Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes

Identifying work-related factors associated with work-family conflict of care workers in nursing homes: A cross-sectional study

AIMS

To investigate which work-related factors are associated with work-family conflict of care workers in nursing homes, this study aimed to: (a) describe the prevalence of work-family conflict of care workers in nursing homes and (b) assess the association of work-related factors with work-family conflict.

DESIGN

Cross-sectional multicentre sub-study based on data from the Swiss Nursing Homes Human Resources Project 2018.

METHODS

Data were collected between September 2018 and October 2019. Work-family conflict of care workers was assessed with the Work-Family Conflict Scale (range 1-5). Prevalence was described in percentages. We used multilevel linear regression to assess the association of time-based factors (working overtime or during one's free time, employment percentage, presenteeism, shift working) and strain-based factors (staffing adequacy, leadership support) with work-family conflict.

RESULTS

Our study sample consisted of 4324 care workers working in a total of 114 nursing homes. Overall, 31.2% of respondents stated to have experienced work-family conflict (>3.0 on the Work-Family Conflict Scale). The overall mean score of the study sample for work-family conflict was 2.5. Care workers experiencing presenteeism 10 or more days per year showed the highest scores for work-family conflict (mean: 3.1). All included predictor variables were significant (p < .05).

CONCLUSION

Work-family conflict is multifactorial. Possible intervention points to tackle work-family conflict could be strengthening care workers' influence in planning work schedules, enabling flexible planning to ensure adequate staffing, lowering presenteeism and implementing a supportive leadership style.

IMPACT

Care workers' jobs become less desirable when workplace demands interfere with family life. This study highlights the multifaceted nature of work-family conflict and suggests intervention options to prevent care workers from experiencing work-family conflict. Action is needed at nursing home and policy level.

Work-Family Conflict and Depression Among Healthcare Workers: The Role of Sleep and Decision Latitude

BACKGROUND

Healthcare workers report a higher incidence of depression than the general population. Work-family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work-family conflict into depression.

METHODS

In 2018, a cross-sectional survey was collected from healthcare workers (n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants' work-family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables.

FINDINGS

There was a significant association between work-family conflict and depression (β = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family-conflict and depression was stronger among workers with low decision latitude.

CONCLUSIONS

Depression was prevalent among healthcare workers and was associated with work-family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association.

APPLICATION TO PRACTICE

Evidence-based interventions seeking to alleviate the effect of work-family conflict and improve healthcare workers' mental health should consider promoting employee sleep quality and improving employees' decision-making on the job.

Tiredness Takes Its Toll: An Integrative Review on Sleep and Occupational Outcomes for Long-Term Care Workers

Poor sleep quality and duration among health care professionals have negative impacts on worker safety, work readiness, and well-being. However, the consequences of impaired sleep among long-term care (LTC) workers remain understudied. The current integrative review sought to explore associations between sleep and occupational outcomes in LTC workers. Multiple database searches yielded 1,543 articles; nine articles met inclusion criteria. Results synthesized from included articles revealed sleep-associated occupational outcomes across three themes, Burnout/Fatigue, Mental and Physical Health, and Well-Being, which may affect performance measures and predict injuries/errors. Exploring outcomes of poor sleep quality and duration among LTC workers has highlighted the needs of this population and may inform future intervention development. LTC organizations should consider implementing strategies to better support the sleep quality of their workforce. In addition, further research is needed to explore how impaired sleep contributes to negative worker outcomes and patient care quality. [Journal of Gerontological Nursing, 49(1), 27-33.].

Work-family imbalance, social support and health: a population-based study

BACKGROUND

Work-family imbalance is a crucial determinant of workers' health. Studies examining the impact of multiple roles in the workplace, conducted in low- and middle-income countries, are limited.

AIMS

To determine the association of work-family imbalance with self-perceived health (SPH) both in men and women, and to examine the interaction of social support with work-family imbalance on this association in a district in western Turkey.

METHODS

This population-based cross-sectional study's sample was randomly derived from working residents aged 30-64 living in Balcova District, Turkey. Univariate and multivariate regression analyses were conducted for the associations between SPH, social support at home and at work, work-family conflict (WFC) and family-work conflict (FWC). Social support variables were considered as possible effect modifiers.

