[Depressive disorders of working Poles during the COVID-19 pandemic (2019-2022)]. / Zaburzenia depresyjne pracujacych Polaków w okresie pandemii COVID-19 (lata 2019­2022).

BACKGROUND: The problem of the intensification of mental disorders, including depressive disorders, is well documented in the world, but in Poland data on this subject are still insufficient. It can be assumed that the worldwide increase in mental health problems resulting from the outbreak of the COVID-19 pandemic in the winter of 2019 could also change the current statistics with regard to depressive disorders occurring in Poland. MATERIAL AND METHODS: Longitudinal studies diagnosing depressive disorders were carried out on a representative group of 1112 Poles working in various occupations, employed on the basis of various types of employment contracts in the period January-February 2021, and a year later. During the first measurement of depressive disorders, the respondents were also asked to retrospectively assess the severity of these disorders in the early autumn of 2019, i.e., 6 months before the outbreak of the COVID-19 pandemic. Depression was diagnosed using the Patient Health Questionnaire PHQ-9 (PHQ-9). RESULTS: The results of the research presented in the article indicate a significant increase in the level of depression among working Poles in the period 2019-2022, as well as an exacerbation of the severity of its symptoms, probably resulting from the outbreak of the pandemic. However, in the years 2021-2022, a growing level of depression was observed only among working women, less educated people, people engaged in physical and mental work, as well as people with less stable employment (temporary work contracts, specific-task contracts and fixed-term contracts). CONCLUSIONS: Due to the high individual, organizational and social costs that generate depressive disorders, there is an urgent need to develop a comprehensive depression prevention strategy, including programs to prevent these disorders in the workplace. This need applies in particular to working women, people with lower social capital and those with less stable type of employment. Med Pr. 2023;74(1):41-51.

Personality-related and psychosocial correlates of sick leave days in Germany during the COVID-19 pandemic: findings of a representative survey.

BACKGROUND: The aim of our study was to assess the personality-related and psychosocial correlates of sick leave days in Germany during the COVID-19 pandemic. METHODS: We used data from a representative online-survey covering the general German adult population (data collection: mid-March 2022). We restricted our sample to full-time employed individuals aged 18 to 64 years (n = 1,342 individuals). Sick leave days in the preceding 12 months served as outcome measure. Validated and established tools were used to quantify personality characteristics and psychosocial factors (such as the Coronavirus Anxiety Scale or the De Jong Gierveld loneliness tool). Negative binomial regression models were used. RESULTS: After adjusting for various sociodemographic and health-related factors, regressions showed that a higher number of sick leave days was associated with lower levels of conscientiousness (IRR: 0.84, 95% CI: 0.73-0.97), higher levels of openness to experience (IRR: 1.19, 1.04-1.35), less coronavirus anxiety (IRR: 0.90, 95% CI: 0.86-0.93), and more depressive symptoms (IRR: 1.06, 1.02-1.11). CONCLUSION: After adjusting for various sociodemographic and health-related factors, our study showed an association between personality-related and psychosocial factors with sick leave days. More research is required to clarify the underlying pathways.

Impact of Omicron on sick leave across industries: A population-wide study.

AIMS: To estimate the industry-specific impact of the COVID-19 pandemic (Omicron wave) on sick leave. METHODS: Using individual-level data from the Norwegian Emergency Preparedness Register, the study covers all workers in different industries (N = 2,733,751 people) on a monthly level in the time periods January-March 2017-2020 (except March 2020) and 2022 (38,199,536 person-months). We estimated the industry-specific increase in monthly average sick leave during the Omicron wave in 2022 compared with the corresponding months in 2017-2020. RESULTS: We found an average increase in monthly sick leave rates of 2.92 percentage points (95% CI 2.9-2.94) during the three first months of 2022. The increases were strongest within food and accommodation (4.42 percentage points increase, 95% CI 4.33-4.51) and administrative support services (3.94 percentage points increase, 95% CI 3.85-4.03). CONCLUSIONS: The Omicron wave resulted in a substantial increase in sick leave, which was unevenly distributed across industries. The results of this study highlight the importance of industry-specific contingency planning when facing the rapid spread of infectious diseases.

