Work Related Stress, Well-Being and Cardiovascular Risk among Flight Logistic Workers: An Observational Study

The influence of burnout on cardiovascular disease: a systematic review and meta-analysis

Background

Burnout is a public health problem with various health consequences, among which cardiovascular disease is the most investigated but still under debate. Our objective was to conduct a systematic review and meta-analysis on the influence of burnout on cardiovascular disease.

Methods

Studies reporting risk (odds ratio, relative risk, and hazard ratio) of cardiovascular disease following burnout were searched in PubMed, PsycINFO, Cochrane, Embase, and ScienceDirect. We performed a random-effect meta-analysis stratified by type of cardiovascular disease and searched for putative influencing variables. We performed sensitivity analyses using the most adjusted models and crude risks.

Results

We included 25 studies in the systematic review and 9 studies in the meta-analysis (4 cross-sectional, 4 cohort, and 1 case-control study) for a total of 26,916 participants. Burnout increased the risk of cardiovascular disease by 21% (OR = 1.21, 95% CI 1.03 to 1.39) using the most adjusted risks and by 27% (OR = 1.27, 95% CI 1.10 to 1.43) using crude risks. Using stratification by type of cardiovascular disease and the most adjusted risks, having experienced burnout significantly increased the risk of prehypertension by 85% (OR = 1.85, 95% CI 1.00 to 2.70) and cardiovascular disease-related hospitalization by 10% (OR = 1.10, 95% CI 1.02 to 1.18), whereas the risk increase for coronary heart disease (OR = 1.79, 95% CI 0.79 to 2.79) and myocardial infarction (OR = 1.78, 95% CI 0.85 to 2.71) was not significant. Results were also similar using crude odds ratio. The risk of cardiovascular disease after a burnout was not influenced by gender. Insufficient data precluded other meta-regressions.

Conclusions

Burnout seems to increase the risk of cardiovascular disease, despite the few retrieved studies and a causality weakened by cross-sectional studies. However, numerous studies focused on the pathophysiology of cardiovascular risk linked to burnout, which may help to build a preventive strategy in the workplace.

Sense of coherence promotion and occupational and family stress mitigation may improve heart health behaviors in middle-aged working women: a structural equation modelling approach

Aims

This study aimed to construct a model that describes heart health behaviors in middle-aged working women and verify the goodness-of-fit of the model based on Salutogenesis.

Methods and results

This study adopted a cross-sectional design. Participants were 330 middle-aged working women in South Korea. Data were analyzed using structural equation modelling with Sobel's Z test. In the multiple mediation model, stress coping strategy (β = 0.26; p < 0.001), social support (β = 0.41; p < 0.001), and health self-efficacy (β = 0.36; p < 0.001) had significant direct effects on sense of coherence (SOC). SOC had a significant direct effect on occupational (β = -0.72; p < 0.001) and family stress (β = -0.76; p < 0.001). Additionally, SOC (β = 0.67; p < 0.001), occupational stress (β = -0.46; p < 0.001), and family stress (β = -0.28; p < 0.001) had significant direct effects on heart health behaviors. Moreover, SOC had a significantly partial mediating effect on heart health behaviors through occupational stress (Z = 3.17; p = 0.002) and family stress (Z = 2.26; p = 0.024).

Conclusion

Occupational and family stress mediated the relationship between SOC and heart health behaviors in middle-aged working women.

Clinical evidence

Interventions that mitigate occupational and family stress may improve heart health behaviors among middle-aged working women.

Insights into abusive workplace behavior

Objectives

This paper explores definitions, incidences, and outcomes of workplace abuse - a widespread, worldwide social phenomenon impinging on the well-being of workers in a developing labor market - and possible directions for delineating and standardizing classifications of the phenomenon that facilitate workers' protection. Furthermore, we employ Tepper's Abusive Supervision Survey Questionnaire [ASSQ] to identify managerial abuse in organizations regarding the type of organization (public/private), gender of the perpetrator, gender of the target, and the managerial role, of each of the abuse items. Finally, we suggest directions for further research and practical measures designed to facilitate the diminution of behavioral abuse in the workplace in the foreseeable future.

Hypotheses

No hypotheses are submitted in this exploratory paper.

