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Working overtime hours: relations with fatigue, work motivation, and the quality of work.

OBJECTIVES: We sought to better understand the relationship between overtime and mental fatigue by taking into account work motivation and the quality of overtime work and studying theoretically derived subgroups. METHODS: We conducted a survey-study among a representative sample of the Dutch full-time workforce (n = 1807). The prevalence of overtime work and the associations between overtime and job demands, job variety, decision latitude, fatigue, and work motivation was studied through descriptive statistics. We used MANCOVA (covariates: age, gender, salary level) to compare six overtime-fatigue subgroups with respect to work motivation and job characteristics. RESULTS: A total of 67% of the respondents worked overtime (mean, 3.5 hours). Overtime workers appeared to be nonfatigued, motivated workers with favorable work characteristics. MANCOVA revealed no significant overtime-fatigue interaction. CONCLUSIONS: Moderate overtime is common among Dutch workers, who seem to be happy workers with attractive jobs rather than fatigued employees.

Adolescent↗

Work satisfaction among community-based mental health service providers: the association between work environment and work satisfaction.

This is a study of work environment and work satisfaction among 601 community mental health service providers in the central United States. Aspects of the work environment may limit resources and strategies available to minimize staff burnout and maximize effective service delivery. Three human resource issues related to work satisfaction are reviewed: (a) unique constraints in rural mental health service delivery, (b) the role of paraprofessionals in service delivery, and (c) community-based services for seriously mentally ill individuals. This study demonstrates hypothesized associations between work environment and work satisfaction variables. The results suggest that staff members working with seriously mentally ill individuals are vulnerable to dissatisfaction and stress, and may require special skill and mastery enhancement.

Community Mental Health Services↗

[Workload in software development work. A consideration based on work-characteristics and analysis on workload factors of each working group].

To clarify workload factors in software developing work, we designed questionnaires composed of questions of work-content based on the interview survey. For the analysis of workload, Cumulative Fatigue Symptom Index (CFSI) and the stress-rating-method by 7-likert-scale were used. With the cooperation of the Japanese Software Engineers' Association (SEA) responses were obtained from 270 out of 1,100 members and from 553 non-member software engineers in 18 companies in Japan. The CFSI score obtained was higher than those of other groups of other industries obtained in our previous studies. The stress-rating showed that "time-pressure," "too much amount of work, and "ambiguity in job specification" were the highest stressors. The work groups were categorized by the results of CFSI profile into 4 types. The results of stress-ratings were significantly different between the 4 type groups. Based on the multiple comparison analysis, the workload factors of each group could be specified. Out of the foregoing 4 types, the work groups which showed the deviation in F1B (depression) in CFSI and the work groups which showed high scores in every category in CFSI were higher in "ambiguity of specification" in stress-ratings. This result indicates that "ambiguity in specification" is a significant stressor in software engineers. This stressor is caused by the complicated communication process between users and engineers and by the shortage of tools or rules in this process. This stressor is considered to be the most typical workload which characterizes the software developing work.

Adult↗

[Morbidity status, causes for work disability and social factors influencing work disability in pregnancy. 2. Causes for work disability].

The higher level of patients of pregnant woman in comparison with non-pregnant ones results from a higher unfitness for work which nearly corresponds to the increase of sicknesses depending on gestation. From all causes of unfitness for work more than 60% were depending on gestation. Causes for the half of the release from work depending on gestation were the three diagnoses threatening abortion, threatening premature birth and bleedings. On the total level of patients of 11.66% they had a share of 5.70% points. Infections of the ureter, the diagnosis' 'Other complications in pregnancy', hyperemesis and gestoses followed. Infections of the upper respiratory tract and influenza were the causes of all releases from work which were not depending on gestation. Their share on the level of patients amounted to 0.9% points. Releases from work because of sicknesses of circulation and of the digestive tract followed in their frequency. A number of further causes of unfitness for work had only a small share on the happenings of unfitness for work.

Abortion, Spontaneous↗

Work limitations among working persons with rheumatoid arthritis: results, reliability, and validity of the work limitations questionnaire in 836 patients.