Protocol for a feasibility randomised controlled study of a multicomponent intervention to promote a sustainable return to work of workers on long-term sick leave - PROWORK: PROmoting a Sustainable and Healthy Return to WORK.

BACKGROUND: The cost of sickness absence has major social, psychological and financial implications for individuals and organisations. Return-to-work (RTW) interventions that support good quality communication and contact with the workplace can reduce the length of sickness absence by between 15 and 30 days. However, initiatives promoting a sustainable return to work for workers with poor mental health on long-term sickness absence across small, medium and large enterprises (SMEs and LEs) are limited. This paper describes the protocol of a pilot randomised controlled trial (RCT) to test the feasibility of implementing a RTW intervention across SMEs and LEs across all sectors. METHODS AND DESIGN: A two-arm feasibility RCT with a 4-month intervention will be conducted in SMEs and LE enterprises from the Midlands region, UK. At least 8 organisations (4 controls and interventions), and at least 60 workers and/or managers, will be recruited and randomised into the intervention and control group (30 interventions, 30 controls). Workers on long-term sickness absence (LTSA) (between 8 and 50 days) and managers with a worker on LTSA will be eligible to participate. The intervention is a behavioural change programme, including a managers and workers RTW toolkit, focused on supporting sickness absence and RTW through the provision of knowledge, problem-solving, action planning, goal setting and positive communication that leads to a sustainable RTW. Organisations assigned to the control group will continue with their usual practice. Measurements of mental health, RTW, work outcomes, quality-of-life, workplace support and communication and other demographic data will be taken at baseline, 2 months and 4 months. Feasibility will be assessed based on recruitment, retention, attrition, completion of measures and intervention compliance for which specific process and research outcomes have been established. A process evaluation will explore the experiences and acceptability of the intervention components and evaluation measures. Exploratory economic evaluation will be conducted to further inform a definitive trial. DISCUSSION: This is a novel intervention using a worker-manager approach to promote a sustainable return to work of workers on long-term sick leave due to poor mental wellbeing. If this intervention is shown to be feasible, the outcomes will inform a larger scale randomised control trial. TRIAL REGISTRATION: ISRCTN90032009 (retrospectively registered, date registered 15th December 2020).

Some of the workforce face post COVID after the acute phase of the illness: The employer's supportive role

BACKGROUND: A considerable proportion of workers that recover from an acute phase of COVID-19 are confronted with post COVID-19 symptoms of varying severity and duration. Employers have an important role in addressing this new condition. OBJECTIVE: The aim of this study was to review organisational practises that could help employees suffering from long COVID-19 return to work and to link these suggestions to theoretical frameworks from the field of work and organisational psychology. METHODS: Since scientific publications on post COVID-19 are published daily, but sound empirical studies are still scarce, the synthesis of the scientific and professional literature was performed in the form of a narrative review. RESULTS: The results were organised according to the healthy workplace model and explained through the lens of the job demands-resources theory. The role of the employer has three aspects: collaboration, instructional pillars, and key actors. The main guidelines for implementation of the policies are an individualised approach, flexibility, and support. Supportive policies, practises, and relationships might have a direct impact on workers' psychological resources. CONCLUSIONS: The model could help employers understand the conditions and necessary adaptations for workers with post COVID-19, as well as advance research in work and organisational psychology.

Process Evaluation of the Child and Youth Healthcare Intervention 'Medical Advice for Sick-Reported Students in Primary School' (MASS-PS).

School attendance is crucial for the development of a child. Sickness absence is the most common type of absenteeism and can be a red flag for underlying problems. To address sickness absence, the intervention Medical Advice for Sick-reported Students for Primary School (MASS-PS) was recently developed. It targets children at risk and is a school-based child and youth health care intervention. The present study is a process evaluation of the intervention. MASS-PS was implemented and evaluated in 29 schools in the West-Brabant region of the Netherlands, during three school years (2017-2020). Attendance coordinators (ACs) from the different schools were interviewed in six focus group interviews as well as in over 200 individual conversations, of which logbooks were kept. Content analysis was used based on a framework of implementation elements. During the first year of the study, the uptake was low. Changes were made by the project group to improve the uptake. The ACs generally considered the MASS-PS as compatible and relevant, but suggested improvements by adding a medical consultation function with a child and youth healthcare physician and increasing the threshold for selecting children at risk. They saw several personal benefits, although time was necessary to learn to use the intervention. An organisational barrier was the lack of teaching staff. A strength in the organisational structure was the appointment of ACs. A major event in the sociological structure was the COVID-19 pandemic. ACs felt that the intervention helped them keep track of sickness absence during the pandemic. The Medical Advice for Sick-reported Students for Primary School intervention was implemented successfully, and the process evaluation gave insight into possible improvements.

Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial.

BACKGROUND: Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. OBJECTIVE: The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. METHODS: A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. RESULTS: At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. CONCLUSIONS: A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave. TRIAL REGISTRATION: ClinicalTrials.gov NCT03404583; https://clinicaltrials.gov/ct2/show/NCT03404583.

Difference in Pandemic-Related Experiences and Factors Associated with Sickness Absence among Nurses Working in COVID-19 and Non-COVID-19 Departments.

BACKGROUND: The aim of this study is to determine the main variables associated with nurses' sickness absence (SA) and to improve the prediction of SA based on pandemic-related experiences. The second aim is to examine the differences between COVID-19 (CoV) and non-COVID-19 (non-CoV) nurses in levels of post-traumatic stress disorder (PTSD) symptoms, personality traits, coping strategies and professional stressors experienced. METHODS: This historical prospective study enrolled 1305 nurses from the University Hospital of Split, Croatia. A total of 380 subjects participated in the study, 163 non-CoV and 217 CoV subjects. Nurses' pandemic-related experience questionnaires, Big Five Inventory (BFI), Post-traumatic Stress Disorder Checklist (PCL-5), Coping Inventory for Stressful Situations (CISS) and Occupational Stress Questionnaire, were used for evaluation. RESULTS: Non-CoV nurses felt more fear of infection, were more socially distanced, had more PTSD symptoms and neuroticism and felt more stress due to public criticism and job requirements compared to CoV nurses; p < 0.001. The groups of SA users and non-SA users could be distinguished based on predictor variables in CoV and non-CoV nurses, with a correct classification of 84.8% vs. 79.1%. CONCLUSIONS: It was possible to predict the probability of using SA among nurses due to pandemic professional experience, personality traits and coping strategies.

Ethnic differences in risk of severe Covid-19: To what extent are they driven by exposure?

BACKGROUND: This study quantifies the risk of Covid-19 among ethnic groups of healthcare staff during the first pandemic wave in England. METHODS: We analysed data on 959 356 employees employed by 191 National Health Service trusts during 1 January 2019 to 31 July 2020, comparing rates of Covid-19 sickness absence in different ethnic groups. RESULTS: In comparison with White ethnic groups, the risk of short-duration Covid-19 sickness absence was modestly elevated in South Asian but not Black groups. However, all Black and ethnic minority groups were at higher risk of prolonged Covid-19 sickness absence. Odds ratios (ORs) relative to White ethnicity were more than doubled in South Asian groups (Indian OR 2.49, 95% confidence interval (CI) 2.36-2.63; Pakistani OR 2.38, 2.15-2.64; Bangladeshi OR 2.38, 1.98-2.86), while that for Black African ethnicity was 1.82 (1.71-1.93). In nursing/midwifery staff, the association of ethnicity with prolonged Covid-19 sickness absence was strong; the odds of South Asian nurses/midwives having a prolonged episode of Covid-19 sickness absence were increased 3-fold (OR 3.05, 2.82-3.30). CONCLUSIONS: Residual differences in risk of short term Covid-19 sickness absences among ethnic groups may reflect differences in non-occupational exposure to SARS-CoV-2. Our results indicate ethnic differences in vulnerability to Covid-19, which may be only partly explained by medical comorbidities.

Changing patterns of sickness absence among healthcare workers in England during the COVID-19 pandemic.