Methods

Employees of two large organizations (the Katzrin Local Council and Tigbur Ltd.) and another small national organization in Israel were approached, requesting their assistance in this investigation. We introduced the questionnaire, noting its anonymity and the academic context, and that subject participation was voluntary. The questionnaire consisted of fifteen statements on a five-point response scale ranging from 1 = "I cannot remember him/her ever using this behavior with me" to 5 = "He/she uses this behavior very often with me" (alpha = 0.97, M = 1.81, SD = 1.03). One hundred five respondents comprised the final sample: men (39%) and women (61%) aged 23-66. 66.7% of the respondents were employed in a public organization, 28.5% in a private organization, and 4.8% in a national organization. Years of education: less than 12 (14.3%); 12 full years (17.1%); tertiary education (10.5%); bachelor's degree (40%); and master's degree and above (18.1%). While 28.6% held managerial positions, 71.4% did not. Job tenure ranged between 0.5 and 42 years. The participants in national and private organizations were combined to avoid the problem of unbalanced groups. Notably, the gender balance of the managers was men (50.5%) and women (49.5%). To ensure statistical validity, we conducted a factor analysis and performed Pearson correlations to examine the relationships between the general latent variable and the abuse items and their intercorrelations. Additionally, we conducted t-tests for independent samples (with Bonferroni corrections for multiple comparisons: see, for example) to compare (1) the respondent's gender; (2) manager's gender; and (3) the managerial role with each of the abuse items, and (4) the type of organization (private/public); including the general abuse variable.

Results

High, positive, and significant correlations were recorded between each questionnaire item and the total score of abusive behavior. The results ranged from r = 0.92 for the statement, "Puts me down in front of others" (r = 0.92) to r = 0.69 for the statement, "Does not allow me to interact with my co-workers" (r = 0.69). Reported abuse in the respondents' organizations was relatively low (1.81), while among women managers marginally less than their male equivalents (in absolute value, the mean difference in the mean scores fell between 0.28 and 1.25). Abusive behavior in private organizations was more prevalent than in public concerns. Not surprisingly, workers reported more incidents of abuse than managers: in absolute value, the mean difference between employees and managers fell between 0 and 0.67 in the mean scores. Women reported fewer abusive behavior incidents than men; however, the differences found were insignificant.

Conclusion

The reports of abusive behaviors were meager. Explanations include: (1) Any instance of alleged workplace abuse can be interpreted variously by different individuals, a function of subjective perceptions and interpretations of objective data informed by several internal and external factors impinging on workers' wellness at work. (2) The extant "trust gap," which is part of the pervading culture, mitigates against honest reporting of workplace abuse for fear of reprisals. (3) A single report of behavioral abuse at work may be attributable to the same perpetrator repeating the aggression several times. The lower incidence of reported abuse among female managers could be understood in line with studies that indicate that men display aggression more frequently than women playing out their expected respective stereotypical roles in society. Furthermore, following women reflect more stable personality dispositions and are less likely than men to aggress against others without provocation. In line with these observations, women's management style projects "an ethics of care," focusing on interpersonal relations and a greater tendency than male managers toward cooperation, creativity, innovation, and shared decision-making. Because the differences found in all the variables in our investigation investigated were not significant, we cannot conclude that the results indicate a trend. Finally, we assume that appropriate sanctions against perpetrators at the workplace and regulation in public organizations would reduce the incidence of workplace abuse. In a more optimistic vein, we recommend that management and HR personnel initiate positive measures to raise awareness of behavioral abuse and eliminate it from their organizations. They should initiate training workshops, events, and support groups akin to those extant in organizations focused on eliminating racial prejudice and advocating sustainability and wellness in the workplace. Ultimately, the goal is to protect workers' dignity, the integrity of the organizations, and the welfare of society.

Self-rated health (SRH), recovery from work, fatigue, and insomnia among commercial pilots concerning occupational and non-occupational factors

Background

This study investigated associations of self-rated health (SRH), recovery from work, fatigue, and insomnia with working conditions, the psychosocial work environment, lifestyle, and sense of coherence (SOC) among commercial pilots.

Methods

A standardized questionnaire was sent to all pilots in an airline company, of whom 354 (61%) responded. Associations were analyzed via ordinal and logistic regression with mutual adjustment.

Results

Overall, 21.8% of participants reported low SRH, 13.0% reported not recovering from work during their free time, 61.9% experienced fatigue, and 70.6% experienced insomnia symptoms. A high level of demand at work was associated with poor SRH and more fatigue, and low social support at work was associated with insomnia and poorer recovery from work. Habits surrounding exercise and BMI were associated with SRH. Part-time pilots and captains reported experiencing better recovery from work than their counterparts, while female pilots and younger pilots reported less fatigue. Amount of free time after work and the type of airplane operated were associated with experience of insomnia symptoms. Finally, having a strong sense of coherence was protectively associated with all health outcomes.

Conclusion

The psychosocial environment at work is essential for the health of pilots, and a strong sense of coherence can be protective. Occupational conditions may influence recovery from work, fatigue, and insomnia. Moreover, engaging in exercise, maintaining a healthy weight, working part-time, and having more free time after the working day could improve pilots' health.

