to use substances (alcohol and other drugs; p < 0.001) to help them cope. Unlike UGs, second-year GEs showed less perceived stress (p = 0.007) and psychological morbidity (p = 0.006) than first-year GEs although levels of both were still high.

CONCLUSION

Our results show that both GE students and their younger UG counterparts on a traditional medical course have similar profiles of stress symptoms. They do, however, cope with stress differently. GEs are more likely to use active problem-focused coping strategies, and they are also more likely to cope by using substances (alcohol or other drugs). GE students need interventions to prevent maladaptive coping styles and encourage adaptive coping that are tailored to their needs. Such interventions should be targeted at first-year students. It is vital that these students develop positive coping skills to benefit them during training and in a future career that is inherently stressful.

The Association between Job-Related Psychosocial Factors and Prolonged Fatigue among Industrial Employees in Taiwan

Background and Objectives

Prolonged fatigue is common among employees, but the relationship between prolonged fatigue and job-related psychosocial factors is seldom studied. This study aimed (1) to assess the individual relations of physical condition, psychological condition, and job-related psychosocial factors to prolonged fatigue among employees, and (2) to clarify the associations between job-related psychosocial factors and prolonged fatigue using hierarchical regression when demographic characteristics, physical condition, and psychological condition were controlled.

Methods

A cross-sectional study was employed. A questionnaire was used to obtain information pertaining to demographic characteristics, physical condition (perceived physical health and exercise routine), psychological condition (perceived mental health and psychological distress), job-related psychosocial factors (job demand, job control, and workplace social support), and prolonged fatigue.

Results

A total of 3,109 employees were recruited. Using multiple regression with controlled demographic characteristics, psychological condition explained 52.0% of the variance in prolonged fatigue. Physical condition and job-related psychosocial factors had an adjusted R² of 0.370 and 0.251, respectively. Hierarchical multiple regression revealed that, among job-related psychosocial factors, job demand and job control showed significant associations with fatigue.

Conclusion

Our findings highlight the role of job demand and job control, in addition to the role of perceived physical health, perceived mental health, and psychological distress, in workers’ prolonged fatigue. However, more research is required to verify the causation among all the variables.

Demographic Factors and their Relation to Fatigue and Mental Disorders in 12-Hour Petrochemical Shift Workers

BACKGROUND

Shift workers may be exposed to fatigue and mental disorders due to various work-related risk factors. This study evaluated the impact of demographic characteristics on fatigue and mental disorders among 12-hour shift workers in petrochemical industries.

METHODS

This study was conducted among 290 shift workers of Pardis Petrochemical Company in Iran. Data were collected using a general questionnaire for the demographic characteristic as well as multidimensional fatigue inventory (MFI-20) and general health questionnaire (GHQ-28).

RESULTS

Married workers were less likely to suffer from reduced activity levels (P< 0.027), depression (P< 0.032) and mental disorders (P< 0.040). Social dysfunction score (P< 0.029) and mental disorders (P< 0.048) decreased with shift work experience. Shift workers with non-academic education less likely to suffer from reduced activity levels (P< 0.000) and mental fatigue (P< 0.028).

CONCLUSION

Despite the significant difference between the variables, this study showed a weak effect of individual and occupational demographic characteristics on fatigue and mental disorders.

Prevalence of fatigue and associated factors in chronic low back pain patients

OBJECTIVES

to determine the prevalence and key factors associated with fatigue in chronic low back pain patients.

METHODS

cross-sectional study of 215 chronic low back pain patients from three health care centers and two industrial corporations. The crude prevalence of fatigue and its 95% confidence interval (CI) were calculated. Associations between fatigue and the independent variables were measured.

RESULTS

the prevalence of fatigue among the participants was 26.0% [95% CI: 20.3-32.5]. Fatigue was independently associated with depression and self-efficacy. An increase of one unit in the score of depression increased the risk of fatigue by 9%; an increase of one unit in the score of self-efficacy reduced the risk of fatigue by 2%.

CONCLUSIONS

fatigue was prevalent in chronic low back pain patients and associated with depression and self-efficacy. Knowing these factors can direct strategies for prevention and control of fatigue in chronic low back pain patients.

The effect of stress on health and its implications for nursing

Stress is an important issue within nursing and it is difficult to find agreement among those who are expert in the area regarding a concise definition of stress. Nevertheless stress is seen as a negative feeling affecting people's health either physically and/or psychologically. However, stress is a normal part of life and considered necessary to increase functional capacity, whereas stress over a prolonged period or when extreme can cause distress which may have debilitating effects that reduce work output, increase absenteeism and reduce one's ability to cope with situations. The most important resource in any organisation is the employee; therefore maintaining and supporting their health is vital to ensure their ability to work, maintain standards and continuously improve standards of care. Leadership styles within organisations must facilitate staff to be involved in decision making; thereby staff feel more valued and work in an autonomous way. This article identifies and discusses the effect of stress on health and its relationship to nursing.

