The Gutenberg health study: a five-year prospective analysis of psychosocial working conditions using COPSOQ (Copenhagen psychosocial Questoinnaire) and ERI (effort-reward imbalance)

Background Psychosocial working conditions were previously analyzed using the first recruitment wave of the Gutenberg Health Study (GHS) cohort (n = 5000). We aimed to confirm the initial analysis using the entire GHS population at baseline (N = 15,010) and at the five-year follow-up. We also aimed to determine the effects of psychosocial working conditions at baseline on self-rated outcomes measured at follow-up. Methods At baseline, working GHS participants were assessed with either the Effort-Reward-Imbalance questionnaire (ERI) (n = 4358) or with the Copenhagen Psychosocial Questionnaire (COPSOQ) (n = 4322); participants still working after five years received the same questionnaire again (ERI n = 3142; COPSOQ n = 3091). We analyzed the association between working conditions and the outcomes job satisfaction, general health, burnout, and satisfaction with life at baseline, at follow-up and also prospectively from baseline to follow-up using linear regression models. We examined the outcome variance explained by the models (R2) to estimate the predictive performance of the questionnaires. Results The models’ R2 was comparable to the original baseline analyses at both t0 and t1 (R2 range: ERI 0.10–0.43; COPSOQ 0.10–0.56). However, selected scales of the regression models sometimes changed between assessment times. The prospective analysis showed weaker associations between baseline working conditions and outcomes after five years (R2 range: ERI 0.07–0.19; COPSOQ 0.07–0.24). This was particularly true for job satisfaction. After adjusting for the baseline levels of the outcomes, fewer scales still explained some of the variance in the distribution of the outcome variables at follow-up. The models using only data from t0 or t1 confirmed the previous baseline analysis. We observed a loss of explained variance in the prospective analysis models. This loss was greatest for job satisfaction, suggesting that this outcome is most influenced by short-term working conditions. Conclusions Both the COPSOQ and ERI instruments show good criterion validity and adequately predict contemporaneously measured self-reported measurements of health and (occupational) well-being. However, the COPSOQ provides a more detailed picture of working conditions and might be preferable for improvment strategies in workplaces. Additional prospective research with shorter follow-up times would be beneficial for estimating dose-response relationships.

Do good psychosocial working conditions prolong working lives? Findings from a prospective study in Sweden

Due to an ageing population, governments in European countries are striving to keep older workers longer in the workforce. Remarkably few studies have paid attention to the influence of psychosocial working conditions on timing of retirement for older workers in and beyond normative retirement age. The aim of the present study was to examine whether good psychosocial working conditions contribute to prolonged working lives among older workers (59 years and above). A particular question was whether such conditions increase in importance with age. Seven waves (2006–2018) of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were used (N = 6000, observations = 10,632). Discrete-time event history analyses showed that higher levels of job resources (decision authority [OR 1.13, 95% CI 1.06–1.22], skill use [OR 1.17, 95% CI 1.07–1.29], learning opportunities [OR 1.22, 95% CI 1.13–1.31], social support [OR 1.29 (95% CI 1.16–1.42], work-time control [OR 1.07, 95% CI 1.01–1.13], and reward [OR 1.40, 95% CI 1.24–1.57])—but not lower levels of job demands (quantitative and emotional demands or effort)—were associated with working longer (continued work two years later). Also, low effort-reward imbalance (OR 0.84 [95% CI 0.73–0.96]) was associated with working longer. In addition, skill use, work-time control, reward, and low effort-reward imbalance increased in importance with age for continued work. These results suggest that providing older workers with control over their work tasks, giving opportunities for learning and using their skills, as well as rewarding and acknowledging their achievements, may keep them in the workforce longer. Especially, job resources may grow in importance with age.

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

Background The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence. Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010–2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)–iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence). Results A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence. Conclusions Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.

Psychosocial Working Conditions Play an Important Role in the Return-to-Work Process After Total Knee and Hip Arthroplasty

