[Association between mental health, fear of COVID-19, and job insecurity among bus service workers during the COVID-19 pandemic].

OBJECTIVE: The purpose of this study is to examine the association between mental health, fear of COVID-19, and job insecurity among bus service workers during the second wave of the coronavirus disease 2019 (COVID-19) pandemic in Japan. METHODS: In September 2020, 1,889 employees of three private railway bus companies in the Tokai region were administered an anonymous self-questionnaire to be filled out at their workplace. The survey items were depression, anxiety, fear of COVID-19, job insecurity, demographics, and work characteristics. Logistic regression analysis was used to calculate the odds ratio and 95% confidence interval. RESULTS: Overall, 1,316 valid responses, excluding those from workers with a history of mental illness and others, were included in the analysis (valid response rate: 69.7%). Multiple logistic regression analysis revealed that the prevalence of depression and anxiety were significantly higher in groups with medium and high levels of fear of COVID-19 or job insecurity than in the group with a low level of fear of COVID-19 or job insecurity. DISCUSSION AND CONCLUSION: Fear of COVID-19 and job insecurity were found to be risk factors for depression and anxiety among bus service workers during the second wave of the COVID-19 pandemic, the latter being the stronger risk factor. Hence, comprehensive COVID-19 prevention measures as well as mental health-related measures to reduce job insecurity should be implemented in the bus service industry.

Effects of work-family life support program on the work-family interface and mental health among Japanese dual-earner couples with a preschool child: A randomized controlled trial.

OBJECTIVES: This study examined the effectiveness of a newly developed work-family life support program on the work-family interface and mental health indicators among Japanese dual-earner couples with a preschool child(/ren) using a randomized controlled trial with a waitlist. METHODS: Participants who met the inclusion criteria were randomly allocated to the intervention or the control groups (n = 79 and n = 85, respectively). The program comprised two 3-h sessions with a 1-month interval between them and provided comprehensive skills by including self-management, couple management, and parenting management components. The program sessions were conducted on weekends in a community center room with 3-10 participants. Outcomes were assessed at baseline, 1-month, and 3-month follow-ups. Primary outcomes were work-family balance self-efficacy (WFBSE), four types of work-family spillovers (i.e., work-to-family conflict, family-to-work conflict, work-to-family facilitation, and family-to-work facilitation), psychological distress, and work engagement reported by the participants. RESULTS: The program had significantly pooled intervention effects on WFBSE (P = .031) and psychological distress (P = .014). The effect sizes (Cohen's d) were small, with values of 0.22 at the 1-month follow-up and 0.24 at the 3-month follow-up for WFBSE, and -0.36 at the 3-month follow-up for psychological distress. However, the program had nonsignificant pooled effects on four types of work-family spillovers and work engagement. CONCLUSIONS: The program effectively increased WFBSE and decreased psychological distress among Japanese dual-earner couples with a preschool child(/ren).

Hospital organizational structure factors related to discharge planning activities for alcoholics by nurses in Japan.

AIM: Nurses play a significant role in providing discharge support for alcoholics. We aimed to explore the organizational structures of hospitals that are related to effective discharge planning activities provided by nurses. METHODS: We conducted a cross-sectional survey of Japanese hospitals with psychiatric wards that accept alcoholics. The survey questionnaire was administered to one nurse per hospital from August to September 2019. The Discharge Planning Scale for Ward Nurses (DPWN) was used to assess the actual status of the hospital nurse teams' discharge planning activities. The DPWN consists of four subscales: subscale I, "collect information from patients and their families"; subscale II, "supports for decision-making for the patients and families"; subscale III, "utilization of social resources"; and subscale IV, "discharge guidance by cooperating with community support teams and multidisciplinary teams." RESULTS: From the valid responses of 116 hospitals, scores on subscale IV were significantly lower than scores on subscales I, II, and III, indicating that medical care guidance through multidisciplinary collaboration between hospitals and the community was inadequate. In addition, multiple regression analysis showed that "hospital management and administrators understanding about nurses' discharge support activities," and "planning discharge schedules, such as using clinical paths" were significantly and independently related to the total DPWN and each of subscale scores, regardless of the hospital's establishment body and size. "Multidisciplinary discharge support" was significantly related to subscale II. CONCLUSIONS: These findings have implications for the management of discharge planning activities provided by nurses for alcoholics through multidisciplinary collaboration.