Relationship between job stress and self-rated health among Japanese full-time occupational physicians

OBJECTIVE

We investigated relationship between job stress and self-rated health among Japanese nese full-time occupational physicians (OPs).

METHODS

In 2000, we mailed self-administrated questionnaires to 716 OPs. Of these OPs, 349 (49%) returned sufficiently completed questionnaires for analyses. oblique-rotated principal factor analysis of the job stress questionnaire extracted three components; low understanding of occupational health services in companies (low understanding), conflicts between occupational physicians and their coworkers (conflicts), and discrepancies between occupational physicians' routine work and occupational health services (discrepancies).

RESULTS

The model, in which low understanding contributed to self-rated health through job satisfaction and self-rated health was influenced by job satisfaction and discrepancies, provided a good fit to the data.

CONCLUSIONS

We found that a potential relationship between job stress and self-rated health among Japanese full-time OPs. The present results implied that among full-time OPs, low understanding contributed negatively to self-rated health through job satisfaction, and that self-rated health was influenced positively by job satisfaction and negatively by discrepancies.

Do negative aspects of social relations influence fatigue? A cross-sectional study on a non-clinical sample of middle-aged Danish men

OBJECTIVE

Fatigue is a common complaint among young and old adults and may be associated with negative aspects of social relations. Hence, the purpose of this study was to explore the association between demands from and conflicts with different sources of social relations and fatigue.

METHODS

The study was based on sub-populations of the 6292 members of the Danish Metropolit Cohort. The cohort comprises men born in 1953 in the Copenhagen Metropolitan area who participated in a questionnaire survey in 2004. Data were analysed using χ(2)-tests and multivariable logistic regression.

RESULTS

The results showed that demands from and conflicts with children were independently associated with fatigue in a dose-response pattern. The adjusted odds ratio for fatigue was 1.48 (95% CI: 1.01-2.17) when the men experienced frequent demands from children and 1.89 (95% CI: 1.17-3.06) when they had frequent conflicts with their children. Crude analyses of demands from or conflicts with spouse, relatives or friends, respectively showed associations with fatigue compared to no demands or no conflicts. However, adjustment for depression and physical chronic disease cancelled out these associations.

CONCLUSION

We concluded that middle-aged Danish men, who had frequent negative social interactions with their children, more frequently experienced fatigue. However, negative social interactions with spouse, relatives or friends were not associated with fatigue.

The predictive value of fatigue for nonfatal ischemic heart disease and all-cause mortality

OBJECTIVE

To investigate whether fatigue predicts nonfatal ischemic heart disease (IHD) and all-cause mortality in middle-aged men.

METHODS

The study population consisted of 5216 middle-aged men born in the Copenhagen metropolitan area in 1953. At baseline, men free of angina pectoris and previous IHD were asked if they felt fatigued. Information on IHD diagnosis and all-cause mortality was register based. The Cox proportional hazard model was used to test the association at 4-year follow-up.

RESULTS

Fatigue was associated with hospitalization for nonfatal IHD (hazard ratio [HR] = 1.98, 95% confidence interval [CI] = 1.09-3.61) and all-cause mortality (HR = 3.99, 95% CI = 2.27-7.02). These associations became nonsignificant in multivariable-adjusted models (HR = 1.57, 95% CI = 0.82-3.01 and HR = 1.90, 95% CI = 0.95-3.80). Imputation of missing data did not modify conclusions. Fatigue was a strong independent predictor of first hospitalization for nonfatal IHD among nonsmoking men (HR = 6.00, 95% CI = 2.00-18.04), and the fatigue-by-smoking status interaction was significant (p = .04). Findings should be interpreted with caution because of the small number of participants with IHD (n = 21, 1.5%). Compared to nonfatigued nonsmokers, both fatigued nonsmokers and fatigued smokers had higher hazard of dying (HR = 4.99, 95% CI = 1.31-19.09 and HR = 3.74, 95% CI = 1.32-10.57, respectively), although the fatigue-by-smoking status interaction was not significant (p = .12).

CONCLUSIONS

Fatigue is a potential risk indicator for IHD and mortality. Further research is needed to establish the role of smoking and other life-style characteristics.

