Mediating and Moderating Variables in the Relationship Between Emotional Demands and Teachers’ Emotional Exhaustion / [Variables mediadoras y moderadoras de la relación entre exigencias emocionales y agotamiento emocional en docentes]

Teachers tend to suffer high levels of emotional exhaustion, a variable that is associated with poor mental health and lower job performance. The present study analyzed how emotional demands, emotional dissonance, and self-efficacy to cope with stress interact in predicting teachers’ emotional exhaustion. To conduct this longitudinal research, 108 Andalusian teachers (57.3% women; mean age = 45.30, SD = 8.68) completed an online survey at three different time points. Moderated mediation analysis suggested that emotional dissonance mediated the relationship between emotional demands and emotional exhaustion, with self-efficacy acting as a moderator between the two. Teachers who perceived high emotional demands saw their levels of emotional dissonance increase, which in turn led to an increase in emotional exhaustion. In addition, self-efficacy acted as a protective factor against emotional exhaustion, buffering the negative effect of emotional dissonance. Strengthening these protective variables through interventions that increase levels of self-efficacy to cope with stress and reduce levels of emotional dissonance could help prevent teachers’ emotional exhaustion.(AU)

Los docentes tienden a sufrir un nivel elevado de agotamiento emocional, variable que se asocia con una mala salud mental y un bajo desempeño laboral. El estudio analiza cómo interactúan en la prevención del agotamiento emocional de los docentes las exigencias emocionales, la disonancia emocional y la autoeficacia para afrontar el estrés. Para llevar a cabo esta investigación de carácter longitudinal, 108 profesores andaluces (57.3% mujeres, edad media = 45.30, DT = 8.68) cumplimentaron una encuesta online en tres momentos distintos. El análisis de mediación moderada indicaba que la disonancia emocional mediaba la relación existente entre las exigencias emocionales y el agotamiento emocional, actuando como moderadora entre ambos la autoeficacia. Los profesores que percibieron exigencias emocionales elevadas vieron aumentar su grado de disonancia emocional, lo que a su vez aumentó el agotamiento emocional. Además, la autoeficacia actuó como factor protector del agotamiento emocional, amortiguando el efecto negativo de la disonancia emocional. Reforzar estas variables protectoras a través de intervenciones que aumenten el grado de autoeficacia para afrontar el estrés y reduzcan la disonancia emocional podría ayudar a prevenir el agotamiento emocional de los docentes.(AU)

Rampart of Health-Specific Leadership and Social Support of Colleagues to Overcome Burnout in an Emotionally Demanding Situations: The Mediating Role of Stress.

Introduction: Past studies have neglected the role of resources that enhance motivation, such as health-specific leadership (H-SL) and social support colleagues (SSC), in dealing with the prerequisites of psychological health of workers, especially the duo of stress and burnout. Objective: This empirical study aimed to identify the impact of psychosocial job demands (emotional demands) and psychosocial job resources (health-specific leadership and social support of colleagues) on the psychological health (stress, burnout) of 284 Malaysian industrial workers (who participated both times). Methods: The Hierarchical regression analysis was employed to examine all study hypotheses and a time lagged study design was used with a lag of three months between T1 and T2 for data collection. Results: The survey data found a significant impact of emotional demands on stress and burnout, while we found insignificant findings of health-specific leadership and social support from colleagues on workers' psychological health. Future Directions: Future studies should consider the different formations of psychosocial job resources and higher dimensions of health promotion leadership.

Emotional demands and entrepreneurial burnout: the role of autonomy and job satisfaction.

Entrepreneurs can exhibit the entrepreneurial burnout syndrome, which retards entrepreneur and firm performance. Building upon insights from the conservation of resources theory of stress response and psychology theory, this study examined the role of entrepreneur emotional demands as well as job autonomy and satisfaction resources with regard to entrepreneurial burnout. Multivariate regression analysis relating to 273 entrepreneurs in France revealed that emotional demands were positively associated with entrepreneurial burnout, while job autonomy and satisfaction were negatively associated with entrepreneurial burnout. Job autonomy buffered the negative effect of emotional demands on entrepreneurial burnout. However, job satisfaction did not buffer the negative effect of emotional demands on entrepreneurial burnout. Implications are discussed.