BACKGROUND: Patterns of sickness absence shed useful light on disease occurrence and illness-related behaviours in working populations. METHODS: We analysed prospectively collected, pseudonymized data on 959 356 employees who were continuously employed by National Health Service trusts in England from 1 January 2019 to 31 July 2020, comparing the frequency of new sickness absence in 2020 with that at corresponding times in 2019. RESULTS: After exclusion of episodes directly related to COVID-19, the overall incidence of sickness absence during the initial 10 weeks of the pandemic (March-May 2020) was more than 20% lower than in corresponding weeks of 2019. Trends for specific categories of illness varied substantially, with a fall by 24% for cancer, but an increase for mental illness. A doubling of new absences for pregnancy-related disorders during May-July of 2020 was limited to women with earlier COVID-19 sickness absence. CONCLUSIONS: Various factors will have contributed to the large and divergent changes that were observed. The findings reinforce concerns regarding delays in diagnosis and treatment of cancers and support a need to plan for a large backlog of treatment for many other diseases. Further research should explore the rise in absence for pregnancy-related disorders among women with earlier COVID-19 sickness absence.

How People with Multimorbidity and Psychosocial Difficulties Experience Support by Rehabilitation Coordinators During Sickness Absence.

PURPOSE: People with multimorbidity face a range of barriers in healthcare, and there is little knowledge about their challenges with regard to return-to-work (RTW). Rehabilitation coordinators, a new function in Swedish healthcare, support people in the RTW process. The present study had two aims: to explore what problems and barriers people with multimorbidity experience during their rehabilitation and RTW process and to explore in which domains the coordinators' support is perceived to be of importance. METHODS: Interviews were conducted with 12 persons with multimorbidity who had contact with a rehabilitation coordinator during their sickness absence. Thematic analysis was guided by the case-management ecological model; this analysis was revised and adapted to the Swedish context. RESULTS: The participants experienced problems in all domains of the model, namely: "the healthcare system", "the labor market and the workplace system", "the sickness insurance system", and "the personal system". Rehabilitation programs that did not accommodate combinations of diseases, social complexities and needs were felt to lead to worse symptoms, thus hindering rather than promoting RTW. An overall finding regarding support by coordinators is that interventions, regardless of domain, were felt to be valuable for people with multimorbidity. The coordinator was perceived to give most support by providing advice about and coordination with healthcare and employers. Sometimes the coordinator gave advice and coordination regarding the Social Insurance Agency, very occasionally the Public Employment Services. The coordinator gave least advice and coordination about social difficulties that hindered rehabilitation and RTW processes. CONCLUSION: People with multimorbidity perceive rehabilitation coordinator interventions as important in all domains investigated. Lack of advice and coordination, or rehabilitation programs that were not modified to the complexities of individual's circumstances, were associated with prolonged sickness absence, worse health, or social risk factors not being recognized.

Working while sick in context of regional unemployment: a Europe-wide cross-sectional study.

BACKGROUND: Research suggests that areas with high unemployment have lower rates of sickness absence, but the underlying mechanisms remain unclear. One assumption is that when unemployment is high people are more likely to work while being sick (discipline hypothesis). Against this background, we investigate the association between regional unemployment and sickness presenteeism. Second, we study interactions with factors of occupational disadvantage. METHODS: We combined survey data of 20 974 employees collected 2015 in 232 regions from 35 European countries with data on regional unemployment rates obtained from Eurostat. Presenteeism was assessed by the fraction of days worked while ill among all days with illness (presenteeism propensity). To investigate if unemployment was related to presenteeism, we estimated multi-level models (individuals nested in regions) that were adjusted for socio-demographic and occupational covariates to account for compositional differences of the regions. RESULTS: The mean presenteeism propensity was 34.8 (SD 40.4), indicating that workers chose presenteeism in 1 out of 3 days with sickness. We found that a change in unemployment by +10 percentage points was associated with a change in presenteeism by +5 percentage points (95% CI 1.2 to 8.6). This relationship was more pronounced among workers with low salary, low skill-level, and industrial and healthcare workers. CONCLUSION: Our results support the assumption that high unemployment elevates presenteeism, and that people in disadvantaged occupations are particularly affected. Policies managing presenteeism should consider the labour market context, particularly during the aftermath of the COVID-19 pandemic.