Occupational stress and mental health among civil servants during COVID-19 in China: The mediation effect of social support and work-family conflict

Mental health problems of various populations during the COVID-19 pandemic have received high attention, but there is little research on the mental health of Chinese civil servants. The present study investigated occupational stress, mental health problems (i.e., anxiety, depression, and insomnia), social support, and work-family conflict in Chinese civil servants during the COVID-19 pandemic. A total of 327 civil servants in Wenzhou city, China, participated in an online survey, which collected data on socio-demographic characteristics, occupational stress, mental health problems (i.e., anxiety, depression, and insomnia), social support, and work-family conflict. Data were analyzed using non-parametric tests and a multiple mediation model. Self-reported risk at work and support from mental health workers were relatively low. Anxiety, depression, and insomnia prevalence were 49.24 %, 47.1 %, and 20.48 %, respectively. Those who held higher ranks at work had lower levels of anxiety and depression. In addition, those who felt bad about their health status had more mental health problems. Social support and work-family conflict mediated the relationship between occupational stress and mental health problems significantly. Stress management training, organizational-level improvement in work arrangements, and professional mental health services are warranted for Chinese civil servants during the pandemic.

The Effect of Pythagorean Self-Awareness Intervention on Stress and Mental Health Characteristics of Civil Servants in Crete, Greece

Evidence is limited regarding the effects of holistic programs on work-related stress, anxiety, and depressive symptomatology. This study aimed to evaluate the effects of the Pythagorean Self-Awareness Intervention (PSAI) on stress and mental health characteristics of civil servants in Crete, Greece. This was a single arm interventional study with PSAI outcome evaluation. Validated, self-reported scales were used to assess stress and mental health characteristics (PSS, DASS, UCLA, RSE, and STAXI). Hair samples were obtained to measure cortisol concentrations as a biological stress marker. Paired-samples t-test or Wilcoxon tests were used to evaluate pre- and post-intervention measures. Overall, 48 civil servants (56.3% women, mean age 51 years) participated in the study. Statistically significant reductions were observed in all self-reported stress scales (p < 0.05). Although hair cortisol decreased, this difference was not statistically significant (p = 0.109). Statistically significant improvements were also observed on depressive symptomatology (p < 0.001), self-esteem (p < 0.001), loneliness (p < 0.001), self-efficacy (p = 0.002), and anger (p = 0.017). The PSAI appeared beneficial with respect to all self-reported outcomes. Larger studies including control groups and further follow-up evaluations are needed to ascertain these findings.

A Comparative Assessment of Intimate Partner Violence Perpetration among Male Military Personnel and Civil Servants in Ibadan, Nigeria

The mode of training and work of the military personnel is different from that of civil servants and may affect their relationships with their intimate partners. This study assessed and compared the prevalence and correlates of self-reported Intimate Partner Violence (IPV) perpetration against female partners by male military personnel and civil servants in Ibadan, south-western Nigeria. A cross sectional survey of 1240 respondents, comprising 631 military personnel and 609 civilians, was conducted using a multistage sampling technique. A self-administered questionnaire was used to collect data on the respondents' characteristics and the different types of IPV perpetrated by them. Chi square test was used to compare the proportions of the different types of IPV perpetration and logistic regression analysis was used to determine the predictors of IPV perpetration in the two study groups. Military personnel reported significantly more IPV such as physical abuse, psychological abuse and controlling behaviors than the civil servants. Childhood exposure to inter-parental IPV and history of physical fight with another woman significantly increased the odds of perpetration of each type and any form of IPV in the two populations after controlling for other variables. Military personnel were significantly more likely to perpetrate any form of IPV than the civil servants. IPV was prevalent in both groups but was more among the military personnel. There is a need for multidisciplinary interventions such as psycho-education and conflict management skills to address violence against female intimate partners especially among the military population in Nigeria.

The perceptions and priorities of professionals in health and social welfare and city planning for creating a healthy living environment: a concept mapping study

BACKGROUND

It is helpful for collaboration if professionals from the field of health and social welfare and the field of city planning are aware of each other's concepts of what a healthy living environment entails and what its components are. This study examined perceptions about creating a healthy living environment of professionals from these two fields, as well as the differences between them.

