Anxiety and Depression Mediate the Relationship Between Perceived Workplace Health Support and Presenteeism: A Cross-sectional Analysis

Effect of perceived workplace health support on absenteeism and presenteeism among Japanese workers: a prospective cohort study

OBJECTIVES

This study aimed to investigate the impact of perceived workplace health support (PWHS) on absenteeism and presenteeism among Japanese workers to determine the significance of health and productivity management in improving labor productivity.

METHODS

This prospective cohort study, using data from the Work Systems & Health Internet Research (WSHIR) study, involved 1879 Japanese workers aged 20-69 years. The intensity of PWHS was assessed using self-administered questionnaires. The participants were followed up from October 2021 to October 2022 to evaluate the incidence of absenteeism and presenteeism based on the level of PWHS.

RESULTS

The study findings revealed that higher PWHS significantly correlated with lower presenteeism, indicating better work productivity. Conversely, the relationship between PWHS and absenteeism was less clear, with no consistent trend observed across different levels of PWHS intensity.

CONCLUSIONS

Enhanced PWHS was associated with reduced presenteeism among Japanese workers, underscoring the importance of workplace health support for improving employee productivity. This finding emphasizes the need for companies to focus on health promotion activities and recognize the potential of PWHS as a performance indicator in corporate health management.

Perceived Workplace Health Support and Severe Psychological Distress Among Japanese Workers: A Prospective Cohort Study

OBJECTIVE

This study aimed to assess the extent to which the intensity of perceived workplace health support (PWHS) affected the incidence of psychological distress.

METHODS

At the baseline, data from 4540 eligible participants throughout Japan were obtained using an Internet survey. Among them, 2362 participants who could be followed up 1 year after the initial study were included in the analysis. The intensity of PWHS was determined using an original questionnaire. Psychological distress was assessed using the Kessler Psychological Distress Scale.

RESULTS

Participants with high PWHS were less likely to experience severe psychological distress than those with low PWHS even after adjusting for confounding factors including work-related factors. The incidence of severe psychological distress decreased as the intensity of PWHS increased.

CONCLUSIONS

Enhanced PWHS reduced psychological distress and positively affected workers' mental health.

The Validity and Reliability of the Workplace Culture of Health Scale-Short Form

OBJECTIVE

A positive workplace culture of health can have significant benefits for both employees and organizations. The objective of this study was to test the validity and reliability of the Workplace Culture of Health (COH) Scale-Short Form.

METHODS

We conducted a confirmatory factor analysis on data collected from a sample of 12,907 employees across 14 organizations. We examined the construct validity of the 14-item short-form version of the Workplace COH scale and assessed its reliability using internal consistency measures.

RESULTS

Our confirmatory factor analysis demonstrated that the Workplace COH Scale-Short Form had strong model fit, indicating good construct validity. In addition, we found that all constructs had strong internal consistency reliability.

CONCLUSIONS

Findings suggest that the Workplace COH Scale-Short Form is a valid and reliable way to practically assess workplace culture of health from the employee perspective.

A Scoping Review of Workplace Culture of Health Measures

OBJECTIVE

This study aimed to review existing measures of workplace culture of health and to examine the health and wellbeing outcomes associated with workplace culture of health.

DATA SOURCES

PubMed/Medline, Web of Science, and PsycINFO databases searched through February 2022.

STUDY INCLUSION AND EXCLUSION CRITERIA

Articles were included if they used a specific measure to assess culture of health in the workplace and were published in English. Articles were excluded if there was no quantitative measure of health culture.

DATA EXTRACTION

Data from each article was extracted using a structured template which included study purpose, participants and setting, study design, intervention strategies (if applicable), culture of health measure, and results.

DATA SYNTHESIS

We described culture of health measures used and summarized key findings from included articles.

RESULTS

The search yielded 31 articles measuring workplace culture of health (three validation, two intervention, and 26 observational studies). Nineteen unique measures were used across all articles. Most studies examined culture of health from the employee perspective (n = 23), while others examined it at the organizational level (n = 7). The studies indicated a positive relationship between health and well-being outcomes and a strong workplace health culture.

