Gender differences in work-home interplay and symptom perception among Swedish white-collar employees

Food and family care during the COVID-19 pandemic: A study of women's domestic workload during the first wave in Chile

This study aimed to explore women's perceptions of domestic work related to food and family care during the first wave of the COVID-19 pandemic in Chile and its association with sociodemographic and health variables. We conducted a cross-sectional, analytical, non-probabilistic study. A sample of 2047 women answered an online self-report survey that included a Likert scale about the perception of domestic work associated with food. The survey also included an open comment section. The survey was available between May and June 2020, during the first wave of the COVID-19 pandemic and when most of the country had some degree of mobility restriction. 70.2% of participants perceived their domestic work as "regular"; being younger, having a higher educational level, caring for children or the elderly, and having worse self-perception of mental and general health status increased the chances of having a lower perception of the burden of these tasks. In comments, women declared how heavy the domestic work was, the challenges of being together with their families and of paid job requirements, and how family demands from them increased. Most women felt that their domestic work was heavier during this pandemic period: some groups of women could be at risk of being more affected by this extra workload at home. The importance of interventions and public policies with a gender perspective becomes relevant, considering the role of women in the home and the necessity to generate a social change regarding the domestic burden associated with gender.

Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workers

AIMS

Employee-based flexible working hours are increasing, particularly among knowledge workers. Research indicates that women and men use work-time control (WTC; control over time off and daily hours) differently: while men work longer paid hours, women use WTC to counteract work-life interference. In a knowledge-worker sample, we examined associations between WTC and overtime, work-life interference and exhaustion and tested whether gender moderates the mediating role of overtime.

METHODS

The sample contained 2248 Swedish knowledge workers. Employing hierarchical regression modelling, we examined effects of control over time off/daily hours on subsequent overtime hours, work-life interference and exhaustion in general and in gender-stratified samples. Using conditional process analysis, we tested moderated mediation models.

RESULTS

Control over time off was related to less work-life interference (βmen= -0.117; 95% confidence interval (CI): -0.237 to 0.003; βwomen= -0.253; 95% CI: -0.386 to -0.120) and lower exhaustion (βmen= -0.199; 95% CI: -0.347 to -0.051; βwomen= -0.271; 95% CI: -0.443 to -0.100). For control over daily hours, estimates were close to zero. While men worked more overtime (42 min/week), we could not confirm gender moderating the indirect effect of control over time off/daily hours on work-life interference/exhaustion via overtime. Independent of gender, effects of control over time off on work-life interference were partly explained by working fewer overtime hours.

CONCLUSIONS

Control over time off was related to lower exhaustion and better work-life balance (in particular for women). We found no evidence for men's work-life interference increasing with higher WTC owing to working more overtime. Knowledge workers' control over time off may help prevent work-life interference and burnout.

Sex and gender aspects in diabetes mellitus: Focus on access to health care and cardiovascular outcomes

Aims

The aim of this study was to elucidate whether sex and gender factors influence access to health care and/or are associated with cardiovascular (CV) outcomes of individuals with diabetes mellitus (DM) across different countries.

Methods

Using data from the Canadian Community Health Survey (8.4% of respondent reporting DM) and the European Health Interview Survey (7.3% of respondents reporting DM), were analyzed. Self-reported sex and a composite measure of socio-cultural gender was constructed (range: 0-1; higher score represent participants who reported more characteristics traditionally ascribed to women). For the purposes of analyses the Gender Inequality Index (GII) was used as a country level measure of institutionalized gender.

Results

Canadian females with DM were more likely to undergo HbA1c monitoring compared to males (OR = 1.26, 95% CI: 1.01-1.58), while conversely in the European cohort females with DM were less likely to have their blood sugar measured compared to males (OR = 0.88, 95% CI: 0.79-0.99). A higher gender score in both cohorts was associated with less frequent diabetes monitoring. Additionally, independent of sex, higher gender scores were associated with higher prevalence of self-reported heart disease, stroke, and hospitalization in all countries albeit European countries with medium-high GII, conferred a higher risk of all outcomes and hospitalization rates than low GII countries.

Conclusion

Regardless of sex, individuals with DM who reported characteristics typically ascribed to women and those living in countries with greater gender inequity for women exhibited poorer diabetes care and greater risk of CV outcomes and hospitalizations.

Time-of-Day Effect on Postural Balance and Its Associations with Menopausal Symptoms in Postmenopausal Women

Postmenopausal women suffer from postural balance issues. During a 24-hour time span, postural performance undergoes radical changes as influenced by the circadian rhythm. In this study, we aimed to investigate time-of-day effects on postural balance in postmenopausal women and balance relationships with menopausal symptoms. Two groups of women, aged 40-50 years, participated in this study: a menopausal group and a control group. We evaluated their postural balance and menopausal symptoms (mood, sleepiness and fatigue) in five sessions over the course of a day: at 06:00 hours, at 10:00, at 14:00, at 18:00 and at 22:00. The results showed that postural balance (center of pressure area (CoP_area)) values of postmenopausal women were significantly worse (p < .05) at 22:00. Moreover, at this time-of-day, participants in the menopausal group were more tired, less vigilant and experienced a lower mood. We found negative correlations between postural balance and both mood and fatigue levels. However, there was no time-of-day effect on postural balance, mood, fatigue, and sleepiness among participants in the control group. Thus, time-of-day should be considered a factor to control when assessing postural balance and designing intervention studies for postmenopausal women; and it is important for these women to be cautious of fall risks at night, as they are then less stable than at other times-of-day.

Influence of Gender in Diabetes Mellitus and Its Complication

In medicine, there is growing evidence that gender differences are important and lead to variations in the pathophysiology and treatment of many diseases with traits that appear to be particularly relevant in influencing the outcomes of many morbid forms. Today, the inclusion of gender in biomedical research, to improve the scientific quality and scientific relevance of knowledge, of technology is an increasingly present element precisely due to the practical implications that derive from it. Gender differences describe the biological variability between women and men, which is, in turn, related to differences in the information contained in sex chromosomes, the specific gene expression of autosomes linked to sex, the different number and quality of sex hormones, and their different effects on systems and organs, without neglecting the fact that each of the sexes has different target organs on which these hormones act. Additionally, both genders undergo metabolic changes throughout their lives, and this is especially true for women who show more dramatic changes due to their role in reproduction. Gender differences are not only the result of our genetic makeup but are also mixed with socio-cultural habits, behaviors, and lifestyles, differences between women and men, exposure to specific environmental influences, different food and lifestyle styles or stress, or different attitude in compliance with treatments and disease prevention campaigns. Gender differences also affect behavior throughout life, and physical changes can have implications for lifestyle, social roles, and mental health. Therefore, determinism and therapeutic outcome in chronic diseases are influenced by a complex combination of biological and environmental factors, not forgetting that there are many interactions of social and biological factors in women and men. This review will address the role of gender differences in the management of various forms of diabetes and its complications considering the different biological functions of hormones, the difference in body composition, physiological differences in glucose and fat metabolism, also considering the role of the microbiota. intestinal, as well as the description of gestational diabetes linked to possible pathophysiological events typical of reproduction.

