Managerial leadership and ischaemic heart disease among employees: the Swedish WOLF study

Can Better Leadership Reduce Nursing Home Staff Turnover?

OBJECTIVES

To assess whether a measure of leadership support for worker safety, health, and well-being predicts staff turnover in nursing homes after controlling for other factors.

DESIGN

This paper uses administrative payroll data to measure facility-level turnover and uses a survey measure of nursing home leadership commitment to workers. In addition, we use data from Medicare to measure various nursing home characteristics.

SETTING AND PARTICIPANTS

Nursing homes with at least 30 beds serving adults in California, Ohio, and Massachusetts were invited to participate in the survey. The analysis sample included 495 nursing homes.

METHODS

We used a multivariable ordinary least squares model with turnover rate as the dependent variable. We used an indicator for nursing homes who scored above the median on the measure of leadership that supports worker safety, health, and well-being. Control variables include bed count (deciles), ownership (corporate/noncorporate × for-profit/not-for-profit), percent of residents on Medicaid, state, being in a nonmetropolitan county, and total nurse staffing per patient day in the 2 quarters before the survey.

RESULTS

The unadjusted turnover rate was lower for those nursing homes that scored higher on leadership commitment to worker safety, health, and well-being. After controlling for additional variables, greater leadership commitment was still associated with lower turnover but with some attenuation.

CONCLUSIONS AND IMPLICATIONS

We find that nursing homes with leadership that communicated and demonstrated commitment to worker safety, health, and well-being had relatively fewer nurses leave during the study period, with turnover rates approximately 10% lower than homes without. These findings suggest that leadership may be a valuable tool for reducing staff turnover.

Work as a social determinant of health in high-income countries: past, present, and future

This paper, the first in a three-part Series on work and health, provides a narrative review of research into work as a social determinant of health over the past 25 years, the key emerging challenges in this field, and the implications of these challenges for future research. By use of a conceptual framework for work as a social determinant of health, we identified six emerging challenges: (1) the influence of technology on the nature of work in high-income countries, culminating in the sudden shift to telework during the COVID-19 pandemic; (2) the intersectionality of work with gender, sexual orientation, age, race, ethnicity, migrant status, and socioeconomic status as codeterminants of health disparities; (3) the arrival in many Organisation for Economic Co-operation and Development countries of large migrant labour workforces, who are often subject to adverse working conditions and social exclusion; (4) the development of precarious employment as a feature of many national labour markets; (5) the phenomenon of working long and irregular hours with potential health consequences; and (6) the looming threat of climate change's effects on work. We conclude that profound changes in the nature and availability of work over the past few decades have led to widespread new psychosocial and physical exposures that are associated with adverse health outcomes and contribute to increasing disparities in health. These new exposures at work will require novel and creative methods of data collection for monitoring of their potential health impacts to protect the workforce, and for new research into better means of occupational health promotion and protection. There is also an urgent need for a better integration of occupational health within public health, medicine, the life sciences, and the social sciences, with the work environment explicitly conceptualised as a major social determinant of health.

Shared Leadership for Total Worker Health in the Construction Industry

OBJECTIVE

The purpose of this study is to investigate the organizational, supervisor, team, and individual factors associated with employee and leader perceptions of shared Total Worker Health (TWH) transformational leadership in teams. Methods: We conducted a cross-sectional study with 14 teams across three construction companies. Results: Shared TWH transformational leadership in teams was associated with employees and leaders' perceptions of support from coworkers. Other factors were also associated it, but it differed by position. Conclusions: We found that leaders may be focused on the mechanics of sharing TWH transformational leadership responsibilities and workers may be more focused on their internal cognitive abilities and motivations. Our results suggest the potential ways of promoting shared TWH transformational leadership among construction teams.

Workplace bullying, symptoms of anxiety and the interaction with leadership quality - a longitudinal study using dynamic panel models with fixed effects

OBJECTIVES

Workplace bullying has been suggested to increase symptoms of anxiety. A reverse relationship has also been proposed. However, so far only few earlier studies have investigated this topic and the reported associations might partly be explained by unmeasured individual characteristics. In this study, we aim to examine the temporality and directionality between workplace bullying and anxiety symptoms, taking time-invariant characteristics into account. Furthermore, we aim to examine whether leadership quality modifies these associations.

METHODS

We included 13 491 individuals from two nationwide cohort studies in Sweden and Denmark. Using cross-lagged structural equation models (SEM) and dynamic panel models with fixed effects, we examined contemporaneous and lagged associations between self-reported workplace bullying and anxiety. Cohort-specific results were estimated and combined using fixed-effect meta-analysis.

RESULTS

The cross-lagged SEM models supported contemporaneous and lagged relationships in both directions (from workplace bullying to symptoms of anxiety and vice versa). In contrast, only contemporaneous relationships remained statistically significant and of considerable magnitude in the dynamic panel models with fixed effects. Specifically, exposure to workplace bullying was related to a concurrent increase in anxiety symptoms (b=0.61, 95% confidence interval 0.32-0.90). No support of interaction with leadership quality was found.

CONCLUSIONS

The results indicate that onset of workplace bullying is associated with an immediate or short-term increase in anxiety symptoms. This study provides novel insights regarding temporal aspects and causal inference of the bullying-anxiety relationship useful for managing psychological hazards and preventing mental illness at work.

Quality of leadership and self-rated health: the moderating role of 'Effort-Reward Imbalance': a longitudinal perspective

OBJECTIVE

Longitudinal studies on the influence of leadership behavior on employees' self-rated health are scarce. As a result, potential mechanisms describing the impact of leadership behavior on health have not been adequately investigated so far. The present study accounts for the influence of leadership behavior on self-rated health within the framework of the Effort-Reward Imbalance model.

METHODS

The study was conducted on the basis of a cohort which comprised a random sample of healthcare workers from ten different hospitals and one elderly nursing home in Germany. A 2-level repeated measurement model with random intercept and slopes was modeled, since it was aimed to account for individual as well as intra-individual variation of subjective health across three time points over 36 months. Beside 'Effort-Reward Imbalance' and 'Quality of Leadership' from the Copenhagen Psychosocial Questionnaire, physical and mental health was assessed by German version of the SF12 multipurpose short-form measure of health status.

RESULTS

'Effort-Reward Imbalance' and a lack in 'Quality of Leadership' negatively affect self-rated physical health. No effect was found for self-rated mental health. Effort-Reward Imbalance significantly moderates the effect of 'Quality of Leadership' on self-rated physical health.

CONCLUSION

The findings, and the interaction effects in particular, suggest that leadership behavior moderated by factors such as appreciation and support, influences self-rated physical health. The study therefore provides an interpretation for leadership behavior and its influence on employees' self-rated health within the 'Effort-Reward Imbalance' model.