METHODS

We recruited 95 professionals from Nijmegen, the Netherlands who worked in the fields of health, social welfare and city planning in governmental and non-governmental capacities. We used the concept mapping method to collect and analyse their thoughts on healthy living environments. Participants first submitted statements on this subject in a brainstorming session, using an online mapping tool. Then they sorted these statements and rated them on priorities and opportunities within urban planning processes.

RESULTS

During the brainstorm, 43 professionals generated 136 statements. After the elimination of duplicates, 92 statements were individually sorted by 32 professionals. Concept mapping software was used to create an overall map, in which the statements were sorted into ten clusters. Each of these clusters represented one of the main features of a healthy living environments. After 36 participants rated these statements, it emerged that professionals from both fields agreed on priorities and opportunities for the clusters 'Spatial quality' and 'Conducive to exercise'. Professionals also agreed on which three clusters had the fewest priorities and possibilities ('Promotes personal wellbeing', 'Encourages healthy choices', 'Conducive to social connections').

CONCLUSION

We found that professionals in health and social welfare and city planning have similar views concerning the most and least important features of a healthy living environment in urban planning process. This could indicate that the differences between the two fields may be more nuanced and specific than previously thought. This knowledge offers perspectives for professionals to strengthen their collaboration and to come to a joint result in urban planning projects.

[Investigation on the awareness of snoring hazard and prevalence of obstructive sleep apnea among civil servants]

Objective: To investigate the awareness of snoring hazard and prevalence of obstructive sleep apnea (OSA) among civil servants. Methods: A cross-sectional survey was conducted to investigate the awareness of snoring hazards among in-service civil servants who had annual medical examination in a Guangdong provincial institution from September to November 2017. The high-risk group for OSA was screened and diagnosed by sleep monitoring. Results: 1 036 of 1 241 civil servants were enrolled in the study for integral data. 60.1% (623/1 036) of the subjects realized that snoring was harmful to health. The most common source to develop OSA awareness was network (59.6%, 371/623), followed by television (48.0%), relatives and friends (46.6%), newspaper (44.5%) and radio (18.9%). The awareness rate of snoring consequences was as follows: decreased sleep quality (71.9%, 448/623), sudden death (52.2%), daytime sleepiness (44.3%), cardiovascular and cerebrovascular diseases (42.9%), hypertension (24.4%) and sexual dysfunction (16.7%). 22.0% (228 / 1 036) of the cases were classified into high-risk OSA. The prevalence of OSA among high-risk group was 46.05%(105/228)and only 0.9% (2/228) of them had been diagnosed with OSA. Conclusion: Civil servants had awareness of snoring hazard to a certain extent. Among civil servants classified into high-risk OSA, the OSA perveance was high but the rate of diagnosis and treatment was very low.

10-year risk for cardiovascular diseases using WHO prediction chart: findings from the civil servants in South-western Nigeria

Background

Globally, cardiovascular diseases (CVDs) have continued to ravage the human existence through the premature deaths of its workforce. Despite this burden, many studies in Nigeria have focused on determining the prevalence of risk factors which alone are insufficient to assess the risk of future cardiovascular events. Therefore, we determined the pattern and predictors of 10-year risk for CVDs in South-western Nigeria.

Methods

We conducted a cross-sectional study among workers at the local government areas (LGAs) of Oyo State. Using a multi-stage sampling technique, we recruited 260 respondents from the LGA secretariats. A pre-tested, interviewer-administered questionnaire was administered to obtain information on the socio-demographics and behavioural attributes. Lipid analysis, anthropometric, blood pressure, fasting blood glucose measurements were done using standard protocols. The respondents’ CVD risk was assessed using WHO prediction chart. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square and binary logistic regression was used to identify the predictors of 10-year risk for CVDs at 5% level of significance.