[Association between social jetlag and presenteeism in Japanese industry: A cross-sectional study].

OBJECTIVES: Research suggests that misalignment of the biological clock and social time, referred to as social jetlag (SJL), can induce physical and mental disorders. SJL may also be associated with presenteeism (i.e., a state in which workers are unable to perform sufficiently due to mental and physical health problems, even though they are going to work). However, the association between SJL and presenteeism among workers in Japan remains unclear. This study aimed to verify the following hypotheses in a sample of workers in an industrial setting in Japan: "Workers exhibiting SJL have a high degree of work functioning impairment due to presenteeism" and "An association between SJL and presenteeism exists, even when taking work style and sleep-related factor into consideration." METHODS: A self-administered questionnaire survey was conducted with 1,573 workers in the manufacturing industry. Of these, 1,501 participants responded (response rate: 95.4%). Individuals who provided invalid answers or used alarm clocks to wake on work-free days were excluded, according to the Munich Chronotype Questionnaire (MCTQ) guidelines. The final sample comprised 980 participants (80.7% male; average age: 44.4 [SD 11.3] years). SJL was assessed using the MCTQ. Presenteeism was measured using the work functioning impairment scale. Using presenteeism as the dependent variable, we conducted hierarchical multiple regression analyses to compare the explanatory power of the different models. Independent variables were SJL, daily rest period between workdays, weekday sleep duration, and subjective insomnia. Models 2 and 3 were adjusted for age, sex, employment position, occupation, employment status, and working regulations. RESULTS: Multiple regression analyses indicated that SJL was significantly and individually associated with presenteeism (ß = .066, p = .038). After adjusting for work- and sleep-related variables (Models 2 and 3), SJL no longer contributed significantly to presenteeism. In the final model, daily rest periods (ß = .076, p = .017) and subjective insomnia (ß = .470, p < .001) remained significantly associated with presenteeism (adjusted R2 = .239). CONCLUSIONS: The hypothesis "Workers experiencing SJL have a high degree of work functioning impairment due to presenteeism" was supported in our univariate analysis. However, after considering the influence of subjective insomnia and daily rest periods, the association disappeared. Therefore, a direct relationship between SJL and presenteeism is not supported. Thus, the risk of presenteeism should be considered in two stages, first confirming the perception of insomnia among workers who experience SJL, and then considering the possibility of presenteeism occurring.

Workaholism, Work Engagement and Child Well-Being: A Test of the Spillover-Crossover Model.

This study examines how working parents' work attitudes (i.e., workaholism and work engagement) are associated with their child's psychological well-being. Based on the Spillover-Crossover model (SCM), we hypothesize that (a) work-to-family spillover (i.e., work-to-family conflict and facilitation) and (b) employee happiness will sequentially mediate the relationship between parents' work attitudes and their child's emotional and behavioral problems. A cross-sectional survey was conducted among Japanese dual-earner couples with pre-school child(ren). On the basis of valid data from 208 families, the hypothesized model was tested using structural equation modeling. For both fathers and mothers simultaneously, workaholism was positively related to work-to-family conflict, which, in turn, was negatively related to happiness. In contrast, work engagement was positively related to work-to-family facilitation, which, in turn, was positively related to happiness. Fathers' and mothers' happiness, in turn, were negatively related to their child's emotional and behavioral problems. Results suggest that parents' workaholism and work engagement are related to their child's emotional and behavioral problems in opposite ways, whereby parents' spillover and happiness mediate this relationship. These findings support the SCM and suggest that decreasing workaholism and improving work engagement may not only improve employees' happiness, but also decrease their child's emotional and behavioral problems.

Support for balancing cancer treatment and work by occupational health nurses: support structures and implementation status.