Workplace psychosocial resources and risk of cardiovascular disease among employees: a multi-cohort study of 135 669 participants

OBJECTIVE

In terms of prevention, it is important to determine effects on cardiovascular disease (CVD) when some workplace psychosocial resources are high while others are low. The aim of the study was to assess the prospective relationship between clustering of workplace psychosocial resources and risk of CVD among employees.

METHODS

We pooled data from three cohort studies of 135 669 employees (65% women, age 18-65 years and free of CVD) from Denmark, Finland and Sweden. Baseline horizontal resources (culture of collaboration and support from colleagues) and vertical resources (leadership quality and procedural justice) were measured using standard questionnaire items. Incident CVD, including coronary heart and cerebrovascular disease, was ascertained using linked electronic health records. We used latent class analysis to assess clustering (latent classes) of workplace psychosocial resources. Cox proportional hazard models were used to examine the association between these clusters and risk of CVD, adjusting for demographic and employment-related factors and pre-existing physical and mental disorders.

RESULTS

We identified five clusters of workplace psychosocial resources from low on both vertical and horizontal resources (13%) to generally high resources (28%). High horizontal resources were combined with either intermediate [hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.74-0.95] or high (HR 0.88, 95% CI 0.78-1.00) vertical resources were associated with lower risks of CVD compared to those with generally low resources. The association was most prominent for cerebrovascular disease (eg, general high resources: HR 0.80, 95% CI 0.67-0.96).

CONCLUSIONS

Individuals with high levels of workplace psychosocial resources across horizontal and vertical dimensions have a lower risk of CVD, particularly cerebrovascular disease.

Predicting Leadership Success in Extreme Organizations: A Prospective Study From Pre-Recruitment Through Leading in Real-Life

Organizations performing in stressful life-risking environments have unique features that directly influence human lives and communities’ well-being. Such organizations allocate vast resources to identify potential leaders as early as possible to direct and train them for leadership positions. Combat military contexts represent such organizations. The current manuscript offers a 5-year prospective study, addressing a critical gap in the literature regarding the generalization of established predictive leadership success models to leadership in extreme conditions. The study integrates leaders’ characteristics, followers’ perceptions, leadership training, and real-life contexts. Findings show that leadership traits measured years before enlistment related to leadership success, years down the line, when congruent with specific training contexts. Candidates higher in both task and relationship characteristics and in leadership emergence progressed to the senior leadership course compared to dropouts. Leadership emergence, measured in the first phase of leadership training, was the most relevant, stable, and reliable leader’s success predictor, directly and indirectly, of leadership development, above and beyond leadership characteristics. Findings emphasize the important influence of contextual congruency on leadership success in extreme organizations. Current findings may foster better leadership prospects for communities’ well-being and may improve cost-effectiveness in the leadership development processes in extreme occupations.

Job demands, job resources, and health outcomes among nursing professionals in private and public healthcare sectors in Sweden - a prospective study

Background

Nursing professionals exhibit high prevalence of stress-related health problems. Job demands and job resources are parallel drivers of health and well-being among employees. Better job resources associate with better job satisfaction, job motivation and engagement even when job demands are high. To date, there is limited research which explores the association between job demands, job resources and health outcomes among nursing professionals in the Swedish context. The aim of this study was therefore to investigate Swedish nursing professionals’ job demands and job resources in relation to health outcomes, with comparisons between the private and public healthcare sectors. The specific research questions were as follows: (1) Are there differences between private and public healthcare regarding job demands, job resources, and health outcomes? and (2) Are there prospective associations between job demands and job resources in relation to health outcomes?

Methods

Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2016 and 2018, including 520 nurses and 544 assistant nurses working in the private and public healthcare sectors from 2016 (baseline). Data were analyzed using binary logistic regression.

Results

Nursing professionals reported higher threats, lower bullying, lower control, lower social support, and lower cohesion in the public healthcare units compared to the private healthcare units. The prospective analyses showed that job resources in terms of social support and rewards were associated with higher self-rated health and lower burnout. Cohesion was associated with higher self-rated health. Job demands in terms of psychological demands and job efforts were associated with lower self-rated health, higher burnout, and higher sickness absence, while emotional demands were associated with higher burnout.

Conclusions

Nursing professionals’ job resources are deficient in public healthcare units. Job resources are associated with positive health outcomes, whereas job demands are associated with negative health outcomes, among nursing professionals. Strengthening job resources among nursing professionals in the private and public healthcare sectors can promote and sustain their work-related health.

The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians

Objectives

The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic.

Method

The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout.

Results

Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements.

Conclusions

In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.

The association between direct supervisor's behavior and employee presenteeism in Korean wage workers: findings from the fifth Korean Working Condition Survey

Background

Presenteeism is a phenomenon in which employees go to work, but physical or mental health problems make it impossible for them to properly demonstrate their abilities, and productivity decreases accordingly. Recent studies have considered the behavior of direct supervisors to be an important factor in the pathogenesis of various health-related outcomes. This study aimed to investigate the association between the direct supervisor's behaviors and presenteeism among wage workers in South Korea.

Methods

A total of 25,798 participants from the fifth Korean Working Condition Survey conducted in 2017 were included in the analysis. The behaviors of direct supervisor were assessed by 6 questionnaire items. In this study, the distribution of the scores was categorized into 4 categories (very good, good, bad, and very bad). To assess presenteeism, the corresponding questionnaire item was used. χ² tests and multiple logistic regression analyses adjusted for general, occupational, and psychosocial factors were performed to determine the association between the behaviors of direct supervisor and presenteeism.

Results

Direct supervisor's behavior were significantly associated with presenteeism. The adjusted odds ratios (aORs) of presenteeism in the good, bad, and very bad groups were 1.297 (95% confidence interval [CI]: 1.153-1.458), 1.191 (95% CI: 0.941-1.507), and 1.604 (95% CI: 1.184-2.175), compared with the very good group. Associations between presenteeism and the behaviors of direct supervisor were significant in male workers, but not in female workers. For male workers, the aORs of presenteeism in the good, bad, very bad groups were 1.661 (95% CI: 1.425-1.936), 1.445 (95% CI: 1.053-1.982), 2.340 (95% CI: 1.569-3.491), respectively.

Conclusions

This study suggests that the behavior of a direct supervisor can influence the occurrence of presenteeism, particularly in men. The proper management of senior employee's behaviors is necessary to reduce the risk of presenteeism in the workplace.

