Exposure to Client-Perpetrated Violence in the Child Welfare Service: Prevalence and Outcomes Using Two Different Measurement Methods.

This study compared how two different measurement methods of client-perpetrated violence influence findings on prevalence rates and mental health outcomes in a probability sample of 660 Norwegian public sector child welfare workers. Using a single-item self-labeling approach, 15.4% reported exposure to physical violence, and 19.3% reported exposure to threats. Using a 15-item behavioral experience inventory, the prevalence rates ranged from 4.4% to 65.7%. A comparison of these methods uncovered a high number of false negatives when using the single-item approach as 62.2% of those who indicated that they had not experienced any workplace violence when answering the single-item questions reported being exposed 1 to 2 times when responding to the behavioral inventory. Results based on the behavioral inventory further revealed that the most frequently occurring actions in the child welfare service were direct and indirect forms of threats (24.5%-65.7%), while the least reported behaviors were threats and violence including objects (4.4.%-9.1%). Although client-perpetrated violence was significantly associated with mental health problems (e.g., symptoms of anxiety, depression, and post-traumatic stress [PTS]) for both assessment methods, the magnitude of the effect sizes differed from η2 = .000 to η2 = .121. These findings highlight that the use of different measurement methods for workplace violence has significant consequences for the assessment of prevalence rates, as well as on results of associated outcomes. Consequently, the decision on how to assess workplace violence has practical implications for uncovering how prominent the issue is, as well as the way in which this negative workplace exposure is subsequently addressed and counteracted. Therefore, both scholars and the child welfare service, and similar fields in which workplace violence frequently occurs, should take these findings into consideration for future assessments.

Associations between stressful working conditions and psychosomatic symptoms among Palestinian nurses: a cross-sectional survey.

BACKGROUND: Stressful working conditions among nurses have adverse effects on their physical and mental health. We investigated associations between self-reported stressful working conditions and psychosomatic symptoms among nurses in the Hebron district, occupied Palestinian Territory, and whether there are differences the sexes in the perceptions of working conditions and psychosomatic symptoms. METHODS: We did a cross-sectional survey between Oct 7 and Dec 10, 2012, among registered nurses in all health sectors in Hebron district. A nine-point ordinal scale of working conditions was used to categorise perception of stress as low, medium, or high, and seven psychosomatic symptoms were recorded on a checklist coded as never (0), seldom (1), occasionally (2), or often (3), allowing for a total score between 0 and 21. All analyses were done with STATA (version 10). P values of less than 0·05 were significant. Participation in the study was voluntary, and written informed consent was obtained from each participant. The study was approved by the Regional Committee for Medical and Health Research Ethics, Norway. Permission to do the study was obtained from the Palestinian Ministry of Health. FINDINGS: Among 372 eligible nurses, ten were on extended leave from work, 16 declined to participate, and four had incomplete data, giving a final sample of 342 nurses (92% response rate). 212 (62%) were women and 130 (38%) were men. Low levels of stress were reported by 42 (12%) nurses, medium levels by 206 (60%), and high levels by 94 (28%). The mean score of psychosomatic symptoms for the group was 10·4 (SD 4·02, range 0-21). Scores did not differ significantly between men and women. Mean symptom scores differed between nurses with self-reported highly stressful working conditions and those with low levels of stress (12.6 vs 8.4, difference 4·1, 95% CI 2·7-5·5; p<0·001). Among male nurses, those with self-reported highly stressful working conditions had a mean psychosomatic symptom score of 13.0, compared with that was 7.7 among those working in low-stress conditions (difference 5·3 units, p<0·001). This effect remained significant after adjustment for the covariates age, education, number of children, work schedule, and years of experience (12·6 vs 7·7, difference 4·9 units, 95% CI 2·6-7·2). Among female nurses, the scores among those with high-stress working conditions was 12.4 and for those with low-stress working conditions was 9.0 (difference 3·4 units, p<0·001). After adjustment the difference remained similar (12·4 vs 9·0, difference 3·5 units, 95% CI 1·7-5·3, p<0·001). INTERPRETATION: We found that psychosomatic symptoms increased as self-reported perception of stressful working conditions increased, irrespective of sex. The study had a cross-sectional design and both exposure and outcomes were measured using self-report and, therefore, interpretation of the results should be made with caution. Longitudinal epidemiological studies are recommended. Future studies should investigate whether stressful working conditions affect the quality of patients' care in health services. FUNDING: Norwegian Programme for Development, Research and Education.