Assessing Job Satisfaction and Stress among Pharmacists in Cyprus

Background: Inadequate staffing, increased responsibilities and a high workload are some of the factors that are directly related to stress levels experienced by pharmacists, which in turn affect job satisfaction. Objective: The aim of this study was to assess job satisfaction and stress levels of pharmacists in Cyprus, involving those working in the public and private sector. Materials and Methods: A cross-sectional study was performed which involved the completion of the Job Satisfaction Survey (JSS) questionnaire to estimate job satisfaction, and the Perceived Stress Scale-14 (PSS-14) questionnaire to evaluate perceived stress. Data collection took place between January and March 2020 and the participation rate was 71.6% (n = 585). Results: Employees in private pharmacies overall reported higher levels of job satisfaction compared to public sector pharmacists. Public sector pharmacists were found to have stronger self-efficacy beliefs compared to other groups (p < 0.001). Female pharmacists had a higher average level of perceived helplessness than male pharmacists (p = 0.001). Regarding public sector pharmacists, it was generally observed that pharmacists working under the management of the Ministry of Health (MoH) had reduced job satisfaction than those working for other organizations. Additionally, pharmacists working under the management of the State Health Services Organization (SHSO) had the least overall perceived stress levels (p = 0.008), high self-efficacy beliefs (p = 0.006) and low perceived helplessness (p = 0.031) compared to pharmacists in other workplaces. Employees of private pharmacies were found to have higher levels of job satisfaction (p < 0.001) than SHSO pharmacists. However, those employees demonstrated increased perceived stress levels (p < 0.001) in comparison with SHSO pharmacists. Conclusions: Pharmacists’ job satisfaction is negatively correlated with perceived stress levels and helplessness, and positively correlated with self-efficacy beliefs. In the public sector, it seems that a re-evaluation is critical regarding the determinants that adversely influence job satisfaction amongst pharmacists.

Type 2 Diabetes in Women: Differences and Difficulties

BACKGROUND

Lifestyle modification, along with medication, has improved the quality of life of patients with type 2 diabetes (T2D), but the treatment of diabetes in women still lacks a gender-centric approach.

METHODS

Expert opinions to improve diabetes management in women were collated from the open discussion forum organized by the sixth Jothydev's Professional Education Forum Diabetes Convention, which included global diabetes care experts and the general public. The review is also based on the studies published in electronic databases such as PubMed and Google Scholar that discussed the problems and challenges faced by the Indian diabetes care sector in treating women with diabetes.

RESULTS

The complex interplay of biological, socioeconomic, psychosocial, and physiological factors in women with type 2 diabetes has not been well addressed to date. Biological factors such as neurohumoral pathways, sex hormones, genetic predisposition as well as gender-based environmental and behavioural differences must be considered for modern personalized diabetes treatment. Most importantly, pregnant women with diabetes deserve special attention. This vulnerable phase has a marked impact on the future health of both the mother and the offspring.

CONCLUSION

The review provides an overview of the challenges and issues that exist in the clinical management of diabetes and its complications among women in India. Women-centric clinical approaches should be encouraged for the effective management of diabetes in Indian women.

Unequal burden of equal risk factors of diabetes between different gender in India: a cross-sectional analysis

Many studies have supported that the burden of diabetes is shared differently by different genders due to various factors associated with it. This study aims at capturing whether women and men with a similar background, dietary and smoking habits, and biological conditions (blood pressure and body mass index (BMI)) are being affected equally or differently by diabetes. We have used cross-sectional data of NFHS-4 by covering the age group 15-49 years. Association between socio-economic background, dietary habits, biological conditions, and diabetes has been estimated using two separate multivariate logistic regression models. Results show that the overall prevalence of diabetes is higher among men (2.63%) than women (2.35%). Whereas, women belonging to urban areas (3.53%), Christian category (3.92%), richer section (3.22%), women with no schooling (2.51%), those reported never to consume pulses (2.66%) and green vegetables (2.40%) and daily consuming eggs (3.66%) and chicken or meat (3.54%) are more affected by diabetes than their men counterparts. Whereas men residing in rural areas (2.30%), belonging to the general category (3.12%), SCs (2.37%) and STs (1.72%) are more affected than their women counterparts. Results have also shown a higher prevalence of diabetes among obese men (11.46%), non-vegetarian (2.71%) and those who watch television almost every day (3.03%) as compared to their women counterparts. Regression analyses show that the richest, hypertensive, and obese women and men are significantly more likely to suffer from diabetes. This study concludes that women and men with similar socio-economic status, biological conditions, dietary and smoking habits are being affected differently by diabetes. Thus, there is a need for gender dimension in research to understand and validate the differences in the needed interventions for diabetes control in India.

Occupational prestige and sickness absence inequality in employed women and men in Sweden: a registry-based study

OBJECTIVES

Socioeconomic position has been linked to sickness absence (SA). However, less is known about the role of occupational prestige, a measure of social status afforded by one's occupation, in SA. We investigated the association between occupational prestige and SA and the distribution of the association in women and men. We also examined the effect of intersections of gender and occupational prestige on SA.

DESIGN

Longitudinal.

SETTING

A nationwide representative sample of Swedish working population.

PARTICIPANTS

97 397 employed individuals aged 25-59 years selected from the 2004, 2007 and 2010 waves of the Swedish Labour Force Survey and prospectively linked to the Swedish Longitudinal Integration Database for Health Insurance and Labour Market Studies.

OUTCOME MEASURES

The number of SA days in any particular year during a 3-year follow-up and long-term (>120 days) SA based on those with at least one sick leave spell during the follow-up.

RESULTS

Occupational prestige was weakly associated with SA in the total sample after adjusting for potential confounders. In the gender-stratified analysis, women in lower prestige occupations had higher absenteeism rates than women in high prestige occupations; men in lower prestige occupations had higher odds for long-term SA than men in high prestige occupations. In the intersectional analysis, women regardless of prestige level and men in lower prestige occupations had higher probability of SA compared with men in high prestige occupations. Women in high prestige occupations had the highest absenteeism rates (incidence rate ratio (IRR), 2.25, 95% CI, 2.20 to 2.31), while men in medium prestige occupations had the lowest rates (IRR, 1.17, 95% CI, 1.13 to 1.20). Compared with the rest of the groups, men in low and medium prestige occupations had higher odds for long-term absence.

CONCLUSION

There is need to pay close attention to occupational prestige as a factor that may influence health and labour market participation.

