[Features and evaluations of organizational support provided by occupational health nurses in private practice for the implementation of sustainable health and productivity management in medium-sized enterprises].

OBJECTIVES: This study aimed to clarify the features and evaluations of the organizational support provided by occupational health nurses (OHNs) in private practice to promote sustainable health and productivity management (HPM) in medium-sized enterprises. METHODS: Corporate managers and employees of four enterprises with fewer than 300 employees received support from an experienced OHN in private practice through five support sessions per company, primarily targeting company managers. The OHNs documented their support steps and evaluations. After completing the support process, we conducted semi-structured interviews with company managers and OHNs to evaluate the support provided by the OHNs. The support processes were organized for each company according to an analytical framework based on the consolidated framework for implementation research; the support features of OHNs were extracted. The evaluations of the support provided by OHNs from the perspective of company personnel were categorized using content analysis. RESULTS: Six features of support by OHNs for the promotion of HPM were extracted, including clarifying corporate needs while focusing on relationships of trust with company representatives, providing appropriate health information, and introducing external resources to facilitate independent and continuous efforts in the company to promote sustainable HPM. The managers' evaluations of the support provided by the OHNs included the following six categories: 1) identified and recognized current internal health issues; 2) received specific assistance tailored to the company; 3) gained an opportunity to work on health promotion measures; 4) considered the development and continuation of future health promotion measures; 5) learned about the existence of OHNs as easy to consult with; and 6) identified aspects of support from OHNs that were different from what they expected. CONCLUSIONS: This study clarified the features and evaluations of the support provided by OHNs in private practice in medium-sized enterprises for the promotion of HPM. Our findings suggest that the involvement of OHNs in private practice may increase the number of medium-sized enterprises that can autonomously commit themselves to HPM in a sustainable manner.

Effectiveness of a support program for balancing treatment and work in small and medium-sized enterprises promoted by occupational health nurses using a web meeting system: A cluster randomized controlled trial.

OBJECTIVES: In this study, we conducted a cluster randomized control trial to verify the effectiveness of a treatment work balance support (TWBS) program promoted by occupational health nurses (OHNs) in small and medium-sized enterprises (SMEs) using a web meeting system. METHODS: We analyzed data from 64 managers (32 each in the control and intervention groups) and 541 workers (246 and 295 in the control and intervention groups, respectively) from 22 SMEs (11 in each group) with less than 200 workers. The TWBS program comprised online consultations for managers and seminars for workers by an OHN. TWBS leaflets were distributed among both groups. The "Recognition and Attitude Scale toward TWBS" was administered and workplace climate, psychological safety (PS), and work engagement (WE) scores were measured at baseline and endpoint. The increase in scores of each group was analyzed using a linear mixed-effects model. RESULTS: Increases in managers' scores on all three recognition and attitude subscales were significantly greater in the intervention than in the control group (P = .048, .003, and .032, respectively). Workers' score increases were significantly higher on two subscales-recognition of workplace initiatives and understanding of professionals' roles-in the intervention than in the control group (P = .043 and .001, respectively). There was no difference between the two groups in the amount of increase in PS and WE, as perceived by managers and workers. CONCLUSIONS: The TWBS program by OHNs increased recognition and attitude among SME managers and workers, indicating the usability of promoting TWBS in SMEs.

[Initiatives, outcomes, and facilitating factors to changing workplace environments in small- and medium-sized enterprises due to the COVID-19 pandemic: Interviews with employers and human resource managers].