The role of managerial leadership in sickness absence in health and social care: antecedent or moderator in the association between psychosocial working conditions and register-based sickness absence? A longitudinal study based on a swedish cohort

BACKGROUND

The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence.

METHODS

Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010-2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)-iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence).

RESULTS

A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence.

CONCLUSIONS

Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.

Effectiveness of health-oriented leadership interventions for improving health and wellbeing of employees: a systematic review

Aim

To identify and summarize the evidence for the effect of health-oriented leadership interventions on health and well-being outcomes at the employee level following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (Moher et al. 2009).

Subject and Methods

A systematic search of relevant studies was conducted in multiple databases. Randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs) and controlled before–after studies (CBAs) were included based on the following criteria: interventions that addressed supervisors, to raise awareness for the importance of health issues, teach mindfulness practices for conscious awareness, reduce stress and promote resources at the level of individual behavior, and evaluated the effect on at least one outcome of psychomental stress, absenteeism and well-being on the employee level.

Results

Of 6126 publications retrieved, ten studies were identified for analysis. Significant effects of leadership training were reported on exhaustion tendency, self-reported sickness absence, work-related sickness absence and job satisfaction in studies comparing health-oriented training programs to no intervention. Studies comparing health-oriented leadership training to other training did not report significant effects. Risk of bias was judged to be high in seven studies and unclear in three studies.

Conclusion

Evidence for the effectiveness of health-oriented leadership interventions on employees’ stress, absenteeism or well-being is judged to be low, clearly indicating the need for more and higher-quality research.

How Human Resources Index, Relational Justice, and Perceived Productivity Change after Reorganization at a Hospital in Sweden That Uses a Structured Support Model for Systematic Work Environment Management

To facilitate systematic work environment management, which should be a natural part of business development, a structured support model was developed. The Stamina model has previously been used in Swedish municipalities, showing positive results. The aim was to study how the Human Resources Index (HRI), relational justice, short-term recovery and perceived productivity changed in a recently reorganised perioperative setting in a hospital in Sweden that uses a structured support model for systematic work environment management. A longitudinal design that took measurements at four time points was used in a sample of 500 employees in a perioperative hospital department. The results for the overall sample indicated a positive trend in the HRI (Mt1 = 48.5, SDt1 = 22.5; Mt3 = 56.7, SDt1 = 21.2; p < 0.001). Perceived health-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 3; p < 0.001) and perceived work environment-related production loss (Mdt1 = 2, IQR = 3; Mdt3 = 0, IQR = 4; p < 0.001) showed major improvements. Short-term recovery showed a minor improvement (Mt1 = 2.61, SDt1 = 1.33; Mt3 = 2.65, SDt3 = 1.22; p = 0.872). In conclusion, the implementation of the Stamina model, of which the HRI constitutes an important part, seems to be a helpful tool to follow-up on work environment processes, and minimise production losses due to health and work environment-related issues.

Leadership Quality and Risk of Long-term Sickness Absence Among 53,157 Employees of the Danish Workforce

OBJECTIVE

To examine whether low leadership quality predicts long-term sickness absence (LTSA) in Denmark.

METHODS

Using Cox models, we estimated the association between exposure to low leadership quality and onset of register based LTSA (more than or equal to 6 weeks) during 12-months follow-up among 53,157 employees without previous LTSA.

RESULTS

During 51,155 person-years, we identified 2270 cases of LTSA. Low leadership quality predicted LTSA with a dose-respone pattern after adjustment for confounders. The hazard ratio (HR) of LTSA in the lowest compared with the highest quartile of leadership quality was 1.61 (95% CI: 1.43 to 1.82). Further, change from high to low leadership quality over time predicted risk of LTSA (HR = 1.42, 95% CI: 1.02 to 1.97) compared with persistent high leadership quality.

CONCLUSIONS

Exposure to low leadership quality is a risk factor of LTSA in the Danish workforce.

Can the Human Resources Index (HRI) Be Used as a Process Feedback Measurement in a Structured Support Model for Systematic Work Environment Management?

The aim of the study was to estimate the level of the human resources index (HRI) measure among Swedish municipal employees, and to investigate the association between human resources index (HRI) and relational justice, short-term recovery, work environment-related production loss, and health-related production loss. A cross-sectional design was used with one sample of municipal employees (n = 6402). The results showed a positive association (r = 0.31) between human resources index (HRI) and relational justice; a positive (r = 0.27) association between HRI and short-term recovery; a negative association between HRI and work environment-related production loss (r = −0.37); and a negative association between HRI and health-related production loss (r = −0.23). The findings implicate that HRI captures important aspects of the work environment such as productivity, relational justice, and short-term recovery. The HRI measure is part of a support model used in workplaces to systematically address work environment-related issues. Monitoring changes in the HRI measure, it is possible to determine whether the measures taken effect production loss, perceived leadership, and short-term recovery in a work group. The support model using HRI may thus be used to complement traditional work environment surveys conducted in Swedish organizations as obliged by legal provisions.

Evaluation of a Total Worker Health® leadership program for small business leaders

Leaders play a critical role in the development and execution of Total Worker Health (TWH). Small businesses, in particular, can benefit from strong leadership support for TWH as the burden of work-related injury, illness and fatality, as well as poor health and well-being is high in this population. In the present study, we conducted a program evaluation of a TWH leadership development program for small business leaders using the RE-AIM framework. The goal of the program was to help change leaders' behaviors around health, safety and well-being practices following the theory of transformational leadership. Two leaders from each business participated in pre-training activities on their own, a 6-hour in-person training, and three months of access to virtual training transfer activities, including coaching and goal tracking. Our results suggest that the TWH leadership development program is effective at improving leaders' self-reported TWH leadership practices and that the in-person training was implemented successfully. However, leaders did not report improvements in their personal health and in fact reported increased levels of work stress after the program. We also observed some challenges when implementing our training transfer strategies. Our study suggests that leaders may benefit from attending TWH leadership trainings alongside other colleagues in their organization to facilitate a shared vision and goals for TWH in their organization. As a next step, it will be important to determine the program's effectiveness in changing business TWH policies and practices, employee perceptions of TWH and leadership, and employee health and safety outcomes.

Leadership Style, Headache, and Neck Pain: The Moderating Role of the Catechol-O-Methyltransferase (COMT) Genotype

OBJECTIVE

Leadership styles can influence subordinates' health. We investigated how the gene encoding the Catechol-O-Methyltransferase (COMT) enzyme (ie, COMT rs4680 Val158Met) influenced effects of abusive supervision and transformational leadership on subordinates' headache and neck pain.

METHODS

Multiple group structural equation modeling (SEM) was employed to test associations of leadership with subordinates' pain 6 months after in a representative sample of the Norwegian working population (n = 996). Genotyping was performed by TaqMan technology.