Influence of Palliative Care Qualifications on the Job Stress Factors of General Practitioners in Palliative Care: A Survey Study

Due to demographic change, the number of patients in palliative care (PC) is increasing. General Practitioners (GPs) are important PC providers who often have known their patients for a long time. PC can be demanding for GPs. However, there are few studies on the job stress factors of GPs performing PC and the potential influence of their PC training. To get more insights, a postal survey was performed with GPs in North Rhine, Germany. The questionnaire was based on a literature search, qualitative pre-studies, and the Hospital Consultants' Job Stress & Satisfaction Questionnaire (HCJSSQ). Participants state that a high level of responsibility, conflicting demands, and bureaucracy are the most important stressors they experienced in PC. The influence of PC qualification level on their perceived job stress factors is low. Only advanced but not specialist qualification shows a correlation with renumeration-related stress. Gender and work experience are more dominant influences. In our study, female GPs and physicians with more work experience tend to be more stressed. In conclusion, organisational barriers, such as administration, should be reduced and renumeration should be increased to facilitate the daily work of GPs.

Assessing the Impact of Conversational Artificial Intelligence in the Treatment of Stress and Anxiety in Aging Adults: Randomized Controlled Trial

BACKGROUND

While mental health applications are increasingly becoming available for large populations of users, there is a lack of controlled trials on the impacts of such applications. Artificial intelligence (AI)-empowered agents have been evaluated when assisting adults with cognitive impairments; however, few applications are available for aging adults who are still actively working. These adults often have high stress levels related to changes in their work places, and related symptoms eventually affect their quality of life.

OBJECTIVE

We aimed to evaluate the contribution of TEO (Therapy Empowerment Opportunity), a mobile personal health care agent with conversational AI. TEO promotes mental health and well-being by engaging patients in conversations to recollect the details of events that increased their anxiety and by providing therapeutic exercises and suggestions.

METHODS

The study was based on a protocolized intervention for stress and anxiety management. Participants with stress symptoms and mild-to-moderate anxiety received an 8-week cognitive behavioral therapy (CBT) intervention delivered remotely. A group of participants also interacted with the agent TEO. The participants were active workers aged over 55 years. The experimental groups were as follows: group 1, traditional therapy; group 2, traditional therapy and mobile health (mHealth) agent; group 3, mHealth agent; and group 4, no treatment (assigned to a waiting list). Symptoms related to stress (anxiety, physical disease, and depression) were assessed prior to treatment (T1), at the end (T2), and 3 months after treatment (T3), using standardized psychological questionnaires. Moreover, the Patient Health Questionnaire-8 and General Anxiety Disorders-7 scales were administered before the intervention (T1), at mid-term (T2), at the end of the intervention (T3), and after 3 months (T4). At the end of the intervention, participants in groups 1, 2, and 3 filled in a satisfaction questionnaire.

RESULTS

Despite randomization, statistically significant differences between groups were present at T1. Group 4 showed lower levels of anxiety and depression compared with group 1, and lower levels of stress compared with group 2. Comparisons between groups at T2 and T3 did not show significant differences in outcomes. Analyses conducted within groups showed significant differences between times in group 2, with greater improvements in the levels of stress and scores related to overall well-being. A general worsening trend between T2 and T3 was detected in all groups, with a significant increase in stress levels in group 2. Group 2 reported higher levels of perceived usefulness and satisfaction.

CONCLUSIONS

No statistically significant differences could be observed between participants who used the mHealth app alone or within the traditional CBT setting. However, the results indicated significant differences within the groups that received treatment and a stable tendency toward improvement, which was limited to individual perceptions of stress-related symptoms.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04809090; https://clinicaltrials.gov/ct2/show/NCT04809090.

The relationship between perceived stress and support with blood pressure in urban Haiti: A cross-sectional analysis

Haiti is a low-income country whose population lives under repeated and chronic stress from multiple natural disasters, civil unrest, and extreme poverty. Stress has been associated with cardiovascular (CVD) risk factors including hypertension, and the impact of stress on blood pressure may be moderated by support. The distribution of stress, support, and their association with blood pressure has not been well described in low-income countries. We measured stress and support using validated instruments on cross-sectional enrollment data of a population-based cohort of 2,817 adults living in Port-au-Prince, Haiti between March 2019 and April 2021. Stress was measured using the Perceived Stress Scale, while support was measured using the Multidimensional Scale of Perceived Social Support. Continuous scores were categorized into three groups for stress (low (1-5), moderate (6-10), high (11-16), and five groups for support (low (7-21), low-moderate (22-35), moderate (36-49), moderate-high (50-64), high (65-77)). Linear regression models were used to quantify the associations between: 1) support and stress adjusting for age and sex, and 2) stress and blood pressure adjusting for age and sex. A moderation analysis was conducted to assess if support moderated the relationship between stress and blood pressure. The cohort included 59.7% females and the median age was 40 years (IQR 28-55). The majority had an income <1 US dollar per day. The median stress score was moderate (8 out of 16 points, IQR 6-10), and median support score was moderate to high (61 out of 77 points, IQR 49-71). Stress was higher with older ages (60+ years versus 18-29 years: +0.79 points, 95% CI 0.51 to 1.08) and in females (+0.85 points, 95% CI +0.65 to +1.06). Support was higher in males (+3.29 points, 95% CI 2.19 to 4.39). Support was inversely associated with stress, adjusting for age and sex (-0.04 points per one unit increase in support, 95% CI -0.04 to -0.03). Stress was not associated with systolic or diastolic blood pressure after adjustment for age and sex. Support did not moderate the association between stress and blood pressure. In this urban cohort of Haitian adults living with chronic civil instability and extreme poverty, perceived levels of stress and social support were moderate and high, respectively. Contrary to prior literature, we did not find an association between stress and blood pressure. While support was associated with lower stress, it did not moderate the relationship between stress and blood pressure. Participants reported high levels of support, which may be an underutilized resource in reducing stress, potentially impacting health behaviors and outcomes.