OBJECTIVES: This study identified changes in the work environment due to the COVID-19 pandemic, subsequent initiatives and outcomes, and facilitating factors from the perspective of company officials in small- and medium-sized enterprises (SMEs). METHODS: In 2021, semi-structured interviews were conducted with employers or human resource managers of SMEs with less than 300 employees regarding changes in the work environment due to the pandemic, initiatives, outcomes, and facilitating factors. Thereafter, codes were extracted from verbatim transcripts or interview notes and categorized based on similarities in content. RESULTS: Based on interviews with 16 companies, the following four major categories of changes in the work environment were identified: "conflict and anxiety about infection when employees were forced to attend work despite the rapid transmission of the infection," "unfamiliarity and loneliness with the new working style that was suddenly imposed on them," "loss of emotional ties with workmates and opportunities for mood changes," and "future anxiety, feelings of alienation, and mental illness." The following seven initiatives were implemented to address these issues: "a hands-on approach to infection prevention and physical healthcare," "urgent introduction of telework for business continuity," "development and promotion of online information sharing," "establishment of a place and opportunity to maintain emotional connections within the company," "economic and management measures to protect employees and ensure company continuity," "support for employees for health maintenance," and "measures to respond to employees' needs and ideas, and support the continuation of activities." Four major categories of outcomes were: "increased efficiency of information sharing and enhanced performance," "maintenance and promotion of emotional ties and a sense of solidarity," "increased independence and sense of health among employees," and "adaptation of employees to novel situations." The initiatives were facilitated by factors classified into the following three major categories: "workplace culture wherein employees shared opinions and helped each other," "management's attitude and philosophy of valuing employees," and "proactive attitude toward information acquisition and resource utilization." CONCLUSIONS: The rapid introduction of teleworking as a new working style in response to the need to balance infection control and business continuity resulted in increased loneliness and other associated stressors. Many SMEs stated that they could maintain a sense of solidarity in the workplace and improve employee autonomy through their efforts to incorporate employees' opinions and maintain human connections.

[Current status of collaboration with public health services by occupational health nurses, and related factors].

OBJECTIVES: The Japanese government launched a project to facilitate collaboration between public health services and occupational health services with the aim of promoting overall health and wellbeing. However, collaboration at the practitioner level, including professionals who develop health support activities, has not yet been achieved. This study was conducted to clarify the actual state of collaboration between public health services and occupational health nurses as well as the factors related to their experiences with such collaboration. It also aimed to gather suggestions for promoting collaboration between occupational health nurses and public health and occupational health services. METHODS: A self-administered questionnaire-based survey was conducted in 2017, targeting 2,574 occupational health nurses belonging to the Japan Society for Occupational Health. Survey items included basic attributes, recognition of the need for collaboration and the reasons behind it, whether or not they had collaboration experience, and self-study and learning experiences. RESULTS: Of the 756 nurses surveyed, 34.0% had experience collaborating with public health services and 80.8% felt such collaboration was necessary. Experience of collaboration was related to the number of years of experience as an occupational health nurse, experience reading guidelines and participating in workshops and study groups organized by public health services, opportunities to receive guidance, and recognition of the need for collaboration. CONCLUSION: Because only a few respondents had experience collaborating with public health services and some did not even recognize the need for such collaboration, it was deduced that occupational nurses might have few opportunities to collaborate with public health services and may find it difficult to recognize the need for such collaboration. This finding suggests that occupational nurses may be able to promote collaboration with public health services by reinforcing learning from life events. A mechanism should be created to obtain information on public health services. Furthermore, opportunities can be provided for those with experience in collaboration to communicate with those with no experience through specific examples of such teamwork.

[Institutional measures and desired supports regarding COVID-19 pandemic among small and medium-sized enterprises: An interview study in Japan].

OBJECTIVES: Owing to the spread of COVID-19, many companies are likely to experience a significant impact on not only the safety and health of employees, but also on their businesses. The impact may be more severe for small and medium-sized enterprises (SMEs) than large enterprises, given their limited management resources. This study aims to clarify the good practices of institutional measures, the challenges in implementing these measures, and the required supports among SMEs. METHODS: The authors conducted an interview survey in August-October 2020 covering 27 SMEs in Japan regarding the infection control measures implemented and the desired supports in the future. Based on the content analysis, four researchers, comprising two occupational physicians and occupational health nurses each, extracted small categories by focusing on the commonality of codes, and gradually increased the degree of abstraction, subsequently extracting large categories. RESULTS: The study consolidated the implemented institutional measures into four categories: "making immediate decisions," "obtaining accurate information and sharing it with all employees," "strengthening infection control measures," and " launching efforts to continue business." In addition, challenges in implementing institutional measures were classified into five categories: "information gathering," "counter measures against unknown virus," "poor accessibility to Polymerase Chain Reaction (PCR) test," "consensus building," and "balancing business continuity and infection control." Furthermore, desired support in the future was classified into three categories: "information gathering," "accessibility to PCR test," and "compensation and subsidy." CONCLUSIONS: With taking the advantage of the characteristics of SMEs, not a few companies implemented the four categories of institutional measures. Therefore, it is imperative for SMEs to provide accurate information to employers for appropriately recognizing the risks. Accordingly, it is desirable for occupational health professionals at SMEs to provide support to employers to help them identify appropriate information.

