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Work and headache: A prospective study of psychological, social, and mechanical predictors of headache severity
Abstract
Headache is a common health complaint responsible for substantial suffering and disability. Although musculoskeletal complaints such as back and neck pain have frequently been associated with occupational psychological and social factors, headache has received less attention as a possible outcome of such exposures. The aim of the present study was to identify occupational psychological, social, and mechanical factors that predicted headache severity. Furthermore, using a full panel design, cross-lagged and synchronous structural equation models were employed to test reverse causality. Data were obtained by work environment surveys in a wide variety of organizations in Norway, with a two-year follow-up period. At baseline 6421 employees responded and 3574 employees also responded at follow-up. Ordinal logistic regression models revealed that 7 of 16 psychological/social/mechanical factors were prospectively related to headache severity. Most consistently, higher quantitative demands and role conflict, and lower decision control, control over work intensity, and job satisfaction were related to more severe headache at follow-up. Cross-lagged models indicated an impact across a 2-year period of decision control, control over work intensity, and job satisfaction on headache severity. Reverse effects from headache severity to quantitative demands were indicated. For role conflict, no cross-lagged effects were observed. However, synchronous models supported the notion of an effect of each of these factors on headache severity over a time span shorter than 2years.
... Indeed, high quantitative job demands were only significantly associated with the odds of headache in the cross-sectional analyses using an individual measure of exposure. Previous studies have found an association between high quantitative demands and headache 14,16 or an inverse U-shaped association, 15 while another study found no association. 13 Thus, the findings of previous studies are mixed, and the observed cross-sectional association in our study could be due to information bias or confounding by individual factors. ...
... The estimates corresponded with the results in the analyses using individual exposure measures. Again, the findings of previous studies are mixed, as one study reported an association between indicators of job control (decision control) and headache, 14 while other studies did not find an association. 13,15 Employees working in work-units with a high degree of role conflicts had higher odds of headache in the cross-sectional, but not in the longitudinal analyses. ...
... The same pattern was observed for the analyses using the individual measures. Previous studies have found an association between role conflicts and headache, [14][15][16] and these findings were partly corroborated by the present study. ...
Objective:
To investigate the cross-sectional and longitudinal association between psychosocial work factors, assessed as work-unit averages, and headache. For comparison, we applied individual exposure measures.
Methods:
We used questionnaire-data on headache and psychosocial work factors (PWF). In total, 2247 employees were included in the cross-section analyses and 553 in the longitudinal analyses using work-unit averages. The corresponding numbers for the analyses using individual exposure measures were 4261 and 942 employees.
Results:
Low skill discretion and low decision authority were most consistently associated with higher odds of headache across all analyses. Role conflicts, bullying, and effort-reward imbalance were associated with headache in some analyses. All PWF were associated with headache in cross-sectional analyses with individual exposure measures.
Conclusion:
This study partly supports the hypothesis of an effect of PWF, as a source of psychological stress, on the risk of headache.
... So, long working hours easily restrict daily sleep and increase sleep problems (Basner et al. 2007;Krueger and Friedman 2009;Magee et al. 2009;Nakashima et al. 2011;Virtanen et al. 2009), and Japanese averagely work longer and sleep shorter than people in other developed areas (OECD 2009(OECD , 2011. Both occupational stress (Christensen and Knardahl 2012;Kopec and Sayre 2004;Mäki et al. 2008;Tynes et al. 2013) and sleep restriction/problems (Boardman et al. 2006;Lund et al. 2014;Ødegård et al. 2011;Sivertsen et al. 2014) are linked with a higher prevalence/incidence of headache. The previous results suggest that sleep restriction/problems are intermediate factors in the causal pathway from occupational stress to headache and that occupational stress directly and indirectly (via sleep restriction/problems) induces headache. ...
... Since Japanese employees work long hours and sleep short duration (OECD 2009(OECD , 2011, headache should be carefully attended in daily managements of their health and working hours. Four prospective follow-up studies (Christensen and Knardahl 2012;Kopec and Sayre 2004;Mäki et al. 2008;Tynes et al. 2013) in large populations of employees (n = 3325-19,469) have presented that occupational stress increases the risk of headache/migraine and deteriorates their severity, but have not fully examined influences of working hours on headache. In a 3-year follow-up study in 3325 Norwegian subjects (Tynes et al. 2013), the incidence of headache is not different between two groups of employees working ≤45 and >45 h/week. ...
... Either in another 4-year follow-up study in 6062 Canadian subjects (Kopec and Sayre 2004), part-time and full-time employees working <30 and ≥30 h/week, respectively, have no differences in the incidence of migraine (all of our subjects worked ≥35 h/week). Two other studies in European employees (Christensen and Knardahl 2012;Mäki et al. 2008) have presented no data on working hours, suggesting that long working hours are not common in the subjects. As previously reported (OECD 2011), European and Canadian employees in the four previous studies (Christensen and Knardahl 2012; Kopec and Sayre 2004;Mäki Tynes et al. 2013) may not have worked so long hours to induce headache compared to Japanese employees in this study. ...
Objective:
Headache in employees may be linked with both overwork and sleep restriction induced by long working hours. Inter-relationships among working hours, sleep duration and headache were investigated.
Methods:
Cross-sectional analyses for prevalent headache (n = 35,908) and 1-year follow-up analyses for incident headache (n = 19,788) were conducted in apparently healthy white-collar men aged 25-59 years. Headache (yes/no), working hours and sleep duration were based on self-administered questionnaire. After determination of relationships between working hours and sleep duration, logistic regression analysis estimated odds ratio (OR) and 95% confidence interval for prevalent and incident headache according to working hours (35-44, 45-49, 50-59 and ≥60 h/week) and sleep duration (≥7, 6-6.9, 5-5.9 and <5 h/day), and tested linear trends in OR. Additionally, interactive effects of working hours and sleep duration on OR were checked. Covariates in the analyses were age, body mass index, drinking, smoking and exercise.
Results:
Prevalent and incident headache was found in 1979 (5.5%) men and 707 (3.6%) men, respectively. Working hours were inversely associated with sleep duration. OR for prevalent and incident headache rose with increasing working hours and with reducing sleep duration, regardless of influences of the covariates. Working hours and sleep duration had no interactive effects on OR for prevalent or incident headache.
Conclusions:
The results indicate that long working hours directly and indirectly (via short sleep duration) induce headache even in apparently healthy white-collar men. Headache in employees may be useful for early detection of adverse health effects by long working hours.
... 22 The present study considered the relations between psychological/social work factors and sleep problems. A comprehensive set of possible predictors was included, some of which have been associated with other health outcomes in the previous studies, [24][25][26][27][28] and some of which are relatively novel in this field. While most previous studies have focused on a small set of fairly general and abstract factors ("stress," demand, control), the current study focused on specific factors that should be amendable to modification, and could therefore be targeted in employee health and well-being interventions. ...
... Within this project several work factors have been associated with health outcomes such as neck and back pain, headache, and mental distress. [24][25][26][27][28] The mechanisms of putative impacts of psychological and social work factors on sleep are unknown and most likely diverse, and the nature of longitudinal effects of work factors on sleep are still underexplored. 9,14,22 Moreover, the duration of exposure needed to produce effects is unknown-as is the expected duration of troubled sleep after exposure is discontinued. ...
... Previous studies from this project have found associations between work factors and health outcomes such as neck and back pain, headache, and mental distress. [24][25][26][27][28] While some work factors seem to have associations with all investigated health outcomes, such as decision control, other work factors which the present study has found to be a strong predictor, such as quantitative job demands, do not show associations with other health outcomes. Future research may want to explore interactions between work factors, sleep, and other health outcomes such as pain. ...
Study objectives:
This prospective cohort study examined previously underexplored relations between psychological/social work factors and troubled sleep in order to provide practical information about specific, modifiable factors at work.
Methods:
A comprehensive evaluation of a range of psychological/social work factors was obtained by several designs; i.e., cross-sectional analyses at baseline and follow-up, prospective analyses with baseline predictors (T1), prospective analyses with average exposure across waves as predictor ([T1 + T2] / 2), and prospective analyses with change in exposure from baseline to follow-up as predictor. Participants consisted of a sample of Norwegian employees from a broad spectrum of occupations, who completed a questionnaire at two points in time, approximately two years apart. Cross-sectional analyses at T1 comprised 7,459 participants, cross-sectional analyses at T2 included 6,688 participants. Prospective analyses comprised a sample 5,070 of participants who responded at both T1 and T2. Univariable and multivariable ordinal logistic regressions were performed.
Results:
Thirteen psychological/social work factors and two aspects of troubled sleep, namely difficulties initiating sleep and disturbed sleep, were studied. Ordinal logistic regressions revealed statistically significant associations for all psychological and social work factors in at least one of the analyses. Psychological and social work factors predicted sleep problems in the short term as well as the long term.
Conclusions:
All work factors investigated showed statistically significant associations with both sleep items, however quantitative job demands, decision control, role conflict, and support from superior were the most robust predictors and may therefore be suitable targets of interventions aimed at improving employee sleep.
... The theory suggests that the riskiest form of suicidal desire is introduced and provoked by the interplay between perceived burdensomeness and thwarted belongingness. In addition, Christensen et al. [39] found that the interplay between perceived burdensomeness and the thwarted belongingness predicts suicidal ideation. It is interesting to note that in their findings interpersonal theory of suicide explained more variance than the epidemiological models using demographic factors, including depression, anxiety, traumatic and stressful events as predictors [39]. ...
... In addition, Christensen et al. [39] found that the interplay between perceived burdensomeness and the thwarted belongingness predicts suicidal ideation. It is interesting to note that in their findings interpersonal theory of suicide explained more variance than the epidemiological models using demographic factors, including depression, anxiety, traumatic and stressful events as predictors [39]. ...
Predicting the impact of suicide on incidental witnesses at an early stage helps to avert the possible side effect. When suicide is committed in public, incidental observers are left to grapple with it. In many cases, these incidental witnesses tend to experience the emotional side effect with time. In this study, we employed a Machine learning algorithms to predict the impact of suicide and suicidal attempt on incidental witnesses. This prediction was based on the accounts of suicide given by selected participants who have witnessed the act. The accounts, which was pre-processed into a corpus, were manually annotated with predefined emotion categories. While sadness emerged as the most salient emotional impact on the witnesses, fear was found as the lowest of the emotional impact on the witnesses. However, the machine learning prediction yielded highest in predicting depression with insignificant variations in the other emotional categories. This nonetheless shows that people who have witnessed suicide or suicidal attempts are inherently affected by some form of emotions that may require urgent attention to alleviate. By evaluating the performance of the Machine learning algorithms, the Support Vector Machine was superior, in terms its prediction, then the Multinomial Naïve Bayes algorithm. The outcome of the study contributes to the pool of research that sought to advocate the use of Machine Learning for predicting social phenomenon.