RESULTS

Work to family variables had an independent, significant association with poor SPH [odds ratio (OR) = 2.92 (95% CI 1.47-5.78) for WFC, and 2.38 (95% CI 1.22-4.67) for FWC] in only women. In advanced analyses, both social support at work and at home were effect modifiers of the association between FWC and SPH in women (P < 0.001). In men, SPH was significantly associated only with job insecurity [OR = 2.52 (1.22-5.21)].

CONCLUSIONS

Further studies should be conducted to implement effective population prevention strategies to establish work-family balance and to reduce this double burden on women, specifically in low- and middle-income countries.

Emotional distress symptoms and their determinants: screening of non-clinical hospital staff in an Egyptian University hospital

BACKGROUND

Non-clinical hospital staff were rarely studied despite their potential exposure to workplace stressors. We aimed to measure the prevalence of depression, anxiety, and stress (emotional distress symptoms) and determine their association with perceived job stress level and socioeconomic factors among non-clinical hospital staff.

METHODS

This cross-sectional study was conducted in Ain-Shams University Hospitals from March to May 2019. Tools were the Arabic Depression, Anxiety, and Stress Scale-21, Workplace Stress Scale, and Socioeconomic status scale. Independent correlates were determined using multivariable ordinal regression.

RESULTS

Out of 462 participants, 72.5% reported receiving insufficient income and 54.8% showed Effort-reward imbalance. Job stress was scored as severe/potentially dangerous by 30.1%. The prevalence of depression, anxiety, and stress were 67.5, 69.0, and 51.7%; and the severe/extremely severe levels were 20.8, 34.6, and 17.6% respectively. Across all the severity levels, the likelihood of depression, anxiety, and stress were progressively higher with more serious levels of income insufficiency [in debt versus able to save, OR:5.82 (95%CI:2.35-14.43), OR:3.84 (95%CI:1.66-8.91), and OR:3.01 (95%CI:1.20-7.55) respectively] and with higher job stress levels. Specifically, the likelihood of depression, anxiety, and stress increased by 74, 56, and 53% respectively with feelings of unpleasant/unsafe work conditions and by 64, 38, and 62% respectively with the presence of work-life conflict; while the likelihood of depression and stress increased by 32 and 33% respectively when there was difficult communication with superiors; and only the likelihood of depression increased by 23% with underutilization of skills.

CONCLUSION

Non-clinical hospital staff were commonly affected by emotional distress symptoms with high rates of severe/very severe levels, and they often considered their workplace stress as severe/potentially dangerous. Workplace stress and income insufficiency were strong correlates with emotional distress symptoms. Decreasing work-life conflict, enhancing leadership skills, and mitigation of the economic hardship are needed.

The relationship between the emergency nurses' sleep quality and the sleep quality of their spouses: A cross‐sectional descriptive‐analytical study

Background and Aims

Due to the heavy working shifts, emergency nurses may have to sleep at unusual times of the day, affecting their spouse's sleep. This study proposed to detect the relationship between the woman emergency nurse's sleep quality and the sleep quality of their spouses.

Methods

This cross‐sectional descriptive‐analytical study has lasted for 4 months since June 21, 2020. The study population was all women nurses working at a hospital emergency department. The data was collected by a demographic questionnaire and Pittsburgh sleep quality index (PSQI) for nurses and their spouses. The data were analyzed by descriptive and inferential statistics.

Results

The prevalence of sleep quality disorder among female emergency department nurses and their husbands was 82.7% and 80.6%, respectively. The mean sleep quality score of female nurses and their husbands was 8.46 ± 4.43 and 6.50 ± 2.52, respectively. A strong and positive correlation was found between the PSQI score of female nurses and their husbands (p < 0.001). The regression model showed that increasing the body mass index (BMI) of female emergency nurses can decrease their sleep quality. However, increasing the BMI of female emergency nurses' spouses and their work experience in the emergency department can improve their sleep quality.

Conclusion

The sleep quality of female emergency department nurses was directly correlated with their husbands' sleep quality. Therefore, the sleep quality of nurses working in the emergency departments and their spouses should be examined periodically.