Results

The mean age of respondents was 46.0 + 6.7 years. The proportion of respondents with good knowledge of risk factors was 57.7%. The prevalence of CVD risk factors were as follows: systolic hypertension (29.6%), visceral obesity (35.8%), diabetes mellitus (18.8%), smoking (5.8%), elevated total cholesterol (55.4%) and physical inactivity (84.6%). The proportion of respondents with low, moderate and high risk of developing CVDs within 10 years was 76.9, 8.5 and 14.6% respectively. Respondents with age ≥ 40 years (aOR = 2.6, 95% CI = 1.3–8.5), management cadre (aOR = 3.8, 95% CI = 1.6–9.6), obesity (aOR = 4.8, 95% CI = 1.2–120), abnormal waist circumference (aOR = 2.8, 95% CI = 1.3–5.2) and physical inactivity (aOR = 2.4, 95% CI = 1.2–4.7) were associated with the higher likelihood of developing CVDs.

Conclusion

About one-sixth of the respondents had high risk of developing CVDs within the next 10 years and it is likely that it will reduce the productivity of the State. Lifestyle modification and early detection of risk factors through regular screening programmes for those with high CVD risk is therefore recommended.

Mediating role of occupational stress and job satisfaction on the relationship between neuroticism and quality of life among Chinese civil servants: a structural equation model

Background

Knowledge on the quality of life (QOL) of civil servants is limited. Therefore, the aims of this study were to investigate the QOL of civil servants, and examine whether occupational stress and job satisfaction mediated the association between neuroticism and QOL in civil servants from Shandong, China.

Methods

The cross-sectional study included 559 civil servants aged 27 to 60 years from Shandong province in China. Participants completed questionnaires assessing neuroticism, occupational stress, job satisfaction, and QOL. Structural equation modeling (SEM) was conducted to examine the hypothetical model.

Results

Among the civil servants, the average score for QOL was 75.49 ± 14.73. The SEM analysis showed a good fit of the data to the hypothesized model. Neuroticism, occupational stress, and job satisfaction explained 38% of the variance of QOL. Neuroticism was positively correlated with occupational stress and negatively correlated with job satisfaction and QOL. A strong direct effect (− 0.386, P < 0.01) and moderate indirect effect (− 0.133, P < 0.01) of neuroticism on QOL mediated by occupational stress and job satisfaction were observed. In addition, a direct effect (− 0.197, P < 0.01) and an indirect effect (− 0.044, P < 0.01) of occupational stress on QOL mediated by job satisfaction were also observed.

Conclusions

Occupational stress and job satisfaction partly mediated the relationship between neuroticism and QOL among Chinese civil servants. Thus, selecting individuals with a low level of neuroticism as civil servants, reducing occupational stress, and increasing job satisfaction may be important measures to improve their QOL.

Correlations among Work Stressors, Work Stress Responses, and Subjective Well-Being of Civil Servants: Empirical Evidence from China

BACKGROUND

The work stress of civil servants has gradually increased as a result of the modernization of China's national governance system and capacity. However, research on the correlations among work stressors, work stress responses, and subjective well-being (SWB) of civil servants is scarce.

METHODS

In accordance with the current research status on work stress and SWB, a survey of 874 civil servants in China was carried out from May to June 2018. The revised stress response questionnaire of civil servants, work stressors questionnaire of civil servants, and a simplified edition of the SWB scale of China's urban residents were used in this study.

RESULTS

Superiors impose the major work pressure on civil servants, followed by interpersonal relationship, work particularity, career prospect, work task, perfectionism, and job responsibility. The work stressors of civil servants were significantly related to gender, age, marital status, working years, educational background, and position (P<0.05). The work stressors of civil servants were significantly positively correlated with work stress responses (P<0.05). The work stressors and work stress responses had a significantly negative correlation with SWB.

CONCLUSION

SWB can be accurately predicted by work stressors and work stress responses. These findings can provide references and guidance for the society and government sectors to accurately understand and cope with the treatment of civil servants, formulate work stress management countermeasures, and create a high-level working environment for civil servants.

A PILOT TRIAL OF THE IMPACT OF FINANCIAL INCENTIVE ON THE UTILIZATION OF DENTAL SERVICES AMONG CIVIL SERVANTS IN IBADAN, NIGERIA

BACKGROUND

Financial constraints have been reported as major barriers to utilization of dental services in developing countries. It is however unknown if financial incentives will improve dental service utilization among civil servants in Nigeria.