Purpose Both personal and work-related factors affect return to work (RTW) after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Little is known about work-related factors associated with the recovery process. This study aimed to determine which work-related factors are associated with time to RTW for both TKA and THA patients. Methods A prospective multicenter survey study was conducted that included patients aged 18–63, had a paid job and were scheduled to undergo primary TKA/THA. Surveys were completed preoperatively, 6 weeks, and 3, 6, and 12 months postoperatively, and included four domains of work-related factors: work characteristics, physical working conditions, psychosocial working conditions and work adjustments. Control variables included age, sex, education, and comorbidity. Time to RTW was defined as days from surgery until RTW. Multivariate linear regression analyses were conducted separately for TKA/THA patients. Results Enrolled were 246 patients (n = 146 TKA, n = 100 THA, median age 56 years, 57% female). Median time to RTW was 79 days (IQR 52.0–146.0). Mainly physical tasks (TKA: B 58.2, 95%CI 9.5–106.8; THA: B 52.1, 95%CI 14.1–90.2) and a combination of physical and mental tasks (TKA: B 50.2, 95%CI 6.4–94.0; THA B 54.0, 95%CI 24.2–83.7) were associated with longer time to RTW after both TKA and THA. More possibilities for personal job development (B − 12.8, 95%CI − 25.3–0.4) and more work recognition (B − 13.2, 95%CI − 25.5 to − 0.9) were significantly associated with shorter time to RTW after TKA. Higher quality of supervisor leadership (B − 14.1, 95%CI − 22.2 to − 6.0) was significantly associated with shorter time to RTW after THA. Conclusion The findings of this study stress the importance of psychosocial working conditions, besides type of job tasks, in RTW after TKA/THA. Further research on work-related factors is needed, as arthroplasty is being performed on an increasingly younger population of knee and hip OA patients for whom participating in work is of critical importance.

Importance of the Working Environment for Early Retirement: Prospective Cohort Study with Register Follow-Up

Background: This study investigates the role of physical work demands and psychosocial work factors for early retirement among older workers. Methods: Data from three Danish surveys on work environment and health among employed older workers (age 55–59) were merged with a national register containing information on labour market participation. Robust Poisson regression modelled the risk ratios (RR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and early retirement, that is, not working after the age of 64. Results: Of the 2800 workers, 53% retired early. High physical work demands (RR 1.33, 95%CI 1.19–1.48), poor overall psychosocial working conditions (RR 1.43, 95%CI 1.26–1.61), and access to early retirement benefits (RR 1.79, 95%CI 1.53–2.10) predicted early retirement. Subgroup analyses revealed that poor overall psychosocial working conditions were a stronger predictor for early retirement among workers with seated jobs than those with physically active jobs. Conclusions: High physical work demands and poor psychosocial working conditions are factors that can push older workers out of the labour market prematurely. Poor psychosocial working conditions seem to be a particularly strong push factor among workers with seated work.

Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants

Adverse psychosocial working conditions in the health care sector are widespread and have been associated with a reduced quality of patient care. Medical assistants (MA) assume that their unfavorable working conditions predominantly lead to a poorer quality of care in terms of slips and lapses, and poorer social interactions with patients. We examined those associations for the first time among MAs. A total of 944 MAs in Germany participated in a survey (September 2016–April 2017). Psychosocial working conditions were measured by the effort-reward imbalance (ERI) questionnaire and a questionnaire specifically designed for MAs. Slips and lapses (3 items, e.g., measurement or documentation errors) and the quality of interactions (3 items) with patients were measured by a questionnaire developed by the study team based on prior qualitative research. We ran Poisson regression to estimate multivariable prevalence ratios (PRs). The ERI ratio and MA-specific working conditions were significantly associated with frequent self-reported slips and lapses (PR = 2.53 and PR ≥ 1.22, respectively) or poor interactions with patients (PR = 3.62 and PR ≥ 1.38, respectively) due to work stress. Our study suggests that various types of adverse psychosocial working conditions are associated with perceptions of slips and lapses or poorer interaction with patients due to work stress among MAs.

Psychosocial Working Conditions and Social Participation. A 10-Year Follow-Up of Senior Workers

Social participation is important for health, and it is well known that high strain jobs impact negatively on mental and physical health. However, knowledge about the impact of psychosocial working conditions on social participation from a long-term perspective is lacking. The purpose of this study was to investigate the associations between different job types and social participation from a long-term perspective. A comprehensive public health questionnaire “The Scania Public Health Survey”, was used, and psychosocial working conditions were measured with a Swedish translation of the Job Content Questionnaire. Based on data from 1098 working respondents aged 55 at baseline and a 10-year follow-up when the respondents were not working, the analyses revealed that social participation varied by job type. Jobs with high decision latitude, as in active and relaxed jobs, seem to predict high social participation, even after cessation of employment. Besides that, the result suggests that high social participation during working life is a predictor of high social participation from a long-term perspective which promotes healthy aging. Incentives for working longer are strongly related to good working conditions. A supportive work environment with possibilities for employees to participate in decision making, i.e., high control, is vital for a sustainable working life. This may contribute to an extended working life and may also support social participation prior to retirement as well as after retirement and thus to healthy aging.