Mentally tiring work and type 2 diabetes in women: a 22-year follow-up study

Hypothesis Previous work suggested no or inconsistent associations between components of work-related stress and type 2 diabetes risk, but suggested sex-specific differences should be further investigated, as women potentially had higher risks. Methods We analyzed data from 73 517 women, mostly teachers, from the E3N cohort study followed for 22 years (1992-2014), to study the association between mentally tiring work, used as a proxy of job demands, and type 2 diabetes risk. Univariate and multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals. Results A total of 4187 incident cases of type 2 diabetes cases were observed. There was a higher type 2 diabetes risk for women with a 'Very mentally tiring work' when compared to women with 'Little or not mentally tiring work' (HR = 1.21 (1.09-1.35)). This association was independent of unhealthy lifestyle and traditional metabolic factors. An interaction between mentally tiring work and BMI was detected (P < 0.0001), with a stronger association being observed in non-overweight women, HR = 1.26 (1.08-1.47) vs HR = 1.14 (0.98, 1.32), in overweight women. Conclusions We observed an increased risk of type 2 diabetes associated with mentally tiring work, used as a proxy of job demands. These observational results suggest the importance of taking into consideration the potential long-term metabolic impact of work-related stress for women working in a demanding environment. Increased support for such women should be investigated in intervention studies.

Struggling with everyday life after mild stroke with cognitive impairments – The experiences of working age women

Introduction

The aim of this study was to explore how women of working age who have had a mild stroke resulting in cognitive impairment experience and manage their everyday lives.

Method

Data were collected using semi-structured interviews. The participants consisted of 10 women of working age who had sustained cognitive impairment after a mild stroke. The interviews were analysed using qualitative content analysis.

Results

Three main categories appeared: The everyday is affected by the symptoms, Living strategies, and The social environment effects and changes. Participants feel insecure about their abilities and capabilities, experience anxiety and fear in relation to work, and find it hard to live up to demands and expectations. They are required to plan their daily activities in a new way and to prioritise chores that benefit the family, rather than follow their own interests and social activities. In order to cope with everyday life, they need to allocate chores to other family members.

Conclusions

The constant impact of fatigue and cognitive impairments affects everyday life. The women said that they had to learn to continuously manage their limitations through their experience of everyday life, something that can be facilitated with occupational therapy.

A prospective study of work-private life conflict and number of pain sites: moderated mediation by sleep problems and support

The objective of the current study was to elucidate how work-private life conflict prospectively affects musculoskeletal pain complaints by exploring possible mediation through sleep problems. In addition, the study determined whether support from coworkers and superior moderate this mediated relationship. The study incorporated a two-wave full panel design and participants included 4681 Norwegian working men and women. Path analyses were performed to study direct and indirect effects of work-private life conflict on sleep problems and multisite musculoskeletal pain, moderated by support. This study suggested time-lagged relationships of work-private life conflict with number of pain sites. Furthermore, sleep problems may mediate the effects of work-private life conflict on number of pain sites. While support has been found to affect the direct relationship between work-private life conflict and number of pain sites, it does not significantly moderate the indirect mediation effect, i.e. no moderated mediation effect of support was established. Findings from the present study suggest sleep may be one explaining factor in the complex work-pain mechanism, and this may aid the development of theories on work-private life conflict and pain. Since both work-private life conflict and support are modifiable work factors, primary workplace interventions by the employer aiming to reduce sleep problems and musculoskeletal pain in employees could target these specific work factors, and help prevent work-related pain complaints.

Paid and unpaid working hours among Swedish men and women in relation to depressive symptom trajectories: results from four waves of the Swedish Longitudinal Occupational Survey of Health

BACKGROUND

Long working hours and unpaid work are possible risk factors for depressive symptoms. However, little is known about how working hours influence the course of depressive symptoms. This study examined the influence of paid, unpaid working hours and total working hours on depressive symptoms trajectories.

METHODS

The study was based on data from four waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH 2008-2014). We applied group-based trajectory modelling in order to identify trajectories of depressive symptoms and studied paid and unpaid working hours and total working hours as risk factors.

RESULTS

Six trajectory groups were identified with symptoms: 'very low stable', 'low stable', 'doubtful increasing', 'high decreasing', 'mild decreasing' and 'high stable'. More time spent on unpaid work was associated with the 'low stable' (OR 1.16, 95% CI 1.04 to 1.30) and the 'high stable (OR 1.40, 95% CI 1.18 to 1.65) symptom trajectories compared with being in the 'very low stable' symptom group. In addition, more total working hours was associated with a higher probability of having 'high decreasing' (OR 1.30, 95% CI 1.14 to 1.48) and 'high stable' (OR 1.22, 95% CI 1.01 to 1.47) symptoms, when adjusting for sex, age, civil status and socioeconomic status. The results, however, differed somewhat for men and women. More unpaid working hours was more clearly associated with higher symptom trajectories among women. More total working hours was associated with 'high stable' symptoms among women only.

CONCLUSIONS

This study supported heterogeneous individual patterns of depressive symptoms over time among the Swedish working population. The results also indicate that a higher burden of unpaid work and longer total working hours, which indicate a double burden from paid and unpaid work, may be associated with higher depressive symptom trajectories, especially among women.

Gender, time use and overweight and obesity in adults: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Perceived time constraints have been highlighted in sociological studies as representing a core issue in determining quality of life. The objective of this study was to test the hypothesis that gender inequalities regarding insufficiency of time play a role in the development of overweight and obesity in adults. The study used baseline data (2008–2010) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), which monitors a cohort of 15,105 civil servants of 35 to 74 years of age. Insufficient time for personal care and leisure due to professional and domestic duties, as detailed in a structured questionnaire, comprised the main exposure variable. The outcome variable was overweight/obesity measured according to body mass index. Prevalence ratios were calculated using multinomial logistic regression. A greater proportion of women compared to men reported insufficient time for personal care and leisure (34.5% versus 23.8%, respectively). The prevalence of overweight was greater in men, while obesity was more common in women. Insufficient time for personal care and leisure was associated with overweight (PR = 1.29; 95% CI: 1.04–1.61) and obesity (PR = 1.65; 95% CI: 1.28–2.12) only in women working over 40 hours/week. No significant association was found for males. These results suggest that the length of the working week influences factors underlying weight gain, possibly issues linked to behavior and/or stress mechanisms. The fact that such an association was restricted to women suggests that the results originate from gender inequalities involving relationships between time and health. The findings of this study provide data on which to base public policies aimed at encouraging the redistribution of domestic responsibilities in the direction of gender equity, as well as macrosocial policies such as providing public schools for workers’ children.

Using Gamma and Quantile Regressions to Explore the Association between Job Strain and Adiposity in the ELSA-Brasil Study: Does Gender Matter?