Developing a web-based stress management intervention for occupational support workers

BACKGROUND

Occupational support workers in the mental healthcare sector are exposed to considerable occupational stress and have little access to stress management facilities.

AIMS

This article describes the process behind creating a web-based stress management intervention (SMI) for occupational support workers in the mental healthcare sector.

METHOD

Mixed methods were used to inform the content of the web-based SMI, following MRC strategy for designing interventions and PRIMA-EF guidelines for best practice in SMI design. We conducted a literature review to ascertain the content of interventions that had been shown to be successful in reducing stress in mental healthcare populations. In addition, we conducted focus groups in order to assess specific stressors that individuals in the occupational support sector deemed to be important.

RESULTS

The literature review showed that a variety of methods had been successful for reducing occupational stress in the mental healthcare sector including: Relaxation and Cognitive Behavioural Therapy techniques, and skills training in; time management, problem-solving and communication. Individuals in the focus groups identified both personal and organisational stressors to be addressed in the intervention.

CONCLUSIONS

This intervention was developed with reference to a design strategy, using input from the target population.

Effort-reward imbalance and depression among private practice physicians

PURPOSE

Current private practice physicians provide medical services in a harsh economic situation. The effort-reward imbalance (ERI) model puts its emphasis on an imbalance between high efforts spent and low rewards received in occupational life. ERI model includes three different reward factors from task to organizational levels. We examined whether ERI in terms of low organizational reward (poor prospective and job insecurity) could be the most relevant and strongly associated with depression among private practice physicians.

METHODS

This is a cross-sectional questionnaire study of 1,103 private practice physicians who were currently working in clinical settings and completed the data of exposure and outcome. The study questionnaire was mailed to all the physicians listed as members of a local branch of the Japan Medical Association (n = 3,441) between November and December 2008. Outcomes were prevalence of depression as measured by the Center for Epidemiologic Studies Depression Scale and adjusted odds ratios (OR) of depression with respect to ERI.

RESULTS

Fifty-seven percent of physicians were exposed to ERI, and 18% of the physicians were depressed. Logistic regression analyses revealed that ERI was significantly associated with depression (OR and 95% confidence interval = 3.57; 2.43-5.26). ERI with regard to organizational reward was most prevalent (60%) and had the strongest association with depression (5.14; 3.36-7.92).

CONCLUSION

Predominant prevalence of ERI in terms of organizational level low reward and strong associations between the ERI component and depression suggests that countermeasures from social perspective are crucial.

Cortisol variability and self-reports in the measurement of work-related stress

We examined whether a high cortisol awakening response (CAR) and low cortisol decline over the day (CDD) are related to self-reported work stress and well-being, and whether there are gender differences in these relationships. Three hundred eighty-three working men and women responded to a survey measuring job stress factors, mastery at work, symptoms and well-being. Salivary cortisol was sampled at awakening, after 45 min and at 21:00, from which the variables CAR and CDD were defined. A high CAR was associated with lower perceived job control and work mastery, and poorer well-being. Low CDD was associated only with higher job demands, but the self-report scores showed a number of interactions between cortisol group and gender. Among women, those showing a low CDD, compared with those with a higher CDD, had more favourable scores on a number of job stress factors and symptom load. In contrast, among men, a similar comparison showed those with low CDD to have poorer scores on job stress factors and symptom load. We conclude that individuals displaying high CAR or low CDD differ from those not displaying these cortisol profiles in self-report of work stress and well-being, and that gender differences appear in these relationships.

Contribution of the psychosocial work environment to psychological distress among health care professionals before and during a major organizational change

The aim of this study was to investigate the relationships between 4 dimensions of the psychosocial work environment (psychological demands, decision latitude, social support, and effort-reward) among health care professionals as well as their psychological distress during a reorganization process. A correlational descriptive design was used for this quantitative study. A total of 159 health care professionals completed the questionnaire at T1, and 141 at T2. First, before the work reorganization, effort-reward imbalance was the sole variable of the psychological work environment that significantly predicted psychological distress. Second, the high overall level of psychological distress increased during the process of organizational change (from T1 to T2). Finally, effort-reward imbalance, high psychological demands, and low decision latitude were all significant predictors of psychological distress at T2, during the organizational change. In conclusion, to reduce the expected negative outcomes of restructuring on health care practitioners, managers could increase the number of opportunities for rewards, carefully explain the demands, and clarify the tasks to be performed by each of the employees to reduce their psychological burden and increase their perceptions of autonomy.