OBJECTIVE

To evaluate the effect of financial incentive on the utilization of dental services among civil servants in Ibadan, Nigeria.

METHODS

This was a pilot trial among two clusters of civil servants in Ibadan, Nigeria. In both groups, the civil servants participated in an oral health education programme, a dental screening exercise and referral for dental treatment. In addition to this, the experimental group got a financial incentive to present for treatment. The two groups were followed up for a period of twelve weeks. Data were analysed using SPSS.

RESULTS

A total of 109 civil servants participated in the study. There were 62 in the control group and 47 in the experimental group. The mean age of the study participants in the control group was 42.1 ± 8.75 years, mean DMFT was 0.95 ± 1.87 and 94% of them had an unmet dental need. Similarly, in the experimental group the mean age was 44.7 ± 11.68 years, mean DMFT was 0.45 ± 0.95 and 98% of them had an unmet need. There was no significant difference between the two groups at baseline. At twelve weeks, none of those referred for treatment in the control group presented for treatment while only 3 (6.4%) experimental group presented for dental treatment. No statistical difference was observed (p=0.077).

CONCLUSION

In this study financial incentive did not result in significant increased utilization of dental care services among adults.

Civil servants' demand for social health insurance in Northwest Ethiopia

Background

Absence of reliable health insurance schemes is a key challenge to meet the universal health coverage target of the Sustainable Development Goals (SDGs). Ethiopian health system is characterized by under financing, low protection mechanisms for the poor, and lack of mechanisms of risk pooling and cost sharing. Ethiopia is implementing social health insurance (SHI) scheme to reduce out of pocket payment (OOP) and improve access and use of healthcare. This study aimed to determine the demand for SHI among civil servants and associated factors in Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted in Bahir Dar city from 557 randomly selected civil servants using structured and self-administered questionaire. The questionnaire included questions measuring demand for SHI and demographic, socio-economic, healthcare related and personal and behavioral factors. Data were first entered in Epi-Info version 7.0 and transferred to SPSS version 20 for analysis. Descriptive statistics, bivariate and multivariable logistic regression analysis were performed.

Results

From the total calculated sample size of 557, 488 respondents returned the questionnaire giving a response rate of 88%. Nearly three-fourth of the respondents, 355 (72.7%), reported their need to be enrolled in a SHI scheme. Two-third of the respondents 325 (66.6%) were willing to pay for their enrollment. Overall, three hundred and two (61.9%) were demanding SHI. Having good awareness about health insurance [AOR = 4.39, 95% CI = (1.82-12.89)] and trust on a health insurance agency [AOR = 3.0, 95% CI = (1.57-5.72)], were significantly associated with the demand for SHI among civil servants.

Conclusion

The demand for SHI among civil servants were higher. The awareness towards SHI and trust on the SHI agency were significantly associated with demand for SHI. As Ethiopia aspires to insure all employees of the formal sector, and improving the awareness of civil servants about SHI and the agency providing the service could improve demand for SHI. Further research is important on healthcare organizational and professional readiness to handle the upcoming insurance driven quality health service need and health seeking behavioral change.

[What does the decision to opt for private health insurance reveal about public provision?]

OBJECTIVE

This study examines individuals' choice of private health insurance in Spain. Private health insurance choices reveal the attributes of health care most highly valued by the population, and the perceived responsiveness of the public system in delivering those preferences.

METHOD

The paper exploits the 2004, 2009 and 2014 waves of the national Health Barometer survey, examining the health insurance choice separately for the general population and a small but influential sector of elite public-sector employees who can opt out from the public health system (civil servants).

RESULTS

Public healthcare is a highly regarded provider in terms of technology and doctor training, even by those who chose private health insurance, but falls short in terms of amenities such as comfort and speed of attendance. These findings confirm well-known strengths and criticisms of the public system. However, the study also finds that citizens are concerned about the performance of the public sector in key domains of health system responsiveness, such as personal contact and information and these concerns also influence their decision to opt for private provision. Finally, civil servants, even the minority who opted for public provision, tend to have a lower opinion of the public health service than non-civil servants, especially in terms of personal contact, information, primary care and specialist care.