This paper explores the association between job strain and adiposity, using two statistical analysis approaches and considering the role of gender. The research evaluated 11,960 active baseline participants (2008-2010) in the ELSA-Brasil study. Job strain was evaluated through a demand-control questionnaire, while body mass index (BMI) and waist circumference (WC) were evaluated in continuous form. The associations were estimated using gamma regression models with an identity link function. Quantile regression models were also estimated from the final set of co-variables established by gamma regression. The relationship that was found varied by analytical approach and gender. Among the women, no association was observed between job strain and adiposity in the fitted gamma models. In the quantile models, a pattern of increasing effects of high strain was observed at higher BMI and WC distribution quantiles. Among the men, high strain was associated with adiposity in the gamma regression models. However, when quantile regression was used, that association was found not to be homogeneous across outcome distributions. In addition, in the quantile models an association was observed between active jobs and BMI. Our results point to an association between job strain and adiposity, which follows a heterogeneous pattern. Modelling strategies can produce different results and should, accordingly, be used to complement one another.

Work-Life Imbalance and Musculoskeletal Disorders among South Korean Workers

Employed workers often have family responsibilities such as childcare or homemaking. This dual burden may increase work-related health problems, particularly if there are conflicts between work and family responsibilities. This study assessed whether difficulty in work–life balance is associated with musculoskeletal disorders (MSD) among Korean employees. Data from the population-based Korean Working Conditions Survey of 2011, including 28,640 male and 21,392 female workers, were used. Men and women were analyzed separately to investigate gender differences. MSD were defined as pain in the back, neck, shoulder, or extremities during the past year. Self-assessed difficulty in work–life balance was defined as a work–life conflict (WLC). Adjustments for physical factors, as well as other occupational and socio-demographic variables, were made using multiple logistic regression analysis. Interaction terms including WLCs and key covariates were also incorporated. WLC was significantly associated with increased frequency of MSD in both men (OR: 1.49) and women (OR: 1.50). There were significant interaction effects between WLC and some key covariates (job stress for men and job stress, work hours, physical demand, and frequent overtime work for women). We suggest that having the flexibility to coordinate work and family life is important to prevent MSD among employees.

Work-Family Conflict and Self-Rated Health: the Role of Gender and Educational Level. Baseline Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Purpose

This study examined gender differences in the association between work–family conflict and self-rated health and evaluated the effect of educational attainment.

Method

We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34–72 years. Work–family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care.

Results

Women experienced more frequent work–family conflict, but in both genders, increased work–family conflict directly correlated with poorer self-rated health. Women’s educational level interacted with three work–family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19–1.99) than less educated women (OR = 1.14; 95 % CI = 0.92–1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48–2.47) and OR = 1.40 (95 % CI 1.12–1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95–3.47) and OR = 1.11 (95 % CI = 0.90–1.38), respectively.

Conclusion

Women’s education level affects the relationship between work–family conflict and self-rated health. The results may contribute to prevention activities.

Association between Emotional Symptoms and Job Demands in an Asian Electronics Factory

Various work-related issues including mental health have been described for the electronic industry. Although East Asian countries play important roles in the electronics industry, the association between job demands and emotional symptoms has been rarely examined. The present study recruited 603 workers from either office or clean room environments in an electronics factory in Taiwan. Their personal factors, work-related factors, and emotional symptoms were assessed by a self-administered questionnaire. The symptoms of depression and hostility were reported in 24.88% and 24.38% of the subjects, respectively, while 14.93% reported both. A multivariate analysis showed that, overall, women workers were more likely to have emotional symptoms than male workers (odds ration (OR) = 1.50, 95% CI = 1.02-2.18). Among clean room workers, working under high pressure (OR = 1.84, 95% CI = 1.05-3.21), conflicting demands (OR = 2.15, 95% CI = 1.30-3.57), and social isolation at work (OR = 2.99, 95% CI = 1.23-7.30) were associated with emotional symptoms. The findings suggest that in the Asian electronics industry, for women, working under high pressure, conflicting demands, and social isolation at work are risk factors for emotional symptoms, especially for clean room workers. Further large-scale, longitudinal studies are necessary to confirm and prevent the mental health problems in this fast-evolving, highly competitive industry.

The Psychosocial Implications of Managing Work and Family Caregiving Roles: Gender Differences Among Information Technology Professionals

An increasing number of adults, both men and women, are simultaneously managing work and family caregiving roles. Guided by the stress process model, we investigate whether 823 employees occupying diverse family caregiving roles (child caregiving only, elder caregiving only, and both child caregiving and elder caregiving, or "sandwiched" caregiving) and their noncaregiving counterparts in the information technology division of a white-collar organization differ on several indicators of psychosocial stress along with gender differences in stress exposure. Compared with noncaregivers, child caregivers reported more perceived stress and partner strain whereas elder caregivers reported greater perceived stress and psychological distress. With the exception of work-to-family conflict, sandwiched caregivers reported poorer overall psychosocial functioning. Additionally, sandwiched women reported more family-to-work conflict and less partner support than their male counterparts. Further research on the implications of combining a white-collar employment role with different family caregiving roles is warranted.

Work-related psychosocial stress and the risk of type 2 diabetes in later life

OBJECTIVES

Although work-related psychosocial stress and type 2 diabetes mellitus (T2DM) have been investigated, the association between lifelong work stress and T2DM in later life remains unclear. This study examined whether high work stress increased the risk of T2DM risk in later life, accounting also for other sources of stress outside work, such as burden from household chores.

METHODS

From the population-based prospective study SNAC-K, 2719 diabetes-free participants aged ≥60 years were identified and followed up for 6 years. T2DM was ascertained by glycated haemoglobin level, self-report, hypoglycaemic medication use and clinical records. Levels of job control and demands over the whole working life were assessed by a validated matrix. Household chores load was assessed by hours spent on such chores. Multivariate logistic regression models were used to estimate the association between job strain and T2DM.

RESULTS

During the 6-year follow-up, 154 incident cases of T2DM were identified. High job strain was associated with T2DM occurrence amongst the 60-year-old cohort (OR = 3.14, 95% CI: 1.27-7.77), and only amongst women (OR = 6.18, 95% CI: 1.22-31.26), but not in men. When taking into account household chores load, a more pronounced risk of T2DM was associated with high job strain in combination with heavy household chores load in women aged 60 years at baseline (OR = 9.45, 95% CI: 1.17-76.53).

CONCLUSION

Work-related psychosocial stress may increase the risk of T2DM only amongst women in their early 60s. The risk can be amplified by high household chores load.