Job satisfaction and mental health of Palestinian nurses with shift work: a cross-sectional study.

BACKGROUND: Shift work is associated with sleep disturbances, mental health problems, and job dissatisfaction. Disparities between male and female nurses in the effect of shift work on mental distress and job satisfaction have been scarcely studied. We aimed to examine differences between female and male nurses in the associations between shift work and job satisfaction and mental health. METHODS: In this cross-sectional study, male and female nurses were recruited to rate their job satisfaction on the Generic Job Satisfaction Scale and to complete the General Health Questionnaire (GHQ-30). Associations between shift work, mental distress, and satisfaction were estimated from χ2 tests and linear regression analyses using Stata/IC10. The study was approved by the ministry of health. Written informed consent was provided by all participants. FINDINGS: In 2012, we recruited 372 registered nurses from the Hebron governorate in the occupied Palestinian territory. 28 (8%) nurses were excluded, and the final sample (n=344) included 213 (62%) women and 131 (38%) men. 338 nurses rated their job satisfaction, and 309 nurses completed the GHQ-30. After adjusting for covariates, men with shift work reported significantly lower job satisfaction (ß-coefficient -3·3, 95% CI -6·2 to -0·5) than men with day schedules. Women with shift work reported significantly higher levels of mental distress (3·6, 95% CI 0·3 to 7·0) than women with day schedules. Distress was reported by more women than men, but this difference concerned only nurses working day shifts. No differences in job satisfaction associated with shift work was seen between men and women. We found no demonstrable interaction between sex and shift work for job satisfaction (ß-coefficient -1·6, 95% CI -4·4 to 1·2) or distress (-0·03, 95% CI -5·3 to 5·3). INTERPRETATION: Shift work was associated with low job satisfaction in male nurses and high distress in female nurses. Because the study had a cross-sectional design and both exposure and outcomes were measured using self-report, the results should be interpreted with caution. Further studies should investigate whether shift work affects the quality of patient care. FUNDING: The Norwegian Programme for Development, Research and Education (NUFU; NUFU pro x1 50/2002 and NUFUSM-2008/10232) and The National Norwegian State Education Loan Funds.

Perception of threat and safety at work among employees in the Norwegian ministries after the 2011 Oslo bombing.

BACKGROUND AND OBJECTIVES: Terrorism can heighten fears and undermine the feeling of safety. Little is known, however, about the factors that influence threat and safety perception after terrorism. The aim of the present study was to explore how proximity to terror and posttraumatic stress reactions are associated with perceived threat and safety after a workplace terrorist attack. DESIGN AND METHODS: A cross-sectional questionnaire survey was administered to employees in 14 of 17 Norwegian ministries 9-10 months after the 2011 bombing of the government headquarters in Oslo (n = 3520). RESULTS: About 198 of 1881 employees completing the survey were at work when the bomb exploded. Regression analysis showed that this high-exposed group had elevated perceived threat (ß = 0.36; 95% CI = 0.19 to 0.53) and reduced perceived safety (ß = -0.42; 95% CI = -0.62 to -0.23) compared to a reference group of employees not at work. After adjusting for posttraumatic stress reactions, however, proximity to the explosion no longer mattered, whereas posttraumatic stress was associated with both high perceived threat (ß = 0.55; 95% CI = 0.48 to 0.63) and low perceived safety (ß = -0.71; 95% CI, -0.80 to -0.63). CONCLUSION: Terror-exposed employees feel more threatened and less safe after a workplace terrorist attack, and this is closely linked to elevated levels of posttraumatic stress reactions.