Association Between Extraversion Personality With the Blood Pressure Level in Adolescents

Purpose

The association between extraversion personality and high blood pressure (BP) has not been well-studied. This study aims to explore the association between extraversion personality and the BP level in a large sample of adolescents.

Methods

As an ongoing study, 5,246 children aged 6–9 years were recruited using a stratified cluster sampling method in 2014. The extraversion personality trait, assessed by the Eysenck personality questionnaire (EPQ, answered by adolescents) in 2019, was used in the main analysis. A total of 3,407 participants were eligible and included in this analysis.

Results

The EPQ extraversion score was negatively associated with a systolic BP, a diastolic BP, and mean arterial pressure (MAP) in a univariate analysis. After adjusting for other covariates, high extraversion score was negatively associated with systolic BP (β = −0.026; 95% CI = −0.047, −0.004; p = 0.002). There was an interaction between regions and the extraversion score on systolic BP (P_interaction = 0.037). The stratified analysis showed that, in rural areas, the extraversion score was negatively associated with systolic BP (β = −0.050; 95% CI = −0.081, −0.016; p = 0.004). However, we did find an association between the extraversion score and systolic BP in urban areas (β = 0.000; 95% CI = −0.028, 0.028; p = 0.996). Similar results were observed for the extraversion assessed by parents.

Conclusions

We observed that extraversion personality was negatively associated with high BP in adolescents, especially for those who were living in rural areas. Our results suggested that a comprehensive intervention should be implemented to promote psychological health in adolescents.

Modeling the relationship between shift work and cardiometabolic risk through circadian disruption, sleep and stress pathways

The purpose of this study is to elucidate the multiple pathways linking shift work exposure to cardiometabolic risk (CMR) through the intermediates of circadian disruption, sleep disturbances, and stress. A cross-sectional study was conducted at Kingston Health Sciences Center that included female hospital workers, 160 who worked a day-only schedule and 168 who worked rotating days and nights. Participants completed questionnaires, a clinical exam, and wore accelerometers to collect sleep data for 8 days. Participants also collected urine samples at each void during a 24-h collection period, on the day shift for day-only workers and the night shift for rotating shift workers, for cortisol and melatonin measures. We adapted and tested a conceptual model proposed by Knutsson and Boggild for circadian disruption, sleep, and stress mechanistic pathways linking shift work to CMR using structural equation modeling techniques. Status as a rotating shift worker was associated with increased circadian disruption of cortisol and melatonin production compared to day-only workers (P < .001). Increased circadian disruption was associated with an increased CMR (P = .01). Rotating shift work was associated with sleep disturbances (P = .002) and increased job stress (P < .001), but neither was associated with CMR. We conclude that rotating shift work is associated indirectly with increased CMR. This association is mediated by circadian disruption as indicated by attenuated melatonin and cortisol, and flatter cortisol curves.

Identifying Predictors of University Students' Wellbeing during the COVID-19 Pandemic-A Data-Driven Approach

BACKGROUND

The COVID-19 pandemic has posed risks to public mental health worldwide. University students, who are already recognised as a vulnerable population, are at elevated risk of mental health issues given COVID-19-related disruptions to higher education. To assist universities in effectively allocating resources to the launch of targeted, population-level interventions, the current study aimed to uncover predictors of university students' psychological wellbeing during the pandemic via a data-driven approach.

METHODS

Data were collected from 3973 Australian university students ((median age = 22, aged from 18 to 79); 70.6% female)) at five time points during 2020. Feature selection was conducted via least absolute shrinkage and selection operator (LASSO) to identify predictors from a comprehensive set of variables. Selected variables were then entered into an ordinary least squares (OLS) model to compare coefficients and assess statistical significance.

RESULTS

Six negative predictors of university students' psychological wellbeing emerged: White/European ethnicity, restriction stress, perceived worry on mental health, dietary changes, perceived sufficiency of distancing communication, and social isolation. Physical health status, emotional support, and resilience were positively associated with students' psychological wellbeing. Social isolation has the largest effect on students' psychological wellbeing. Notably, age, gender, international status, and educational level did not emerge as predictors of wellbeing.