What work schedule characteristics constitute a problem to the individual? A representative study of Swedish shift workers

The purpose was to investigate which detailed characteristics of shift schedules that are seen as problems to those exposed. A representative national sample of non-day workers (N = 2031) in Sweden was asked whether they had each of a number of particular work schedule characteristics and, if yes, to what extent this constituted a "big problem in life". It was also inquired whether the individual's work schedules had negative consequences for fatigue, sleep and social life. The characteristic with the highest percentage reporting a big problem was "short notice (<1 month) of a new work schedule" (30.5%), <11 h off between shifts (27.8%), and split duty (>1.5 h break at mid-shift, 27.2%). Overtime (>10 h/week), night work, morning work, day/night shifts showed lower prevalences of being a "big problem". Women indicated more problems in general. Short notice was mainly related to negative social effects, while <11 h off between shifts was related to disturbed sleep, fatigue and social difficulties. It was concluded that schedules involving unpredictable working hours (short notice), short daily rest between shifts, and split duty shifts constitute big problems. The results challenge current views of what aspects of shift work need improvement, and negative social consequences seem more important than those related to health.

Examples of sex/gender sensitivity in epidemiological research: results of an evaluation of original articles published in JECH 2006-2014

BACKGROUND

During the last decades, sex and gender biases have been identified in various areas of biomedical and public health research, leading to compromised validity of research findings. As a response, methodological requirements were developed but these are rarely translated into research practice. The aim of this study is to provide good practice examples of sex/gender sensitive health research.

METHODS

We conducted a systematic search of research articles published in JECH between 2006 and 2014. An instrument was constructed to evaluate sex/gender sensitivity in four stages of the research process (background, study design, statistical analysis, discussion).

RESULTS

In total, 37 articles covering diverse topics were included. Thereof, 22 were evaluated as good practice example in at least one stage; two articles achieved highest ratings across all stages. Good examples of the background referred to available knowledge on sex/gender differences and sex/gender informed theoretical frameworks. Related to the study design, good examples calculated sample sizes to be able to detect sex/gender differences, selected sex/gender sensitive outcome/exposure indicators, or chose different cut-off values for male and female participants. Good examples of statistical analyses used interaction terms with sex/gender or different shapes of the estimated relationship for men and women. Examples of good discussions interpreted their findings related to social and biological explanatory models or questioned the statistical methods used to detect sex/gender differences.

CONCLUSIONS

The identified good practice examples may inspire researchers to critically reflect on the relevance of sex/gender issues of their studies and help them to translate methodological recommendations of sex/gender sensitivity into research practice.

Association between Work-Related Stress and Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

BACKGROUND/OBJECTIVE

The prevalence of type 2 diabetes is increasing rapidly around the world. Work-related stress is thought to be a major risk factor for type 2 diabetes; however, this association has not been widely studied, and the findings that have been reported are inconsistent. Therefore, we conducted a meta-analysis of prospective cohort studies to explore the association between work-related stress and risk for type 2 diabetes.

METHODS

A systematic literature search and manual search limited to articles published in English were performed to select the prospective cohort studies evaluated the association between work-related stress and risk for type 2 diabetes up to September 2014 from four electronic databases including PubMed, EMBASE, the Cochrane Library and Web of Science. A random-effects model was used to estimate the overall risk.

RESULTS

No significant association was found between work-related stress and risk for type 2 diabetes based on meta-analysis of seven prospective cohort studies involving 214,086 participants and 5,511 cases (job demands: relative risk 0.94 [95% confidence interval 0.72-1.23]; decision latitude: relative risk 1.16 [0.85-1.58]; job strain: relative risk 1.12 [.0.95-1.32]). However, an association between work-related stress and risk for type 2 diabetes was observed in women (job strain: relative risk 1.22 [1.01-1.46]) (P = 0.04). A sensitivity analysis conducted by excluding one study in each turn yielded similar results. No publication bias was detected with a funnel plot despite the limited number of studies included in the analysis.

CONCLUSIONS

The results of this meta-analysis did not confirm a direct association between work-related stress and risk for type 2 diabetes. In subgroup analyses we found job strain was a risk factor for type 2 diabetes in women.

Mediating pathways and gender differences between shift work and subjective cognitive function

OBJECTIVES

Increased injury risk among shift workers is often attributed to cognitive function deficits that come about as a result of sleep disruptions. However, little is known about the intermediate influences of other factors (eg, work stress, health) which may affect this relationship. In addition, gender differences in these the complex relationships have not been fully explored. The purpose of this study is to (1) identify the extent to which work and non-work factors mediate the relationship between shift work, sleep and subsequent subjective cognitive function; and (2) determine if the mediating pathways differ for men and women.

METHODS

Data from the 2010 National Population Health Survey was used to create a cross-sectional sample of 4255 employed Canadians. Using path modelling, we examined the direct and indirect relationships between shift work, sleep duration, sleep quality and subjective cognitive function. Multigroup analyses tested for significantly different pathways between men and women. Potential confounding effects of age and self-reported health and potential mediating effects of work stress were simultaneously examined.

RESULTS

Work stress and sleep quality significantly mediated the effects of shift work on cognition. Age and health confounded the relationship between sleep quality and subjective cognition. No differences were found between men and women.

CONCLUSIONS

Occupational health and safety programmes are needed to address stress and health factors, in addition to sleep hygiene, to effectively address cognitive function among shift workers.

Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus

The steep rise of type 2 diabetes mellitus (T2DM) and associated complications go along with mounting evidence of clinically important sex and gender differences. T2DM is more frequently diagnosed at lower age and body mass index in men; however, the most prominent risk factor, which is obesity, is more common in women. Generally, large sex-ratio differences across countries are observed. Diversities in biology, culture, lifestyle, environment, and socioeconomic status impact differences between males and females in predisposition, development, and clinical presentation. Genetic effects and epigenetic mechanisms, nutritional factors and sedentary lifestyle affect risk and complications differently in both sexes. Furthermore, sex hormones have a great impact on energy metabolism, body composition, vascular function, and inflammatory responses. Thus, endocrine imbalances relate to unfavorable cardiometabolic traits, observable in women with androgen excess or men with hypogonadism. Both biological and psychosocial factors are responsible for sex and gender differences in diabetes risk and outcome. Overall, psychosocial stress appears to have greater impact on women rather than on men. In addition, women have greater increases of cardiovascular risk, myocardial infarction, and stroke mortality than men, compared with nondiabetic subjects. However, when dialysis therapy is initiated, mortality is comparable in both males and females. Diabetes appears to attenuate the protective effect of the female sex in the development of cardiac diseases and nephropathy. Endocrine and behavioral factors are involved in gender inequalities and affect the outcome. More research regarding sex-dimorphic pathophysiological mechanisms of T2DM and its complications could contribute to more personalized diabetes care in the future and would thus promote more awareness in terms of sex- and gender-specific risk factors.