Risk factors for work-related fatigue in students with school-year employment

PURPOSE

To explore potential risk factors for acute and chronic work-related fatigue in students working at a paid job while pursuing school studies. Although work-related fatigue was identified as a potential hazard for youth health, academic achievement, and occupational safety, very few studies have specifically addressed its correlates and possible predictors.

METHODS

Cross-sectional data from an ongoing prospective cohort study of health risk behaviors in adolescents was used to identify factors associated with increased levels of acute and chronic fatigue in 209 students aged 17-18 years working during the school year. Multiple stepwise regression analyses were performed with acute and chronic fatigue levels as dependent variables, and demographic, work, and health factors as potential explanatory variables.

RESULTS

Average hours worked per week by students was 14.7 hours. It was observed that higher psychological distress, poorer health perception, greater sleep debt, and higher exposure to physical work factors were associated with higher levels of acute fatigue. Also, it was observed that higher psychological distress, poorer health perception, higher exposure to physical work factors, and holding multiple jobs were associated with higher levels of chronic fatigue. The number of hours worked weekly was associated with neither acute nor chronic work-related fatigue.

CONCLUSIONS

Findings suggest that prevention strategies devised to minimize work-related fatigue in students should consider exposure to physical work factors. Results also re-emphasize the importance of obtaining sufficient sleep so as to prevent high levels of acute work-related fatigue.

Conflict between the work and family domains and exhaustion among vocationally active men and women

Exhaustion is consistently found to be more prevalent in women than in men. Women suffer from job strain more often, which may constitute a partial explanation for this phenomenon, but experienced shortcomings in combining work and family demands may also contribute to ill health. The aim of this study was to investigate, and analyse by gender, how work-related and family-related factors, as well as the interface between them, i.e. work-to-family conflict (WFC) and family-to-work conflict (FWC), are related to exhaustion. The study was cross-sectional with self-administered questionnaires assessing exposures and outcome with previously well-validated instruments. The participants were 2726 men and 2735 women, aged 45-64, vocationally active, and residing in Malmö, Sweden. Sixteen percent of the women and 8% of the men considered themselves exhausted. WFC, FWC, job strain, and low job support were all strongly correlated to exhaustion in both genders. In the multivariate analyses, adjusting for other work and family risk factors, WFC and FWC remained statistically significant risk factors for exhaustion in both men and women. Job strain, low job support, and having a somatic disorder were also independently associated with exhaustion. While WFC was more prevalent among men, it was more strongly associated with exhaustion in women than in men. In women, WFC and FWC contributed to a larger part of the explanatory power of the model, which amounted to 22% of the variance in women and 14% in men. The results imply that the concept of 'work stress' should be regarded in a wider context in order to understand gender related issues of exhaustion among vocationally active individuals.

The incidence of anxiety and depression among employees--the role of psychosocial work characteristics

BACKGROUND

Anxiety and depression are prevalent among employees and are associated with functional disability and work impairment. To date, little is known about the incidence and possible risk factors for developing anxiety and depression in the working population. Study aims were to (a) determine the incidence of subclinical anxiety and depression in a general working population and (b) identify the psychosocial work characteristics associated with the onset of subclinical anxiety and depression.

METHODS

This prospective study is based on 3,707 employees participating in the Maastricht Cohort Study on Fatigue at Work. Psychosocial work characteristics were measured in May 2000; anxiety and depression were measured with the Hospital Anxiety and Depression Scale in April 2002.

RESULTS

The cumulative 23-month incidence for subclinical anxiety and depression was 4.6 and 3.3%, respectively. High psychological job demands increased the risk for both subsequent anxiety and depression. Moreover, low social support was predictive for the onset of anxiety, whereas job insecurity increased the risk for the onset of depression. These prospective associations were independent of potential confounding variables and the other psychosocial work characteristics.

CONCLUSIONS

Adverse psychosocial work characteristics are significant predictors for the onset of subclinical anxiety and depression in the general working population. These findings encourage intervention studies testing whether modifying the psychosocial work environment reduces both anxiety and depressive symptoms among employees.

The fatigue in workers of Iran Central Iron Ore Company in Yazd

AIMS

To evaluate fatigue, sub-dimensions, and job satisfaction among workers of Iran Central Iron Ore Co., and obtain the relationship between them.

MATERIALS AND METHODS

In a cross-sectional study, fatigue and the dimensionality were measured using Iranian version of Piper Fatigue Scale questionnaire (PFS). Job satisfaction was estimated with the job satisfaction scale (JSS) as well.

RESULTS

The score of severe fatigue in four sub-scale/dimensions and total fatigue scores were: 11.9, 15.2, 11.3, 10.8 and 10.6%, respectively. Furthermore, there was significant difference between total fatigue and all its sub-dimensions in relation to job satisfaction of workers.