[A two-year program to promote participatory workplace environmental improvements at small enterprises with fewer than ten employees].

OBJECTIVE: This study aimed to determine the influence of participatory workplace environmental improvement program on reducing job stress and workers' psychological distress at small enterprises (i.e., less than 10 employees). Furthermore, this study aimed to clarify important factors for success of this program as well. METHODS: The model program was tested in a small enterprise with eight employees between October 2014 and January 2017. Moreover, five employees participated in the annual work environment improvement workshops for two consecutive years. During both years, the New Brief Job Stress Questionnaire (80-item version) was used to measure work-related stress before (baseline) and after (post-three months and post-12 months) the workshops. To assess the extent of an intervention effect, the questionnaire data were analyzed using the Friedman test and the multiple comparison test annually. In addition, continuous data were analyzed during the two years. The statistical significance of the differences across time was determined at the p < .10 cutoff value because the number of participants was small. The effect size was also calculated. The participants were interviewed regularly. RESULTS: For both years, the employees implemented action plans within one month of completing the workshops. In the first year, the data for the Friedman test indicated a significant change in role conflict, job resources (workgroup-level), respect for individuals, fair personnel evaluations, work-self balance (positive), workplace social capital, and job satisfaction. In the multiple comparison test, significant changes manifested in role conflict and workplace social capital. In the second year, significant changes were found regarding role conflict and fair personnel evaluations for the Friedman test, demonstrating significant changes in role conflict in the multiple comparison test. As per the two-year survey results, the Friedman test indicated significant changes in role conflict, respect for individuals, and fair personnel evaluations, while the multiple comparison test demonstrated no significant changes. Over time, favorable changes were found regarding role conflict in the first year; however, undesirable changes were found regarding the other statistically significant items. The interviews revealed both positive and negative opinions. CONCLUSIONS: This study found the effects of the participatory workplace environment improvement program to be limited. Thus, the program should be improved to reduce its adverse effects as well as the participants' negative opinions.

[Relation between concrete activities and results of activities planned in conferences of the regional and occupational health fields in secondary medical care zones].

Objectives　This study aimed to clarify the current implemented conditions of collaborations between regional and occupational health fields in secondary medical care zones, taking into account the difficulties, and to suggest measures to promote further collaboration.Methods　Self-rating questionnaires were distributed to public health nurses (PHNs) who were responsible for collaboration at 464 regional health care centers (HCCs). We asked for answers on four cases regarding the implementation and results of 22 different collaboration activities.Results　We analyzed 176 questionnaires from PHNs who had been in charge of conferences for an average of two years. We found the implementation rate of conferences promoting collaboration between regional and occupational health fields to be approximately 80%, with an average duration of four years since these conferences began. Collaborative activities between regional and occupational health fields were divided into three categories: A) "Information exchange among the people involved from regional and occupational fields," B) "Collaboration in health education and counseling," and C) "New health projects based on surveys." The first and third categories (A and C) were significantly higher in the "implemented" group than in the "not implemented" group. The results of the collaborations were organized into six categories: a) "PHNs and members of the conferences (members) could learn about various resources in the community," b) "PHNs and members could build a good relationship among one another and understand community health needs appropriately," c) "Sense of accomplishment and forward progress in the construction of information exchange systems as well as improved cost effectiveness," d) "Progress in health promotion efforts was made," e) "Improvement of health literacy," and f) "An increase in the quality and quantity of participants in health services." The first to three categories (a to c) were higher in cases where three or more conferences were held per year. In addition, we found significant associations between "Collaboration in health education and counseling" (B) and "New health projects based on surveys" (C) as well as with most collaboration result categories.Conclusion　This study identified three collaborative activity categories and six cooperative achievement categories. We clarified their relation with the implementation of the council and the number of conferences held. In addition, we demonstrated the possibility that successful cooperation can be realized by active engagement in collaborative activities, such as planning of substantial collaboration and new projects.

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.

Development and evaluation of a training program for occupational health nurses regarding support for workers with cancer and their workplaces.