Work-family conflict, cardiometabolic risk, and sleep duration in nursing employees

We investigated associations of work-family conflict and work and family conditions with objectively measured cardiometabolic risk and sleep. Multilevel analyses assessed cross-sectional associations between employee and job characteristics and health in analyses of 1,524 employees in 30 extended-care facilities in a single company. We examined work and family conditions in relation to: (a) validated, cardiometabolic risk score based on measured blood pressure, cholesterol, glycosylated hemoglobin, body mass index, and self-reported tobacco consumption and (b) wrist actigraphy-based sleep duration. In fully adjusted multilevel models, work-to-family conflict but not family-to-work conflict was positively associated with cardiometabolic risk. Having a lower level occupation (nursing assistant vs. nurse) was associated with increased cardiometabolic risk, whereas being married and having younger children at home was protective. A significant Age × Work-to-Family Conflict interaction revealed that higher work-to-family conflict was more strongly associated with increased cardiometabolic risk in younger employees. High family-to-work conflict was significantly associated with shorter sleep duration. Working long hours and having children at home were both independently associated with shorter sleep duration. High work-to-family conflict was associated with longer sleep duration. These results indicate that different dimensions of work-family conflict may pose threats to cardiometabolic health and sleep duration for employees. This study contributes to the research on work-family conflict, suggesting that work-to-family and family-to-work conflict are associated with specific health outcomes. Translating theory and findings to preventive interventions entails recognition of the dimensionality of work and family dynamics and the need to target specific work and family conditions.

Working hours and mental health in Australia: evidence from an Australian population-based cohort, 2001-2012

OBJECTIVES

This paper assesses the impact of working less than or more than standard full-time hours on mental health, as well as possible differences in this relationship by gender and skill level.

METHODS

The study design was a longitudinal cohort with 12 annual waves of data collection over the period 2001-2012, yielding a sample of 90,637 observations from 18,420 people. Fixed effects within-person regression was used to control for time invariant confounding. The Mental Component Summary of the Short Form 36 (SF-36) measure was used as the primary outcome measure. Working hours over the preceding year was measured in five categories with standard full-time hours (35-40 h/week) as the reference.

RESULTS

Results indicated that when respondents were working 49-59 h (-0.52, 95% CI -0.74 to -0.29, p<0.001) and 60 h or more (-0.47, 95% CI -0.77 to -0.16, p=0.003) they had worse mental health than when they were working 35-40 h/week (reference). The difference in mental health when working 49-59 h was greater for women than for men. There were greater declines in mental health in relation to longer working hours among persons in higher compared to lower occupational skill levels.

CONCLUSIONS

Study results suggest the need for employers and governments to regulate working hours to reduce the burden of mental ill health in the working population.

Gender differences in psychosocial work factors, work-personal life interface, and well-being among Swedish managers and non-managers

PURPOSE

To explore differences in psychosocial work factors, work-personal life interface, and well-being between managers and non-managers, female and male managers, and managers in the public and private sectors.

METHODS

Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2010, including 602 female managers, 4174 female non-managers, 906 male managers, and 2832 male non-managers. Psychosocial work factors, work-personal life interface, satisfaction, and well-being were investigated among non-managers and managers and male and female managers, using logistic regression analyses adjusted for age, educational level, staff category, and labour market sector.

RESULTS

Both female and male managers reported high job demands and interference between work and personal life, but also high influence, high satisfaction with work and life, and low amount of sickness absence more often than non-managers of the same sex. However, female managers reported high quantitative and emotional demands, low influence, and work-personal life interference more frequently than male managers. More psychosocial work stressors were also reported in the public sector, where many women work. Male managers more often reported conflicts with superiors, lack of support, and personal life-work interference. Female managers reported poor well-being to a greater extent than male managers, but were more satisfied with their lives.

CONCLUSION

Lack of motivation due to limited increase in satisfaction and organisational benefits is not likely to hinder women from taking on managerial roles. Managerial women's higher overall demands, lower influence at work, and poorer well-being relative to men's could hinder female managers from reaching higher organisational levels.

Gender inequality at home is associated with poorer health for women

Background: As more women have joined the work force, the difference in employment rate between men and women has decreased, in Sweden as well as many other countries. Despite this, traditional gender patterns regarding, for example, responsibility for household duties still remain. Women are on sick leave more often than men, and previous studies have indicated that an unequal split of household responsibilities and perceived gender inequality could be associated with negative health outcomes. Aims: The aim of the present study was to explore whether an unequal distribution of responsibilities in the home was related to various health related outcomes among women. Methods: A sample consisting of 837 women living in a relationship, and working at least 50% of full time, responded to a questionnaire including information about division of responsibilities at home as well as various psychological and physiological health related outcomes. Results: The results showed that women living in relationships with perceived more unequal distribution of responsibility for house hold duties showed significantly higher levels of perceived stress, fatigue, physical/psychosomatic symptoms, and work family conflict compared with women living in more equal relationships. They also had significantly increased odds for insufficient time for various forms of recovery, which may further contribute to an increased risk of poor health. Conclusions: Although an increasing employment rate among women is valuable for both society and individuals, it is important to work towards greater gender equality at home to maintain this development without it having a negative effect on women’s health and well-being.

Work-family conflict, emotional exhaustion and performance-based self-esteem: reciprocal relationships

Objectives

The three constructs of work–family conflict, emotional exhaustion and performance-based self-esteem are all related to tremendous negative consequences for the individual, the organization as well as for society. Even though there are studies that connect two of those constructs, the prospective relations between all three of them have not been studied yet.

Methods

We explored the prospective relations between the three constructs in a large Swedish data set representative of the Swedish workforce. Gender differences in the relations were investigated. Longitudinal data with a 2-year time lag were gathered from 3,387 working men and women who responded to the 2006 and 2008 waves of the Swedish Longitudinal Occupational Survey of Health. Four different cross-lagged models were analysed.

Results

In the best fitting model, higher levels of work–family conflict at time 1 were associated with an increased level of performance-based self-esteem at time 2, but not with emotional exhaustion, after controlling for having children, gender, education and age. Also, relationships between emotional exhaustion at time 1 and work–family conflict and performance-based self-esteem at time 2 could be established. Furthermore, relationships between performance-based self-esteem time 1 and work–family conflict and emotional exhaustion time 2 were found. Multiple-group analysis did not show any differences in the relations of the tested constructs over time for either men or women.

Conclusions

We conclude that the three constructs are interrelated and best understood through a reciprocal model. No differences were found between men and women.

Mothers' lived experiences of support when living with young children with congenital heart defects

PURPOSE

The purpose of this study was to illuminate the meanings of support as disclosed by mothers of children with congenital heart defects (CHD).

DESIGN AND METHOD

Narrative interviews were conducted with 10 mothers of children with CHD. A phenomenological-hermeneutic method was used for interpretation of the transcribed interviews.

RESULTS

The comprehensive understanding of mothers' lived experiences of support emerged as the experiences of receiving good support, receiving "poor support," and absence of support.

PRACTICE IMPLICATIONS

Mothers receiving person-centered and family-centered care feel more supported and are more likely to adapt to the stresses of parenting a child with CHD.