CONCLUSION

There are many different approaches to measuring workplace health culture. Overall, workplace culture of health is related to positive employee and organizational health and wellbeing outcomes.

Complex effects of childhood abuse, subjective social status, and trait anxiety on presenteeism in adult volunteers from the community

Background

Presenteeism, which is reduced productivity levels owing to physical or mental problems, causes substantial economic loss. It is known to be associated with personal and working environment factors, but the mechanism has not been fully clarified to date. Therefore, we analyzed the effects of childhood abuse on presenteeism of general adult workers, and the mediating effects of subjective social status and trait anxiety.

Methods

From 2017 to 2018, a cross-sectional survey was performed, and 469 adult workers provided written consent. Demographic information, and results from the Child Abuse and Trauma Scale, Subjective Social Status, State-Trait Anxiety Inventory form Y, and Work Limitations Questionnaire were investigated. Multiple linear regression and path analyzes were performed.

Results

Childhood abuse indirectly affected current presenteeism via subjective social status and trait anxiety. Presenteeism was directly affected only by trait anxiety, childhood abuse directly affected subjective social status and trait anxiety, and subjective social status affected trait anxiety.

Conclusion

This study clarified the long-term effects of childhood abuse on presenteeism in adulthood via trait anxiety. Therefore, assessing childhood abuse, subjective social status, and trait anxiety may help to elucidate the mechanism of workplace presenteeism and develop measures against it.

Psychosocial Determinants of Recommended Lifestyle Behaviors among Hypertensive Patients: An Integrative Literature Review

Healthy lifestyle levels are low among adults with hypertension (HTN). Unfortunately, psychosocial factors contributing to patients' inability to meet healthy lifestyle recommendations are not well-understood. This integrative review examined the relationships of three psychosocial factors (self-efficacy, outcome expectancy, and social support) with dietary adherence (DA) and physical activity (PA) among adults with HTN. In total, 24 peer-reviewed studies were assessed. Results showed self-efficacy had small-to-large relationships with PA (r = 0.02-0.46) and DA (r = 0.06-0.79), with the strength of the associations varying by the assessed domain and country of origin. However, few studies reported a small relationship between the remaining factors (outcome expectancy and social support) and PA and DA. Thus, more efforts are needed to delineate the contributions of social support and outcome expectancies on DA or PA. When designing an intervention that focuses on improving PA or DA among adults with HTN, these psychosocial factors should be targeted.

Association between Perceived Organizational Support for Infection Prevention and Work Engagement during the COVID-19 Pandemic among Japanese Workers: A Prospective Cohort Study

Although the correlation between perceived organizational support (POS) and work engagement has been investigated in several studies, the relationship between health-focused POS and work engagement has not been clarified. We prospectively evaluated the influence of workers’ POS for infection prevention (POS-IP) on employees’ work engagement. This prospective cohort study was conducted from December 2020 (baseline) to December 2021 (1-year follow-up) using a self-administered internet questionnaire. At follow-up, there were 18,560 respondents, and after excluding 6677 respondents who had changed jobs or retired since baseline or who were self-employed; thus, 11,883 participants were included in the analysis. We asked participants a single question on POS-IP and the three-item Utrecht Work Engagement Scale (UWES-3), and then analyzed the relationship between POS-IP at baseline and UWES-3 at follow-up using multilevel regression analysis. Work engagement at follow-up was significantly higher in the groups with “low”, “high”, and “very high” POS-IP at baseline as compared with the “very low” group (all, p < 0.001). A dose-response relationship was also observed between the POS-IP categories at baseline and work engagement at follow-up (p for trend < 0.001). During the COVID-19 pandemic, POS-IP can increase work engagement after 1 year.

Association between presenteeism and mental health among logistic center workers

Background

Workers in logistics centers are always pressed for time to collect and pack products. They also participate in high-intensity manual labor in which various musculoskeletal hazards exist. In the case of logistic center labor, it is estimated that there is a high risk of presenteeism due to the above characteristics which can cause deterioration of workers' mental health. However, there is insufficient research on this topic.