CONCLUSION

To cost-effectively support student wellbeing through 2021 and beyond, universities should consider investing in internet- and tele- based interventions explicitly targeting perceived social isolation among students. Course-based online forums as well as internet- and tele-based logotherapy may be promising candidates for improving students' psychological wellbeing.

'What a Pretty Assistant You Have': Addressing Sex-Based Harassment by Patient Offenders in Undergraduate Medical Training

Sex-based harassment remains a concern in the medical workplace environment and is negatively associated with physical and mental health complications. Presently, undergraduate medical education fails to provide students with the appropriate toolset to successfully handle sex-based harassment by patient offenders. Through peer discussion and personal experience from a medical student perspective, herein we suggest strategies for individuals at all levels of medical training to help mitigate these uncomfortable situations. Simulation-based training and implementation of frameworks regarding microaggressions are crucial components of the medical curricula which must be incorporated expediently to create cultural change and help combat pre-existing historical precedents.

Job Stress and Cardiometabolic Lifestyle Modification Behaviors Among Workers in High-risk and Low-risk Workplaces

OBJECTIVE

There is scarce evidence revealing an association between job stress and cardiometabolic lifestyle modification behaviors among workers.

METHODS

A cross-sectional, correlation study was conducted among workers in high-risk and low-risk workplaces by work characteristics.

RESULTS

Workers in high-risk workplaces had significantly higher job stress levels than low-risk workplaces. Higher job stress was significantly associated with lower cardiometabolic lifestyle modification behaviors (β = -0.14, P = .001). This significant association was evident only for high-risk workplaces in total job stress (β = -0.16, P = .001), including job demand (β = -0.16, P = .005) and job insecurity (β = -0.11, P = .026).

CONCLUSIONS

Strategies for alleviating job stress should be prioritized to high-risk workplaces, and these efforts may concomitantly contribute to cardiometabolic risk reduction.

The Dark and the Light Side of the Expatriate’s Cross-Cultural Adjustment: A Novel Framework Including Perceived Organizational Support, Work Related Stress and Innovation

The new context of the Psychology of Sustainability and Sustainable Development has reached the attention of the scientific community in recent years, due to its comprehensive approach aimed at enhancing the sustainability of interpersonal and intrapersonal talent, as well as of groups and communities. In this scenario, research on employee cross-cultural adjustment (CCA) is considered a key theme in human resource management. It is known that psychological support in the host country may alleviate distress and facilitate the integration of the expatriate workers. However, there is a lack of research investigating expatriate adjustment as an antecedent of the perceived organizational support. The aim of the study was to investigate the relationship among cross-cultural adjustment (CCA), perception of organizational support (POS), work-related stress (WRS), and innovation, considering these factors as a part of a unique innovative framework. A cross sectional study was performed using a sample of 234 expatriate workers of a multinational organization. Data were collected through a monitoring survey for the assessment of work-related stress risk factors of their expatriate staff. The results showed a positive correlation between CCA, POS, and innovation. On the other hand, a negative correlational effect of CCA and WRS, CCA and POS on WRS, and POS and WRS was found. Finally, POS was found to be a significant antecedent of CCA. These findings have implications for both international human resource management researchers and practitioners.

Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment-A Narrative Review

Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014-2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted.

Association between Work-Related Stress and QT Prolongation in Male Workers

Background: Work-related stress is a potential cardiovascular risk factor, but the underlying mechanism is not fully explained. The autonomic nervous system control of cardiac function might play a specific role; therefore, monitoring the QT interval in the electrocardiogram can highlight an autonomic imbalance induced by occupational stressors. The aim of our study was to explore the QT interval parameters as early indicators of imbalance of the autonomic cardiac function in relation to work-related stress. Methods: During 2015–2016 annual workplace health surveillance, we measured work-related stress in 484 workers of a logistic support company using the Health and Safety Executive (HSE) tool. We assessed the frequency-corrected QT (QTc) interval and the QT index (QTi) on the electrocardiogram of each participant, and collected demographic and clinical data. We compared the QTc values by the four Karasek’s categories (active/passive jobs, low/high strain job), and by job support (present/lacking), and conducted multivariate analysis to adjust for possible confounders. Results: The results of the multivariate regression analysis showed that QTc was prolonged among workers operating at a specific site where stress level was found to be elevated. Regular physical activity showed a beneficial effect against QTc prolongation. We did not observe an effect on QTc length by the cross-combined Karasek’s categories of job control, job demand, and job support. Conclusions: Our study suggests subclinical effects of conditions associated with work-related stress on the autonomic regulation of cardiac function. Further research is warranted to elucidate the combined effect of work organization and lifestyle factors on autonomic cardiac function.

Well-being at work from a multilevel perspective: what is the role of personality traits?