OBJECTIVE: To describe workplace limitations and the validity and reliability of the Work Limitations Questionnaire (WLQ) in persons with rheumatoid arthritis (RA). METHODS: A total of 836 employed persons with RA reported clinical and work related measures and completed the WLQ, a 25 item questionnaire that assesses the impact of chronic health conditions on job performance and productivity. Limitations are categorized into 4 domains: physical demands (PDS), mental demands (MDS), time management demands (TMS), and output demands (ODS), which are then used to calculate the WLQ index. RESULTS: Of the 836 completed WLQ, about 10% (85) could not be scored, as more than half the items in each domain were not applicable to the patient's job. Demographic and clinical variables were associated with missing WLQ scores including older age (OR 1.7, 95% CI 1.3-2.1), male sex (OR 1.9, 95% CI 1.2-3.0), and Health Assessment Questionnaire (HAQ) scores (OR 1.4, 95% CI 1.0-2.0). Work limitations were present in all work domains: PDS (27.5%), MDS (15.7%), ODS (19.4%), and TMS (28.6%), resulting in a mean WLQ index of 5.9 (SD 5.6), which corresponds to a 4.9% decrease in productivity and a 5.1% increase in work hours to compensate for productivity loss. The WLQ index was inversely associated with Medical Outcomes Study Short Form 36 (SF-36) Mental Component Score (MCS; r = -0.60) and Physical Component Score (PCS; r = -0.49). Fatigue (0.5), pain (0.46), and HAQ (0.56) were also significantly associated with the WLQ index. Weaker associations were seen with days unable to perform (0.29), days activities cut down (0.38), and annual income (-0.10). CONCLUSION: The WLQ is a reliable tool for assessing work productivity. However, persons with RA tend to select jobs that they can do with their RA limitations, with the result that the WLQ does not detect functional limitations as well as the HAQ and SF-36. The WLQ provides special information that is not available using conventional measures of assessment, and can provide helpful knowledge about individual patient problems in the workplace. Whether this information will have greater predictive ability and clinical relevance compared with surrogate measures such as the HAQ and SF-36 has not been determined, but should be the subject of future studies.

Absenteeism↗

Carpal tunnel syndrome and work organisation in repetitive work: a cross sectional study in France. Study Group on Repetitive Work.

OBJECTIVES: To study the determinants of signs of carpal tunnel syndrome (CTS) in repetitive industrial work, with special attention to occupational constraints at group level and management practices of the companies. METHOD: A cross sectional study was conducted in three sectors: assembly line; clothing and shoe industry; food industry. A total of 1210 workers in repetitive work, from 53 different companies, was compared with a control group of 337 workers. Constraints at the workplace were partly self declared, and partly assessed by the occupational physicians in charge of the employees of the company. The definition of CTS was based on a standardised clinical examination. RESULTS: CTS was associated with repetitive work, especially packaging. It was more frequent among subjects who declared psychological and psychosomatic problems and those with a body mass index > or = 27. Dissatisfaction with work, lack of job control, short cycle time, and having to press repeatedly with the hand were associated with the syndrome. An odds ratio (OR) of 2.24 was found for "just in time" production. CONCLUSION: The results emphasise the complexity of the determinants of CTS, the role of psychosocial factors at work and the potentially negative effects of some practices of the companies aimed at enhancing their competitiveness.

Adult↗

Physical working capacity of old workers and physiological background for work tests and work evaluations.

The worker's fitness for different jobs will be determined by a number of functions of which many are influenced by age. The physical working capacity has undoubtedly a maximum between 20 and 35 years of age. The decline after 35 years will be different in every individual, but certain average figures can be given. The reduction is mainly due to a decrease in the maximal values for circulation and respiration rate, that is, in the oxygen-transport system. Also the muscular strength will be reduced in the higher age-groups. The problem in work rationalization is to determine the maximum rate of work that man can carry on continuously and still retain vigour to an advanced age.The result of several work-analyses shows that actually in manual labour the workmen often utilize up to 50% of their aerobic capacity but avoid exceeding this percentage. As the aerobic capacity decreases with age it is important to know the upper limits and the safety margin for the different age-groups. For that reason one has to determine the working capacity of the man and the physiological stress of the job. It is also important to determine to what degree skill and experience can compensate for age-changes. A superior individual will, even in old age, exceed the average of the young. Age differences may often be of less importance than individual differences.It is still not known what physiological qualifications the different jobs demand, or what age-changes in the physiological functions are of importance for these jobs. The gradual increase in the average age of the population makes investigations in this field important.

Aged↗

Mastery of postprostatectomy incontinence and impotence: his work, her work, our work.

PURPOSE/OBJECTIVES: To describe couples' experiences of postprostatectomy incontinence and impotence. DESIGN: Descriptive, qualitative. SETTING: Northeastern U.S. metropolitan area. SAMPLE: Subsample of 20 (10 control and 10 intervention) couples from a large quantitative clinical trial of a Standardized Nursing Intervention Protocol (SNIP) postprostatectomy. METHODS: Interviews were conducted using a semistructured guide. Data were analyzed using grounded theory techniques. MAIN RESEARCH VARIABLE: Couples' experiences of coping with postprostatectomy incontinence and impotence. FINDINGS: Managing postprostatectomy incontinence and impotence required work. Men's work focused on regaining mastery and encompassed understanding incontinence as healing, mastering incontinence, networking, confronting impotence and putting it into perspective, and prioritizing. Wives were supportive by managing anxiety, encouraging mastery, putting impotence into perspective, and reassuring their spouses. Established routines brought couples through the experience together while strengthening intimacy. SNIP couples found the nurses to be sources of information, support, and affirmation. CONCLUSIONS: Couples worked to deal with postprostatectomy incontinence and impotence within the context of surviving cancer and maintaining a loving relationship. This gave unique meaning to their symptoms and led the couples to value the fact that the men were alive and work toward regaining mastery. Mastery emerged as a key concept from the findings. IMPLICATIONS FOR NURSING PRACTICE: Nurses can gain from an enhanced understanding of postprostatectomy incontinence and impotence as meaningful within the greater context of patients having had cancer. Nurses can hasten couples' abilities to regain a sense of mastery by providing information, supporting couples' work, providing positive affirmation, and being available.

