Are effort-reward imbalance and social isolation mediating the association between education and depressiveness? Baseline findings from the lidA(§)-study.

OBJECTIVES: To investigate multiple mediations of the association between education and depressive symptoms (BDI-V) by work-related stress (ERI) and social isolation, the regional variation of the first mediation and a potential moderating effect of regional unemployment rate. METHODS: 6339 employees born in 1959 and 1965 were randomly recruited from 222 sample points in a German cohort study on work, age, health and work participation. A multilevel model of moderated lower-level mediation was used to investigate the confirmatory research question. Multiple mediations were tested corresponding to Baron and Kenny. These analyses were stratified for age and adjusted for sex, negative affectivity and overcommitment. RESULTS: In the association between education and depressive symptoms, indirect effects of work-related stress and social isolation were significant in both age cohorts whereas a direct association was observable in the younger cohort, only. The significant regional variation in the association between work-related stress and depressive symptoms was not statistically explained by regional unemployment rate. CONCLUSIONS: Our findings point out that work-related stress and social isolation play an intermediary role between education and depressive symptoms in middle-aged employees.

[Exposure to aggressive patient behaviour and its' association with the nurses' "work ability" in Germany]. / Konfrontation mit aggressiven Klienten-- Auswirkungen auf die Arbeitsfähigkeit von Pflegekräften in Deutschland.

BACKGROUND: Aggressive behavior and violence in patients, residents or clients are growing challenges in nursing. Aggressive behavior can have both, physical and psychological consequences for nurses and can lead to a reduced performance at work, demotivation, sickness absence and the premature exit from the nursing profession. To develop purposive strategies and to deal with aggressive behavior and health promotion programs, it is crucial to know more about the prevalence of aggressive behavior from patients and the effect on the work ability of nurses in different types of institutions. METHOD: Data of 1735 German nurses was derived from the European NEXT-Study. Description and analysis of variance for each working area (hospital ward, Intensive Care Unit, psychiatric ward, nursing home and home care) were conducted. The work ability was measured with the Work Ability Index (WAI). The aggressive behavior was measured by one item developed by the NEXT Study Group. Linear regression models were applied to analyze the effect of aggressive behavior on the work ability of nurses in a comparison of the five different working areas. RESULTS: A total of 84.9 percent of the nurses were "sometimes" or "often/always" confronted with aggressive behavior from patients. In the comparison of the five working areas, nurses were exposed to different levels of aggressive behavior, while differences in the work ability of nurses were also observed. It was found that aggressive behavior from patients was associated with reduced work ability in nurses working in hospital wards, nursing homes and home care, but not nurses working in ICUs and psychiatric wards. CONCLUSIONS: The findings indicate that many nurses in Germany are exposed to aggressive behavior from patients, which has negative effect on the nurses' work ability. However, it is assumed that strategies to deal with aggressive behavior could play a buffer role between aggressive behavior and work ability of nurses, highlighting one possibility of intervention in future.

[A comparison of general health and potential predictors of general health among nurses in different age groups in Germany]. / Vergleich der Gesundheit und Identifizierung von Prädiktoren der Gesundheit in verschiedenen Altersgruppen Pflegender in Deutschland.

The increasing need for certified nursing staff moves healthy ageing in the nursing profession into the focus of scientific consideration. The purpose of this investigation consisted a) in an age-differentiated, longitudinal consideration of the general state of health and b) in an age differentiated identification of variables which forecast the general state of health of the nursing forces after 12 months. The identification of suitable predictors should give indications in which areas interventions could begin. The investigation based on data of the NEXT study. The analysis of the general health situation by means of ANOVA proved that older persons showed a worse state of health than younger. Besides, the general state of health changed stronger in older nursing forces after one year. The identification of the health predictors was carried out by means of linear regression. Results exhibited that work family-conflict was a significant predictor in every age group. While leadership quality for younger persons was another important factor, quantitative demands and social support from colleagues forecasted the health situation after one year for medium old employees. For older nursing forces, a good relationship with the superiors seemed to be an important component for preservation of a good health status. The different results in the examined age groups indicate that intervention measures, which have the purpose to hold up the general state of health as long as possible, should be implemented age-differentiatedly.