The Cross-Level Moderation Effect of Resource-Providing Leadership on the Demands-Work Ability Relationship.

Employees in female-dominated sectors are exposed to high workloads, emotional job demands, and role ambiguity, and often have insufficient resources to deal with these demands. This imbalance causes strain, threatening employees' work ability. The aim of this study was to examine whether resource-providing leadership at the workplace level buffers against the negative repercussions of these job demands on work ability. Employees (N = 2383) from 290 work groups across three countries (Germany, Finland, and Sweden) in female-dominated sectors were asked to complete questionnaires in this study. Employees rated their immediate supervisor's resource-providing leadership and also self-reported their work ability, role ambiguity, workload, and emotional demands. Multilevel modeling was performed to predict individual work ability with job demands as employee-level predictors, and leadership as a group-level predictor. Work ability was poor when employees reported high workloads, high role ambiguity, and high emotional demands. Resource-providing leadership at the group level had a positive impact on employees' work ability. We observed a cross-level interaction between emotional demands and resource-providing leadership. We conclude that resource-providing leadership buffers against the repercussions of emotional demands for the work ability of employees in female-dominated sectors; however, it is not influential in dealing with workload or role ambiguity.

The Influence of Social Support on the Relationship between Emotional Demands and Health of Hospital Nurses: A Cross-Sectional Study.

Social support reduces the negative results of emotional labor. A more detailed analysis should be performed to facilitate adequate social support for nurses. Therefore, this study was conducted to examine the relationships among nurses' emotional demands, social support, and health. A cross-sectional survey was conducted at two tertiary hospitals in South Korea. A sample of 117 nurses from eight units participated. Between-group differences in the main variables were analyzed using the t-test or Mann-Whitney test, and analysis of variance or the Kruskal-Wallis test. Nurses were classified into eight groups according to emotional demands and type of social support, and the effects of social support were analyzed based on mean scores. Greater social support from colleagues was associated with better health on all measures. However, greater social support from supervisors was associated with a higher incidence of burnout, stress, and sleeping troubles. Nurses' high emotional demands must be managed actively by hospitals to maintain and promote their health. Providing appropriate social support with consideration of the nurse's unit experience would help decrease the effects of emotional demands. Enhancing social support from nursing colleagues is a powerful way to manage the negative effects of nurses' emotional demands.

Chronic health conditions and work-related stress in older adults participating in the Dutch workforce.

The proportion of workers with chronic health conditions (CHCs) will increase over the years as pension reform is increasing the age of retirement in many European countries. This will increase the percentage of older adults with CHCs performing highly demanding work. This study sought to examine the association between common CHCs [cardiovascular disease (CVD), diabetes, arthritis, respiratory and sleep disorders] and three domains of work stress in older Dutch workers. This study used data from the first wave of the NIDI Pension Panel Study for working adults aged 60-65 years (n = 6793). Logistic regression models examined the strength of association between CHCs and (1) general work stress, (2) emotional, and (3) physical demands. All five CHC were independently associated with one or more domains of stress. After including all CHCs in the model, CVD, sleep disorders, and arthritis were significantly associated with general stress. Respiratory disorders, sleep disorders, and arthritis were significantly associated with physical demands. Diabetes (1.25, 95% CI 1.01-1.53), sleep disorders (1.99, 95% CI 1.72-2.31), and arthritis (1.18, 95% CI 1.06-1.31) were significantly associated with emotional demands. Our findings demonstrate that work stress is associated with prevalent CHCs, and these conditions are differentially associated with several domains of work stress in adults approaching retirement. More research is needed to understand the causal relationship between CHCs and work stress. Such research may provide insights for effective workplace and public health interventions to ensure that older workers remain physically and mentally healthy, and productive through their working years.