CONCLUSIONS

These perceptions and concerns of the public about the performance of the public health service will be of interest for policy makers and should be investigated further.

FACTORS INFLUENCING HEALTH-SEEKING BEHAVIOUR AMONG CIVIL SERVANTS IN IBADAN, NIGERIA

BACKGROUND

Health-seeking behaviours (HSB) are closely linked with the health status of a nation and thus its economic development. Several studies have described HSB within the context of various diseases. However, knowledge of HSB among population sub-groups is still scanty. This study aims to determine factors most important to civil servants when seeking health care.

METHODS

A descriptive cross-sectional study was conducted among 337 civil servants working in the Federal Secretariat, Ibadan, Nigeria. An intervieweradministered semi-structured questionnaire was used to collect information. Chi-square tests were used to test for associations while binary logistic regression test was used for determining predictors. All data analysis were done at 5% level of significance.

RESULTS

Members of the poorest quartile were 6 times more likely to have inappropriate HSB than the richest quartile (Q4:Q1= 5.83;O.R: 16.12, 95% C.I: 2.61-11.03). Visits to the hospital or clinic (62.2%) was the most common source of healthcare sought. This was followed by visits to the chemist (33.0%), traditional healers (4.3%). A little more than one-third (34.5%) of respondents considered good service delivery as the most important factor affecting HSB. This was followed by proximity (23.9%), affordability (20.4%), prompt attention (8.8%) and readily-available drugs (7.1%). Completing only basic education [O.R: 0.24 (0.06, 0.96)] and out of pocket payment [O.R: 0.04 (9.16, 82.45)] were associated with a reduction in the likelihood of seeking healthcare from formal sources.

CONCLUSION

Appropriate health-seeking behaviour was found to be high among civil servants. However, lower cadre workers and those with lower levels of education need to be targeted during policy formulation to improve health-seeking behaviour. In addition, health insurance schemes should be extended to cover more of the population in order to improve health-seeking behaviour.

Overweight and obesity prevalence among public servants in Nadowli district, Ghana, and associated risk factors: a cross-sectional study

BACKGROUND

Globally, overweight and obesity are becoming a mounting concern, impacting negatively on the health of populations especially in low-income settings. However, there is paucity of epidemiological information available in Ghana to support intervention activities. We conducted a study among public servants to estimate overweight/obesity, hypertension and diabetes prevalence and associated risk factors.

METHODS

A descriptive cross sectional survey involving 271 purposively sampled public servants aged 20 to 59 years was conducted. We used a structured questionnaire to collect data on eating patterns, risk factors for overweight and obesity, as well as data on socio-demographics and physical activity. Anthropometric measurements were carried out and body mass index (BMI) calculated. Information on blood pressure and diabetes was also gathered. We used descriptive statistical and logistic regression analyses to, respectively, estimate overweight/obesity prevalence, and examine associations between behavioral factors and overweight/obesity and hypertension/diabetes.

RESULTS

The overall hypertension/diabetes, overweight and obesity prevalence were 20, 29.9 and 4.8% respectively. The study found that marital status (p < 0.001), leisure time with physical activity and level of physical activity during work (p < 0.035) as well as morbidities such as diabetes and hypertension (p < 0.012) were significantly associated with BMI. Findings showed no significant relationship between mealtime, eating habits, education, age and body mass index. Even though prevalence of overweight/obesity was higher among respondents who travelled to work by car compared to respondents who used motor bikes or walked, the association between weight status and means of transport was not statistically significant. Both smoking (p = 0.730) and alcohol consumption (p = 0.109) were not linked to weight status.

CONCLUSION

Population-based interventions are needed to promote nutritious food selection and consumption, physical activity and healthy life styles. We also recommend that age and gender-specific interventions should be designed and implemented by relevant authorities to promote and support healthy living and healthy-lifestyles at home and in workplaces.