Purpose

It is of great importance for organizations to identify what can influence employees’ well-being. The theoretical model that the authors propose combines psychological and social determinants of stress at work. The purpose of this paper is to evaluate the contribution of work organization conditions, personality traits and their interaction to well-being in a sample of Canadian workers and companies.

Design/methodology/approach

Multilevel regression analyses were performed on a sample of 1,957 workers employed in 63 Quebec firms. Work organization conditions included (skill utilization, decision authority, psychological demands, physical demands, job insecurity, irregular schedule, number of working hours, social support from colleagues and supervisors, job promotion, and recognition) and personality traits included (self-esteem, locus of control and Big Five).

Findings

Work organization conditions (psychological demands, number of hours worked and job insecurity) and personality (self-esteem, locus of control, extraversion, neuroticism and conscientiousness) were significantly associated with well-being. The results of the analysis show that none of the personality traits included in this study interacts with work organization conditions to explain workers’ level of well-being.

Originality/value

This study provides support for the implementation of human resource management (HRM) practices in order to diminish the presence of stressful working conditions as well as for the eventual development of training programs designed to raise personality traits.

The JDCS Model and Blue-Collar Bullying: Decent Working Conditions for a Healthy Environment

Violence in the workplace and its health consequences still represent one of the main obstacles to obtaining decent working conditions. In particular, blue-collar workers run a greater risk of experiencing episodes of violence, also because of a lack of autonomy and fewer social interactions. According to the work environment hypothesis, factors such as high workload, lack of social support and lack of job control represent the antecedents of workplace bullying. Following the job demand-control-support model (JDCS), violence can be the symptom of a high-strain environment. Moreover, it is still unclear if workplace bullying can mediate the effects of work-related stress on workers' health outcomes. The aim of the present study is to analyse the relationship between the components of the JDCS and the health of the workers considering workplace bullying as a mediating variable. By a cross sectional study design, we tested the following theoretical hypotheses: first, JDCS components (conceptualized as stress) are supposed to significantly predict the level of workers' health. Second, workplace bullying is supposed to mediate the relationship between the JDCS components and the level of health. The sample consists of 400 blue-collars from three different Italian companies. Work-related stress, health outcomes and workplace bullying were measured by specific self-administered questionnaires and the relationships between the variables of interest were tested through a structural equation model (SEM) analysis. The results showed that while the direct relationship between the components of the JDCS and the level of psychological health is weaker (standardized path coefficients SPC = 0.21), the partial mediation hypothesis shows that workplace bullying mediate the relationship between JDCS components and health outcomes (χ²/df ratio = 2.70; path from stress to workplace bullying SPC = 0.78; path from workplace bullying to general health SPC = 0.51; p = 0.01). The JDCS components (workload, lack of control, lack of support) are useful predictors for workplace bullying. On the other hand, bullying plays a mediating role between the stress experienced and the health consequences. The present study adds new insights into the relationship between violence seen as a form of social behavioural strain and the psychological health of workers. The theoretical and practical implications are discussed. Future research on blue-collars could use longitudinal designs in order to analyse the relationship between social environment, job design and strain reactions.

Digital Leadership Skills and Associations with Psychological Well-Being

Due to increasing digitalisation, today's working world is changing rapidly and provides managers with new challenges. Digital leadership is an important factor in managing these challenges and has become a key concept in the discussion about what kinds of skills managers need for digital transformation. The main research question our study explored was if digital leadership is associated with psychological well-being in upper-level managers. Based on a qualitative pilot study and relevant literature, we developed a new scale for digital leadership in managers. We conducted an online survey with a sample of 368 upper-level managers from a large German ICT-company. Using a stepwise logistic regression analysis, potential effects of digital leadership on psychological well-being (WHO-5) were analysed. Logistic regression analyses showed that better skills in digital leadership were significantly associated with higher well-being. Results also showed that gender, age and managerial experience had no effect in our model. Our study provides a valuable insight into the association between digital leadership and well-being in managers. However, further research is necessary to validate the newly developed scale for digital leadership and to confirm a causal effect in the relationship between digital leadership and well-being.

Exploration of the adverse effects of shift work in a multicultural environment

BACKGROUND

Given that shift work spreads across many different business sectors, studies of its adverse effects are very topical. Much research has been done on the negative impact of shift work, but many researchers have not focused on its impact in a multicultural environment.

OBJECTIVE

The aim of this study was to map out how shift work is perceived by workers in two different shift regimes and two national groups.

METHODS

The research was carried out on Czech manufacturing workers and Turkish airport ground personnel using a questionnaire. The impact of shift work was studied from physical, mental, social and health aspects with connection to family status and gender. For statistical evaluation, Pearson's chi-squared test of independence was used. The effect of shift work on workers' performance and scrap rate was analysed only on the sample of the manufacturing workers.