Not All Emotional Demands Are the Same: Emotional Demands from Clients' or Co-Workers' Relations Have Different Associations with Well-Being in Service Workers.

There has been an increased interest in the study of emotional demands (ED) at work and its impact on workers' well-being. However, ED have been conceptualized as a unitary concept, focused on interactions with clients, and excluding other potential sources of ED at work. Therefore, the aim of the current study is to explore the relation between ED from different relational sources (clients/patients/customers and colleagues, supervisors, and employees) and service workers' exhaustion and engagement. Cross-sectional data from a sample of 2742 service workers were analysed using structural equation modelling. Results showed that ED from both sources (clients and colleagues) were associated with more emotional exhaustion, particularly if dealing with clients was not an integrated part of the role. Further, ED from clients' relations were negatively associated with engagement for managers with staff responsibility, but positively for managers without staff responsibility. We also found moderating effects of psychosocial safety climate (PSC), whereby ED had the strongest effect on emotional exhaustion when PSC was low. This study suggests that different relational sources of ED at work have a different impact on employees' well-being. Strategies that promote a reduction of extra-role ED, and the development of a PSC in the organization, could therefore offer possible solutions to promote employees' psychological well-being and motivation.

Emotional experiences and coping strategies of nursing and midwifery practitioners in Ghana: a qualitative study.

BACKGROUND: Emotional regulation forms an integral part of healthcare delivery. In the performance of the core duties of nursing and midwifery, health professionals are expected to enhance occupationally/organisationally required emotions. The purpose of this study is to explore.The meaning nurses and midwives give to emotional labour as well as the coping resources employed by these professionals in order to manage the emotional demands of their profession. METHOD: A qualitative study was conducted using a semi-structured interview guide with fifteen (15) purposively selected nurses and midwives. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to analyse the data. RESULTS: Our findings showed that participants conceptualized emotional labour as display of rules. Sadness, abuse and bullying, poor incentivisation, emotional exhaustion and emotional mix bag were reported by the participants as emotional demands and deficits. Nurses and midwives coped with emotional labour through the use of five (5) main resources: psychological capital, routinisation of emotions, religious resources, social support and job security. CONCLUSION: Nursing and midwifery professional duties are accompanied with emotional regulations which tend to have consequential effects on a myriad of work-related issues. Clinical healthcare training needs to intensify and equip professionals with the skills of regulating and managing their emotions since managing emotional demands are central to effective healthcare delivery.

Hard Enough to Manage My Emotions: How Hardiness Moderates the Relationship Between Emotional Demands and Exhaustion.

The frequency of conflicts with patients' families is one of the main contributors to the amount of emotional demands that healthcare professionals must tackle to prevent the occurrence of burnout symptoms. On the other hand, research evidence suggests that hardiness could enable healthcare professionals to handle their responsibilities and problems effectively. Based on the health impairment process of the Job Demands-Resources model, the main goal of this study was to delve deeper into the relationship between conflict with patients' families, emotional demands, and exhaustion, as well as to test the buffering role of hardiness. Data were collected from a sample of N = 295 healthcare professionals working in a private hospital in Northern Italy. Most of them were women (78.6%) with a mean age of 40.62 years (SD = 9.50). The mediation of emotional demands within the association between conflict with families and emotional exhaustion and the moderating role of hardiness was tested using a bootstrapping approach. In the current sample, emotional demands mediated the association between conflict with families and exhaustion among healthcare professionals. Moreover, this relationship decreased among individuals with higher levels of hardiness. These findings contribute to the current understanding of the negative impact played by conflict with families on healthcare professionals' psychological well-being. Furthermore, they corroborated the role of hardiness as a personal resource that could prevent the occurrence of burnout symptoms. In addition to manage-and decrease-episodes of conflict with patients and their families, organizations in the healthcare sector should develop interventions aimed at fostering employees' hardiness and, consequently, tackle job demands ingrained in their profession (i.e., emotional demands).