Methods

Workers in a logistic center were surveyed using an Internet questionnaire. The survey items included demographic characteristics, labor intensity and work-related factors, and mental health aspects such as depression and anxiety. The survey was conducted for about a month from July 26, 2021 and a total of 353 people were analyzed. Through the χ² test and t-test, the characteristics of workers who experienced presenteeism were examined and the prevalence ratios (PRs) of depression and anxiety experiences were calculated by multivariable Poisson regression. Afterwards, stratification analysis considering gender, the type of contract, and labor intensity was implemented.

Results

In the group that experienced presenteeism, the number of working days per week was higher and fixed-term workers, high labor intensity, and sleep deprivation were more common. In the multi-Poisson regression analysis conducted by adjusting the demographic characteristics, working hours, and work-related factors, the PRs of depression and anxiety were 1.98 (95% confidence interval: 1.24-3.18) and 1.81 (1.22-2.68), respectively. In particular, the p-value for interactions was significant when stratified with the type of contract.

Conclusions

As a result of the study, presenteeism and mental health were associated in logistic center workers. To prevent mental health issues of logistic center workers, management of presenteeism is necessary and a prospective study is needed.

Association of Workplace Culture of Health and Employee Emotional Wellbeing

The study aimed to examine associations between workplace culture of health and employee work engagement, stress, and depression. Employees (n = 6235) across 16 companies voluntarily completed the Workplace Culture of Health (COH) Scale and provided data including stress, depression, and biometrics through health risk assessments and screening. We used linear regression analysis with COH scores as the independent variable to predict work engagement, stress, and depression. We included age, gender, job class, organization, and biometrics as covariates in the models. The models showed that total COH scores were a significant predictor of employee work engagement (b = 0.75, p < 0.001), stress (b = -0.08, p < 0.001), and depression (b = 0.08, p < 0.001). Job class was also a significant predictor of work engagement (b = 2.18, p < 0.001), stress (b = 0.95, p < 0.001), and depression (b = 1.03, p = 0.02). Gender was a predictor of stress (b = -0.32, p < 0.001). Overall, findings indicate a strong workplace culture of health is associated with higher work engagement and lower employee stress and depression independent of individual health status. Measuring cultural wellbeing supportiveness can help inform implementation plans for companies to improve the emotional wellbeing of their employees.

[Evaluation index for a healthy workplace culture in health and productivity management]

OBJECTIVES

This study aimed to establish a healthy workplace culture, rather than simply enhancing the content of intervention programs, aimed toward reducing health risks and maintaining and increasing productivity. Previous studies have found that the higher the awareness of employees' subjective evaluation of support for their health, the smaller is the health risk and problem of presenteeism. In health and productivity management, it is necessary to make evaluations from the employees' perspective. This study created an index of healthy workplace culture from the employees' perspective and examined its usefulness as an evaluation index for health and productivity management.

METHODS

A questionnaire survey was conducted using 20 indicators derived from a literature review of the workplace culture of health. The survey was conducted among 50 organizations that were certified as excellent healthcare corporations in 2019. A questionnaire was distributed to 886 employees in 25 cooperating organizations, and responses were received from 435 employees.

RESULTS

The analysis was performed among employees at 43 large and 263 small and medium-sized organizations, and 123 organizations with unknown certification status. Comparison by size showed that the following were significantly better in large organizations: policy on maintaining and promoting health, procedures for handling health issues, program and support for returning to work after a long absence, program and support for improving mental health, and places to consult with employees about health and safety issues. However, the following were significantly better in small and medium-sized organizations: feedback on health issues from supervisors to employees and provision of useful information about health promotion. Organizations with unknown certification status showed significantly worse results for all items. It was evident with all indicators that a strong workplace culture of health resulted in reduced health risks and diminished presenteeism.

CONCLUSIONS

The validity of the index developed in this study demands future verification. However, the index allows the degree of the workplace culture of health to be assessed and may be beneficial in health and productivity management for evaluation from the employees' perspective.