... 13 In a recent Norwegian prospective study, high quantitative demands, low decision control, low control over work intensity, high role conflict, and low job satisfaction were identified as risk factors for headache severity at the follow-up. 14 An earlier prospective study of migraine reported an association with high effort-reward imbalance at work, but no effects of low job control, high job demands, or job strain. 15 Similarly, Kopec and Sayre 16 observed no association between psychosocial work factors and subsequent physician-diagnosed migraine. ...
... This result agrees with a recently published study from Norway, which used the same instrument to measure role conflict. 14 In contrast to that Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. ...
To determine the effects of work-related psychosocial and organizational factors on headache.
A random cohort from the Norwegian general population (aged 18 to 66 years) had been observed for 3 years. Eligible respondents answered a question about headache, and were engaged in paid employment during the reference weeks in 2006 and 2009, or were temporarily absent from such work (N = 3325).
In the fully adjusted model, the main risk factors were high role conflict (highest odds ratio [OR] = 2.86; 95% confidence interval [CI] = 1.49 to 5.48), low social climate (highest OR = 2.21; 95% CI = 1.09 to 4.49), bullying/harassment (OR = 3.94; 95% CI = 1.36 to 11.42), and downsizing (OR = 2.38; 95% = 1.20 to 4.71).
Role conflict, low social climate, and bullying/harassment were the main predictors of headaches. These factors should be considered to prevent headaches at work.
... Interestingly, an effective adaptation called "hedonic habituation" has been observed in high or lowfrequency migraine sufferers [102], and weekend headaches may be seen as a negative expression of high work-related stress on days devoted to relaxation [103]. Job satisfaction, which is also related to decision control and control over the intensity of work, can impact on headache [104]. The perception of migraine intensity may interfere with levels of job-related gratification [105]. ...
A case–control study including 446 workers reporting headaches (cases; 136 males and 310 females, mean age 46.71 ± 10.84 years) and 446 age- and sex-matched colleagues without headaches (controls; mean age 45.44 ± 10.13) was conducted in the second half of 2020 in a sample drawn from socio health and commercial services companies to investigate the association of headache with lifestyle, metabolic, and work-related factors. Workers suffering from headache reported higher body weight (OR: 1.92, 95% CI: 1.46–2.53, p < 0.001), higher blood cholesterol (OR: 2.01, 95% CI: 1.46–2.77, p < 0.001), triglyceride (OR: 2.01, 95% CI: 1.20–3.35, p < 0.01), blood glucose (OR: 1.91, 95% CI: 1.16–3.24, p < 0.01), and blood pressure levels (OR: 1.76, 95% CI: 1.23–2.52, p < 0.01). In the year preceding the survey, cases had experienced a higher frequency of workplace violence (OR: 2.29, 95% CI: 1.25–4.20, p < 0.01 for physical aggression, OR: 2.22, 95% CI: 1.45–3.41, p < 0.001 for threat, OR: 2.74, 95% CI: 1.72–4.38, p < 0.001 for harassment) and were more frequently distressed (effort/reward ratio > 1) (OR: 1.82, 95% CI: 1.39–2.40, p < 0.001) than the controls. Compared to the controls, cases also had higher scores on anxiety and depression scales, lower scores on happiness, and lower levels of sleep quality (p < 0.001). The association of headaches with metabolic and mental health problems suggests that monitoring headaches in the workplace could help to identify workers at risk of impairment.
... In order to get a more comprehensive picture of the work-pain relationship the present study included lesser studied psychosocial work factors. While some of these work factors have been studied with other health outcomes [11][12][13][14][15][16][17][18], to our knowledge, their effects on NPS have not been studied. All psychosocial work factors included in the present study are amenable to modification and should therefore represent specific targets of employee health interventions. ...
Background:
Objective of the current study was to determine which of thirteen specific psychosocial work factors were related to number of musculoskeletal pain sites (NPS) prospectively over a two-year time span. Furthermore, the study aimed to explore possible mediation of these prospective relationships through sleep problems.
Methods:
The study was a two-wave full panel study. Participants included 6277 employees of Norwegian companies, representing a wide range of occupations. Structural equation modelling was employed to analyze direct and indirect effects of thirteen specific psychological- and social work factors on sleep problems and NPS.
Results:
Out of the thirteen work factors studied, positive challenges at work, role conflict, decision control, superior support, coworker support, empowering leadership, and social climate were statistically significantly related to subsequent NPS, both directly and indirectly through sleep quality. Sleep quality was related to NPS in all analyses. Most psychosocial work factors exhibited direct effects on either sleep or number of pain sites. Decision demands and control over work pacing were not statistically significantly related to sleep or pain.
Conclusion:
In conclusion, the results suggested sleep quality to be involved in the mechanisms by which work affects the number of pain complaints employees experience.
Significance:
Findings from this study suggest sleep may play a role in the complex mechanism from work stressors to musculoskeletal pain. Workplace interventions aiming to reduce musculoskeletal pain may wish to target work factors described in this study, as they affect sleep and may thereby increase number of musculoskeletal pain sites.
... Because the indicators of leader behavior and bullying were self-report measures, the findings may be influenced by problems that are common to self-report methodology, such as response set tendencies. However, as the items have been constructed with the aim of avoiding emotive content and social desirability bias, the measures of supportive, fair, and empowering leader behavior should be rather insensitive to respondents' emotions or personality traits (Christensen and Knardahl, 2012). Workplace bullying was measured with a single-item self-labeling question. ...
The aim of this study was to determine (1) associations between workplace bullying and subsequent risk and duration of medically certified sickness absence, (2) whether employees’ perceptions of supportive, fair, and empowering leader behavior moderate the association between bullying and absence, and (3) whether prior sickness absence increases the risk of being a new victim of bullying. Altogether, 10,691 employees were recruited from 96 Norwegian organizations in the period 2004–2014. The study design was prospective with workplace bullying and leader behavior measured at baseline and then linked to official registry data on medically certified sickness absence for the year following the survey assessment. For analyses of reverse associations, exposure to bullying was reassessed in a follow-up survey after 24 months. The findings showed that workplace bullying was significantly associated with risk (risk ratio = 1.23; 95% CI = 1.13–1.34), but not duration (incidence rate ratio = 1.05; 95% CI = 0.89–1.25) of medically certified sickness absence after adjusting for age, gender, and supportive, fair, and empowering leader behavior. None of the indicators of leader behavior moderated the association between bullying and sickness absence (both risk and duration). Adjusting for baseline bullying, age, and gender, prior long-term sickness absence (>21 days) was associated with increased risk of being a new victim of bullying at follow-up (odds ratio = 1.86; 95% CI = 1.28–2.72). Effective interventions toward workplace bullying may be beneficial with regard to reducing sickness absence rates. Organizations should be aware that long-term sickness absence might be a social stigma as sick-listed employees have an increased risk of being bullied when they return to work.
... De statistiske analysene baserer seg på data fra to ulike spørreundersøkelser gjennomført i oljeservicebedriften. Den første er en arbeidsmiljøundersøkelse foretatt i desember 2008 og den andre en kulturundersøkelse foretatt i perioden mars til april 2009, begge utført ved hjelp av elektroniske spørreskjema. Spørsmålene i arbeidsmiljøundersøkelsen er hentet fra QPS Nordic, et veletablert spørreskjema innen forskning og organisasjonsutvikling (Christensen & Knardahl 2012;Wannstrom et al. 2009). Skjemaet inneholder blant annet spørsmål om arbeidsinnhold og holdning til ledelse og kollegaer. ...
Flere har den siste tiden etterspurt nye innfallsvinkler til klasser og arbeid. Denne etterspørselen begrunnes ofte med at nyere klassetilnærminger av kulturelle forskjeller ikke tar hensyn til arbeidsrelasjoner. Basert på en kultur- og arbeidsmiljøundersøkelse i en norsk oljeservicebedrift, anvender denne artikkelen Bourdieus hovedbegreper for å studere hvorvidt det er meningsfullt å snakke om klasseforskjeller i dagens arbeidsliv. Ved å inkludere informasjon om de ansattes bedriftsinterne- og bedriftseksterne eksistensbetingelser, avdekker analysene en tredimensjonal sosial struktur i bedriften. Mens et arbeidsmiljø preget av lite variasjon, innflytelse og utvikling karakteriserer de mindre privilegerte, ser høy grad av variasjon og innflytelse ut til å følge de mer privilegerte i denne bedriftsinterne sosiale struktur, men disse har mindre kontroll over arbeidsmengde. Ansiennitet, i større grad enn utdanning, har en betydning for ens opplevde arbeidsmiljø, men dette avhenger av om man jobber i manuelle yrker eller ei.
... Specifying the relationship between hindrance and challenging demands, and presenteeism can be complicated by individual differences in the emotional and cognitive effort associated with coping with such demands (LePine, Podsakoff and LePine, 2005). Research has repeatedly found, however, that hindrance demands, such as role conflict, are related to negative outcomes, including decreased job satisfaction and burnout (Kirk-Brown and Wallace, 2004), psychological distress (Finne, Christensen and Knardahl, 2014;Johannessen, Tynes and Sterud, 2013), sleep disturbance (Eriksen et al., 2008;Vleeshouwers, Knardahl and Christensen, 2016), headaches (Christensen and Knardahl, 2012) and neck pain (Christensen and Knardahl, 2010). It was therefore expected in the current study that hindrance demands would increase presenteeism regardless of the state of the employee's mental health. ...
This study aimed to investigate how variations in mental health and nationality affect the influence of job demands and job resources on presenteeism among physicians. By differentiating between hindrances and challenging job demands and between buffering and motivational job resources, the current study investigated the mechanisms of physicians’ presenteeism by conducting separate analyses for respondents with good and poor mental health within two countries. A total of 1596 physicians employed at Swedish and Norwegian university hospitals were split into four subsamples according to nationality and mental health status. A score of ≥4 on the General Health Questionnaire-12 defined poor mental health. A set of 't'-tests showed that overall, the Norwegian sample experienced higher presenteeism, lower demands, and higher resources than the Swedish sample. Within the national samples, the samples with poor mental health indicated that they experienced higher demands and lower resources and showed higher presenteeism than the samples with good mental health. A set of regression analyses in the four subsamples showed that hindrance demands were positively associated with presenteeism and buffering resources were negatively associated with presenteeism in all four subsamples. However, only the subsamples of physicians with good mental health were found to have positive associations between both challenging demands and motivating resources and presenteeism. The study concludes that the association of both demands and resources with presenteeism depend upon how they interact with both personal health and national context.