RESULTS

Abusive supervision was associated with increased risk, and transformational leadership with decreased risk, of headache and neck pain. Both leadership styles exhibited more pronounced effects in individuals with the Met/Met genotype.

CONCLUSION

Met/Met employees were relatively vulnerable to adversity, but also relatively responsive to constructive leadership. Many workers may benefit more from constructive leadership than population-averaged associations might suggest.

Work/Family Conflict of More Importance than Psychosocial Working Conditions and Family Conditions for Mental Wellbeing

Studies have indicated the importance of family life and psychosocial working conditions for mental wellbeing. More recently, studies have highlighted that a good balance between work and family is crucial for good mental wellbeing. However, few studies compare the relative importance of these factors for mental wellbeing. The main aim of this study was to analyse the relative importance of psychosocial working conditions, family conditions and work/family conflict for mental wellbeing. The analyses are based on a Swedish data set, including questions regarding working life, family life and mental wellbeing. A total of 12,461 married/cohabiting individuals employed in Swedish organisations were included in the study. Results show that psychosocial working conditions, family conditions and work/family conflict all were related to mental wellbeing. In the final regression model, the strongest correlation was found between mental wellbeing and the variables work/family conflict, satisfaction with private life and partner relationship, with work/family conflict appearing to be of greatest importance. These findings highlight the necessity of including measurements of work/family conflict when studying the importance of work and family conditions for individual mental wellbeing. For workplace health promotion and improvement, it may be beneficial to consider not only psychosocial working conditions, but also family conditions, and particularly work/life conflict.

Cumulative Exposure to Long Working Hours and Occurrence of Ischemic Heart Disease: Evidence From the CONSTANCES Cohort at Inception

Background

Long‐working hours (LWH) are a probable risk factor for ischemic heart diseases (IHD); however, no previous study has considered duration of exposure to LWH when addressing this topic. We aimed to determine the association between cumulative exposure to LWH and IHD while accounting for relevant confounders.

Methods and Results

In this retrospective study, we included all baseline participants from the French population‐based cohort CONSTANCES. Part‐time employees and those who reported a cardiac event in the 5 years before LWH exposure were excluded. From self‐administered questionnaires and clinical examinations, we obtained participants’ age, sex, body mass index, occupational status, smoking habits, high blood pressure, diabetes mellitus, familial history of cardiovascular disease, dyslipidemia, exposure to LWH, and its duration. We defined LWH as working for >10 hours daily for at least 50 days per year. The main outcome was reported history of IHD, ie, myocardial infarction or angina pectoris, during a clinical examination. Of 137 854 included participants, 69 774 were men. There were 1875 cases (1.36%) of IHD, and exposure to LWH was reported by 42 462 subjects (30.8%) among whom 14 474 (10.50%) reported exposure for at least 10 years. Overall, exposure to LWH for ≥10 years was associated with an increased risk of IHD, adjusted odds ratio (aOR) 1.24 (1.08–1.43), P=0.0021. In stratified analyses, this effect was not observed in women, but was significant amongst men, aOR 1.28 (1.11–1.48), P=0.0008.

Conclusions

This large population‐based study supports an association between cumulative exposure to LWH and IHD in men. Future research should consider relevant strategies for reducing LWH exposure and duration.

First-Line Managers' Experiences of Working with a Structured Support Model for Systematic Work Environment Management

Background: This paper describes the experiences of first-line managers when working with a structured support model for systematic work environment management in their work groups. First-line managers play a key part in influencing the work environment. Methods: In this study, a sample of managers implementing a structured support model, the Stamina model, in Swedish municipalities were interviewed. A total of 31 (n = 31) interviews were conducted at two time points during a one-year period. The collected data were analysed using a qualitative thematic approach. Results: The results showed that managers experienced discomfort when giving the responsibility of working with work environmental issues to employees. However, managers also experienced and were impressed by how well it worked in allowing employees to take on work environmental issues. Managers found that they balanced between being quiescent and, at the same time, actively monitoring progress in the work groups. Conclusions: The results from this study implicate that managers need to be sensitive to the needs and capacity of their work groups. The oracle in Delphi stated know yourself. We conclude: Know your group!

Effect of Occupational and Personal Stress on Job Satisfaction, Burnout, and Health: A Cross-Sectional Analysis of College Teachers in Punjab, India

Aim:

This research is an attempt to gauge the effect of stress on job satisfaction, burnout and health that prevails among faculty members of select public and private colleges in Punjab, India.

Materials and Methods:

The study uses cross-sectional research methods to collect 412 samples by stratified random sampling. It uses scales like the socio-demographic questionnaire (SDQ), Chronic Burden Scale (CBS), Maslach Burnout Inventory Human Services Survey (MBI-HSS), and General Health Questionnaire (GHQ-28) to collect data. The data were analyzed using the IBM Statistical Package for the Social Sciences (SPSS) Statistics software, revealing that college teachers are facing the consequences of both occupational and personal stress.

Results:

The study revealed significant impact of occupational and personal stress on burnout, job satisfaction, and health of college teachers.

Conclusion:

The result of the study found that organizational environment significantly affects stress level in college teachers. Hence, it is suggested that a humane policy related to higher education is need of the hour to protect interests of teachers which share responsibility of carving out future of the country.

Measuring Best Practices for Workplace Safety, Health, and Well-Being: The Workplace Integrated Safety and Health Assessment

OBJECTIVE

To present a measure of effective workplace organizational policies, programs, and practices that focuses on working conditions and organizational facilitators of worker safety, health and well-being: the workplace integrated safety and health (WISH) assessment.

METHODS

Development of this assessment used an iterative process involving a modified Delphi method, extensive literature reviews, and systematic cognitive testing.

RESULTS

The assessment measures six core constructs identified as central to best practices for protecting and promoting worker safety, health and well-being: leadership commitment; participation; policies, programs, and practices that foster supportive working conditions; comprehensive and collaborative strategies; adherence to federal and state regulations and ethical norms; and data-driven change.

CONCLUSIONS

The WISH Assessment holds promise as a tool that may inform organizational priority setting and guide research around causal pathways influencing implementation and outcomes related to these approaches.

Managerial Quality and Risk of Depressive Disorders Among Danish Eldercare Workers: A Multilevel Cohort Study

Objective:

To examine whether low managerial quality predicts risk of depressive disorders.

Methods:

Using multilevel mixed-effects logistic regression analyses we examined the prospective association of individual-level and workplace-mean managerial quality with onset of depressive disorders among 5244 eldercare workers from 274 workplaces during 20 months follow-up.