Perceived Supervisor Support for Health Affects Presenteeism: A Cross-Sectional Study

We investigated the relationship between perceived supervisor support for health (PSSH) and presenteeism by adjusting for psychological distress and employee work engagement. These are the mediators of the two paths shown in the job demands-resources model. A cross-sectional study was conducted using a questionnaire survey among 15,158 non-managerial employees from seven companies in Japan considered to have relatively high perceived organizational support for health (POSH). PSSH was evaluated with a single question, “My supervisor supports employees to work vigorously and live a healthy life”, on a four-point scale. Presenteeism was estimated using the quantity and quality method. Multilevel logistic regression analyses nested by company were conducted. Lower PSSH was more likely to be associated with presenteeism, but after adjusting for psychological distress evaluated by K6 and for work engagement, the relationship between PSSH and presenteeism weakened. Our results suggested that lower PSSH is linked to presenteeism through both psychological states because of its role as a resource, and other independent factors, even with relatively high POSH. Increased PSSH could act as a measure against presenteeism in the workplace. To achieve this, it is important to create an environment where supervisors can easily encourage employees to improve their health.

Effectiveness of Psychological Support to Healthcare Workers by the Occupational Health Service: A Pilot Experience

Work-related stress is a significant risk for healthcare workers (HCWs). This study aims at evaluating the effectiveness of an individual psychological support programme for hospital workers. In all, 35 workers participated (n). A control group of 245 workers (7n) was set. Occupational distress was measured by the General Health Questionnaire, (GHQ-12), the quality of life by the Short Form-36 health survey, (SF-36), and sickness absence was recorded. Costs and benefits of the service were evaluated and the return on investment (ROI) was calculated. The level of distress was significantly reduced in the treated group at the end of the follow-up (p < 0.001). Quality of life had significantly improved (p < 0.003). A 60% reduction of sickness absence days (SADs) following the intervention was recorded. After the treatment, absenteeism in cases was significantly lower than in controls (p < 0.02). The individual improvement of mental health and quality of life was significantly correlated with the number of meetings with the psychologist (p < 0.01 and p < 0.03, respectively). The recovery of direct costs due to reduced sick leave absence was significantly higher than the costs of the programme; ROI was 2.73. The results must be examined with caution, given the very limited number of workers treated; this first study, however, encouraged us to continue the experience.

Including Mental Health Screenings in Annual Wellness Programs

Mental health is an important component of overall wellness and is a growing concern in occupational settings. Approximately one half of Americans will experience a mental health disorder at some time in their life. The current descriptive correlational study used a convenience sample of manufacturing employees (N = 236) to examine the association of mental and physical health risks collected during an annual wellness program. A researcher-developed questionnaire was used to holistically screen for health risks. Pearson's r and chi-square tests were performed to determine the relationship among variables. Younger workers and individuals with higher body mass index had increased anxiety and depression scores (p = 0.005). Results suggest younger workers may have increased risk for mental health and biometabolic disorders. Due to the connections between mental and physical health, screening for anxiety and depression should be included in annual worker wellness programs to potentially improve overall health and wellness outcomes. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

A cross-sectional study on perceived workplace health support and health-related quality of life

OBJECTIVE

Many companies in Japan have been increasingly interested in "health and productivity management (H&PM)." In terms of H&PM, we hypothesized that companies can enhance their employees' perceived workplace health support (PWHS) by supporting workers' lively working and healthy living. This could then improve their health-related quality of life (HRQOL) by increasing PWHS. Consequently, this study explored the relationship between PWHS and HRQOL.

METHODS

In December 2020, during the COVID-19 pandemic, we conducted an Internet-based nationwide health survey of Japanese workers (CORoNaWork study). A database of 27 036 participants was created. The intensity of PWHS was measured using a four-point Likert scale. We used multilevel ordered logistic regression to analyze the relationship between PWHS intensity and the four domains of the Centers for Disease Control's HRQOL-4 (self-rated health, number of poor physical health days, number of poor mental health days, and activity limitation days during the past 30 days).

RESULTS

In the sex- and age-adjusted and multivariate models, the intensity of PWHS significantly affected self-rated health and the three domains of unhealthy days (physical, mental, and activity limitation). There was also a trend toward worse HRQOL scores as the PWHS decreased.

CONCLUSIONS

We found that the higher the PWHS of Japanese workers, the higher their self-rated health and the fewer their unhealthy days. Companies need to assess workers' PWHS and HRQOL and promote H&PM. H&PM is also necessary to maintain and promote the health of workers during the COVID-19 pandemic.