OBJECTIVES: This study aimed to develop and evaluate a training program for occupational health nurses (OHNs) regarding support for workers with cancer and their workplaces. METHODS: Based on our prior research, we engaged in multiple discussions on the development of training program for OHNs. For examining the effectiveness of the developed training program, we collected and analyzed the data from three repeated surveys conducted before, immediately after, and 3 months after the training on self-confidence levels of the participants regarding 23 items associated with support for workers with cancer and their workplaces. RESULTS: We made a 3-hour training program including a lecture and a group work. First, we gave a lecture explaining the support scheme consisting of 4 parts and the 12 hints in action phrase while using the guidebook. Second, we conducted the group work regarding the case of a female worker diagnosed with breast cancer. Of the participants who supported workers with cancer in actuality during the 3-month post-training, 86% acknowledged the utility of the training in implementing support. As for the pre-post evaluation of the training program, most items of the participants' self-confidence significantly increased from pretraining to immediately after and 3 months post-training. DISCUSSION: This study demonstrated that the developed training program was effective in that the participants learned the support schemes and skills and gained self-confidence in implementing supports in real-work settings. We hope that this training program will be extensively used in the future, enabling OHNs to contribute toward balancing cancer treatment and work.

Examining Occupational Health Nurse Competencies when Collaborating with Public Health Services.

OBJECTIVES: The purpose of this study was to examine the competencies of occupational health nurses who collaborate with public health services. METHODS: Ten occupational health nurses who work for companies that collaborate with public health services were the subjects. They were the finalists selected from among those occupational health nurses who participated in a preparatory survey and phone interviews that inquired about their collaborative activity experiences with public health services; they were selected because of their greater experience with these collaborations. Semi-structured interviews using an interview guide were conducted, and a Qualitative Content Analysis approach developed by Mayring was used for data analysis. First, collected data were coded based on four aspects of collaborative activity: "Routine engagement"; "Execution of collaboration"; "Engagement for better understanding in the organization"; and "Perceptions, attitudes, and thoughts as foundations of collaboration." Then, categories and subcategories of responses were generated by similarity sorting. RESULTS: Our findings clarified the following specific competencies required of occupational health nurses when collaborating with public health services: "Collection of public health information," "Construction of good relationships with public health personnel," "Extraction of problems within the family among employees," "Connection of employees and their family members with public health personnel," "Utilization of public health resources," and "Demonstration of the importance of collaboration with public health services." Furthermore, the following attitudes and thoughts were clarified: "Retention of supportive attitude and viewpoint toward the entire life of employees and their family factors," "Retention of attitude of promoting collaboration with public health services by occupational health nurses," and "Being aware of the importance of occupational health nurses." CONCLUSIONS: These findings suggest that occupational health nurses need to engage in collaborative activities with more holistic attitudes and thoughts to consider the whole lives of employees and their families. Thus, it is important to provide occupational health nurses with more opportunities to acquire these competencies. Subjects in this study were making efforts to collaborate with public health personnel to enrich their support services by exhibiting "Construction of good relationships with public health personnel" and "Utilization of public health resources," even in understaffed environments with only one occupational health nurse.

[Development of a Tool for Training and Evaluation of the Competencies in Occupational Mental Health Necessary for Labor and Social Security Attorneys].

Labor and Social Security Attorneys (LSSAs) advise their clients about occupational mental health, but the competencies necessary in this field are not clear to them. We standardized the necessary competencies as a counseling guide for LSSAs, and we also designed a related discussion training program. These competencies were summarized in a brainstorming session at a research conference comprised of physicians, an occupational health nurse, LSSAs, an instructional design expert, and a management consultant, and then a training program (lasting 9 hours 30 minutes) was developed. Nineteen trainees who were introduced by members of the research conference collectively completed a seven-question written test, both before and after the training, in order to assess its effectiveness. Sixteen trainees who completed the training were surveyed, with a recovery rate of 100%. The necessary competencies that they identified were: information about circular notices from the Ministry of Health, Labor and Welfare; behavior such as the gathering of information; and dealing with the reinstatement of employees. The scores were subjected to the Wilcoxon signed-rank test in order to evaluate the training, and the answers from the pre-training were compared with those from the post-training. A significant difference (P < 0.05) was seen for each question. These results show the effectiveness of the developed training program for the learning of the competencies necessary for LSSAs.

[Features of occupational health nurse support for the improvement of psychosocial working environments and related factors: Focusing on required knowledge and skills, and measures to develop them].