Results:

Low managerial quality predicted onset of depressive disorders in both the individual-level (odds ratio [OR] = 1.85, 95% confidence interval [CI] = 1.25 to 2.76) and the workplace-mean analysis (OR = 1.48, 95% CI = 1.06 to 2.07). Low individual-level managerial quality predicted onset of depressive disorders when workplace-mean managerial quality was high (OR = 3.10, 95% CI = 1.71 to 5.62) but not when it was low (OR = 1.07, 95% CI = 0.61 to 1.87). This interaction was statistically significant (P = 0.03).

Conclusions:

Both low individual-level and low workplace-mean managerial quality predicted risk of depressive disorders. The association was strongest among individuals reporting low managerial quality at workplaces with high workplace-mean managerial quality.

Managers' Well-Being in the Digital Era: Is it Associated with Perceived Choice Overload and Pressure from Digitalization? An Exploratory Study

Due to the current digital transition, companies are under pressure to pursue digitalization and often initiate far-reaching transformation processes. As a result, managers must drive change within a company and are involved in important decision-making processes. In the present study, we focused on two cognitive job demands in managers related to change due to digital transformation: perceived choice overload and pressure from digitalization. We assumed that the extent of challenging cognitive demands at work is rising and negatively influencing managers’ psychological well-being. We conducted an online survey with a sample of 368 upper-level managers from a large ICT-company, where, at the time of the study, extensive transformation processes were taking place. Using multivariate regression analysis, potential prognostic effects on well-being were tested. Results showed that lower well-being was significantly associated with higher choice overload, but not with perceived pressure from digitalization. In our explorative study, we investigated two potential job demands in managers that, to our knowledge, have not yet been scientifically tested. Given the unsettled state of the field, it is important to try to further understand when choice overload and pressure from digitalization occur and when these may trigger negative health consequences.

Responsible leadership, affective commitment and intention to quit: an individual level analysis

Purpose

Drawing on social learning theory, the purpose of this paper is to explore the mediational effect of affective commitment on the relationship between responsible leadership and intention to quit.

Design/methodology/approach

This study applied a two-step process of the structural equation modelling technique to test the proposed hypothesised model. A web-based survey was administered to collect data targeting a sample of 200 full-time Australian employees.

Findings

The results suggest that responsible leadership significantly influences employees’ affective commitment and their intention to quit. As predicted, both responsible leadership and affective commitment negatively influenced intention to quit. Notably, the direct influence of responsible leadership on intention to quit was found to be partially mediated by employees’ affective commitment.

Practical implications

This study shows how leaders can expect to reduce employees’ intention to quit by leading responsibly through valuing employees’ affective commitment.

Originality/value

This study makes a unique contribution to responsible leadership literature by linking it with social learning theory. Moreover, there are only a handful of studies examining responsible leadership and its influence on employees’ behavioural outcomes. This study extends the limited understanding of responsible leadership and its relationship with affective commitment and intention to quit.

Total Worker Health: A Small Business Leader Perspective

Total Worker Health® (TWH) frameworks call for attention to organizational leadership in the implementation and effectiveness of TWH approaches. It is especially important to study this within in the small business environment where employees face significant health, safety, and well-being concerns and employers face barriers to addressing these concerns. The purpose of this study was to gain a better understanding of how small business leaders perceive employee health, safety, and well-being in the context of their own actions. We conducted semi-structured interviews with 18 small business senior leaders and used a qualitative coding approach to analyze the transcripts to determine the frequency with which leaders discussed each code. When we asked leaders about their leadership practices for health, safety, and well-being, leaders reflected upon their business (65%), themselves (28%), and their employees (7%). Leaders rarely discussed the ways in which they integrate health, safety, and well-being. The interviews demonstrate that small business leaders care about the health of their employees, but because of the perceived value to their business, not to employees or themselves. Thus, they may lack the knowledge and skills to be successful TWH leaders. The present study supports a need for continued small business TWH leadership research.

Do as you say

Purpose

The purpose of this paper is to uncover the effect of psychosocial safety climate (PSC – a climate for psychological health) on managerial quality and the mediating processes explaining that association. It is posited that the alignment between what is said (espoused PSC) and what is done (enacted PSC via managerial quality) is important for successful organizational interventions. Managers’ own psychosocial work factors act as resources to facilitate the enactment of managerial quality.

Design/methodology/approach

Two waves of survey were administered over a three-month period (n at Time 1=144, n at Time 2=166, overall n=115) in a study of four organizations involved in implementing the Quebec Healthy Enterprise Standard (QHES). A cross-lagged panel analysis was used to determine the temporal direction of the PSC–managerial quality relationship. A longitudinal mediation model of PSC as a determinant of managerial quality was tested using job demands, job control, social support and quality of relationships with subordinates as mediators.

Findings

The cross-lagged panel analysis showed that PSC is temporally prior to managerial quality in that the relationship between PSC at T1 and managerial quality at T2 was stronger than the relationship between managerial quality at T1 and PSC at T2. A two-wave mediation analysis showed that PSC was positively associated with managerial quality, and that job control partially mediated this relationship. Contrary to expectations, managers’ workload, their social support and the quality of their relationships with subordinates did not mediate the PSC–managerial quality relationship.

Research limitations/implications

Despite the small sample size and short timeframe of this study, it contributes to knowledge on the resources facilitating managerial quality, which is important for employees’ psychological health. Little is known regarding the mediating processes that explain how managers’ own context and psychosocial work factors affect their management practices during organizational health interventions.

Practical implications

From a practical view point, this study contributes to the literature showing that managers need to be supported during the implementation of health interventions, and need the leeway to pursue the organization’s prevention objectives.

Originality/value

Whereas previous studies have focused on describing the impact of leadership behaviors on employee health outcomes, the study offers insights into the resources that help managers translate PSC into action in the implementation of a national standard, the QHES.

Lack of supportive leadership behavior predicts suboptimal self-rated health independent of job strain after 10 years of follow-up: findings from the population-based MONICA/KORA study

OBJECTIVES

Emerging cross-sectional research has identified lack of supportive leadership behavior (SLB) as a risk factor for workforce health. However, prospective evidence is hitherto lacking. SLB denotes support in difficult situations, recognition and feedback on work tasks. This study aims to determine the effect of SLB on suboptimal self-rated health (SRH) after 10 years considering potential moderators such as ages, sex, occupation and job strain.

METHODS

The sample included 884 employed participants drawn from the population-based prospective MONICA/KORA Study. SLB, SRH, as well as job strain were assessed by questionnaire. Logistic regressions estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the effect of SLB at baseline on suboptimal SRH at follow-up. Analyses were adjusted for age, gender, lifestyle (alcohol, smoking, physical activity), socioeconomic status as well as for SRH and job strain at baseline.