CONCLUSIONS

Fatigue has caused job dissatisfaction of participants in our study, therefore we should note that the nature of fatigue may affect the psychological aspects of industrial workforce and can be harmful for business activities.

Chronic fatigue of the small enterprise workers participating in an occupational health checkup center in southern Taiwan

PURPOSE

There has been increasing interest in the occupational health of workers in small enterprises, especially in developing countries. This study examines the association between psychosocial job characteristics and fatigue, and attempts to identify risk factors for fatigue among workers of small enterprises in southern Taiwan.

METHODS

A structured questionnaire was administered to workers receiving regular health examinations between August 2005 and January 2006. The questionnaire collected demographic information and data on working conditions, personal health status and life styles. It also collected information on psychosocial job characteristics, fatigue and psychological distress using three instruments.

RESULTS

A total of 647 workers with mean age of 43.7 were completed. Probable fatigue was found in 34.6% of the sample. Fatigue was found by multiple logistic regressions to be associated with the lack of exercise, working in shifts, depression score and lack of social support at workplace.

CONCLUSIONS

This study found associations between life style, psychosocial job characteristics and fatigue. Because the high prevalence of probable fatigue was found in such small enterprises, the authors suggest that a short interview with some quick questionnaires in health checkup for these small enterprise workers are helpful to early detect psychosocial and fatigue problems.

Changes in mental health as a predictor of changes in working time arrangements and occupational mobility: results from a prospective cohort study

OBJECTIVE

The aim of this prospective study was to gain insight into a possible causal relationship between mental health and characteristics of the work situation.

METHODS

Using longitudinal data from the Maastricht Cohort Study, this study examines whether deterioration in mental health (prolonged fatigue, need for recovery, and psychological distress) results in a subsequent change in working time arrangements (assessed by means of logistic regression analysis) or occupational mobility (assessed by means of Cox regression analysis).

RESULTS

Compared to employees not experiencing a deterioration in mental health, employees who became a prolonged fatigue case were more likely to reduce their working hours (OR 2.49; 95% CI 1.42-4.35) and leave a shift work job (OR 3.44; 95% CI 1.42-8.38). Employees who became a need for recovery case were more likely to reduce their working hours (OR 2.83; 95% CI 1.53-5.26) or change jobs within the company (RR 1.31; 95% CI 1.07-1.61). Employees who became a psychological distress case were more likely to change jobs within the company (RR 1.38; 95% CI 1.16-1.65) or to change jobs from one employer to another (RR 1.45; 95% CI 1.03-2.03).

CONCLUSION

The results of this study provide evidence for a possible causal relationship between deterioration in mental health and subsequent change in working time arrangements or occupational mobility. These results suggest that workers adapt to the onset of a mental health problem by reducing their working hours, by leaving a shift work job, by changing jobs within the company, or by changing jobs from one employer to another.

The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures

Fatigue is a common symptom associated with a wide range of chronic diseases. A large number of instruments have been developed to measure fatigue. An assessment regarding the reliability, validity, and utility of fatigue measures is time-consuming for the clinician and researcher, and few reviews exist on which to draw such information. The aim of this article is to present a critical review of fatigue measures, the populations in which the scales have been used, and the extent to which the psychometric properties of each instrument have been evaluated to provide clinicians and researchers with information on which to base decisions. Seven databases were searched for all articles that measured fatigue and offered an insight into the psychometric properties of the scales used over the period 1980-2007. Criteria for judging the "ideal" measure were developed to encompass scale usability, clinical/research utility, and the robustness of psychometric properties. Twenty-two fatigue measures met the inclusion criteria and were evaluated. A further 17 measures met some of the criteria, but have not been tested beyond initial development, and are reviewed briefly at the end of the article. The review did not identify any instrument that met all the criteria of an ideal instrument. However, a small number of short instruments demonstrated good psychometric properties (Fatigue Severity Scale [FSS], Fatigue Impact Scale [FIS], and Brief Fatigue Inventory [BFI]), and three comprehensive instruments demonstrated the same (Fatigue Symptom Inventory [FSI], Multidimensional Assessment of Fatigue [MAF], and Multidimensional Fatigue Symptom Inventory [MFSI]). Only four measures (BFI, FSS, FSI, and MAF) demonstrated the ability to detect change over time. The clinician and researcher also should consider the populations in which the scale has been used previously to assess its validity with their own patient group, and assess the content of a scale to ensure that the key qualitative aspects of fatigue of the population of interest are covered.