RESULTS

Fifty-five Czech male workers, 49 Turkish male workers and 60 Turkish female workers participated in the survey. The dependence between sexes was confirmed for mental aspects and sleeping routines. The main difference between nationalities is in work attitude, social aspects and sleeping routines. According to the family status, the difference was confirmed in all areas except social aspects. The lowest values of productivity and the highest scrap rate were observed on night shifts and the maximum productivity and lowest scrap rates were observed on afternoon shifts.

CONCLUSIONS

Some of the basic assumptions were confirmed which suggests that a multicultural environment has an influence on the perception of shift work by the nations and gende.

Exploration of the adverse effects of shift work in a multicultural environment

BACKGROUND

Given that shift work spreads across many different business sec-tors, studies of its adverse effects are very topical. Much research has been done on the negative impact of shift work, but many researchers have not focused on its impact in a multicultural environment.

OBJECTIVE

The aim of this study was to map out how shift work is perceived by workers in two different shift regimes and two national groups.

METHODS

The research was carried out on Czech manufacturing workers and Turkish airport ground personnel using a questionnaire. The impact of shift work was studied from physical, mental, social and health aspects with connection to family status and gender. For statistical evaluation, Pearson's chi-squared test of independence was used. The effect of shift work on workers' performance and scrap rate was analysed only on the sample of the manufacturing workers.

RESULTS

Fifty-five Czech male workers, 49 Turkish male workers and 60 Turkish female workers participated in the survey. The dependence between sexes was confirmed for mental aspects and sleeping routines. The main difference between nationalities is in work attitude, social aspects and sleeping routines. According to the family status, the difference was confirmed in all areas except social aspects. The lowest values of productivity and the highest scrap rate were observed on night shifts and the maximum productivity and lowest scrap rates were observed on afternoon shifts.

CONCLUSIONS

Some of the basic assumptions were confirmed which suggests that a multicultural environment has an influence on the perception of shift work by the nations and gende.

The Impact of Workplace Harassment on Health in a Working Cohort

Background: Workplace abuse, including sexual harassment, is frequently experienced worldwide and is related to adverse mental health outcomes, and injuries. Flight attendants are an understudied occupational group and are susceptible to harassment due to working in a feminized, client-facing occupation with few protections or sanctioned responses against aggressive behaviors.

Objective: We investigated the relationship between workplace abuse and health in a cohort of cabin crew. We also aimed to characterize perpetrator profiles.

Methods: We conducted our study among 4,459U.S. and Canada-based participants from the Harvard Flight Attendant Health Study using multivariate logistic regression. Our exposures of interest were episodes of workplace abuse in the past year. We evaluated several mental and physical health outcomes, including depression, fatigue, musculoskeletal injuries, and general workplace injuries.

Results: We report that exposures to verbal abuse, sexual harassment, and sexual assault are common among cabin crew, with 63, 26, and 2% of respondents, respectively, reporting harassment in the past year alone. Workplace abuse was associated with depression, sleep disturbances, and musculoskeletal injuries among male and female crew, with a trend toward increasing odds ratios (ORs) given a higher frequency of events. For example, sexual harassment was related to an increased odds for depression (OR = 1.91, 95% confidence interval [CI]: 1.51–2.30), which increased in a dose response-like manner among women reporting harassment once (OR = 1.44, 95% CI: 0.93–1.95), 2–3 times (OR = 1.83, 95% CI: 1.29–2.38), and 4 or more times (OR = 4.12, 95% CI: 3.18–5.06). We found that passengers were the primary perpetrators of abuse.

Conclusions: Our study is the first to comprehensively characterize workplace abuse and harassment and its relation to health in a largely female customer-facing workforce. The strong associations with health outcomes observed in our study highlights the question of how workplace policies can be altered to mitigate prevalent abuses. Clinicians could also consider how jobs with high emotional labor demands may predispose people to adverse health outcomes, educate patients regarding their psychological/physical responses and coping strategies, and be aware of signs of distress in patients working in such occupations in order to direct them to the appropriate treatments and therapies.

The Role of Occupational Stress in the Association between Emotional Labor and Mental Health: A Moderated Mediation Model

This study investigated whether occupational stress factors moderate the effect of emotional labor on psychological distress in call center employees. A cross-sectional and descriptive study using anonymous paper-based survey methods was conducted in a sample of 283 call center employees in South Korea. Participants completed the Emotional Labor Scale, the Depression Anxiety Stress Scale, and the Korean Occupational Stress Scale. Moderated mediation analyses were conducted using the PROCESS macro in order to investigate the relationship among variables. The results showed that the association between surface acting while having emotional labor and psychological distress was mediated by emotional dissonance. The mediated effect of emotional dissonance was moderated by discomfort in occupational climate, suggesting that improving the occupational environment can lessen the level of psychological distress among emotional workers, and that more attention should be devoted to the development of an intervention at the organizational level in order to prevent mental health problems in this population.