Patient-related stressful situations and stress-related outcomes in emergency nurses: A cross-sectional study on the role of work factors and recovery during leisure time.

BACKGROUND: Emergency nurses are frequently exposed to patient-related stressful situations, making them susceptible to emotional exhaustion and symptoms of post-traumatic stress disorder. The current study aims to assess differential effects of patient-related stressful situations (emotionally demanding situations, aggression/conflict situations, and critical events) on stress-related outcomes in emergency nurses, and to identify moderating factors based on the Job Demands-Resources model and the Effort-Recovery model (job demands, job resources, and recovery experiences during leisure time). METHOD: A cross-sectional study was carried out among nurses working in the emergency departments of 19 hospitals in the Netherlands (N = 692, response rate 73%). Data were collected by means of an online survey. Multiple hierarchical regression analyses were performed, controlling for sociodemographic variables. RESULTS: The frequency of exposure to patient-related stressful situations was positively related to stress-related outcomes, with emotionally demanding situations and aggression/conflict situations mainly explaining variance in emotional exhaustion (ß = 0.16, p < .01, ∆R² = 0.08, and ß = 0.22, p < .01, ∆R² = 0.13), whereas critical events mainly explained variance in post-traumatic stress symptoms (ß = 0.29, p < .01, ∆R² = 0.11). Moderating effects were found for within worktime recovery and recovery during leisure time. Work-time demands, autonomy and social support from the supervisor were predictive of stress-related outcomes irrespectively of exposure to patient-related stressful situations. CONCLUSION: As patient-related stressful situations are difficult if not impossible to reduce in an emergency department setting, the findings suggest it would be worthwhile to stimulate within worktime recovery as well as recovery experiences during leisure time, to protect emergency nurses from emotional exhaustion and symptoms of post-traumatic stress. Furthermore, this study underscores the importance of reducing work-time demands and enhancing job resources to address stress-related outcomes in emergency nurses. Practical implications, strengths and limitations are discussed.

Emotional demands, compassion and mental health in social workers.

BACKGROUND: Compassion, described as the act of providing care based on empathy, dignity and respect, is intrinsic to effective health and social care. Although delivering compassionate care has wide-ranging benefits for service users, more insight is needed into its effects on health and social care professionals. The emotional demands of 'helping' work can engender compassion fatigue that may impair well-being, whereas compassion satisfaction and feelings of compassion towards the self could be protective. AIMS: To examine the effects (direct and indirect) of compassion satisfaction, compassion fatigue and self-compassion on mental health in a cohort of social workers. METHODS: We used validated scales to measure emotional demands, compassion satisfaction and fatigue, and self-compassion and the General Health Questionnaire-12 to assess mental health. We tested the main and moderating effects of emotional demands and the three facets of compassion using hierarchical regression analysis. RESULTS: The study sample comprised 306 social workers (79% female). Participants who reported higher levels of compassion satisfaction and self-compassion tended to report better mental health, whereas compassion fatigue was a significant risk factor for well-being. The models explained 44-53% of the variance in mental health symptoms. We found some evidence that compassion satisfaction and self-compassion buffer the negative effects of emotional demand on mental health, contributing 2 and 3%, respectively, to the incremental variance. CONCLUSIONS: Our findings suggest that evidence-based interventions are needed to reduce compassion fatigue and enhance compassion satisfaction and self-compassion in social care work. We consider ways to accomplish this using targeted interventions.

Employees' perceptions of their own and their supervisor's emotion recognition skills moderate emotional demands on psychological strain.