... Longitudinal research has found a strong association between experienced stress and the frequency and intensity of tension headache [25], and there is also, though more limited, evidence linking migraine to stress [26]. More specific for work-related stress, Christensen and Knardahl found higher quantitative demands, higher role conflict, and low job control to be prospectively related to more severe headache at followup [27]. ...
Purpose The aim of the study was to determine (a) to which extent job demands and job resources predict work ability in employees with chronic headaches, and (b) whether work ability in these employees is more hampered by high demands and more enhanced by resources than in employees without chronic disease. Methods All employees with chronic headaches (n = 593) and without chronic disease (n = 13,742) were selected from The Netherlands Working Conditions Survey conducted in 2013. This survey assessed amongst others job characteristics and various indicators of work ability, i.e. sick leave, employability, work engagement, and emotional exhaustion. Hierarchical regression analyses were conducted for employees with chronic headaches and compared to employees without chronic disease, controlling for age, gender and educational level. Results In employees with chronic headaches higher quantitative and emotional demands contributed to higher emotional exhaustion, and higher emotional demands to higher sick leave. Higher cognitive demands were however associated with higher work engagement. Higher autonomy was related to higher employability and lower emotional exhaustion. Higher supervisor and colleague support was associated with higher employability, higher engagement and lower emotional exhaustion. Higher supervisor support was associated with lower sick leave. Supervisor support emerged as a stronger predictor for emotional exhaustion in the employees with chronic headaches than in the employees without chronic disease. Conclusions Job demands and job resources are important for work ability in employees with chronic headaches. Furthermore, results suggest that these employees benefit more strongly from supervisor support than employees without chronic disease.
... Because the questionnaire instruments were self-report measures, the study could be influenced by bias such as response-set tendencies and social desirability. However, it has been argued that the QPS Nordic instrument used to assess role stressors and fair leadership are fairly insensitive to respondents' emotions or personality dispositions in that subjects report frequency of occurrence rather than degrees of agreement or satisfaction and items do not address issues that are inherently negative or positive (Christensen and Knardahl, 2012). ...
While previous research has mainly considered leadership as an antecedent to psychological distress and role stressors (i.e., role ambiguity and role conflict) among subordinates, a reverse relationship where these variables influence reports of leadership is also possible. To determine the directionality of the associations this two-wave prospective study assesses bidirectional relationships between fair leadership and role stressors and examines whether psychological distress mediates the reciprocal associations between fair leadership and the role stressors. Analyses were conducted in a sample of 6,790 Norwegian employees with a 2-year time-lag between measurement points. Fair leadership was associated with lower stability adjusted role ambiguity, but not role conflict, over time. Role conflict, but not role ambiguity, was related to subsequent reports of the immediate leader as less fair. Psychological distress did neither mediate the relationship between fair leadership and subsequent reports of role stressors, nor the association between role stressors and subsequent reports of fair leadership. The findings suggest that the fair leadership – role stressor association is not a one-directional process, but that exposure to role stressors also influence subordinates’ perceptions of leadership. An implication of the findings is that theoretical models of organizational leadership should include this reverse impact of role stressors. To reduce the effects of role stressors, organizations could set consistent, clear and attractive goals and provide employees with necessary information for conducting their work tasks in order to help workers understand and master their roles at the workplace.
... QPS Nordic -items are constructed with the aim of avoiding emotive content and social desirability bias in that subjects report frequency of occurrence rather than degrees of agreement or satisfaction and items do not address issues that are inherently negative or positive. 27 Workplace bullying was measured with a single item self-labeling question. Although there are limitations with single-item measures, there are also potential advantages, such as cost-efficiency, greater face validity, and the increased willingness of respondents to take the time to complete the questionnaire when the number of items is reduced. ...
Objective:
The aim of this study was to determine 1) whether bullying is related to all-cause disability retirement, 2) whether bullying contributes to the variance in disability retirement above high job demands and lack of job control, and 3) to establish gender differences in the relationship.
Methods:
Survey data from 14,501 Norwegian employees on exposure factors linked to registry data on all-cause disability retirement.
Results:
Bullying significantly predicted risk of disability retirement (hazard ratio = 1.55; 95% confidence interval = 1.13 to 2.12). This relationship remained statistically significant after adjusting for job demands and lack of job control. Women had the highest risk of disability, but both bullied men and women had a higher risk of disability than nonbullied employees of the same gender.
Conclusion:
Bullying is a risk factor for disability retirement. Measures taken to prevent bullying may be beneficial for reducing both health problems and disability retirement.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.
... Most studies of demands, control, and job strain, were based on the Job Content Questionnaire instrument (JCQ; Karasek et al. [5]), which measures demands by questions pertaining to time pressure, amount of work, and role conflicts. Role conflicts may produce effects on health that differ from those of demands (e.g., Christensen & Knardahl [14,159]). The control dimension ("decision latitude") of the JCQ includes both "skill discretion" (variety of work and opportunity to use skills) and "decision authority" (control over decisions that influence work) which may affect health differentially [160]. ...
Background
Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability.The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses. Methods
Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies. Data extraction: Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality. Data synthesis: We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study’s sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries. ResultsThere was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior. Conclusions
Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.
... Segundo a organização mundial de saúde (OMS), a saúde envolve o bem-estar físico, mental e social, introduzindo o conceito de qualidade de vida (KUREBAYASHI ET AL, 2015). A cefaléia é um problema comum de saúde, acometendo 46% da população adulta com menos de 60 anos de idade (CHRISTENSEN, KNARDAHL, 2012). Dentre as classificações, a cefaléia do tipo tensional (2,2%) e a enxaqueca (1,4% a 2,2%) são manifestações clínicas mais comuns e incapacitantes (HOULE ET AL, 2012). ...
A cefaleia do tipo tensional (CTT) é um problema comum de saúde que acomete 46% da população adulta com menos de 60 anos de idade (CHRISTENSEN, KNARDAHL, 2012). Representa 78% das dores de cabeça, quando comparadas com a enxaqueca. São incapacitantes e acarretam alto custo de tratamento e por afastamento do trabalho (BOUGEA ET AL, 2013; HOULE ET AL, 2012). Várias hipóteses sobre a causa da CTT e da enxaqueca são propostas, enquanto alguns estudos relacionam a CTT e enxaqueca ao mau funcionamento do sistema biológico (PEARCE, 1977), pesquisas recentes têm indicado que as CTT e enxaqueca são iniciadas por exposição á estresse severo, frustração, raiva e outros fatores emocionais (BOUGEA ET AL, 2013; HAMEDI ET AL, 2013). A percepção do componente emocional nas CTT tem fundamentado estudo que indicam que o tratamento com práticas integrativas podem reduzir e até curar a CTT, principalmente pelo efeito na redução da tensão muscular (BOUGEA ET AL, 2013). As práticas da Medicina Tradicional Chinesa, como auriculoterapia e acupuntura são componentes das práticas integrativas e adotadas em vários sistemas de saúde comunitária. Os primeiros relatos do uso da auriculoterapia (AT) foram datados entre 500 a 300 a.C., sendo uma modalidade complementar de tratamento muito utilizada no Brasil, USA, Canadá, China, Alemanha, Australia, Inglaterra, Espanha e Suiça (TAN ET AL, 2014). Utiliza áreas específicas da auricula para o tratamento de mal-estar e doenças (YEH ET AL, 2014; USICHENKO ET AL, 2005). No contexto da compreensão do novo conceito de saúde da Organização Mundial de Saúde, as práticas da Medicina Tradicional Chinesa buscam tratar o individuo restabelecendo o equilíbrio como forma de tratamento e com esse objetivo os protocolos de tratamento não referem-se á condição de doença, mas á origem do desequilíbrio, seja ele físico ou emocional. Tal concepção de saúde/doença promove uma variada gama de procedimentos e uma ampla discussão sobre a padronização de protocolos direcionados ao de tratamento por tipo de doença. Nesse contexto, esse estudo tem como fundamento os vários estudos que indicam a efetividade da auriculoterapia na CTT e tem como questão norteadora o entendimento do efeito de associação de duas técnicas da medicina tradicional chinesa para o tratamento da CTT. 2. Metodologia Trata-se de um estudo descritivo, experimental e quantitativo. A amostra foi composta por 28 indivíduos cefaleicos de ambos os sexos que foram classificados
... For TTH, the most commonly reported precipitant is psychological distress [29], while non-specific headache associates with numerous work-related stressors [30]. Long-lasting stressors elevate cytokine levels [31] and cytokines may play a role in the activation of trigger points and in peripheral sensitisation in FM [32][33][34][35]. ...
Background:
Fibromyalgia (FM) is a pain syndrome, the mechanisms and predictors of which are still unclear. We have earlier validated a set of FM-symptom questions for detecting possible FM in an epidemiological survey and thereby identified a cluster with "possible FM". This study explores prospectively predictors for membership of that FM-symptom cluster.
Methods:
A population-based sample of 8343 subjects of the older Finnish Twin Cohort replied to health questionnaires in 1975, 1981, and 1990. Their answers to the set of FM-symptom questions in 1990 classified them in three latent classes (LC): LC1 with no or few symptoms, LC2 with some symptoms, and LC3 with many FM symptoms. We analysed putative predictors for these symptom classes using baseline (1975 and 1981) data on regional pain, headache, migraine, sleeping, body mass index (BMI), physical activity, smoking, and zygosity, adjusted for age, gender, and education. Those with a high likelihood of having fibromyalgia at baseline were excluded from the analysis. In the final multivariate regression model, regional pain, sleeping problems, and overweight were all predictors for membership in the class with many FM symptoms.
Results:
The strongest non-genetic predictor was frequent headache (OR 8.6, CI 95 % 3.8-19.2), followed by persistent back pain (OR 4.7, CI 95 % 3.3-6.7) and persistent neck pain (OR 3.3, CI 95 % 1.8-6.0).