Adaptation, Psychological↗

[Knee alloplasty and working ability. The significance of knee alloplasty for working ability of patients who were working prior to surgery].

The effect of a total knee arthroplasty (TKA) on maintaining or restoring working ability for patients who preoperatively still were in active employment has not previously been reported. Between February 1989 and December 1990 a total of 926 patients (1024 knees) had the same type of TKA (AGC-2000) implanted at 14 different Danish hospitals. The patients were followed prospectively. Sixty-two patients (6.7% of the total material) were preoperatively registered as being still engaged in active employment. Follow-up after three years included 51 of these patients (with 62 knees). Fifty-eight percent were still working after three years compared to 79% after the first postoperative year. Only eight out of the 21 who quit their job during the follow-up period stated knee-trouble as being the direct cause. The most common reason for stopping work was ordinary age-determined pension. We found no correlation between the amount of occupational knee-load and the relative risk of not being able to continue working. Thus, four out of five patients who are employed preoperatively will generally be able to return to the same job within a year after a TKA.

Adult↗

Does 'welfare-to-work' work? A systematic review of the effectiveness of the UK's welfare-to-work programmes for people with a disability or chronic illness.

Welfare-to-work programmes promoting employment of people with a disability or chronic illness are an expanding aspect of welfare reform in the UK. What evidence is there of impact on employment outcomes? This paper presents a systematic review of the evidence on UK policy initiatives. Both quantitative and qualitative studies were identified: 5399 abstracts were located, from which 16 studies were critically appraised. Overall, each of the five main welfare-to-work strategies operating in the 1990s helped people with disabilities into work, who were previously on benefits. The proportion of participants gaining employment after involvement ranged from 11% to 50%, dependent on characteristics of participants, such as 'job-readiness', as well as wider labour market context. As most studies were uncontrolled, it was difficult to determine if the improved employment chances were due to the effectiveness of the welfare-to-work interventions themselves or to external factors. Wider impact, such as uptake of schemes as a proportion of the total target population, was weak. The qualitative components identified barriers and facilitators concerned with effective implementation, to aid design of future initiatives.

Chronic Disease↗

[Relation between old age and professional performance requirements--constancy and change of work from the viewpoint or work economics and work sociology].

In connection with the scientific and technical revolution new structures of demands come into existence, which have to correspond with the change of the individual ability to produce during employment. In this connection it is necessary to correct the often one-sided negative interpretation of the change of work during the last twenty years of working employment. As analyses to works-motivations and jobs-satisfaction have shown, it is essential to consider carefully the most opportune time and methods to change of work being performed. Positive effects on the development of individual performance-potential can be expected with the adaption of early preventive measures during the bio-social adaption period.

Aged↗

The diversity of work: differences, similarities and relationships concerning characteristics of the organisation, the work and psychological work reactions in intensive care and non-intensive care nursing.

The aim of this study was to examine differences in organisational characteristics, work characteristics and psychological work reactions, and to investigate relationships between these variables in intensive care units (ICUs) and non-ICUs. Questionnaires were distributed to intensive care (n = 184) and non-intensive care nurses (n = 927) working in 15 general hospitals in the Netherlands. MANOVA showed that ICU nurses reported significantly higher uncertainty, higher complexity, and higher decision authority than non-ICU nurses. Emotional exhaustion was significantly lower among ICU nurses. Regarding the pattern of relationships, the LISREL-analyses revealed that the indirect proposed pattern of relationships was invariant across the two samples, which means a validation of our research model.

Adult↗

Working life across cultures: "Work Life 2000: Quality in Work" and occupational health education in developing countries.

The article reflects on the changing world of work, and the challenges presented to both occupational health and occupational health education. We draw on the 63 preparatory workshops and the international conference in the "Work Life 2000: Quality in Work" program, an initiative of the Swedish Presidency of the European Union. The International Commission on Occupational Health is introduced, with particular concentration on a current practical project initiated by the Department of Health in South Africa, intended to lead to a set of projects, networking for occupational health education in developing countries. The practical initiatives cast light on a new set of issues which arise when occupational health and safety crosses cultural barriers, and previously separate comparative cases are linked.