This study aimed to quantitatively grasp the structure of support for balancing cancer treatment and work among occupational health nurses (OHNs) with the current implementation status. The anonymous questionnaire was designed based on the findings of our previous qualitative study and distributed to OHNs. The degrees of support implementation for workers with cancer, superiors and colleagues, and human resource managers were assessed for each item. Factor analysis of support items was conducted, and Wilcoxon signed-rank test was carried out to compare the support scores between the factors. Support for workers with cancer comprised six factors in which the factor, concerning the provision of information regarding resources inside and outside the company, showed the lowest score. Support for superiors and colleagues was divided into three factors, and that for human resource managers comprised two factors. By Mann-Whitney's U-test, it was found that OHNs, who worked without full-time occupational health physicians for smaller companies, showed significantly higher implementation for several support factors, such as support to human resource managers. This study revealed the structure as well as implementation status of OHNs' support for balancing cancer treatment and work, which will provide suggestions for developing training programs for OHNs to promote these activities.

[Vitalizing public health activities through community assessment: A report of the Committee on Public Health Nursing 2014-2017].

Objectives　This report aims to present the community assessment model developed by the Committee on Public Health Nursing (6th term) of the Japanese Association of Public Health. This new model was designed such that it could be applied to a broad range of public health activities. It aims at theorizing public health nurses' practice-based knowledge and sharing it among other public health professionals.Methods　The model was developed during seven committee meetings held from October 2014 to September 2017. In the first step, we brainstormed the definition and methods of community assessment and constructed a framework for a literature review. In the second step, information on theories, research, and practice relevant to community assessment was reviewed based on this framework. In the third step, the community assessment model was developed based on the results of the literature review and the practice experience of the committee members. In the last step, we examined the applicability of this model to the practice of occupational health and public health administration.Project activities　We defined community assessment as the "skills and methods based on applied science that drive Plan-Do-Check-Action (PDCA) cycles in every activity that aims at achieving a better quality of life (QOL)." We further classified community assessment into two types; comprehensive assessment and targeted assessment. The model underlined that community assessment was a continuous and developmental process that occurs throughout every stage of the PDCA cycle, and that it was oriented toward improving the QOL of community residents. This model also purported that the empirical and scientific intuition, and ethical sensitivity of assessors were among the key determinants of assessment quality.Conclusion　The model on community assessment developed in the present study based on the empirical knowledge of public health nurses could be applied to all types of public health activities in communities.

Randomized controlled trial of Web-based weight-loss intervention with human support for male workers under 40.

OBJECTIVES: Human support can boost weight reduction in Internet-based weight-loss intervention. However, the most effective way to combine human support and the Internet for weight loss is unclear. This study aimed to examine the effects of two weight-loss programs for male workers aged 18-39 that combined different intensities of human support with website support compared to a delayed-intervention group (control group; CG), in a randomized controlled trial. METHODS: Seventy-one participants with overweight or obesity were allocated to one of three 12-week treatment programs. The Standard Support Group (SSG) was provided support via website and two face-to-face group guidance sessions, at the beginning and at the end of the program along with monthly general emails throughout the program. The Enhanced Support Group (ESG) received four remote support sessions based on Supportive Accountability (SA) in addition to the SSG. The CG was provided the same program as SSG after the other two groups had completed the program. The primary outcome was body weight reduction. RESULTS: ESG participants reduced their weight significantly more than SSG and CG participants (P = 0.038, P < 0.001, respectively), and SSG participants reduced their weight significantly more than CG participants (P = 0.033). CONCLUSIONS: The additional remote human support provided to the participants in the ESG was beneficial for weight loss in male workers. The low-intensity program provided to the SSG was also effective. Further studies with more participants in diverse settings and with participants who are less interested in their health and weight management are needed.

The effects of workplace psychosocial factors on whether Japanese dual-earner couples with preschool children have additional children: a prospective study.