Work stress, sense of coherence, and risk of type 2 diabetes in a prospective study of middle-aged Swedish men and women

OBJECTIVE

To investigate the prospective influence of work stress on type 2 diabetes (T2D).

RESEARCH DESIGN AND METHODS

This population-based cohort included 3,205 women and 2,227 men, aged 35-56 years, with baseline normal glucose tolerance measured with oral glucose tolerance test. At follow-up 8-10 years later, T2D was diagnosed in 60 women and 111 men. Work stress factors evaluated by questionnaire (i.e., demands, decision latitude, job strain, shift work, overtime work, and also sense of coherence) were studied in association with T2D. Odds ratios (ORs) and 95% CIs adjusted for age, education, BMI, physical activity, smoking, family history of diabetes, and psychological distress were calculated.

RESULTS

In women, low decision latitude was associated with T2D on its own (OR 2.4 [95% CI 1.1-5.2]) and combined with high demands: job strain (OR 4.2 [2.0-8.7]), adjusted for all available potential confounders. Also, shift work increased the risk of T2D in women (OR 2.2 [1.0-4.7]) when adjusted for age, education, and psychological distress, although this risk was diluted after multifactor adjustment (OR 1.9 [0.8-4.4]). In men, high work demands and high strain decreased the risk of T2D (OR 0.5 [0.3-0.9]) for both measures, as did an active job (high demands and high decision latitude, OR 0.4 [0.2-0.9]).

CONCLUSIONS

Work stress and shift work may contribute to the development of T2D in women. In men, the risk was decreased by high work demands, high strain, and an active job.

Gender differences in the relationship between shiftwork and work injury: examining the influence of dependent children

OBJECTIVE

To examine the relationship between shiftwork and work injury among men and women, taking into account the presence of dependent children.

METHODS

An analysis of respondents to the 2009-2010 Multipurpose Household Survey (n = 6927 women and 7340 men). Logistic regression models examined the work injury risk, adjusting for various covariates.

RESULTS

The risk of work injury associated with shiftwork was higher for women than for men. Nevertheless, gender differences were present only among respondents with dependent children. Shiftworking women with children also had a greater risk of work injury than shiftworking women without children.

CONCLUSIONS

This previously noted elevated risk of injury associated with shiftwork among women compared with that in men may be a product of increased household responsibilities or other factors particular to female shiftworkers with dependent children.

Attitude and flexibility are the most important work place factors for working parents’ mental wellbeing, stress, and work engagement

Aims: The need to combine active employment and parenthood is a reality for many parents today. Knowing more about which work place factors are associated with better or worse health could help employers to form a work environment that provides optimal conditions to maintain or increase health and work engagement in this group. The aim of this study was to explore possible associations between different subjective and objective work factors and benefits, and a range of outcome variables such as stress, symptom report, wellbeing, work-related fatigue, work engagement, and work–family conflict among working mothers and fathers with small children. Methods: Cross-sectional analyses of associations between work place factors categorised into three different dimensions; flexibility, benefits, and attitude and the outcome measures were performed, including questionnaire responses from 1562 working parents. Results: The results showed that work place factors related to flexibility and, especially among women, attitude to parenthood appear to have the strongest effect on working parents’ subjective stress and wellbeing, while benefits appear to have less impact. Except regarding factors related to attitudes at the work place, most associations were similar among men and women. Conclusions: Most likely, different factors are better suited or more important for some individuals than others depending on their total work, as well as family situation and also depending on individual factors such as personality and priorities. A positive attitude towards parenthood and a flexible work situation seem, however, beneficial for the general wellbeing and work engagement among working parents.

Associations between the occupational stress index and hypertension, type 2 diabetes mellitus, and lipid disorders in middle-aged men and women

INTRODUCTION

Retrospective and prospective studies show that stress at work is linked to an increased risk of hypertension, diabetes mellitus, and coronary heart disease. However, the nature of the contributory job stressors and biological mechanisms need further elucidation.

OBJECTIVES

The study is aimed to determine the associations between aspects of the occupational stress index (OSI) and arterial hypertension, diabetes mellitus (DM) type 2, and lipid disorders in working middle-aged men and women.

METHODS

The cross-sectional study involved 989 middle-aged men and women in different occupations. The OSI was calculated by using standardized questionnaires. The total participation rate was 93%. Occupational stressors were divided into seven groups: High Demands, Strictness, Underload, Extrinsic Time Pressure, Noxious Exposure, Avoidance, and Conflict/Uncertainty. Serum lipid levels, glucoregulation, blood pressure, and cardiovascular risk factors were measured.

RESULTS

For both women and men, the total OSI score associated significantly with DM (women: odds ratio [OR] 2.4, 95% confidence intervals [CI] 1.67-3.45; men: 1.21, 1.15-1.45), any type of dyslipidemia (women: 1.54, 1.17-2.03; men: 1.31, 1.24-1.39), and arterial hypertension (women: 1.15, 1.10-1.21; men: 1.58, 1.49-1.68). The group as a whole showed associations between total OSI and low high-density lipoprotein (HDL) cholesterol, high total cholesterol, and high triglyceride levels. Of the OSI aspects, Underload associated significantly in both men and women with arterial hypertension (women: 3.48, 1.91-6.31; men: 2.71, 1.96-3.75) and dyslipidemia (women: 3.26, 2.13-4.99; men: 2.11, 1.76-2.52). Underload was also associated with several lipid abnormalities in the group as a whole. It associated with DM in women only (4.7, 2.84-7.81). All remaining OSI aspects also associated significantly and positively with DM in women only. Conversely, in male workers, but not female workers, High Demand, Conflict/Uncertainty, and Extrinsic Time Pressure associated significantly with arterial hypertension. Strictness and Conflict/Uncertainty associated positively with dyslipidemia in women only. Noxious Exposures associated positively with DM and arterial hypertension in women only.

CONCLUSIONS

The study provides evidence for the association of work stress with metabolic disorders and hypertension. Total OSI associated significantly with DM type 2, arterial hypertension, and dyslipidemia in both genders. Different OSI aspects associated with these health issues in gender- and occupational-specific patterns. Underload, which represents lack of social communication, simple task preparation, and underestimation of working results, associated most strongly of all OSI aspects with disease in both the sexes.

Work-family conflict and health in Swedish working women and men: a 2-year prospective analysis (the SLOSH study)

BACKGROUND

Research has suggested that gender is related to perceptions of work-family conflict (WFC) and an underlying assumption is that interference of paid work with family life will burden women more than men. There is, however, mixed evidence as to whether men and women report different levels of WFC. Even less studies investigate gender differences in health outcomes of WFC. Also the number of longitudinal studies in this field is low.