Response to NIOSH Request for Information on Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health

The root causes of health care worker strain and depression include excessive job demands, extended work schedules, little decision-making opportunity, assault, bullying, and fear of injury. Potential links between working conditions and opioid overuse have also been discussed, beginning with psychological job strain or with physical pain leading to medication use. Promising solutions have been identified and many would be cost-effective, as enhanced working conditions could improve workers' mental health, job satisfaction, retention, and patient outcomes. Considering the number of health care workers leaving work during the global COVID-19 pandemic, it is urgent to address preventable root causes. In 2021, the US Congress called for educating health workers and first responders on the primary prevention of mental health conditions and substance use disorders. The CDC issued a Request for Information; this submission summarized research from CPH-NEW, a NIOSH Center of Excellence in Total Worker Health®, supplemented by a selective literature review.

Work-Family Conflict, Organizational Identification, and Professional Identification Among Chinese Nurses From a Resource Perspective

BACKGROUND

The miserable work conditions faced by many nurses around the world make them particularly prone to work-family conflict.

PURPOSE

This study was designed to explain from a resource perspective how and when nurses experiencing work-family conflict are more likely to exhibit decreased levels of organizational identification and professional identification.

METHODS

A time-separation research design was used, and data were collected from 322 nurses in five hospitals in China. All of the hypotheses were tested using conduct structural equation modeling.

RESULTS

The results showed that work-family conflict had negative effects on organizational identification and professional identification via emotional exhaustion. In addition, job meaningfulness may have a buffering effect on the negative impact of work-family conflict on emotional exhaustion, organizational identification, and professional identification.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The results advance knowledge on how and when work-family conflict damages organizational identification and professional identification. Providing family support, relieving emotional exhaustion, and enhancing job meaningfulness are necessary to support the organizational and professional identification of nurses.

Employment Industry and Occupational Class in Relation to Serious Psychological Distress in the United States

Occupational characteristics may influence serious psychological distress (SPD) and contribute to health inequities; yet, few studies have examined multiple employment industries and occupational classes in a large, racially diverse sample of the United States. Using data from the National Health Interview Survey, we investigated employment industry and occupational class in relation to SPD in the overall population and by race/ethnicity, gender, age, household income, and health status. We created eight employment industry categories: professional/administrative/management, agricultural/manufacturing/construction, retail trade, finance/information/real estate, educational services, health care/social assistance, accommodation/food services, and public administration/arts/other services. We also created three occupational class categories: professional/management, support services, and laborers. SPD was measured using the Kessler Psychological Distress Scale and scores ≥13 indicated SPD. We adjusted for confounders and used Poisson regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Among the 245,038 participants, the mean age was 41.7 ± 0.1 years, 73% were Non-Hispanic (NH)-White, and 1.5% were categorized as having SPD. Compared to the professional/administrative/management industry, working in other industries (e.g., manufacturing/construction (PR = 0.82 [95% CI: 0.70–0.95]) and educational services (PR = 0.79 [95% CI: 0.66–0.94])) was associated with lower SPD. Working in support services and laborer versus professional/management positions were both associated with 19% higher prevalence of SPD (95% CI: 1.04–1.35; 95% CI: 1.04–1.38, respectively). Furthermore, working in a support services or laborer versus professional/management position was associated with higher SPD in most employment industries. Industry-specific workplace interventions to equitably improve mental health are warranted.

Relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses

Background

Nursing has a reputation for being one of the most stressful occupations. As a result of their work, many nurses suffer from anxiety and depression. Nurses are also at risk of poor sleep owing to their work nature. This study aimed to examine the relationship between work–family conflict, sleep quality, and depressive symptoms among mental health nurses. A descriptive cross-sectional study design was utilized in this study. Setting/sample: This study was conducted at El Azazi Hospital for Mental Health, Al-Sharkia Governorate on 139 mental health nurses. Four tools were used in this study: Socio-demographic data sheet, Work–Family Conflict Scale, Arabic Pittsburgh Sleep Quality Index, and Arabic Center for Epidemiologic Studies Depression Scale.

Results

Results revealed that, a significant percentage of mental health nurses suffered from poor sleep quality and depressive symptoms, there were highly statistically significantly positive correlations between work–family conflict (WFC) and both of Pittsburgh Sleep Quality Index (PSQI) and depressive symptoms among nurses.