This study explored the effect of workplace psychosocial factors (job demand, job control, and workplace social support) on dual-earner couples in Japan having additional children, using a prospective study design. We conducted a 2-year prospective cohort study with 103 dual-earner couples with preschool children in Japan, as part of the Tokyo Work-Family Interface Study II. We used multivariable logistic regression analyses to evaluate the prospective association of job strain (categorized into low-strain job, active job, passive job, and strain job groups) and workplace social support (high and low) with couples having additional children during the follow-up period, adjusting for age, for men and women separately. Men in the active job group (i.e., with high job demands and high job control) had a significantly higher odds ratio (OR) of having additional children during the follow-up period, after controlling for age (OR 9.07, 95% confidence interval: 1.27-64.85). No significant association between any workplace psychosocial factor and having additional children was confirmed among women. Having an active job may have a positive influence on having additional children among men in dual-earner couples.

Association between Parental Workaholism and Body Mass Index of Offspring: A Prospective Study among Japanese Dual Workers.

The purpose of the study was to investigate the association between parental workaholism and child body mass index (BMI) among Japanese dual-income families. In 2011, 379 dual-income families from urban Tokyo with children aged 0-5 years were recruited for a baseline survey, and 160 (42.2%) were followed up in 2012. Demographics, workaholism, work demands, work control, time spent with children, and parental and child weights and heights were assessed using a questionnaire. Structural equation modeling was performed to determine the association between maternal and paternal workaholism in 2011 and child BMI in 2012, considering the mediating effects of time spent with children. Paternal workaholism showed a direct significant positive association with child BMI after 1 year (standardized coefficient: 0.19; p < 0.001), while maternal workaholism was not associated with child BMI. Both maternal and paternal time spent with children did not mediate the association. Paternal work demands showed a strong positive association with workaholism but paternal work control did not. Paternal, but not maternal, workaholism was associated with an increase in child BMI over 1 year. Interventions that target workaholism by reducing paternal work demands might be effective in preventing overweight in offspring.

The effect of skill mix in non-nursing assistants on work engagements among home visiting nurses in Japan.

AIM: This study evaluated the effect of a skill-mix programme intervention on work engagement in home visiting nurses. BACKGROUND: A skill-mix programme in which home visiting nurses are assisted by non-nursing workers is assumed to foster home visiting nurses' work engagement. METHOD: Pre- and post-intervention evaluations of work engagement were conducted using self-administered questionnaires. A skill-mix programme was introduced in the intervention group of home visiting nurses. After 6 months, their pre- and post-intervention work engagement ratings were compared with those of a control group. RESULT: Baseline questionnaires were returned by 174 home visiting nurses (44 in the intervention group, 130 in the control group). Post-intervention questionnaires were returned by 38 and 97 home visiting nurses from each group. The intervention group's average work engagement scores were 2.2 at baseline and 2.3 at post-intervention; the control group's were 3.3 and 2.6. Generalised linear regression showed significant between-group differences in score changes. CONCLUSION: The skill-mix programme might foster home visiting nurses' work engagement by improving the quality of care for each client. Future research is needed to explain the exact mechanisms that underlie its effectiveness. IMPLICATIONS FOR NURSING MANAGEMENT: In order to improve the efficiency of services provided by home visiting nurses and foster their work engagement, skill-mix programmes might be beneficial.

Individual and organizational factors related to work engagement among home-visiting nurses in Japan.

AIM: The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. METHODS: An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. RESULTS: Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. CONCLUSION: Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses.

Relationship between perceived time pressure during visits and burnout among home visiting nurses in Japan.

AIM: The rapidly rising number of older people has inevitably caused an increasing demand for home visiting nurses. Nursing managers must develop a healthy workplace to recruit and retain a workforce of nurses. This study focused on home visiting nurses' perceptions of time pressure as a changeable work demand. The aim was to investigate perceptions of time pressure and reveal the relationship between perceived time pressure and burnout among home visiting nurses. METHODS: From 32 agencies in three districts, 28 home visiting nurses agreed to participate in this study. Two hundred and eight home visiting nurses received an anonymous self-administered questionnaire by mail, and 177 (85.1%) filled out and returned the questionnaire to the researchers. The Job Demands-Resources model for burnout, which explains the relationship between a work environment and employee well-being, was used as a conceptual guide. Three survey instruments were employed: questions on sociodemographic variables and worksite environments, including time pressure; the Japanese burnout inventory; and a Japanese version of the job content questionnaire. Multiple regression analyses were performed to examine the relationships between time pressure and burnout inventory scores. RESULTS: About 30% of home visiting nurses perceived time pressure frequently. When home visiting nurses perceived time pressure more frequently, they experienced higher emotional exhaustion and depersonalization. CONCLUSION: Time pressure was often perceived as another job demand and had a significant relationship with burnout. This indicates the importance of lessening time pressure to develop healthy work places for community health nurses.