This research builds on prior studies showing the role of employee emotion recognition in the stress process to be mixed and conflicting. As such, it was proposed that the extent to which employees' emotion recognition skills buffer or exacerbate emotional demands depends on the extent to which employees believe their supervisor also is skilled in emotion recognition. Two samples of Australian employees completed cross-sectional questionnaires. Sample 1 consisted of 149 employees in a medical research institution, and Sample 2 consisted of 161 government employees in an equipment supplies and logistics service. A three-way interaction among emotional demands, employee emotion recognition, and perceived supervisor emotion recognition was found on psychological strain in both samples and on job dissatisfaction in Sample 1. As predicted, when employee emotion recognition was high, those who perceived their supervisor to be high in emotion recognition were buffered from emotional demands. In contrast, stress-exacerbating effects were found when employees were high in emotion recognition, but supervisors were perceived to be low in emotion recognition. Overall, these results highlight the importance of emotion recognition in the stress process, and that the same skill set needs to be perceived in one's supervisor, an interpersonal resource, for this intrapersonal resource to be adaptive for employees.

Perceived and content-related emotional demands at work and risk of long-term sickness absence in the Danish workforce: a cohort study of 26 410 Danish employees.

OBJECTIVES: This study aimed to examine whether high emotional demands at work predict long-term sickness absence (LTSA) in the Danish workforce and whether associations differ by perceived and content-related emotional demands. METHODS: We included 26 410 individuals from the Work Environment and Health in Denmark Study, a nationwide sample of the Danish workforce. Emotional demands at work were measured with two items: one assessing perceived emotional demands (asking how often respondents were emotionally affected by work) and one assessing content-related emotional demands (frequency of contact with individuals in difficult situations). LTSA was register based and defined as spells of ≥6 weeks. Respondents with LTSA during 2 years before baseline were excluded. Follow-up was 52 weeks. Using Cox regression, we estimated risk of LTSA per one-unit increase in emotional demands rated on a five-point scale. RESULTS: During 22 466 person-years, we identified 1002 LTSA cases. Both perceived (HR 1.20, 95% CI 1.12 to 1.28) and content-related emotional demands (HR 1.07, 95% CI 1.01 to 1.13) predicted risk of LTSA after adjustment for confounders. Further adjustment for baseline depressive symptoms substantially attenuated associations for perceived (HR 1.08, 95% CI 1.01 to 1.16) but not content-related emotional demands (HR 1.05, 95% CI 1.00 to 1.11). Individuals working in occupations with above-average values of both exposures had an increased risk of LTSA (HR 1.32, 95% CI 1.14 to 1.52) compared with individuals in all other job groups. CONCLUSIONS: Perceived and content-related emotional demands at work predicted LTSA, also after adjustment for baseline depressive symptoms, supporting the interpretation that high emotional demands may be hazardous to employee's health.

Affective organizational commitment among nursing home employees: A longitudinal study on the influence of a health-promoting work environment.

AIM: To investigate whether affective organizational commitment (AOC) among nursing home employees is enhanced by a health-promoting work environment, conceptualized as high levels of job resources, work-related sense of coherence (work-SOC) and low levels of job demands. DESIGN: This study used a longitudinal design. Survey data were collected with a 1-year interval between 2015/2016-2016/2017 among nursing home employees in Norway. METHODS: Structural equation modelling was used to analyse the longitudinal data (N = 166) and cross-sectional data from the first time point (N = 558). RESULTS: The results supported that work-SOC was strongly and positively related to AOC. Job resources and job demands were positively and negatively related, respectively, to work-SOC but were not related to future AOC. The indirect effects of autonomy and supervisor support on AOC, via work-SOC, were significant. The indirect effects regarding social community at work, emotional demands and role conflict were unclear.

Microbusinesses and Occupational Stress: Emotional Demands, Job Resources, and Depression Among Korean Immigrant Microbusiness Owners in Toronto, Canada.