Culture↗

Preparing social work students to work with grandparents in kinship care: an approach to infusion of content materials into selected core social work courses.

Grandparents in kinship care represent an expanding population of older adults assuming primary parenting responsibilities for their grandchildren at a time when many grandparents may also be experiencing developmental changes accompanying their own aging process. Research documents a lack of social workers prepared to respond to the needs of an aging population in general, and grandparents in kinship care in particular, as curricular content on this population has been limited in undergraduate and graduate social work programs. This article describes an infusion model proposed for an undergraduate social work program's GeroRich Project designed to introduce content on an aging population in four foundation courses to expand students' knowledge of older adults and grandparents as kinship care providers.

Aged↗

Perceived work conditions and work-related symptoms among employed Finns.

The aim of the study was to determine the number and nature of perceived harmful work conditions and perceived work-related symptoms among employed Finns by sex and socioeconomic group. The associations between perceived harmful work conditions and perceived symptoms were also investigated. Knowledge of perceived work-related ill health can serve as a basis for health promotion at work. In a computer-assisted telephone interview of 2744 salaried employees and wage-earners, the respondents were asked about perceived harmful work conditions as well as perceived health complaints, and their relatedness to work. At least one harmful factor at work was reported by 94% of the respondents, and half of them reported more than three such factors. The most commonly occurring harmful factors were increased work pace, mental demand, repetitive movements, and noise. Of the symptoms perceived as work-related, musculoskeletal symptoms were the most common. They were reported by 44% of the respondents, followed by mental symptoms (26%), psychosomatic symptoms (19%), and respiratory or sensory symptoms (15%). Both the reporting of perceived harmful work factors and perceived work-related symptoms varied by socioeconomic group and sex. Perceived work-related musculoskeletal symptoms were associated with perceived ergonomic harmful work factors among both the men and the women, with physical or chemical work factors among the men, and with psychosocial or work organizational factors among the women. Perceived work-related respiratory symptoms were associated with perceived harmful physical or chemical work factors among both the men and the women, and both groups also reported mental and psychosomatic symptoms in relation to harmful psychosocial or organizational work factors. Among the women psychosomatic symptoms and harmful ergonomic work factors were also related. Perceived harmful factors at work and work-related symptoms are common among the work force. Even though the degree of work-related ill health was related to socioeconomic group, the reporting of particular symptoms indicated the probability of a particular work factor being considered harmful independently of socioeconomic group, although there was some relationship to sex. The implications for occupational health services are evident; employees' work-related symptoms can serve as an indicator of (preventable) perceived problems at work.

Adult↗

Study on work load of matrons under shift work in a special nursing home for the elderly.

In order to find out the work load of matrons under shift work in a special nursing home for the elderly (SNH), six healthy female matrons volunteered to participate in the present study. For each subject, care working time, heart rate, walking steps, estimated energy expenditure and working time in different postures were determined during day shift work (540 min) and night shift work (960 min). Although the time on duty, working and recess were significantly longer in night shift work than day shift work, the percentages of working and recess time to duty time were nearly the same regardless of shift work. The longest care work in each shift work was individual care of residents in the SNH. The maximum, minimum and mean heart rate and percentages to estimated maximal heart rate were similar in each shift work. Although total walking steps in night shift work were significantly larger than those in day shift work, steps per hour did not differ between them. The estimated total energy expenditure (kcal) was significantly higher in night shift work than in day shift work; however, the work intensity (kcal/kg/min) was significantly higher in day shift work. The longest length and larger percentage of working time were observed in standing posture in each shift work. These findings suggest that physical activity and energy expenditure of matrons under either shift work in the SNH seem to be high. Further studies are needed to clarify the work load of matrons engaged in SNH to formulate countermeasures.

Adult↗

Stress and strain during work among women performing different work tasks.

This study measured the association between the severity of work in occupations performed most frequently by women, workload (as relative aerobic strain and heart rate during work) and the reaction to work measured on the basis of changes after work in the subjective fatigue rating and working ability. The results indicate that there is no rational selection to individual work posts from the point of view severity of work and the level of physical working capacity. Nevertheless, it has been found that the heart rate during work was dependent on the severity of work and not the level of physical working capacity. A decrease of working ability after work was more frequent than an increased level of fatigue, but the work performed, the level of physical working capacity and the relative aerobic strain did not produce any significant differences in these parameters. Thus, the data presented above does not confirm the suggestion that people with a higher level of physical working capacity can engage a higher percentage of VO2max during working time. On the other hand, changes in the reaction to work, especially working ability changes, were significantly statistically dependent on the heart rate during work. Working ability was unquestionably worse when the heart rate during work exceeded 100 beats/min, 50% maximal heart rate or 30% heart rate reserve.

Adolescent↗