RESULTS

Lack of SLB was associated with suboptimal SRH at baseline [OR 2.00, (95% CI 1.19-3.46)] and at follow-up [OR 2.33, (95% CI 1.40-3.89)]. Additional adjustment for job strain did not substantially alter this association [OR 2.06, (95% CI 1.20-3.52)]. However, interactions between SLB and job strain as well as gender became evident, indicating moderating influences on the association between SLB and SRH.

CONCLUSION

Lack of supportive leadership was associated with suboptimal SRH at 10 years' follow-up in men, even if SRH at baseline and other risk factors were taken into account. This effect is likely to be moderated by job strain.

Associations Between Supportive Leadership Behavior and the Costs of Absenteeism and Presenteeism: An Epidemiological and Economic Approach

OBJECTIVE

This study investigates associations between supportive leadership behavior (SLB) and presenteeism/absenteeism, and estimates related costs.

METHODS

Cross-sectional data from a German industrial sample (n = 17,060) assessing SLB and presenteeism/absenteeism were used. Adjusted interval regressions were performed. The study population was split into tertiles with respect to SLB, and minimum and maximum costs for each tertile were estimated on the basis of national industry averages.

RESULTS

Low SLB was associated with higher presenteeism [-0.31, 95% confidence interval (95% CI) -0.33 to -0.28)] and absenteeism (-0.36, 95% CI -0.40 to -0.32). Compared with high SLB, the costs of low SLB for absenteeism are between 534.54 and 1675.16 Euro higher per person and year. For presenteeism, this difference ranges between 63.76 and 433.7 Euro.

CONCLUSIONS

SLB has the potential to reduce absenteeism, presenteeism, and associated costs. To contribute to workforce health, productivity, and efficiency, SLB merits being fostered by corporate policy.

Internet-based stress management for distressed managers: results from a randomised controlled trial

Objective

The aim of this randomised controlled trial (RCT) was to evaluate the efficacy of a guided internet-based stress management intervention (iSMI) among distressed managers compared with a attention control group (AC) with full access to treatment-as-usual.

Method

A total sample of 117 distressed managers, mainly employed in the healthcare, IT, communication and educational sector, were randomised to either iSMI (n=59) or an AC group (n=58). The iSMI consisted of eight modules including cognitive behavioural stress management and positive management techniques. Participants received a minimal and weekly guidance from a psychologist or master-level psychology student focusing on support, feedback and adherence to the intervention. Self-report data were assessed at pre, post and 6 months after the intervention. The primary outcome was perceived stress (Perceived Stress Scale-14). The secondary outcomes included mental and work-related health outcomes.

Results

Participants in the iSMI intervention reported significantly less symptoms of perceived stress (d=0.74, 95% CI 0.30 to 1.19) and burnout (d=0.95, 95% CI 0.53 to 1.37) compared with controls, at postassessment. Significant medium-to-large effect sizes were also found for depression, insomnia and job satisfaction. Long-term effects (6 months) were seen on the mental health outcomes.

Conclusion

This is one of the first studies showing that iSMIs can be an effective, accessible and potentially time-effective approach of reducing stress and other mental-related and work-related health symptoms among distressed managers. Future studies are needed addressing distressed managers and the potential of indirect effects on employee stress and satisfaction at work.

An investigation into the effect of leadership style on stress-related presenteeism in South African knowledge workers

Orientation: Leadership styles influence knowledge workers’ job-stress-related presenteeism (JSRP) and, ultimately, organisational performance. Knowledge workers generally work under strict deadlines in fast-paced, stressful environments, and require organisational support.Research purpose: The objective of this study was to examine empirically the effect of three leadership styles, namely transformational, transactional and laissez-faire, on job-relatedstress presenteeism in knowledge workers across a number of industries in South Africa.Motivation for the study: Absenteeism has been the subject of much investigation but more research is required into the antecedents and consequences of presenteeism, the phenomenon of employees being physically present at work, but not fully functional and therefore unproductive. Illness as an antecedent to presenteeism has been studied, but limited attention has been given to presenteeism caused by stress. There are very few studies that investigate leadership styles as antecedents for JSRP and this study therefore sets out to provide quantitative evidence of this relationship.Research design, approach and method: The researchers used a cross-sectional quantitative approach within the positivism research philosophy. Two questionnaires were administered: the multifactor leadership questionnaire form 6S and the job-related-stress presenteeism questionnaire. Descriptive statistics and Pearson’s product-moment correlation were used to answer the research questions. The participants (N = 242) were knowledge workers, representing 12 widely categorised industries. The researchers analysed job role descriptions to ensure the respondents were all knowledge workers.Main findings: Transformational leadership has a higher negative correlation with JSRP than does transactional leadership, whereas laissez-faire leadership has no significant relationship with job stress or JSRP.Practical/managerial implications: The research provides a compelling case for investment into transformational and transactional leadership development by showing the preventative effect that transformational leadership and, to a lesser degree, transactional leadership, has on stress-associated presenteeism.Contribution/value-add: Presenteeism lowers organisational performance even more than absenteeism does, and exists at huge cost to employees’ quality of work-life. This empirical study, the first to use valid, reliable questionnaires to investigate the relationship between transformational, transactional and laissez-faire leadership on the one hand, and JSRP on the other, suggests that transformational leadership development should be prioritised.

Enemies of Ethics Equals Environmental Exodus, Part 2

Bullying and mobbing in the workplace have accelerated at alarming rates around the world in the past decade. Health care workers, nurses, managers, physicians, and owners of organizations, sometimes choose unethical methodology as a means to obtain personal and/or organizational goals. The consequences of these unethical decisions have a profound impact on the victim, bystanders, the organization, as well as the nursing profession. As a result, victims (nurses) often suffer from physiological and psychological distress, posttraumatic stress disorder, suicide, and erosion of professional confidence; patient's quality of care is undermined; nurses exit the profession; and organizations suffer from decreased morale, decline in productivity, financial loss, and a tarnished reputation.

Effect of a participatory organizational-level occupational health intervention on job satisfaction, exhaustion and sleep disturbances: results of a cluster randomized controlled trial

Background

We examined whether the implementation of a participatory organizational-level intervention aiming to improve the working environment with a focus on the core task at work, increased job satisfaction and reduced exhaustion and sleep disturbances among pre-school employees.

Methods

The study sample consisted of 41 intervention group pre-schools with 423 employees and 30 control group pre-schools with 241 employees. The intervention lasted 25 months and consisted of seminars, workshops, and workplace specific intervention activities that were developed by focusing on the core task at work. We analyzed within-group changes in the three outcome variables from baseline to follow-up with t-tests for paired samples, separately for intervention and control group. Between-group differences in changes in the three outcome variables were analyzed using a mixed model with a repeated statement to account for the clustering effect of workplaces.