Association between burnout and sense of coherence among speech and language therapists: an exploratory study in Italy

Background and aim:

Job burnout has been recognized as a serious occupational hazard among professionals, such as health care professionals. The sense of coherence (SoC) is deemed to be a personal resource capable of reducing the impact of job stressors and, consequently, the experience of job burnout. The purpose of this study was to investigate the relationship between SoC and job burnout among speech and language therapists.

Materials and methods:

A descriptive and cross-sectional analysis was carried out through an online self-reported questionnaire. A total of 217 Italian speech and language therapists were involved in the study. The Anova test, T-test and logistic regression were performed to study the association between SoC and job burnout.

Results:

The Anova test showed that job tenure was not associated to job burnout. The T-test showed that speech and language therapists having a low SoC exhibited significantly higher emotional exhaustion, higher cynicism, and lower professional efficacy (t=-7.190 d.f.=215 p<.001) when compared to those having a high SoC. Finally, the odds ratio showed that low SoC was associated with high emotional exhaustion (OR=11.86; 95% CI=5.52-25.49; p<0.05), low SoC was associated with high cynicism (OR=4.41, CI=2.50-7.80; p<0.05), and low SoC was associated with low personal efficacy (OR=4.70; CI=2.59-8.52; p<0.05).

Conclusion:

Our results are in line with previous studies which showed that SoC is a fundamental personal resource which may activate workers’ reaction to various stressors, thus reducing the experience of burnout. (www.actabiomedica.it)

Correction Workers' Burnout and Outcomes: A Bayesian Network Approach

The present study seeks to demonstrate how Bayesian Network analysis can be used to support Total Worker Health^® research on correction workers by (1) revealing the most probable scenario of how psychosocial and behavioral outcome variables in corrections work are interrelated and (2) identifying the key contributing factors of this interdependency relationship within the unique occupational context of corrections work. The data from 353 correction workers from a state department of corrections in the United States were utilized. A Bayesian Network analysis approach was used to probabilistically sort out potential interrelations among various psychosocial and behavioral variables. The identified model revealed that work-related exhaustion may serve as a primary driver of occupational stress and impaired workability, and also that exhaustion limits the ability of correction workers to get regular physical exercise, while their interrelations with depressed mood, a lack of work engagement, and poor work-family balance were also noted. The results suggest the importance of joint consideration of psychosocial and behavioral factors when investigating variables that may impact health and wellbeing of correction workers. Also, they supported the value of adopting the Total Worker Health^® framework, a holistic strategy to integrate prevention of work-related injury and illness and the facilitation of worker well-being, when considering integrated health protection and promotion interventions for workers in high-risk occupations.

The Perception of Psychosocial Risks and Work-Related Stress in Relation to Job Insecurity and Gender Differences: A Cross-Sectional Study

Introduction

The perception of psychosocial risks exposes workers to develop work-related stress. Recently the attention of scientific research has focused on a psychosocial risk already identified as “job insecurity” that regards the “overall concern about the continued existence of the job in the future” and that also depends on worker's perception, different for each gender.

Aim of the Study

The aim of this cross sectional study is to show if job insecurity, in the form of temporary contracts, can influence the perception of psychosocial risks and therefore increase worker's vulnerability to work-related stress and how the magnitude of this effect differs between genders.

Materials and Methods

338 administrative technical workers (113 males and 225 females) were administered a questionnaire, enquiring contract typology (permanent or temporary contracts), and the Health Safety Executive questionnaire to assess work-related stress. The Health Safety Executive Analysis Tool software was used to process collected questionnaires and the Wilcoxon rank-sum test was used to evaluate the statistical significance of the differences obtained.

Results

Workers with temporary contracts obtained lower scores than workers with permanent contracts in all the domains explored by the Health Safety Executive Analysis questionnaire, statistically significant (P<0,05). The female workers obtained lower scores than male workers in all domains explored by the Health Safety Executive questionnaire.

Conclusions

Authors conclude that perception of psychosocial risks can be influenced by job insecurity, in the form of temporary contracts, and increases worker's vulnerability to work-related stress and differs between genders.

Executive Stress Management: Physiological Load of Stress and Recovery in Executives on Workdays

Objective: The use of high-performance sports technology to describe the physiological load of stress and the quality of recovery in a population of executives during the workday. Methodology: Heart rate variability values were recorded during 48 h from which the relationship between stress/recovery quality (stress balance) was obtained for three differentiated time slots: work, after work, and night in a workday. Results: We observed a negative stress balance during the 24 h of measurement in the course of a workday, being negative at work and after work, and positive at night. The stress generated or maintained outside working hours correlates significantly with a lower quality of recovery during the 24 h workday. Conclusions: It is necessary to prioritize strategies that help improve stress management in executives through the improvement of tools and strategies that mainly promote greater relaxation outside working hours.