Conclusions

Working with psychiatric patients affected their nurses, which disturbed their sleep quality and led to depressive symptoms. As well, increasing work–family conflict in mental health nurses leads to poor sleep quality and depressive symptoms. Family interference with work, sleep quality, and work interference with family were statistically significant predictors of depressive symptoms.

The Impact of Nursing Staffs’ Working Conditions on the Quality of Care Received by Older Adults in Long-Term Residential Care Facilities: A Systematic Review of Interventional and Observational Studies

Background: Little documentation exists on relationships between long-term residential care facilities (LTRCFs), staff working conditions and residents’ quality of care (QoC). Supporting evidence is weak because most studies examining this employ cross-sectional designs. Methods: Systematic searches of twelve bibliographic databases sought experimental and longitudinal studies, published up to May 2021, focusing on LTRCF nursing staff’s working conditions and the QoC they provided to older adults. Results: Of the 3577 articles identified, 159 were read entirely, and 11 were retained for inclusion. Higher nursing staff hours worked per resident per day (HPRD) were associated with significant reductions in pressure sores and urinary tract infections. Overall staff qualification levels and numbers of RNs had significant positive influences on QoC. Conclusions: To the best of our knowledge, this systematic review is the first to combine cohort studies with a quasi-experimental study to explore associations between LTRCF nursing staff’s working conditions and older adult residents’ QoC. Human factors (including HPRD, staff turnover, skill mix, staff ratios) and the specific working contribution of RNs had overwhelmingly significant influences on QoC. It seems essential that LTRCF supervisory and decision-making bodies should promote optimal working conditions for nursing staff because these have such a direct impact on residents’ QoC.

Group-Treatment for Dealing with the Work-Family Conflict for Healthcare Professionals

Healthcare professionals' exposure to work-family conflict negatively affects the health and well-being of the whole family and organizational outcomes. Specified workplace interventions are lacking. Therefore, the aim of the study was to evaluate the feasibility of a two-day group-treatment specifically designed for the needs of healthcare professionals with family responsibilities concerning participation, satisfaction with the intervention and family- and individual-related outcome variables. 24 mostly female (85.7%) participants of a community hospital in southern Germany attended the treatment. Data were collected at baseline (T0), directly after the treatment (T1) and two months later (T2). A two-factor analysis of variance with repeated measures showed a statistically significant time x group effect for self-efficacy (F = 5.29, p = 0.011). Contrasts displayed substantial pre-post (T1-T0, T2-T0) increases of self-efficacy in the intervention group as compared with the control group. Non-parametric Mann-Whitney-U tests are in line with these findings. The results indicate that the group-treatment adapted to the needs of healthcare professionals has the potential to boost self-efficacy among healthcare professionals and that participants were predominantly satisfied. Perspectives for future research and practical implications are discussed in the light of the manifest lack of healthcare professionals.

Depression, Healthcare Utilization, Missed Work, and Health Behaviors Among US Young Workers: Data From the 2015 National Health Interview Survey

OBJECTIVE

We examined the prevalence of depression and its impact on healthcare utilization, work absenteeism, and health behaviors among United States (US) young workers.

METHODS

Data of 1053 young workers (ages 18 to 25) from the 2015 US National Health Interview Survey were analyzed to examine these associations.

RESULTS

Seven percent of US young workers reported feeling often depressed (daily or weekly). Often depressed young workers had increased odds for healthcare provider visits, mental healthcare use, 1 to 2 emergency department visits, and 3 to 5 and more than or equal to 6 missed work days, smoking, and sleeping less than 7 hours.

CONCLUSIONS

Our findings suggest that depressed young workers have increased needs for healthcare utilization and are at increased risk for missing work, smoking, and reduced sleep. Resources should be prioritized for depression screening and prevention programs at the workplace and healthcare settings.

The relationship between health-promoting behaviors, menopause syndrome, and sleep quality in Chinese middle-aged nurses: A cross-sectional study

BACKGROUND

Nursing staff are on the front line of providing healthcare that addresses patients' needs. Sleep quality is highly related to work performance and quality of life among nurses.

AIMS

This study aimed to examine the influence of sociodemographic variables, menopause syndrome, and health-promoting behaviors on sleep quality in a sample of middle-aged nurses in China.