OBJECTIVES: While occupational stress has long been a central focus of psychological research, few studies have investigated how immigrant microbusiness owners (MBOs) respond to their unusually demanding occupation, or how their unresolved occupational stress manifests in psychological distress. Based on the job demands-resources model, this study compared MBOs to employees with regard to the relationships among emotional demands, job resources, and depressive symptoms. METHODS: Data were derived from a cross-sectional survey of 1288 Korean immigrant workers (MBOs, professionals, office workers, and manual workers) aged 30 to 70, living in Toronto and surrounding areas. Face-to-face interviews were conducted between March 2013 and November 2013. RESULTS: Among the four occupational groups, MBOs appeared to endure the greatest level of emotional demands, while reporting relatively lower levels of job satisfaction and job security; but MBOs reported the greatest job autonomy. The effect of emotional demands on depressive symptoms was greater for MBOs than for professionals. However, an inspection of stress-resource interactions indicated that though MBOs enjoyed the greatest autonomy, the protective effects of job satisfaction and security on the psychological risk of emotional demands appeared to be more pronounced for MBOs than for any of the employee groups. CONCLUSIONS: One in two Korean immigrants choose self-employment, most typically in family-owned microbusinesses that involve emotionally taxing dealings with clients and suppliers. However, the benefits of job satisfaction and security may protect MBOs from the adverse mental health effects of job stress.

Relationships among demands at work, aggression, and verbal abuse among registered nurses in South Korea.

BACKGROUND: In order to improve organizational culture and job outcomes, it is important to characterize and better understand the relationship between aggression and verbal abuse among nurses. PURPOSE: To examine the relationships among demands at work, aggression, and verbal abuse among nurses. METHODS: A cross-sectional study was conducted using survey data from three tertiary hospitals located in South Korea. Sixteen nursing units were selected and 378 nurses' data were used as the final sample. The relationships were examined by multiple linear or logistic regression analyses. FINDINGS: More than 70% of the nurses had experienced at least 1 type of verbal abuse. Higher physical aggression and hostility were significantly related to greater verbal abuse experience. CONCLUSION: To prevent the vicious cycle of victims becoming perpetrators, it is necessary to develop and implement concrete strategies to manage verbal abuse and aggression among nurse colleagues.

No Job Demand Is an Island - Interaction Effects Between Emotional Demands and Other Types of Job Demands.

Emotional demands are an inevitable feature of human services, and suggested to be a defining antecedent for workers' stress and ill health. However, previous research indicate that emotional demands can have a favorably association to certain facets of human service workers' motivation and well-being. Furthermore, recent research report that the effect of emotional demands on workers' health and well-being seem to be contingent on the parallel level of other job demands. Still, initial investigations of interaction effects between emotional demands and other types of job demands have primarily focused on negative outcomes in terms of stress-related concerns and absenteeism. The present study investigated interaction effects between emotional demands and other types of job demands in relation to positive outcomes. In a larger sample of human service workers (social workers, n = 725), interaction effects were investigated between emotional demands and other job demands (quantitative demands, work pressure, and role conflict) for meaning in work and quality of work. Hypotheses stated that other job demands would moderate the relationship between emotional demands and positive outcomes, so that emotional demands would have a positive relation (i.e., act as a challenge) when the level of other demands is lower, but have a negative relation (i.e., act as a hindrance) when the level of other demands is high. Overall, the results provided support for the idea that emotional demands may act as a challenge. We found small but significant interaction effects between emotional demands and work pressure - in relation to meaning of work, as well as between emotional demands and quantitative demands, work pressure, and role-conflict, respectively - in relation to quality of work. Yet, the results did not support the assumption that emotional demands act as a hindrance when the level of other types of job demands is high. In sum, the results contribute by showing that emotional demands may promote human-service workers' job attitudes when the level of parallel job demands is lower. We discuss the contribution of the study and the potential practical implications of the results, and give some suggestions for future research.

Microbusinesses and Occupational Stress: Emotional Demands, Job Resources, and Depression Among Korean Immigrant Microbusiness Owners in Toronto, Canada / 예방의학회지