Results

Within-group analyses showed that exhaustion decreased statistically significantly in both the intervention and the control group. There were no statistically significantly changes in job satisfaction and sleep disturbances. Between-group analyses showed that there was no statistically significant difference between the two groups for changes in any of the outcome variables, neither in the unadjusted or in the adjusted analyses.

Conclusions

We found no evidence that participating in an organizational-level occupational health intervention aiming to improve the working environment with a focus on the core task at work has an effect on pre-school employees’ job satisfaction, exhaustion and sleep disturbances.

Trial registration

ISRCTN16271504, November 15, 2016.

Standardized assessment of psychosocial factors and their influence on medically confirmed health outcomes in workers: a systematic review

Previous studies of psychosocial work factors have indicated their importance for workers’ health. However, to what extent health problems can be attributed to the nature of the work environment or other psychosocial factors is not clear. No previous systematic review has used inclusion criteria based on specific medical evaluation of work-related health outcomes and the use of validated instruments for the assessment of the psychosocial (work) environment.

The aim of this systematic review is to summarize the evidence assessing the relationship between the psychosocial work environment and workers’ health based on studies that used standardized and validated instruments to assess the psychosocial work environment and that focused on medically confirmed health outcomes. A systematic review of the literature was carried out by searching the databases PubMed, B-ON, Science Direct, Psycarticles, Psychology and Behavioral Sciences Collection and the search engine (Google Scholar) using appropriate words for studies published from 2004 to 2014. This review follows the recommendations of the Statement for Reporting Systematic Reviews (PRISMA). Studies were included in the review if data on psychosocial validated assessment method(s) for the study population and specific medical evaluation of health-related work outcome(s) were presented.

In total, the search strategy yielded 10,623 references, of which 10 studies (seven prospective cohort and three cross-sectional) met the inclusion criteria. Most studies (7/10) observed an adverse effect of poor psychosocial work factors on workers’ health: 3 on sickness absence, 4 on cardiovascular diseases. The other 3 studies reported detrimental effects on sleep and on disease-associated biomarkers. A more consistent effect was observed in studies of higher methodological quality that used a prospective design jointly with the use of validated instruments for the assessment of the psychosocial (work) environment and clinical evaluation.

More prospective studies are needed to assess the evidence of work-related psychosocial factors on workers´ health.

Causal Impact of Employee Work Perceptions on the Bottom Line of Organizations

Perceptions of work conditions have proven to be important to the well-being of workers. However, customer loyalty, employee retention, revenue, sales, and profit are essential to the success of any business. It is known that these outcomes are correlated with employee attitudes and perceptions of work conditions, but the research into direction of causality has been inconclusive. Using a massive longitudinal database that included 2,178 business units in 10 large organizations, we found evidence supporting the causal impact of employee perceptions on these bottom-line measures; reverse causality of bottom-line measures on employee perceptions existed but was weaker. Managerial actions and practices can impact employee work conditions and employee perceptions of these conditions, thereby improving key outcomes at the organizational level. Perceptions of specific work conditions that engage employees in their work provide practical guidance in how best to manage people to obtain desired results.

Associations between supportive leadership and employees self-rated health in an occupational sample

BACKGROUND

Protecting the health of the work force has become an important issue in public health research.

PURPOSE

This study aims to explore potential associations between supportive leadership style (SLS), an aspect of leadership behavior, and self-rated health (SRH) among employees.

METHOD

We drew on cross-sectional data from a cohort of industrial workers (n = 3,331), collected in 2009. We assessed employees' ratings of supportive, employee-oriented leadership behavior at their job, their SRH, and work stress as measured by the effort-reward model and scales measuring demands, control, and social support. Logistic regression estimated odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) for the association between the perception of poor SLS and poor SRH controlling for work-related stress and other confounders. Sensitivity analyses stratified models by sex, age, and managerial position to test the robustness of associations.

RESULTS

Perception of poor SLS was associated with poor SRH [OR 2.39 (95 % CI 1.95-2.92)]. Although attenuated following adjustment for measures of work-related stress and other confounders [OR 1.60 (95 % CI 1.26-2.04)], the magnitude, direction, and significance of this association remained robust in stratified models in most subgroups.

CONCLUSION

SLS appears to be relevant to health in the workplace. Leadership behavior may represent a promising area for future research with potential for promoting better health in a large segment of the adult 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.

The mediating role of demand and control in the relationship between leadership behaviour and employee distress: a cross-sectional study

BACKGROUND

The relationship between leadership and employee distress is well established, however, the processes involved in this relationship remain largely unclear. For a stretched nursing workforce, understanding in what ways leadership may influence employee distress is particularly important.

OBJECTIVES

To examine possible mediating effects of the work environment factors demand and control in the relationship between leadership behaviour in change, production, and employee orientation and employee distress.

DESIGN

Cross-sectional study design.

SETTINGS

The study was conducted at a large county council in Sweden providing both institutional and non-institutional care.

PARTICIPANTS

A random sample of 1249 employees (primarily nurses, but also a wide range of other healthcare professionals and administrative staff), who had a healthcare manager that was about to enter a leadership development programme (n=171), responded to a web-based questionnaire. The response rate was 62%.

METHODS

The employees rated their healthcare managers' behaviour in change, production, and employee orientation, as well as their own perceptions of level of demand, control (subdivided into decision authority and skill discretion), and five distress outcomes. Multilevel analysis was performed.

RESULTS

The mediators demand, decision authority, and skill discretion were significant predictors of all five distress outcomes for all three leadership orientations. In eight of 15 regressions, the mediators fully explained the relationships between leadership orientations and outcomes. Four of five relationships with distress outcomes were fully mediated for change-oriented leadership, whereas two of five outcomes were fully mediated for production- and employee-oriented leadership. In all three leadership orientations, the relationship between the mediator skill discretion and the distress measure disengagement were particularly strong, with B-coefficients (-.44, p<.001) twice as high as for any of the other relationships.

CONCLUSIONS

It seems that the way that employees perceive healthcare managers' change-oriented behaviour, and how that aspect is related to employee distress, is primarily explained by perception of demand and control. Furthermore, regardless of leadership behaviour orientation, how employees perceive their opportunity to use specific job skills plays an important role in the interplay between perception of healthcare managers' behaviour and disengagement.

Hierarchies of health: health and work-related stress of managers in municipalities and county councils in Sweden

OBJECTIVE

The aim of this study was to investigate the risk of poor health and stress among male and female managers working at different levels in the public sector.