METHODS

A cross-sectional design was employed. A consecutive sample of 424 nurses was recruited from a university-affiliated hospital in Bengbu, China. Self-reported, structured questionnaires, including sociodemographic surveys, the Kupperman Menopausal Index, the Health Promoting Lifestyle Profile II, and the Pittsburgh Sleep Quality Index, were administered between October 2018 and July 2019. This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

Study participants had a mean sleep quality level of 5.30 points (SD = 3.16), indicating potential sleep problems. The results of regression models showed that menopause syndrome and spiritual growth were important predictors of sleep quality for premenopause, perimenopause, and postmenopause groups.

CONCLUSION

Middle-aged nurses with more severe menopause syndrome and less spiritual growth might experience worse sleep quality.

RELEVANCE TO CLINICAL PRACTICE

This study highlights important factors influencing the level of sleep quality in Chinese middle-aged nurses. Identifying the factors that are associated with sleep quality may help with the development of proper interventions.

Rasch Analysis of Work-Family Conflict Scale Among Chinese Prison Police

As a special group of police officer, prison police have to endure more work stress and have significant work-family conflict, which may lead to more physical and mental health problems and need to be noticed by the society. The Work-Family Conflict Scale (WFCS) is a brief self-report scale that measures the conflict that an individual experiences between their work and family roles and the extent they interfere with one another. However, there is limited data on the scale's psychometric properties. The aim of this study was to examine the dimensionality and reliability of the Chinese version of the WFCS. The study sample was made up of a total of 717 Chinese prison police (64.7% male, M = 41.73 years, SD = 8.30 years). The Rasch Rating Scale Model (RSM) was used to determine the latent structure and estimate the quality of items and reliability of scale. The principle component analysis (PCA) showed that the assumption of unidimensionality was fulfilled. The infit and outfit mean square (MNSQ) statistics (0.84-1.47) were of a reasonable range, and point-measure correlations (0.64-0.79) indicted good model fit of each item. The item-person separation and reliability indices both met psychometric standards, illustrating good reliability. The person-item map indicated acceptable fit of items and persons, suggesting an alignment between persons and items. In addition, no evidence emerged of differential item functioning across different gender groups. Overall, the WFCS has good reliability and validity, and can be used to accurately evaluate the level of work-family conflict in Chinese prison police.

Work-family conflict and insomnia symptoms among women working in aged care services in Japan

OBJECTIVE

The association between work-family conflict and insomnia has not been thoroughly studied. Therefore, we sought to examine the relationship between work-family conflict and insomnia symptoms among Japanese working women.

METHODS

In a cross-sectional study, 608 women aged 18-60 years old who worked in aged care services between 2015 and 2016 were selected, and 445 of these women were ultimately included. Insomnia symptoms were measured using the Athens Insomnia Scale. Work-to-family conflict (WFC) and family-to-work conflict (FWC) were assessed through a self-administered questionnaire and were divided into four categories: low work-family conflict (low WFC and FWC), high FWC, high WFC, and high work-family conflict (high WFC and FWC). The prevalence ratio (PR) and 95% confidence interval (CI) of insomnia symptoms were calculated using a Poisson regression model after multivariable adjustment.

RESULTS

The multivariable-adjusted PR (95% CI) of insomnia symptoms was 1.99 (1.34-2.93) in the high work-family conflict group compared to the low work-family conflict group.

CONCLUSIONS

The results from the present study suggest that insomnia symptoms are highly prevalent among working women in aged care services with high work-family conflict.

Health and safety risks affecting part-time nursing students

Background

Professional nurses who are employed full-time can study their postgraduate programmes part-time to add to the basic qualification they obtained through relevant institutions of higher education like universities or colleges. Although there are advantages for part-time study such as improvement of qualifications, enhancement of personal development and increased chance of promotion, there are disadvantages as well, which includes keeping a job, attending to family and social responsibilities, time management to ensure that studying is done after work or in-between work and other activities, attending to assignments and complying with the requirements to acquire the qualification.

Aim

This study aimed to explore health and safety risks faced by nurses who work and study part-time.

Setting

The study was conducted at a university in Gauteng province, South Africa. Nurses who undertake part-time studies at this university were the focus of study.

Method

The research design used in the study was an exploratory, quantitative method that was contextual in nature. Data were collected using a self-administered questionnaire that comprised of demographical and health and safety aspects. Data were analysed by means of descriptive statistics using the Statistics package for Social Sciences version 26.