Conclusions:
Regional pain, frequent headache, and persistent back or neck pain, sleeping problems, and overweight are predictors for having a cluster of symptoms consistent with fibromyalgia.
... (Zeng et al., 2010). The outcome of this situation is a high rate of mental or physiological illnesses, like burnout (Christensen & Knardahl, 2012) and a lower level of quality and productiveness of the department and the employees. ...
The skill shortage is becoming an ever-increasing challenge for IT departments. Allocation of resources in the
best possible way is even more important. The challenge is to improve the enterprise not only on the side of
the organizational and process level, but to develop new strategies and approaches in human resource management.
Only a symbiosis of the disciplines economics, psychology and information technology will enable
relevant and indispensable employees and promote loyalty to the company. A frequent change of the work place,
for a well-trained professional, is so long associated with normality until they find the best environment for
fulfilling their needs and expectations. These expectations are no longer just on a financial level. This paper
will analyse the previous work on these topics and demonstrate first conclusions regarding a way forward.
... Still, the QPS Nordic instrument used in the current study should be fairly insensitive to respondents' emotions or personality dispositions. QPS Nordic items are constructed with the aim of avoiding emotive content and social desirability bias in that subjects report frequency of occurrence rather than degrees of agreement or satisfaction and items do not address issues that are inherently negative or positive (Christensen and Knardahl 2012b). ...
To determine the impact of the healthy worker effect (HWE) as a bias for the external and internal validity of the follow-up assessment in prospective survey research. Specifically, the study examined (1) whether the health status of respondents at the baseline measurement influenced response at the follow-up survey (external validity) and (2) whether HWE is a threat to internal validity by differential attrition, i.e., whether associations between work and health at baseline differ between stayers and dropouts.
In a two-wave questionnaire survey with a 2-year time lag comprising 6283 persons, 4392 responded at both time points (response rate 70 %). Mental distress and somatic symptoms served as indicators of health. Role conflict and role clarity were indicators of work factors.
There were few differences in response rate at follow-up between persons with and without health complaints at the baseline measurement. As response rate increased incrementally with educational level, there seems to be a socio-educational bias, rather than a HWE bias on survey participation. Baseline relationships between work factors and health indicators were equal in magnitude among stayers and dropouts.
The health status of participants at baseline seems to have little impact on the external and internal validity of the follow-up assessment in prospective survey research. Hence, the findings provide little support to the HWE as a potential bias in prospective studies within occupational health research. A limitation of the study is that the findings do not inform about the impact of the HWE on participation in the baseline assessment.
... To the best of our knowledge, the present study is the first to report an excess risk of occupational injuries attributable to role conflict. Nevertheless, recent prospective studies have reported exposure to role conflict as a robust predictor for various health outcomes, i.e., burnout [Maslach and Leiter, 2008], psychological distress , headache [Christensen and Knardahl 2012;Tynes et al., 2013], and musculoskeletal pain [Christensen and Knardahl, 2010]. Although few researchers have made efforts in revealing potential mechanisms between adverse psychosocial factors at work and occupational injuries, it has been suggested that strain induced by adverse psychosocial factors may deplete risk recognition and affect the ability to escape from risks [Nakata et al., 2006;Kim et al., 2009]. ...
Background
We examined the effects of psychosocial stressors at work on subsequent injuries, taking into account organizational and mechanical working conditions.Methods
Randomly drawn from the general population, the cohort comprised respondents with an active employee relationship in 2006 and 2009 (n = 6,745). Outcome measure: “Have you, over the past 12 months, afflicted injuries that were caused by an accident at work, and resulting in time off work after the day of the accident?”.ResultsHigh job strain (Odds ratio [OR] 2.31; 95% confidence interval [CI] 1.16–4.57), high role conflict (OR 3.01; 95% CI 1.70–5.31), and high emotional demands (OR 1.96; 95% CI 1.15–3.35) predicted injury at follow up (P < 0.01). The population risk attributable to each of these factors ranged from 11% to 14%.Conclusions
Excess risk of occupational injuries was attributable to job strain, role conflict, and emotional demands. These factors are potentially amenable to preventive measures. Am. J. Ind. Med. © 2015 Wiley Periodicals, Inc.
... As for the measures of job demands and job control, the QPS Nordic instrument used in the current study should be fairly insensitive to respondents' emotions or personality dispositions. QPS Nordic -items are constructed with the aim of avoiding emotion and social desirability bias in that subjects report frequency of occurrence rather than degrees of agreement or satisfaction and items do not address issues that are inherently negative or positive (38). Finally, having only two measurement points with a two-year time lag could be a limitation as this study design does not allow testing cyclic relationships between the study variables (25). ...
Objectives:
The aim of this two-wave prospective study was to determine how and when job demands are related to alcohol use among employees. By integrating the Job Demands-Control model with the Tension-Reduction theory, we tested a conditional process (moderated mediation) model in which job demands were suggested to have an indirect association with subsequent alcohol use through psychological distress, and where this association was moderated by perceived job control.
Method:
The model was tested in a prospective sample comprising 3642 respondents from a wide variety of occupations. The time-lag between baseline and follow-up was approximately two years. Work factors were measured with scales from the General Nordic Questionnaire for Psychological and Social Factors at Work. Psychological distress was assessed with the 10-item version of the Hopkins Symptoms Checklist. Alcohol use was measured with a global question about how many units of alcohol respondents consumed in a regular week.
Results:
Findings from a comprehensive set of both cross-sectional and prospective analyses in both the main sample and specific subgroups provided little support for the proposed theoretical model. While the cross-sectional results yielded some support to the study hypotheses, no support for the theoretical relationships in question were found in the time-lagged data.
Conclusions:
Although the cross-sectional findings point to a relationship between the study variables, the investigated relationships were not supported longitudinally. Hence, while job demands and job control are related to alcohol use, they seem to have little direct, indirect, and conditional impact on alcohol use over a two-year time period.
... At the same time, we note that the differences we found on HRV imply the same sympathetic activation/lack of inhibitory control reported earlier (e.g., Schmidt and Carlson 2009), even though the methodology we employed was somewhat different. Further, results from the self-report questionnaires are consistent with prior literature (Christensen and Knardahl 2012;Kröner-Herwig and Gassmann 2012;Rausa et al. 2013). ...
To analyze autonomic nervous system activity in headache subjects, measurements of heart rate variability (HRV), skin temperature, skin conductance, and respiration were compared to a matched control group. HRV data were recorded in time and frequency domains. Subjects also completed self-report questionnaires assessing psychological distress, fatigue, and sleep dysfunction. Twenty-one headache and nineteen control subjects participated. In the time domain, the number of consecutive R-to-R intervals that varied by more than 50 ms and the standard deviation of the normalized R-to-R intervals, both indices of parasympathetic nervous system activity, were significantly lower in the headache group than the control group. Groups did not differ statistically on HRV measures in the frequency domain. Self-report measures showed significantly increased somatization, hostility, anxiety, symptom distress, fatigue, and sleep problems in the headache group. The results suggest headache subjects have increased sympathetic nervous system activity and decreased parasympathetic activity compared to non-headache control subjects. Headaches subjects also showed greater emotional distress, fatigue, and sleep problems. The results indicate an association between headaches and cardiovascular functioning suggestive of sympathetic nervous system activation in this sample of mixed migraine and tension-type headache sufferers.
Introduction
Deciding to leave a job is often foreshadowed by burgeoning job dissatisfaction, which is in turn often attributed to characteristics of the job and work environment. However, while we know that job characteristics influence job satisfaction, health, and motivation, their associations with turnover intention is less clear. Moreover, despite aging workforces, an understanding of how working conditions influence workers across the lifespan is lacking. Therefore, drawing on job design theories and bridging turnover- and aging research, we studied 15 specific job characteristics to determine whether they predicted turnover intentions, and whether the predictive value was modified by age.
Methods
Data were collected from various public and private enterprises in Norway. Moderated multilevel regressions were conducted cross-sectionally ( N = 12,485) and prospectively over 2 years ( N = 5,504).
Results
Most work factors were associated with turnover intention at both the individual and work unit levels. A social climate of support, trust, and encouragement was most strongly inversely associated with turnover intentions, while role conflict was most strongly positively associated with turnover intentions. Organizational climate, leadership styles , and job control were more important with age while job demands, predictability and role stressors were more important to younger workers. Ten individual level- and four work-unit level factors predicted turnover intentions prospectively, suggesting turnover intentions due to poor working conditions persisted in employees that did not quit.
Discussion
Our results highlight several specific, modifiable job characteristics that are likely to affect turnover intentions, and the impact of certain factors specifically for older workers.
The effect of digitalization and its transformative power in all aspects of corporate strategies and organizations are visible everywhere. As leaders try to make sense of the “digital tornado” and prepare, try out, and set courses in new business directions, the authors propose to take a step back and focus on what is still at the core of corporate change – the people of your organization. In this chapter, the authors reflect on the forces and challenges that employees are facing in times of rapid and digitally driven change. They also mirror this, considering structural, sociological, and demographic change in the workforce, especially with regards to younger employees. They provide a set of fundamental metrics that can quantify the human resource strategy of an organization to derive measures which can be controlled via a DMAIC cycle. This contribution is an extended version of and includes an enhanced set of metrics to address challenges of digitalization and agile work environments. Further, approaches to possible solutions and first steps for an implementation in companies are presented.
Objectives:
The aim of this study was to determine if (i) working at home and (ii) expectations of being available to the employer in their spare time influences employees' perceptions of their work environment and well-being, health, organizational commitment, or intention to leave.
Methods:
We conducted cross-sectional analyses of survey data from 7861 office workers reporting hours worked at home and 3146 reporting frequency of expectations of being available to the employer in spare time (availability expectations). Prospective analyses (two-year follow up) comprised 5258 and 2082, respectively. Dependent variables were work factors previously associated with health complaints, mental distress, positive affect, work-private life conflict, commitment, and intention to leave. Random intercept linear and logistic regressions controlled for time worked (in addition to regular hours), age, gender, and skill level.
Results:
"Hours working at home" was cross-sectionally associated with higher levels of demands, role ambiguity, role conflicts, decision control, empowering leadership, human resource primacy, commitment, work-private life conflict, and lower support from co-workers. "Availability expectations" was associated with higher levels of demands, role conflicts, neck pain, mental distress, thinking that work was not finished when going to bed, sleep problems, work-private life conflict, intentions to leave and with lower levels of superior support, co-worker support, fair leadership, and commitment. There were no prospective associations.