METHODS

Based on the Swedish Longitudinal Occupational Survey of Health, we prospectively examined the effects of WFC on three different health measures representing a wide spectrum off ill health (i.e. self-rated health, emotional exhaustion and problem drinking). Logistic regression analyses were used to analyse multivariate associations between WFC in 2008 and health 2 years later.

RESULTS

The results show that WFC was associated with an increased risk of emotional exhaustion among both men and women. Gender differences are suggested as WFC was related to an increased risk for poor self-rated health among women and problem drinking among men. Interaction analyses revealed that the risk of poor self-rated health was substantially more influenced by WFC among women than among men.

CONCLUSIONS

We conclude that, despite the fact that women experience conflict between work and family life slightly more often than men, both men's and women's health is negatively affected by this phenomenon.

The course of physical functional limitations and occupational conditions in a middle-aged working population in France

Background

Physical functional limitations (PFL) have mainly been studied in older populations. The aim of this study was to better understand the course of PFL and associations with occupational factors by gender in a middle-aged working population.

Methods

The data came from 16,950 workers in the ESTEV (Enquête Santé Travail et Vieillissement) cohort in France. PFL were assessed using the physical abilities section of the Nottingham Health Profile. Occupational conditions were measured with a self-administered questionnaire covering physical and psychosocial factors in 1990 and 1995. Multivariate analyses were used to assess the associations.

Results

The PFL appearance rate in 1995 was the same by gender (6.3%); the rate of PFL recovery was higher in men (23.9% versus 20.9%). Age was an independent factor of PFL at age 47 years or older in both genders after adjusting for confounding factors. The PFL appearance rate in 1995 was higher with physical occupational exposure in 1990, such as awkward work with a dose relation in both genders, while the PFL recovery rate decreased significantly only for men. Exposure to psychosocial occupational conditions, such as having the means to produce quality work in 1990, was significantly associated with a decreased PFL appearance rate in 1995 in both genders, and having high decision latitude in 1990 was associated with a decreased PFL appearance rate in 1995 only in men. Changes in exposure to occupational factors between 1990 and 1995 were associated with the PFL appearance and recovery rates in 1995 in both genders.

Conclusions

After five years, the course of PFL in this working population changed and was associated with physical and psychosocial occupational factors. Relationships were stronger for the PFL appearance rate in both genders and were weaker for recovery from PFL, mainly among women.

Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work

The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men.

PRACTITIONER SUMMARY

The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.

Gender differences in recovery goals in patients after acute myocardial infarction

PURPOSE

: While cardiac rehabilitation has been established as an essential part of comprehensive cardiac care, participation rates for female patients are substantially lower than for male patients. Lower referral rates and higher ages of female patients partly explain this underutilization. Gender differences in recovery goals of cardiac patients have not been examined.

METHODS

: Five hundred ninety patients (22.2% women) admitted to the hospital because of an acute myocardial infarction answered a questionnaire regarding 24 goals in 5 domains of recovery (physical functioning, risk-factor modification, psychological well-being, independence in daily life, and return to work). In addition, psychological symptoms and medical data were assessed. Gender differences were tested by using χ and Student t tests, as well as multivariate logistic and linear regression models.

RESULTS

: Gender differences were found in 7 of the 24 recovery goals. After adjustment for psychosocial and clinical characteristics, women still reported a higher importance of "performance of household duties" (odds ratio [OR] = 8.62; 95% confidence interval [CI], 5.43-13.66), "independence in activities of daily living" (OR = 2.38; CI, 1.58-3.59), and "emotional equilibrium" (OR = 1.58, CI, 1.01-2.46). Men rated "physical endurance" and "reducing strain at workplace" as more important goals (OR = 0.64; CI, 0.42-0.97 and OR = 0.39; CI, 0.17-0.93). Except for psychological distress, gender differences in health status were not related to differences in goals.

CONCLUSIONS

: Gender roles and differences in social-life conditions may have an important influence on the recovery goals of patients after an acute myocardial infarction. Recovery goals should be explored when planning intervention programs for individual patients.

Self-reported features of sleep, utilization of medical resources, and socioeconomic position: a Swedish population survey

This study examined aspects of self reported qualities of sleep and daytime functioning attributed to sleep, including the utilization of physician consultations and prescription medications, and their relationships with age, gender, and educational attainment in the Swedish population using telephone interviews of 1,000 random households. Women were twice as likely to use hypnotics and experienced more poor quality sleep and excessive daytime sleepiness (EDS). Lower educational attainment was associated with twofold increased hypnotic use, life impacts of sleep problems, and EDS, but not dimensions reflecting poor quality sleep. This study demonstrates that educational attainment, gender, and age combine to shape both the attributions of the effects of sleep on wakeful functioning and patterns of using medical resources.

A longitudinal analysis of total workload and women's health after childbirth

OBJECTIVES

To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth.

METHODS

Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum.

RESULTS

Increased TWL over time was associated with significantly poorer mental health and increased symptoms.

CONCLUSIONS

High TWL--including reduced time for rest, recovery, and sleep--is a risk factor for women's mental health and symptoms 12 months after childbirth. Women's postpartum health was positively associated with social support, which may help to decrease the negative effects of excess work.

Housework and recovery from work among nursing teams: a gender perspective

The impact on health of work carried out within the household is recognized by several authors in the occupational health field. The purpose of this article is to verify whether and to what extent the need for recovery is related to professional work hours and to housework duties in female nursing workers. Workers (N = 1122) completed a questionnaire with data on household chores and professional work, as well as the Need for Recovery from Work scale. Regression analysis showed that the odds for reporting poor recovery were significantly higher for workers showing long domestic work hours, high total work load (professional plus domestic work hours), and housework overload. No association was found for professional work hours per se. Findings highlight the potential detrimental effects of housework, either by itself or in combination with professional work for the group studied, and can generate discussion on gender equality in both the public and private domains.

Occupational Therapy Students' Choice of Client Activities: Does Patients' Gender Matter?

Aim:

In order to achieve a fairer system of health care, it is important that the research and education of health professionals, as well as the organisation of health care, takes into account the gender perspective. The gender order influences women's and men's lifestyles and living conditions and, through this, their health, quality of life and daily activities. The aim of the present study was to explore the perceptions of gender in occupational therapy students in their choice of activities: do students choose activities according to traditional roles?

Method:

The method was a fictional case study containing 16 activities. Each student was given a copy of one of the versions of the case, Eric or Erica. The students were told to underline the three activities regarded as being of most benefit for the actual patient. Eight male and 99 female students participated.

Results:

The most chosen activities were cooking, visits to cafeterias and gardening, and the least chosen were spinning, laundry and computer work. The results showed that the students made choices based on traditional gender roles.

Conclusion:

Extended knowledge is needed about how gender is constructed in occupational therapy, and about whether gendered choices contribute to a prolonged period of treatment or rehabilitation, or the opposite.