Results

Research findings indicated that students who study part-time experience health and safety risks such as fatigue (n = 86; 49%), stress (n = 95; 54%), sleep disorders (n = 60; 34%), poor eating habits (n = 123; 70%), abuse of caffeine (n = 91; 52%) and are prone to road accidents (n = 54; 31%).

Conclusion

Nurses who work and study part-time need support from their employers and families. Employers should grant study leave as a way of support.

The Mediating Role of Self-Efficacy in Sleep Disorder and Depressive Symptoms Among Chinese Caregivers of Stroke Inpatients: A Structural Equation Modeling Analysis

PURPOSE

Caregivers of stroke inpatients are at high risk of sleep disorder, which may lead to depressive symptoms. Self-efficacy has always been regarded as a protective factor against psychological disorders such as depressive symptoms. This study aims to investigate the sleep disorder and depressive symptoms of caregivers of stroke inpatients in China and explore the mediating effect of self-efficacy between sleep disorder and depressive symptoms among Chinese caregivers of stroke inpatients.

PATIENTS AND METHODS

In this cross-sectional study, a total of 305 caregivers who were hospitalized with stroke patients completed the PROMIS Sleep Disorder Short Form Scale, General Self-Efficacy Scale and Patient Health Questionnaire-9 in two general public hospitals in northeast and southeast China. A structural equation model with bootstrap method was performed to determine the mediation of self-efficacy between sleep disorder and depressive symptoms.

RESULTS

Among the participants, 55.4% of caregivers reported depressive symptoms. Sleep disorder and self-efficacy were significant predictors of depressive symptoms. The direct impact of sleep disorder on depressive symptoms was positive, and the path coefficient of sleep disorder with depressive symptoms was decreased from 0.45 to 0.38 (P < 0.01) after addition of self-efficacy in the model. This indicated that self-efficacy played as mediator.

CONCLUSION

The caregivers of stroke inpatients were in poor physical and psychological health, and more than half of the caregivers (55.4%) suffered from depressive symptoms. Our research revealed the mediation of self-efficacy between sleep disorder and depressive symptoms, and emphasized the importance of enhancing self-efficacy to reduce depressive symptoms among caregivers of stroke inpatients. These results demonstrate that focusing on self-efficacy interventions can enhance mental health and reduce depressive symptoms effectively.

A Corporate Wellness Program and Nursing Home Employees' Health

Background: Many employed Americans suffer from chronic conditions like obesity, diabetes, and cardiovascular diseases. Worksite wellness programs provide opportunities to introduce health promotion strategies. While there is evidence of the effectiveness of workplace health promotion, this is tempered by concern that benefits may be less available to low-wage workers with inflexible working conditions. Objective: The aim was to evaluate a workplace health promotion (WHP) in the long-term care sector (skilled nursing facilities). Methods: Nursing home employees from 18 facilities within a single company were surveyed by a standardized, self-administered questionnaire. A company-sponsored WHP program was offered to the facilities, which were free to take it up or not. We categorized the facilities by level of program adoption. Cross-sectional associations were estimated between program category and prevalence of individual-level worker health indicators, adjusting for center-level working conditions. Results: A total of 1,589 workers in 5 job categories completed the survey. Average levels of psychological demands and social support at work were relatively high. Supervisor support stood out as higher in centers with well-developed WHP programs, compared to centers with no programs. There were no differences among program levels for most health outcomes. Workers in centers with well-developed programs had slightly lower average body mass index and (unexpectedly) slightly lower prevalence of non-smoking and regular aerobic exercise. Conclusions: Only small health benefits were observed from well-developed programs and working conditions did not appear to confound the negative results. This low-intensity, low-resourced workplace health promotion program may have benefited a few individuals but seems to have had only modest influence on average levels of the measured health indicators. Many nursing home employees experience obstacles to health behaviors; approaches that provide more environmental and economic supports for healthy behaviors, such as Total Worker Health®, may yield larger health benefits.