Conclusions:
Working at home was associated with both positive and negative factors. Specific factors pertaining to role expectations and support from co-workers pose challenges. Availability expectations was associated with potentially negative work factors and health, organizational commitment, and intentions to leave. There were no long-term effects.
This article describes how because of the ongoing demographic development in most European countries, especially IT-companies, need to find a way to retain or gain productivity with the same or less amount of employees. Therefore, the allocation of available resources in the best possible way is even more important. The challenge for companies is to improve the enterprise not only on the side of the organizational and process level, but to develop new strategies and approaches in human resource management. In this article, the authors propose metrics of a framework to manage scarce resources in IT-departments. These layers aim for different relevant determinants of employee productivity and satisfaction like employee wages, education of employees, psychological development of employees, workplace environment and work life balance. Also, relevant metrics to explore and use untapped labour potential in organizations are included. The use of these metrics provides a valuable insight into the organizational performance, its culture, and future. A company can measure the actual status, recognize potential threats, and derive measures to retain productivity in the upcoming years.
A relação entre as condições de trabalho e problemas de origem musculoesquelética é amplamente estudada, embora que o impacto dos fatores psicossociais (FPs) têm sobre a origem dos distúrbios musculoesqueléticos relacionados ao trabalho (DORTs) ainda não seja tão preciso. Alguns artigos tem observado que condições psicossociais inadequadas podem contribuir para o aparecimento de DORTs, enquanto que outros não encontram indícios suficientes para afirmar que os FPs colaboram para o surgimento e agravamento dos DORTs. O setor secundário da economia é formado por indústrias que apresentam elevadas estatísticas de DORTs. Assim, o objetivo desse artigo é fazer uma revisão sistemática de estudos que avaliem a influência dos fatores psicossociais sobre aparecimento de distúrbios musculoesqueléticos em indústrias do setor secundário da economia. Para tanto, uma revisão sistemática foi realizada no Web of Science, Science Direct e Periódicos Capes para refletir sobre a relação entre FPs e DORTs. Adotou-se a Standardized Quality Scale para avaliar a qualidade dos artigos. Foram encontrados 6366 artigos, dos quais 37 se alinharam ao objetivo desse artigo e ao critério de qualidade exigido. Os resultados apresentam indícios que fatores psicossociais, tais como elevadas demandas de trabalho, baixo controle sobre o trabalho, ausência de apoio social, entre outros, contribuem para o surgimento de DORTs nas áreas do corpo de trabalhadores, tais como pescoço, ombros, costas, lombar. Assim, para que intervenções nos postos de trabalho e organizações desse ramo da economia sejam feitas de maneira mais eficaz, os fatores psicossociais devem ser observados. A construção de modelos matemáticos que possam XXXV ENCONTRO NACIONAL DE ENGENHARIA DE PRODUCAO Perspectivas Globais para a Engenharia de Produção Fortaleza, CE, Brasil, 13 a 16 de outubro de 2015.
This article questions the usefulness of a traditional class divide as a tool for understanding a contemporary working environment among manual and non-manual workers in the oil service industry. The case of study is an enterprise within a supply chain with asymmetrical relationships between companies. Our findings show that the traditional manual/non-manual class division is still relevant for understanding differences in perceived work situation in a modern work organisation. However, alongside a cleavage between manual and non-manual workers, we find a cleavage between workers with differing amounts of contact with employees in organisations higher up in the supply chain.
Previous studies on the effects of work factors on absence and disability retirement have only addressed a limited set of factors and little is known about the mechanisms that govern relationships between work exposures and sickness absence/disability retirement. The main aims of the present project are (1) to examine the impact of a comprehensive set of psychological, social, organizational, and mechanical work factors work factors on sickness absence and disability retirement, and (2) to identify moderating and mediating variables that determine how and when exposures at the workplace are related to sickness absence and disability retirement.
The study design is prospective and based on longitudinal survey data linked to registry data on sickness absence and disability. Altogether 14,501 respondents have given their permission to the linking of their survey questionnaire data to registry data. The project has been approved by the Regional Committees for Medical and Health Research Ethics and has permission from The Norwegian Data Protection Authority. The questionnaire instruments contain psychometrically validated items and inventories on demographic background factors, work exposures, individual dispositions and attitudes, somatic health, mental distress, well-being, lifestyle factors, and work ability.
The findings will have relevance for, and benefit working life and the larger society in a number of ways. Firstly, it will lead to a more knowledge about which work factors that contribute to health, sickness absence, and participation in/exit from the labour force. Secondly, a better understanding of which mediators and moderators that modify and govern these relationships. Both are central to the development of laws and regulations and to any political decision on measures to tackle sickness absence and early retirement.
Background:
It is unknown whether living with neck and back pain, disability, and mental disorders influences the perception of psychological and social factors at work among sick-listed patients.
Objectives:
The primary aim of the present study was to examine the associations between pain, disability, anxiety, depression, and perceived psychological and social factors at work among sick-listed patients with neck and back pain.
Methods:
We performed a cross-sectional study of 380 sick-listed patients with neck and low-back pain who were referred to spine clinics at two Norwegian university hospitals. Ordinal regression was applied, with psychological and social factors at work as the dependent variable.
Results:
Pain was not associated with psychological and social factors at work. Disability was associated with a minor increase in the perception of demands among women, but not men. Women with high anxiety or depression scores experienced less control over work situations and less positive challenges at work. Men with high depression scores perceived low support.
Conclusions:
Sick-listed patients with neck and back pain who had concurrent anxiety or depression reported increased psychological and social challenges at work. To provide suitable treatment in the clinical setting, further attention should be paid to the interaction between anxiety or depression and perceived job strain.
We review fundamental issues in one traditional structural equation modeling (SEM) approach to analyzing longitudinal data — cross-lagged panel designs. We then discuss a number of new developments in SEM that are applicable to analyzing panel designs. These issues include setting appropriate scales for latent variables, specifying an appropriate null model, evaluating factorial invariance in an appropriate manner, and examining both direct and indirect (mediated), effects in ways better suited for panel designs. We supplement each topic with discussion intended to enhance conceptual and statistical understanding.
The authors provide a basic set of guidelines and recommendations for information that should be included in any manuscript that has confirmatory factor analysis or structural equation modeling as the primary statistical analysis technique. The authors provide an introduction to both techniques, along with sample analyses, recommendations for reporting, evaluation of articles in The Journal of Educational Research using these techniques, and concluding remarks.
This study addressed the methodological quality of longitudinal research examining R. Karasek and T. Theorell's (1990) demand-control-(support) model and reviewed the results of the best of this research. Five criteria for evaluating methodological quality were used: type of design, length of time lags, quality of measures, method of analysis, and nonresponse analysis. These criteria were applied to 45 longitudinal studies, of which 19 (42%) obtained acceptable scores on all criteria. These high-quality studies provided only modest support for the hypothesis that especially the combination of high demands and low control results in high job strain. However, good evidence was found for lagged causal effects of work characteristics, especially for self-reported health or well-being outcomes.
Background
Neck pain, which is assumed to be a multifactorial disease, is a major problem in modern society.Methods
To identify the most important psychosocial risk factors for neck pain, a systematic review of the literature was carried out. The methodological quality of all studies in the review was assessed. Four levels of evidence were defined to assess the strength of evidence for potential risk factors for neck pain (strong, moderate, some or inconclusive evidence).ResultsSome evidence was found for a positive relationship between neck pain and high quantitative job demands, low social (coworker) support, low job control, high and low skill discretion and low job satisfaction. Inconclusive evidence was found for high job strain, low supervisor support, conflicts at work, low job security, and limited rest break opportunities.Conclusions
The procedure of the assessment of the methodological quality and the rating system applied to distinguish between high- and low-score studies, had a considerable influence on the level of evidence, indicating that changes in this procedure may have a major impact on the overall conclusions of this review. Am. J. Ind. Med. 39:180–193, 2001. © 2001 Wiley-Liss, Inc.
Objectives:
The prevalence of job stress, distributions of major job stressors, and the associations of job stress with multiple self-reported health complaints were examined in a national survey conducted in 1994 in Taiwan.
Methods:
A total of 9,746 men and 5,599 women who were employed at the time of the survey and aged between 25 and 65-years were studied. Information on employment status, perceived level of job stress, major job stressors, and health complaints were obtained by a self-administered questionnaire.
Results:
Overall, 7.6% of men and 6.5% of women reported often or always feeling very stressed at work. Higher levels of perceived job stress were found among subjects who were younger, with higher education level, working in a larger firm, working for longer hours per week, and who were administrators or managers. Problems with individual job content were ranked as the most important job stressor in men across all employment categories and in most women. Other major job stressors included problems with monetary rewards and lack of career prospects. The patterns of major job stressors appear to vary by employment grade and by gender. After adjustment for age and education, employees who perceived higher levels of job stress had significantly increased risks of multiple health problems, including strained eyes, ringing ears, chronic cough with phlegm, chest tightness. stomach problems, headache, and musculoskeletal discomfort.
Conclusions:
These results suggest that psychosocial stress in the workplace has profound impacts on health. This study identified high-risk groups and major types of job stressors for further investigation.
We believe that journal reviewers (as well as editors and dissertation or thesis committee members) have to some extent perpetuated
misconceptions about common method bias in self-report measures, including (a) that relationships between self-reported variables
are necessarily and routinely upwardly biased, (b) other-reports (or other methods) are superior to self-reports, and (c)
rating sources (e.g., self, other) constitute measurement methods. We argue against these misconceptions and make recommendations
for what reviewers (and others) should reasonably expect from authors regarding common method bias. We believe it is reasonable
to expect (a) an argument for why self-reports are appropriate, (b) construct validity evidence, (c) lack of overlap in items
for different constructs, and (d) evidence that authors took proactive design steps to mitigate threats of method effects.
We specifically do not recommend post hoc statistical control strategies; while some statistical strategies are promising,
all have significant drawbacks and some have shown poor empirical results.
KeywordsCommon method bias-Method variance-Self-report measures-Reviewing
The aims of this study were to examine trajectories of headache in relation to retirement and to clarify the role of work stress and stress-prone personality.
Headache prevalence during the 7 years before and after retirement was measured by annual questionnaires from GAZEL cohort comprising French national gas and electricity company employees (n = 12,913). Odds ratios and 95% confidence intervals for headache during pre- peri- and post-retirement were calculated. The role of effect modifiers (work stress, type A or hostile personality) was tested by multiplicative interactions and synergy indices.