OBJECTIVES: While occupational stress has long been a central focus of psychological research, few studies have investigated how immigrant microbusiness owners (MBOs) respond to their unusually demanding occupation, or how their unresolved occupational stress manifests in psychological distress. Based on the job demands-resources model, this study compared MBOs to employees with regard to the relationships among emotional demands, job resources, and depressive symptoms. METHODS: Data were derived from a cross-sectional survey of 1288 Korean immigrant workers (MBOs, professionals, office workers, and manual workers) aged 30 to 70, living in Toronto and surrounding areas. Face-to-face interviews were conducted between March 2013 and November 2013. RESULTS: Among the four occupational groups, MBOs appeared to endure the greatest level of emotional demands, while reporting relatively lower levels of job satisfaction and job security; but MBOs reported the greatest job autonomy. The effect of emotional demands on depressive symptoms was greater for MBOs than for professionals. However, an inspection of stress-resource interactions indicated that though MBOs enjoyed the greatest autonomy, the protective effects of job satisfaction and security on the psychological risk of emotional demands appeared to be more pronounced for MBOs than for any of the employee groups. CONCLUSIONS: One in two Korean immigrants choose self-employment, most typically in family-owned microbusinesses that involve emotionally taxing dealings with clients and suppliers. However, the benefits of job satisfaction and security may protect MBOs from the adverse mental health effects of job stress.

Work intensity in men and work-related emotional demands in women are associated with increased suicidality among persons attending primary care.

BACKGROUND: A large proportion of persons died by suicide are employed at the time of death and work-related factors partly contribute to suicide risk. Our aim was to examine the association between multiple aspects of work organization and suicidal ideation in a study conducted in primary care. METHODS: Data came from a study of 2027 working patients attending a GP representative of patients in the Nord Pas-de-Calais region in France (April-August 2014). Suicidality was assessed using the MINI (Mini International Neuropsychiatric Interview). Six emergent worked-related factors were explored (work intensity, emotional demands, autonomy, social relationships at work, conflict of values, insecurity of work). Several covariates were considered: patient's and GP's characteristics, and area-level data (material and social deprivation, psychiatrist and GPs' density, suicide attempts and suicide rates). RESULTS: 8.0% of participants reported suicidal ideation in the preceding month (7.5% of men and 8.6% of women, p = .03). In multivariate analyses adjusted for covariates, suicidality was significantly associated with work intensity (OR = 1.65; 95%CI [1.18-2.31]) in men and with work-related emotional demands (OR = 1.35; 95%CI [1.01-1.80]) in women. Area-level data were not associated. LIMITATIONS: Our cross-sectional study cannot assess the direction of the relationships under study. CONCLUSION: Our results emphasise a central role for GPs in suicide prevention among workers and highlight the importance of work-related factors with regard to suicidality in primary care.

Danish Observational Study of Eldercare work and musculoskeletal disorderS (DOSES): a prospective study at 20 nursing homes in Denmark.

PURPOSE: Musculoskeletal disorders (MSDs), sickness absence and premature retirement are highly prevalent among eldercare workers. We conducted a prospective observational workplace study with the main purpose to investigate longitudinal associations between physical and psychosocial working conditions and occurrence of MSD and its consequences (pain-related interference with daily work activities and sickness absence) among Danish eldercare workers. PARTICIPANTS: At 20 Danish nursing homes, a total of 941 eldercare workers employed in day and evening shifts were invited to the study. Of those, 553 participated in the baseline measurements, and 441 completed the total period of 12 months follow-up. FINDINGS TO DATE: Data were collected from September 2013 to January 2016. Physical and psychosocial working conditions were assessed with multiple methods (observations, accelerometer measurements and work schedules), and multiple levels of information (nursing home, ward, resident and eldercare worker) were incorporated in the data collection. MSD and the consequences hereof were assessed monthly during a 1-year follow-up. Study participants and non-participants were comparable on most of the 27 sociodemographic, health and working condition characteristics at baseline. The exceptions were higher neck-shoulder pain intensity, less sickness absence, more exposure to negative behaviour from residents and a higher percentage of working day shifts and fewer evening shifts among participants compared with non-participants. FUTURE PLANS: The first publications will report on the associations of physical and psychosocial working conditions with occurrence of MSD and its consequences. In addition, the cohort gives the opportunity to investigate the importance of organisational, management and team factors for distribution of physical work demands and development of MSD among the workers. This will provide important knowledge for future workplace interventions to reduce MSD and sickness absence.