Caring for the carers: Advice for dealing with sleep problems of hospital staff during the COVID-19 outbreak

Hospital staff are at the frontline in the COVID‐19 outbreak. The stressors they experience may induce sleep problems in a population already at risk. Sleep deprivation, long shifts and insomnia in hospital staff have been associated with individual, organizational and public health hazards. These include increased risk of mental and somatic disorders, altered immune responses, medical errors, misunderstandings, drowsy driving and burnout. In March 2020, the World Health Organization called for providing access to mental health and counselling for health professionals involved in the COVID‐19 outbreak. To answer this call, we propose practical advice for the management of sleep problems (sleep deprivation, insomnia and shift work) that can be included in supportive interventions. The advice is based on psychobiological principles of sleep regulation and on guidelines for the treatment of insomnia and was implemented within an initiative offering psychological support to the staff of three university hospitals in Rome.

Occupational balance and sleep among women

BACKGROUND

In occupational therapy, while several studies have focussed on occupational balance, few have investigated it in the context of sleep.

AIMS

The aim of this study was to investigate the associations between sleep and occupational balance among women.

MATERIAL AND METHODS

In total, 157 women responded to the Occupational Balance Questionnaire and Karolinska Sleep Questionnaire. Linear regression was used to analyse data.

RESULTS

The median score for occupational balance was 12 (interquartile range [IQR] 9), while that for sleep was 86 (IQR 16). Sleep and sleepiness fatigue were significantly associated (p < 0.1) with satisfaction with the number of occupations during a regular week. Difficulties awakening and snoring disorders were significantly associated (p < 0.1) with balance with physical, social, intellectual, and restful occupations.

CONCLUSIONS

The majority of participants slept well and had a good sleep quality. There is an association between occupational balance and sleep. In particular, aspects related to the number of occupations, adequate time to perform them and the time spent recovering and sleeping were associated with good sleep quality. Balance among physical, social, intellectual, and restful occupations was associated with difficulties awakening and snoring.

SIGNIFICANCE

Our results support the need for occupational therapists to focus on occupational balance, to improve women's sleep.

The Comorbidity of Musculoskeletal Disorders and Depression: Associations with Working Conditions Among Hospital Nurses

Background: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among nurses and are frequently accompanied by depression. However, the association between the comorbidity of MSDs and depression and working conditions has not been studied, which was the aim of this study. Methods: In 2015, all nurses (n = 1,102) employed at a community hospital in the Northeast United States were invited to participate in this cross-sectional study. A survey was distributed in which participants were asked to report on MSDs, depressive symptoms, as well as subjective working conditions assessed including physical demands, psychological demands, decision authority, social support, and work-family conflict. Findings: 397 nurses responded (36%), and the prevalence of the comorbidity of MSDs and depression was 14.5%. Poisson regression (PR) models suggested that work-family conflict was associated with increased risk of the comorbidity (PR = 2.18; 95% confidence interval [CI] = 1.33-3.58), as was 8-hour night shift (PR = 2.77; 95% CI = [1.22, 6.31]) or 12-hour day shift (PR = 2.20; 95% CI = [1.07, 4.50]). Other working conditions were not directly associated with the comorbidity. Conclusions/Application to Practice: The comorbidity of MSDs and depression is prevalent among hospital nurses, and work-family conflict and working night shift or longer shifts were significantly associated with this. Effective workplace programs are needed to address nurses' working conditions to reduce their work-family conflict, thereby improving their musculoskeletal and mental health.

From Neighboring Behavior to Mental Health in the Community: The Role of Gender and Work-Family Conflict

This research emphasizes the potential influences of social community environments on low-income employees' mental health. Using a two-wave panel design, we collect 218 matched data from low-income employees in Harbin City, China. We developed a moderated mediation model to test our hypotheses with the following significant results: (1) neighboring behavior, defined as both giving and receiving various kinds of assistance to and from one's neighbors, positively influenced mental health; (2) work-family conflict mediated the relationship between neighboring behavior and mental health; (3) gender moderated the influences of neighboring behavior on mental health, such that neighboring behavior had a stronger positive influence on mental health for females than for males; (4) gender moderated the mediating effect of work-family conflict; that is, the positive influences of neighboring behavior were stronger for female employees than for male employees. This research explores the mechanism and boundary conditions of the relationship between neighboring behavior and mental health. In practice, community managers support community social workers by organizing community-building social activities and supportive programs to enhance residents' neighboring behavior.