METHODS

A cross-sectional study using register data. A modified Poisson regression approach was used to examine the risk of stress and illness in relation to management level and sex; 1088 managers participated and were categorized into different management levels and sexes.

RESULTS

The results showed a clear hierarchy of health in relation to managerial level and sex with several significant statistical differences. Women with lower-level management positions suffered to a greater extent from poor health and stress.

CONCLUSIONS

Organizations should focus not only on developing individuals in their managerial roles but also on improving the conditions that allow managers to remain healthy and less stressed.

Leadership Behavior as a Health-Promoting Resource for Workers in Low-Skilled Jobs and the Moderating Role of Power Distance Orientation

In this study, the authors analyze leadership behaviors as potential health-promoting resources for low-skilled workers in a highly culturally diverse work setting. The authors hypothesize that subordinates' and supervisors' individual power distance orientations will moderate the effect of subordinates' perceptions of leadership behavior and the subsequent effects on their well-being. Multilevel modeling is used to analyze a sample of data from 474 low-skilled employees (50% immigrants) and 35 direct supervisors from three German companies. Supporting the hypotheses, social support, task-related communication, and positive feedback, as expressions of esteem, are found to positively impact subordinates' well-being, but individual consideration shows no significant effects. Furthermore, results confirm that supervisors' power distance orientation moderates employees' perceptions about supervisors' positive feedback and the subsequent well-being effects. The moderating effect fails to hold for employees' power distance orientation. Results indicate that supervisors can most effectively promote the health of low-skilled workers by showing esteem through positive feedback, but if the supervisor has high individual power distance orientation, the effect is attenuated.

Does good leadership buffer effects of high emotional demands at work on risk of antidepressant treatment? A prospective study from two Nordic countries

PURPOSE

Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects of emotional demands on antidepressant treatment, as an indicator of common mental disorders, are buffered by good leadership.

METHODS

We used data from two nationally representative work environment studies, the Danish Work Environment Cohort Study (n = 6,096) and the Swedish Longitudinal Occupational Survey of Health (n = 3,411), which were merged with national registers on antidepressant purchases. All individuals with poor self-reported baseline mental health or antidepressant purchases within 8.7 months before baseline were excluded, and data analysed prospectively. Using Cox regression, we examined hazard ratios (HRs) for antidepressants in relation to the joint effects of emotional demands and leadership quality. Buffering was assessed with Rothman's synergy index. Cohort-specific risk estimates were pooled by random effects meta-analysis.

RESULTS

High emotional demands at work were associated with antidepressant treatment whether quality of leadership was poor (HR = 1.84, 95 % CI 1.32-2.57) or good (HR = 1.70, 95 % CI 1.25-2.31). The synergy index was 0.66 (95 % CI 0.34-1.28).

CONCLUSIONS

Our findings suggest that good leadership does not substantially ameliorate any effects of emotional demands at work on employee mental health. Further research is needed to identify possible preventive measures for this work environment exposure.

Promoting health and wellness in the workplace: a unique opportunity to establish primary and extended secondary cardiovascular risk reduction programs

Given the burden of cardiovascular disease (CVD), increasing the prevalence of healthy lifestyle choices is a global imperative. Currently, cardiac rehabilitation programs are a primary way that modifiable risk factors are addressed in the secondary prevention setting after a cardiovascular (CV) event/diagnosis. Even so, there is wide consensus that primary prevention of CVD is an effective and worthwhile pursuit. Moreover, continual engagement with individuals who have already been diagnosed as having CVD would be beneficial. Implementing health and wellness programs in the workplace allows for the opportunity to continually engage a group of individuals with the intent of effecting a positive and sustainable change in lifestyle choices. Current evidence indicates that health and wellness programs in the workplace provide numerous benefits with respect to altering CV risk factor profiles in apparently healthy individuals and in those at high risk for or already diagnosed as having CVD. This review presents the current body of evidence demonstrating the efficacy of worksite health and wellness programs and discusses key considerations for the development and implementation of such programs, whose primary intent is to reduce the incidence and prevalence of CVD and to prevent subsequent CV events. Supporting evidence for this review was obtained from PubMed, with no date limitations, using the following search terms: worksite health and wellness, employee health and wellness, employee health risk assessments, and return on investment. The choice of references to include in this review was based on study quality and relevance.

Non-listening and self centered leadership--relationships to socioeconomic conditions and employee mental health

Background

The way in which leadership is experienced in different socioeconomic strata is of interest per se, as well as how it relates to employee mental health.

Methods

Three waves of SLOSH (Swedish Longitudinal Occupational Survey of Health, a questionnaire survey on a sample of the Swedish working population) were used, 2006, 2008 and 2010 (n = 5141). The leadership variables were: “Non-listening leadership” (one question: “Does your manager listen to you?” - four response categories), “Self centered leadership” (sum of three five-graded questions – “non-participating”, “asocial” and “loner”). The socioeconomic factors were education and income. Emotional exhaustion and depressive symptoms were used as indicators of mental health.

Results

Non-listening leadership was associated with low income and low education whereas self-centered leadership showed a weaker relationship with education and no association at all with income. Both leadership variables were significantly associated with emotional exhaustion and depressive symptoms. “Self centered” as well as “non-listening” leadership in 2006 significantly predicted employee depressive symptoms in 2008 after adjustment for demographic variables. These predictions became non-significant when adjustment was made for job conditions (demands and decision latitude) in the “non-listening” leadership analyses, whereas predictions of depressive symptoms remained significant after these adjustments in the “self-centered leadership” analyses.

Conclusions

Our results show that the leadership variables are associated with socioeconomic status and employee mental health. “Non-listening” scores were more sensitive to societal change and more strongly related to socioeconomic factors and job conditions than “self-centered” scores.

Substantiating the concept of work strain: its implication for the assessment of work stressors

OBJECTIVE

To assess which work stressors are substantially contributing to work strain and examine their relative contribution.

METHODS

We prospectively examined the association between work stressors and work strain, which was defined as employees reporting ill due to work stress. Relevant work stressors were combined into a stressor score with each stressor having its own relevance. Standardized odds ratios (SORs) were calculated using logistic regression analysis and used to compare the associations obtained between already existing scales and the stressor score with work strain.

RESULTS

The stressor score yielded an SOR of 1.89 (95% confidence interval: 1.49 to 2.41) for work strain, while psychological demands (JCQ) yielded an SOR of 1.46 (95% confidence interval: 1.09 to 1.88) for work strain.

CONCLUSIONS

We were able to extend and substantiate the range of relevant work stressors into a more comprehensive measure, which should be used to optimize prevention strategies.