An 11-13% reduction in headache prevalence was found during pre- and post-retirement, whereas decline was much steeper (46%) during the retirement transition. In absolute terms, the decline was greater among persons with high work stress or stress-prone personality than among other participants.
Retirement is associated with a decrease in headache prevalence, particularly among persons with a high amount of work stress or proneness to over-react to stress.
This systematic review was designed and conducted in an effort to evaluate the evidence currently available for the many suggested risk factors for work-related musculoskeletal disorders.
To identify pertinent literature we searched four electronic databases (Cinahl, Embase, Medline, and The Cochrane Library). The search strategies combined terms for musculoskeletal disorders, work, and risk factors. Only case-control or cohort studies were included.
A total of 1,761 non-duplicated articles were identified and screened, and 63 studies were reviewed and integrated in this article. The risk factors identified for the development of work-related musculoskeletal disorders were divided and organized according to the affected body part, type of risk factor (biomechanical, psychosocial, or individual) and level of evidence (strong, reasonable, or insufficient evidence).
Risk factors with at least reasonable evidence of a causal relationship for the development of work-related musculoskeletal disorders include: heavy physical work, smoking, high body mass index, high psychosocial work demands, and the presence of co-morbidities. The most commonly reported biomechanical risk factors with at least reasonable evidence for causing WMSD include excessive repetition, awkward postures, and heavy lifting. Additional high methodological quality studies are needed to further understand and provide stronger evidence of the causal relationship between risk factors and work-related musculoskeletal disorders. The information provided in this article may be useful to healthcare providers, researchers, and ergonomists interested on risk identification and design of interventions to reduce the rates of work-related musculoskeletal disorders.
Psychometric properties, particularly predictive validity, of scales in the General Nordic Questionnaire for Psychological and Social Factors at Work (QPS(Nordic)) were assessed. The analysis is confined to the scales in the QPS(Nordic,) and 24 of the 26 scales are included. A large group of Swedish county council employees (n= 3,976; response rate = 65%) participated in a study and were given the QPS(Nordic). Register data for long-term sick leave (>90 days), with diagnosis, were used for predictive analysis. The following main results were obtained: Reliability was generally satisfactory, confirmatory factor analysis indicated good fit, concurrent validity was good, some less often investigated organizational variables predicted sickness absence, and scales were differentially associated with absence due to psychiatric and musculoskeletal disorders. In conclusion, the psychometric testing of the QPS(Nordic) so far suggests that it is a good instrument for assessing health-related factors at work.
Demonstrating causal relationships has been of particular importance in organizational stress research. Longitudinal studies are typically suggested to overcome problems of reversed causation and third variables (e.g., social desirability and negative affectivity). This article reviews the empirical longitudinal literature and discusses designs and statistical methods used in these studies. Forty-three longitudinal field reports on organizational stress were identified. Most of the investigations used a 2-wave panel design and a hierarchical multiple regression approach. Six studies with 3 and more waves were found. About 50% of the studies analyzed potential strain-stressor (reversed causation) relationships. In about 33% of the studies there was some evidence of reverse causation. The power of longitudinal studies to rule out third variable explanations was not realized in many studies. Procedures of how to analyze longitudinal data are suggested.
Part I discusses the Job Content Questionnaire (JCQ), designed to measure scales assessing psychological demands, decision latitude, social support, physical demands, and job insecurity. Part II describes the reliability of the JCQ scales in a cross-national context using 10,288 men and 6,313 women from 6 studies conducted in 4 countries. Substantial similarity in means, standard deviations, and correlations among the scales, and in correlations between scales and demographic variables, is found for both men and women in all studies. Reliability is good for most scales. Results suggest that psychological job characteristics are more similar across national boundaries than across occupations.
The term functional somatic syndrome has been applied to several related syndromes characterized more by symptoms, suffering, and disability than by consistently demonstrable tissue abnormality. These syndromes include multiple chemical sensitivity, the sick building syndrome, repetition stress injury, the side effects of silicone breast implants, the Gulf War syndrome, chronic whiplash, the chronic fatigue syndrome, the irritable bowel syndrome, and fibromyalgia. Patients with functional somatic syndromes have explicit and highly elaborated self-diagnoses, and their symptoms are often refractory to reassurance, explanation, and standard treatment of symptoms. They share similar phenomenologies, high rates of co-occurrence, similar epidemiologic characteristics, and higher-than-expected prevalences of psychiatric comorbidity. Although discrete pathophysiologic causes may ultimately be found in some patients with functional somatic syndromes, the suffering of these patients is exacerbated by a self-perpetuating, self-validating cycle in which common, endemic, somatic symptoms are incorrectly attributed to serious abnormality, reinforcing the patient's belief that he or she has a serious disease. Four psychosocial factors propel this cycle of symptom amplification: the belief that one has a serious disease; the expectation that one's condition is likely to worsen; the "sick role," including the effects of litigation and compensation; and the alarming portrayal of the condition as catastrophic and disabling. The climate surrounding functional somatic syndromes includes sensationalized media coverage, profound suspicion of medical expertise and physicians, the mobilization of parties with a vested self-interest in the status of functional somatic syndromes, litigation, and a clinical approach that overemphasizes the biomedical and ignores psychosocial factors. All of these influences exacerbate and perpetuate the somatic distress of patients with functional somatic syndromes, heighten their fears and pessimistic expectations, prolong their disability, and reinforce their sick role. A six-step strategy for helping patients with functional somatic syndromes is presented here.
To evaluate the current epidemiological evidence linking psychosocial work characteristics with low back pain.
Psychosocial work characteristics have been widely evaluated as potential risk factors for low back injury. However, studies with different study populations and using various types of measures have had conflicting results.
This review is the most extensive to date, reviewing 66 articles that have provided empirical evidence about the relationship between psychosocial work characteristics and initial reporting of lower back pain. The studies are reviewed with an emphasis on certain methodological issues: controlling for potential confounding; timing of the data collection; and measurement of the exposures and outcomes.
The results of this review suggest that controlling for potential confounding from occupational biomechanical demands had a large influence on the associations found between psychosocial work characteristics and lower back pain. In addition, the use of accurate and reliable measures for the occupational exposures (biomechanical and psychosocial) and the lower back pain outcomes appears to influence the strength of the associations found between psychosocial work characteristics and lower back pain.
Given the methodological concerns discussed in this review, it is difficult to draw strong causal inferences from this literature. However, it does appear that psychosocial characteristics are related to some lower back pain outcomes, and that employees' reactions to psychosocial work characteristics (e.g., job dissatisfaction and job stress) are more consistently related to lower back pain than are the psychosocial work characteristics themselves (e.g., work overload, lack of influence over work, quality of relationships with coworkers).
This review attempts to identify and address methodological issues in the literature evaluating the relationship between psychosocial work characteristics and lower back pain. Implications for future research are presented.
To systematically evaluate the available evidence on occupational risk factors of shoulder pain.
Relevant reports were identified by a systematic search of Medline, Embase, Psychlit, Cinahl, and Current Contents. The quality of the methods of all selected publications was assessed by two independent reviewers using a standardised checklist. Details were extracted on the study population, exposures (physical load and psychosocial work environment), and results for the association between exposure variables and shoulder pain.
29 Studies were included in the review; three case-control studies and 26 cross sectional designs. The median method score was 60% of the maximum attainable score. Potential risk factors related to physical load and included heavy work load, awkward postures, repetitive movements, vibration, and duration of employment. Consistent findings were found for repetitive movements, vibration, and duration of employment (odds ratio (OR) 1.4-46 in studies with method scores >/= 60%). Nearly all studies that assessed psychosocial risk factors reported at least one positive association with shoulder pain, but the results were not consistent across studies for either high psychological demands, poor control at work, poor social support, or job dissatisfaction. Studies with a method score >/=60% reported ORs between 1.3 and 4.0. Substantial heterogeneity across studies for methods used for exposure assessment and data analysis impeded statistical pooling of results.
It seems likely that shoulder pain is the result of many factors, including physical load and the psychosocial work environment. The available evidence was not consistent across studies, however, and the associations were generally not strong. Future longitudinal research should evaluate the relative importance of each individual risk factor and the role of potential confounding variables-such as exposure during leisure time-to set priorities for the prevention of shoulder pain in occupational settings.
A systematic review of observational studies.
To assess whether psychosocial factors at work and in private life are risk factors for the occurrence of back pain.
Several reviews on risk factors for back pain have paid attention to psychosocial factors. However, in none of the published reviews was a strict systematic approach used to identify and summarize the available evidence.
A computerized bibliographical search of several databases was performed, restricted to studies with a cohort or case-control design. A rating system was used to assess the strength of the evidence for various factors, based on the methodologic quality of the studies and the consistency of the findings.
Eleven cohort and two case-control studies were included in this review. Strong evidence was found for low social support in the workplace and low job satisfaction as risk factors for back pain. Insufficient evidence was found for an effect of a high work pace, high qualitative demands, low job content, low job control, and psychosocial factors in private life.
Evidence was found for an effect of low workplace social support and low job satisfaction. However, the result for workplace social support was sensitive to slight changes in the rating system, and the effect found for low job satisfaction may be a result of insufficient adjustment for psychosocial work characteristics and physical load at work. In addition, the combined evaluation of job content and job control, both aspects of decision latitude, led to strong evidence of a role for low job decision latitude. Thus, based on this review, there is evidence for an effect of work-related psychosocial factors, but the evidence for the role of specific factors has not been established yet.
To review systematically all epidemiological studies of the past 15 years concerning the factors associated with musculoskeletal disorders (MSDs) or complaints of the neck and upper limbs.
Fifty-seven cross-sectional and seven longitudinal studies were reviewed. A list was made of all personal, occupational, extra-occupational and psycho-organisational factors taken into consideration in each study, and of those that were found in association with MSDs. MSDs of the neck-shoulder region (NSs) and hand-wrist (HWs) were considered separately. About 70 different factors are listed.
This inventory identifies the factors or categories of factors that were generally taken into consideration. It makes it possible also to evaluate the strength of the association with a given factor, in considering the number of studies finding an association, and those that did not consider this factor. Based on this review, some factors taken into consideration (such as weight or hobbies) could be excluded in further studies, and replaced by more specific psycho-organisational factors.