[Fathers' child-rearing behavior and influencing factors].

PURPOSE: Fathers' child-rearing is still limited in Japan. This study describes the current situation of fathers' child-rearing and examines the association with positive spillover. METHOD: Self-administered questionnaires were mailed to fathers of toddlers of nursery schools in a suburban city of Tokyo, Japan. To examine the influence of different factors on fathers' emotional support for mothers in child-rearing and house work, hierarchical multiple regression analyses were performed. RESULTS: From the analysis of 189 respondents, positive spillover of work and family roles, and egalitarian sex role attitudes were related to fathers' emotional support for mothers. Regarding child-rearing and housework, positive spillover of work and family roles and mothers' occupations were related. CONCLUSION: Fathers' child-rearing behavior is related with positive spillover of work and family roles.

Gender difference in work-family conflict among Japanese information technology engineers with preschool children.

Since the Family Policy Act, which requires companies to develop action plans to support their employees who have children in an attempt to reverse the declining birthrate in Japan, was enacted in 2003, many Japanese organizations and occupational health staff have become interested in work-family conflict (WFC), especially WFC in employees with young children. A cross-sectional survey of regularly employed information technology (IT) engineers with preschool children in Japan was conducted to examine the gender difference in WFC, relationship of WFC with outcomes, and predictors of WFC by gender. Data from 78 male and 102 female respondents were analyzed. There was no significant gender difference in total level of WFC. However, the level of work interference with family (WIF) was significantly higher in males than in females and the level of family interference with work (FIW) was significantly higher in females. Regarding outcomes, WIF was significantly related to depression and fatigue in both genders. Moreover, different predictors were related to WIF and FIW by gender. A family-friendly culture in the company was related to WIF only in males. To prevent depression and cumulative fatigue in employees with young children, occupational practitioners have to pay attention to not only employees' work stress but also their family stress or amount of family role in both genders.

[Development of a Japanese Version of the Work-Family Conflict Scale (WFCS), and examination of its validity and reliability].

The purposes of this study were to develop a Japanese version of the multi-dimensional Work-Family Conflict Scale (WFCS) and to examine its reliability and validity. The original 18-item WFCS (Carlson, et al., 2000) has six dimensions of conflict which consist of time-based work interference with family (WIF), time-based family interference with work (FIW), strain-based WIF, strain-based FIW, behavior based WIF, and behavior-based FIW. We developed a Japanese version of the WFCS from the original WFCS which is written in English by the following procedure: forward translation and back translation by several researchers including a native English speaker, and finally, gaining the approval of Carlson et al., the original authors. A self-administered questionnaire including the WFCS was distributed to 180 permanent contract, information technology (IT) engineers with pre-school children, who were employed at 24 IT companies, each with over 300 employees. Test-retest was conducted on a different group of 34 parents whose children were attending nursery school. Cronbach's reliability coefficients for the six subscales ranged from 0.77 to 0.92, showing sufficiently high internal consistency. Only the internal correlation coefficient between behavior-based WIF and behavior-based FIW was above 0.60, indicating that discriminant validity exists among most of the sub-scales. Also, upon comparison of confirmatory factor analysis results among five models, the six-factor model, which is the same model used in the original WFCS, showed the best fit (chi-square=231.82, df=129, CFI=0.95, AIC=315.82, RMSEA=0.07), demonstrating construct validity. On test-retest, weighted kappa coefficients of each item and the intra-class correlations of six subscales, indicated adequate reproducibility. These results suggest that the Japanese version of the WFCS may be a reliable and valid instrument for assessing the conflict between work and family in Japanese workers.