The purpose of this review was to summarize current knowledge concerning the role of psychological workplace variables in back pain. To this end the literature on psychological factors and back pain was systematically searched and analyzed. Psychological and medical databases and cross-referencing were used to locate 975 studies. To be included in this review, studies had to have a prospective design, include a psychological predictor variable, report on back pain, and be published in English. Twenty-one studies fulfilled the criteria for psychological workplace factors. The results showed a clear association between psychological variables and future back pain. There was strong evidence that job satisfaction, monotonous tasks, work relations, demands, stress, and perceived ability to work were related to future back pain problems. Further, moderate evidence was established for work pace, control, emotional effort at work, and the belief that work is dangerous. There was inconclusive evidence about work content. The attributable fraction indicated that substantial reductions in the number of cases of back pain could be achieved if the exposure to the psychological risk factor was eliminated. Although the methodological quality of the studies varied, they were deemed to provide "best evidence," and the consistency of the findings suggests that they are relatively robust. It is concluded that psychological work factors play a significant role in future back pain problems. However, there is still a lack of knowledge concerning the mechanisms by which these operate. These results suggest that a change in the way we view and deal with back pain is needed. Applying knowledge about psychological factors at work might enhance prevention as well as rehabilitation.
Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.
Relevant studies of low back pain (LBP) published between 1990 and 2002 were systematically retrieved via electronic databases and checking of reference lists. Forty papers fulfilled the inclusion criteria; 10 were of high quality. A wide variety of instruments had been used for collection of data on work related psychosocial factors, many of which had not undergone any form of validation. Moderate evidence was found for no association between LBP and perception of work, organisational aspects of work, and social support at work. There was insufficient evidence for a positive association between stress at work and LBP. No conclusions could be drawn regarding perception of work and consequences of LBP. There was strong evidence for no association between organisational aspects of work and moderate evidence for no association between social support at work and stress at work and consequences of LBP.
The term functional somatic syndrome has been applied to several related syndromes characterized more by symptoms, suffering, and disability than by consistently demonstrable tissue abnormality. These syndromes include multiple chemical sensitivity, the sick building syndrome, repetition stress injury, the side effects of silicone breast implants, the Gulf War syndrome, chronic whiplash, the chronic fatigue syndrome, the irritable bowel syndrome, and fibromyalgia. Patients with functional somatic syndromes have explicit and highly elaborated self-diagnoses, and their symptoms are often refractory to reassurance, explanation, and standard treatment of symptoms. They share similar phenomenologies, high rates of co-occurrence, similar epidemiologic characteristics, and higher-than-expected prevalences of psychiatric comorbidity. Although discrete pathophysiologic causes may ultimately be found in some patients with functional somatic syndromes, the suffering of these patients is exacerbated by a self-perpetuating, self-validating cycle in which common, endemic, somatic symptoms are incorrectly attributed to serious abnormality, reinforcing the patient's belief that he or she has a serious disease. Four psychosocial factors propel this cycle of symptom amplification: the belief that one has a serious disease; the expectation that one's condition is likely to worsen; the "sick role," including the effects of litigation and compensation; and the alarming portrayal of the condition as catastrophic and disabling. The climate surrounding functional somatic syndromes includes sensationalized media coverage, profound suspicion of medical expertise and physicians, the mobilization of parties with a vested self-interest in the status of functional somatic syndromes, litigation, and a clinical approach that overemphasizes the biomedical and ignores psychosocial factors. All of these influences exacerbate and perpetuate the somatic distress of patients with functional somatic syndromes, heighten their fears and pessimistic expectations, prolong their disability, and reinforce their sick role. A six-step strategy for helping patients with functional somatic syndromes is presented here.
Interest in the problem of method biases has a long history in the behavioral sciences. Despite this, a comprehensive summary of the potential sources of method biases and how to control for them does not exist. Therefore, the purpose of this article is to examine the extent to which method biases influence behavioral research results, identify potential sources of method biases, discuss the cognitive processes through which method biases influence responses to measures, evaluate the many different procedural and statistical techniques that can be used to control method biases, and provide recommendations for how to select appropriate procedural and statistical remedies for different types of research settings.
This chapter presents a brief overview of principles and current topics in structural equation modeling (SEM). The chapter strives for breadth rather than depth, but includes readable references for those interested in delving deeper into any one topic. It begins with an introduction to the framework with model specification using path diagrams which translate into model equations. Both measurement and structural components of SEM are covered. Some advanced topics including latent growth models, missing data, categorical outcomes, and power are presented briefly. Latent class analysis, mixture models, and multilevel models are mentioned. Readers are encouraged to pursue the cited references for more comprehensive coverage of these important topics.
A meta-analysis of single-item measures of overall job satisfaction (28 correlations from 17 studies with 7,682 people) found an average uncorrected correlation of .63 (SD = .09) with scale measures of overall job satisfaction. The overall mean correlation (corrected only for reliability) is .67 (SD = .08), and it is moderated by the type of measurement scale used. The mean corrected correlation for the best group of scale measures (8 correlations, 1,735 people) is .72 (SD = .05). The correction for attenuation formula was used to estimate the minimum level of reliability for a single-item measure. These estimates range from .45 to .69, depending on the assumptions made.
A meta-analysis of single-item measures of overall job satisfaction (28 correlations from 17 studies with 7,682 people) found an average uncorrected correlation of .63 (SD = .09) with scale measures of overall job satisfaction. The overall mean correlation (corrected only for reliability) is .67 (SD = .08), and it is moderated by the type of measurement scale used. The mean corrected correlation for the best group of scale measures (8 correlations, 1,735 people) is .72 (SD = .05). The correction for attenuation formula was used to estimate the minimum level of reliability for a single-item measure. These estimates range from .45 to .69, depending on the assumptions made.
It has become widely accepted that correlations between variables measured with the same method, usually self-report surveys, are inflated due to the action of common method variance (CMV), despite a number of sources that suggest the problem is overstated. The author argues that the popular position suggesting CMV automatically affects variables measured with the same method is a distortion and oversimplification of the true state of affairs, reaching the status of urban legend. Empirical evidence is discussed casting doubt that the method itself produces systematic variance in observations that inflates correlations to any significant degree. It is suggested that the term common method variance be abandoned in favor of a focus on measurement bias that is the product of the interplay of constructs and methods by which they are assessed. A complex approach to dealing with potential biases involves their identification and control to rule them out as explanations for observed relationships using a variety of design strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
I talk about how I came to write this paper here: https://managementink.wordpress.com/2011/04/05/truth-or-urban-legend/
Gives an overview of statistical analysis with latent variables. Using traditional structural equation modeling as a starting point, it shows how the idea of latent variables captures a wide variety of statistical concepts, including random effects, missing data, sources of variation in hierarchical data, finite mixtures, latent classes, and clusters. These latent variable applications go beyond the traditional latent variable usage in psychometrics with its focus on measurement error and hypothetical constructs measured by multiple indicators. The article argues for the value of integrating statistical and psychometric modeling ideas. Different applications are discussed in a unifying framework that brings together in one general model such different analysis types as factor models, growth curve models, multilevel models, latent class models and discrete-time survival models. Several possible combinations and extensions of these models are made clear due to the unifying framework. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Measurement invariance is usually tested using Multigroup Confirmatory Factor Analysis, which examines the change in the goodness-of-fit index (GFI) when cross-group constraints are imposed on a measurement model. Although many studies have examined the properties of GFI as indicators of overall model fit for single-group data, there have been none to date that examine how GFIs change when between-group constraints are added to a measurement model. The lack of a consensus about what constitutes significant GFI differences places limits on measurement invariance testing. We examine 20 GFIs based on the minimum fit function. A simulation under the two-group situation was used to examine changes in the GFIs (ΔGFIs) when invariance constraints were added. Based on the results, we recommend using Δcomparative fit index, ΔGamma hat, and ΔMcDonald's Noncentrality Index to evaluate measurement invariance. These three ΔGFIs are independent of both model complexity and sample size, and are not correlated with the overall fit measures. We propose critical values of these ΔGFIs that indicate measurement invariance.
Studied the association between psychosocial work factors and musculoskeletal disease, via a qualitative review of the epidemiologic literature. It is concluded that monotonous work, high perceived work load, and time pressure are related to musculoskeletal symptoms. The data also suggest that low control on the job and lack of social support by colleagues are positively associated with musculoskeletal disease. Perceived stress may be an intermediary in this process. In addition, stress symptoms are often associated with musculoskeletal disease, and some studies indicate that stress symptoms contribute to the development of this disease. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study aimed at investigating the relationships between work-related psychosocial factors, worry about work conditions and health complaints (sleeping problems, headache and stomach symptoms) among female and male ambulance personnel. Out of 4000 ambulance personnel in Sweden, 1500 (300 female and 1200 male personnel) were randomly selected. They answered a questionnaire including items on self-reported health complaints, individual characteristics, work-related psychological demands, decision latitude, social support and worry about work conditions. Twenty-five per cent of the female and 20% of the male ambulance personnel reported two or more health complaints sometimes or often. According to the demand-control-support questionnaire, ambulance personnel reported a generally positive psychosocial work environment, although psychological demands were associated with sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Another factor that was significantly associated with health complaints among both genders was worry about work conditions. When worry about work conditions was added to the regression models, this variable took over the role from psychological demands as a predictor for health complaints among the female ambulance personnel. The prevalence of sleeping problems, headache and stomach symptoms were significantly associated with psychological demands among both female and male ambulance personnel. Notably, worry about work conditions seems to be an important risk factor for health complaints. This suggests that worry about work conditions should not be neglected when considering risk factors among ambulance personnel.
In this chapter, the standard logistic model is extended to handle outcome variables that have more than two ordered categories.
When the categories of the outcome variable have a natural order, ordinal logistic regression may be appropriate.
A structural equation model is proposed with a generalized measurement part, allowing for dichotomous and ordered categorical variables (indicators) in addition to continuous ones. A computationally feasible three-stage estimator is proposed for any combination of observed variable types. This approach provides large-sample chi-square tests of fit and standard errors of estimates for situations not previously covered. Two multiple-indicator modeling examples are given. One is a simultaneous analysis of two groups with a structural equation model underlying skewed Likert variables. The second is a longitudinal model with a structural model for multivariate probit regressions.
Studies relating occupational psychological and social factors to back pain have traditionally investigated a small number of exposure factors. The current study explored longitudinally a comprehensive set of specific psychological/social and mechanical work factors as predictors of back pain severity (defined as the product of back pain intensity and duration). Employees from 28 organizations in Norway, representing a wide variety of occupations, were surveyed with a follow-up period of 2 years. Several designs were tested: (1) cross-sectional analyses at baseline and follow-up; (2) prospective analyses with baseline exposure; (3) prospective analyses with average exposure over time [(T1+T2)/2]; and (4) prospective analyses with measures of change in exposure from T1 to T2. A total of 2808 employees responded at both time points. Fourteen psychological/social and two mechanical exposures were measured. Odds ratios (ORs) were computed by ordinal logistic regressions. Several psychological/social factors predicted back pain severity. After adjustment for age, sex, skill level, back pain severity at T1 and other exposure factors estimated to be potential confounders, the most consistent predictors of back pain were the protective factors decision control [lowest OR 0.68; 99% confidence interval (CI): 0.49-0.95], empowering leadership (lowest OR 0.59; 99% CI: 0.38-0.91) and fair leadership (lowest OR 0.54; 99% CI: 0.34-0.87). Some of the most important predictors included in this study were factors that have previously received little attention in back pain research. This emphasizes the importance of extending the list of factors possibly contributing to back pain.
This review presents a practical summary of the missing data literature, including a sketch of missing data theory and descriptions of normal-model multiple imputation (MI) and maximum likelihood methods. Practical missing data analysis issues are discussed, most notably the inclusion of auxiliary variables for improving power and reducing bias. Solutions are given for missing data challenges such as handling longitudinal, categorical, and clustered data with normal-model MI; including interactions in the missing data model; and handling large numbers of variables. The discussion of attrition and nonignorable missingness emphasizes the need for longitudinal diagnostics and for reducing the uncertainty about the missing data mechanism under attrition. Strategies suggested for reducing attrition bias include using auxiliary variables, collecting follow-up data on a sample of those initially missing, and collecting data on intent to drop out. Suggestions are given for moving forward with research on missing data and attrition.
To determine the impact of occupational psychological/social and mechanical factors on neck pain, a prospective cohort study with a follow-up period of 2 years was conducted with a sample of Norwegian employees. The following designs were tested: (i) cross-sectional analyses at baseline (n=4569) and follow-up (n=4122), (ii) prospective analyses with baseline predictors, (iii) prospective analyses with average exposure over time [(T1+T2)/2] as predictor, and (iv) prospective analyses with measures of change in exposure from T1 to T2 as predictors. A total of 2419 employees responded to both the baseline and follow-up questionnaire. Data were analyzed using ordinal logistic regression. After adjustment for age, sex, neck pain at T1, and other exposure factors that had been estimated to be confounders, the most consistent risk factors were role conflict (highest OR 2.97, 99% CI: 1.29-6.74) and working with arms raised to or above shoulder level (highest OR 1.37, 99% CI: 1.05-1.78). The most consistent protective factors were empowering leadership (lowest OR 0.53, 99% CI: 0.35-0.81) and decision control (lowest OR 0.60, 99% CI: 0.36-1.00). Hence, psychological and social factors are important precursors of neck pain, along with mechanical factors. Although traditional factors such as quantitative demands and decision control play a part in the etiology of neck pain at work, in this study several new factors emerged as more important.
Introduction General Conditions for the Randomization-Validity of Infinite-m Repeated-Imputation Inferences Examples of Proper and Improper Imputation Methods in a Simple Case with Ignorable Nonresponse Further Discussion of Proper Imputation Methods The Asymptotic Distribution of (Q̄m, Ūm, Bm) for Proper Imputation Methods Evaluations of Finite-m Inferences with Scalar Estimands Evaluation of Significance Levels from the Moment-Based Statistics Dm and Δm with Multicomponent Estimands Evaluation of Significance Levels Based on Repeated Significance Levels
The idea that pain can lead to feelings of frustration, worry, anxiety and depression seems obvious, particularly if it is of a chronic nature. However, there is also evidence for the reverse causal relationship in which negative mood and emotion can lead to pain or exacerbate it. Here, we review findings from studies on the modulation of pain by experimentally induced mood changes and clinical mood disorders. We discuss possible neural mechanisms underlying this modulatory influence focusing on the periaqueductal grey (PAG), amygdala, anterior cingulate cortex (ACC) and anterior insula as key players in both, pain and affective processing.
To establish whether review articles provide consistent conclusions on associations between workplace psychosocial factors and musculoskeletal pain and, if differences exist, to explore whether this is related to the methods used.
Reviews, reported up to February 2007, that included consideration of workplace psychosocial factors and upper limb, back or knee pain were identified through searches of multiple databases. The specific work-related psychosocial factors considered were job demands, support, job autonomy and job satisfaction. The conclusions of each review on one or more of the psychosocial/musculoskeletal pain associations were extracted.
15 review articles were identified that considered one or more of the regional pain syndromes included in the study. For back pain, the most consistent conclusions (four reviews positive out of six) were with high job demands and low job satisfaction. The studies of upper limb pain were exclusively related to shoulder and/or neck pain, and the most consistent positive conclusions were with high and low job demands (four reviews positive out of six and two reviews positive out of three, respectively). For knee pain, only a single review was identified. For individual reviews of back and upper limb pain, there were marked differences in the number of associations concluded to be positive between reviews.
The reasons for reviews coming to different conclusions included that they were often evaluating different bodies of evidence (according to their search criteria, the year when the review was conducted, the role that quality assessment played in whether studies contributed to evidence, and the combination of risk factors addressed in individual studies), but more important was whether the review specified explicit criteria for making conclusions on strength of evidence. These conclusions emphasise the importance of developing standardised methods for conducting such evaluations of existing evidence and the importance of new longitudinal studies for clarifying the temporal relationship between psychosocial factors and musculoskeletal pain in the workplace.
Headache is a common health problem that causes individual suffering as well as public expense. Because epidemiological studies have shown that headache is most prevalent among persons younger than 55 years, the influence of working conditions is of interest. In this study, we examined the importance of working conditions as a risk factor for frequent headache among the general Swedish population. Data from the Swedish Survey of Living Conditions for the 2-year period, 1988 and 1989, were used. In this survey, a probability sample of the Swedish population aged 16 years and older was interviewed. Frequent headache was defined as a positive answer to the question, "Have you (during the last 2 weeks) had recurrent headache or migraine?" Work stress was studied for two indices: physical work stress and mental work stress. The physical work stress index contained measurements of seven working conditions, and the mental work stress index contained measurements of three working conditions. The proportion of persons who reported frequent headache was greater among women than men, and frequent headache was most common in the age group 25 to 44 years. The logistic regression analyses showed that both physical and mental work stress were strongly associated with frequent headache among both men and women even after controlling for potential confounders. The associations between work stress and frequent headache may be dose-dependent. Heavy mental work stress was most strongly associated with frequent headache among men (odds ratio 3.03 [1.92 to 4.78]) while heavy physical work stress was most strongly associated with frequent headache among women (odds ratio 3.48 [1.13 to 10.65]). Improved working conditions could be one way of preventing headache, thereby decreasing individual suffering and employer as well as public expense.
Common strategies to decide whether a variable is a confounder that should be adjusted for in the analysis rely mostly on statistical criteria. The authors present findings from the Slone Epidemiology Unit Birth Defects Study, 1992-1997, a case-control study on folic acid supplementation and risk of neural tube defects. When statistical strategies for confounding evaluation are used, the adjusted odds ratio is 0.80 (95% confidence interval: 0.62, 1.21). However, the consideration of a priori causal knowledge suggests that the crude odds ratio of 0.65 (95% confidence interval: 0.46, 0.94) should be used because the adjusted odds ratio is invalid. Causal diagrams are used to encode qualitative a priori subject matter knowledge.
In 1993, an extensive review on the role of psychosocial factors in the development of musculoskeletal problems was published by Bongers et al (1993). Since then, additional reviews on this topic have been published; however, none of these focussed on upper limb problems.
In this systematic review, the methodological quality of all studies was assessed and levels of evidence were apriori defined.
The large majority of the studies reported an association between at least one work-related psychosocial factor and adverse upper extremity symptoms or signs. High-perceived job stress was consistently associated with all upper extremity problems (UEP) in high and lower quality studies. Although not often studied, non-work-related stress was also consistently associated with UEP. In addition, there was some evidence for a relationship between high job demands and UEP, although the results did not meet the pre-set criterion for consistency.
High job stress and non-work-related stress reactions are consistently associated with UEP. In addition, high job demands is also in most studies associated with these disorders. Firm conclusions on the role of these factors in the etiology of UEP are not possible due to the cross-sectional nature of most studies.
Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.
Although tension-type headache is the most prevalent headache and affects 78% of the general population, the substantial societal and individual burden associated with this primary headache has been overlooked. In contrast to migraine headache, there has been limited focus on tension-type headache. Most patients with the chronic form of tension-type headache, which affects 3% of the population, are left virtually without any specific treatment. Chronic tension-type headache differs from the episodic form in frequency, lack of effect to most treatment strategies, more medication overuse, and more loss of quality of life. Daily or near daily headaches also constitute a major diagnostic and therapeutic problem and distinguishing chronic tension-type headache from migraine headache and from medication-induced headache is a substantial diagnostic challenge because management strategies are completely different. Considerable benefits for the society can be gained by specific strategies leading to reductions in the amount of sickness absence and impaired working abilities. The burden on the affected patients' and their families' quality of life also may be improved by a general acceptance of the disorder and by the development of a specific treatment strategy.
To review the epidemiologic literature concerning the occurrence of and the risk factors for pain and specific soft-tissue rheumatic conditions that affect the neck and upper limbs.
An extensive search of the literature, including a search of Medline and EMBASE, authoritative recent reviews, and relevant textbooks, was performed. Studies that furnished data about the occurrence of or risk factors for regional pain or specific soft-tissue entities were extracted.
Numerous epidemiologic studies among different populations suggest a high prevalence of pain in the neck (10% to 19%), shoulder (18% to 26%), elbow (8% to 12%), and wrist/hand (9% to 17%) at any point in time. Less clear is the proportion of pain caused by specific upper-limb disorders as compared with nonspecific pain; however, as many as 6% of adults may have carpal tunnel syndrome. Significant risk factors for these disorders include age, female gender, obesity, and association with mechanical exposures (eg, posture, force, repetition, vibration) in the workplace. Also implicated are psychologic well-being and psychosocial workplace factors such as high levels of demand, poor control, and poor support.
Pain and soft-tissue rheumatic disorders of the neck and upper limb are common. It appears that individual, mechanical, and psychosocial factors all contribute to upper-limb disorders, suggesting that future strategies for prevention will need to address each of these factors if they are to be successful.