OBJECTIVE: The purpose of this study was to examine the support activities provided for occupational health nurses aimed at improving psychosocial working environments, related knowledge and skills, and learning environments as well as associations among these factors. In addition, we aimed to create correlated factor models to describe the support activities in order to identify ways to promote these activities among occupational health nurses. METHODS: An anonymous mail-based questionnaire survey was conducted of occupational health nurses who were members of the Japan Society for Occupational Health and belonged to enterprises or independent health insurance societies. Among 356 returned questionnaires (response rate: 46.4%), all the main items were answered in 329 (valid response rate: 92.4%), and these questionnaires were analyzed. Factor analysis was performed for the seven items pertaining to support activities for the improvement of psychosocial working environments and models of each factor of the support activities were developed using covariance structure analysis. RESULTS: In the factor analysis, [Clarifying a stress-related situation and providing advice] and [Facilitating workplace involvement] were identified as support-related factors. The mean implementation rates for these approaches were approximately 50 to 80%, and less than 40%, respectively. [Clarifying a stress-related situation and providing advice] was associated with skills of "providing superiors with explanations to enhance their understanding" and "collecting and analyzing stress survey results by department", and knowledge of "personal stress questionnaires" and "common stress factors in working environments". The above-mentioned knowledge and skills were associated with self-learning of "examining and reporting daily activities for the improvement of working environments" and "reviewing related papers". [Facilitating workplace involvement] was associated with skills of "indirectly supporting discussions led by key persons in working environments" and "giving feedback regarding occupational stress survey results to superiors", and knowledge of "tools for the improvement of working environments" and "appropriate methods to use stress questionnaires". In addition, such knowledge and skills were associated with self-learning and learning environments of "participating in seminars to learn effective methods to use group-work approaches" and "receiving support and advice from mentors of universities and research institutions". DISCUSSION: The features of occupational health nurse support for the improvement of psychosocial working environments were revealed by this study. The implementation rates suggest that it is particularly necessary to promote [Facilitating workplace involvement]. It will be necessary to encourage the acquisition of associated knowledge and skills in order to promote occupational health nurse support for the improvement of psychosocial working environments.

[Implementation, difficulty, knowledge and skill in occupational mental health services of novice occupational health nurses].

PURPOSE: This study aimed to clarify the characteristics of implementation, difficulty, knowledge, and skills in mental health services of novice occupational health nurses (OHNs) in order to obtain ideas for education programs and learning methods for them. METHOD: A questionnaire survey was conducted among OHN members of the Japan Society for Occupational Health. We focused on the responses from novice OHNs who had no more than 5 years' experience in the occupational health field. Cluster analysis was conducted on 36 items of mental health activities in order to classify them into categories. The Novice OHNs' characteristics of implementation status, difficulties, knowledge and skills were analyzed and compared with those of proficient OHNs using the chi-squared test and the Mann-Whitney U test. The relations among the variables were also examined using the data of the Novice OHNs. RESULTS AND DISCUSSION: We obtained responses from 80 Novice OHNs, which formed the basis of the analysis, and responses from 369 proficient OHNs, which were used for comparison. Most of the novice OHNs were engaged in mental health services. The novice OHNs experienced greater difficulties with consultations and follow-ups of individual mental health problems than the proficient OHNs. Many novice OHNs felt they lacked knowledge and skills about mental health activities. We found that the knowledge and skills of the novice OHNs about building mutual trust with workers and supervisors and obtaining information from them were almost at the same level as those of other activities, however the activity was implemented at a significantly higher rate than the other activities. Therefore, it is essential for novice OHNs to learn how to build mutual trust with workers and supervisors and to acquire information from them. The novice OHNs who had supervisors such as OHNs of other enterprises and who read magazines as references for the services did not experience great difficulty with 'support for return to work and collaborations with persons involved inside or outside the company' compared with the OHNs who did not. The novice OHNs who had conducted research and given presentations at conferences experienced little difficulty with "individual consultations on difficult cases" compared with the OHNs who had not.

[Nation-wide research on current status and related factors for collaboration with occupational health services by public health nurses working for municipalities: comparison between major cities and other communities].

PURPOSE: The purpose of the this study was to clarify the nation-wide current status for collaboration between occupational and municipal health services, taking into account related factors and comparing Major Cities (with health centers) and Other communities (other cities and towns). METHOD: A nation-wide questionnaire research was conducted by mail among 350 randomly selected public health nurses (PHNs) taking part in adult health services at municipal health centers (Tokyo was excluded). The valid-response rate was 61.7%. Characteristics of the samples, promoting factors, hindrance factors, and status of implementation of collaboration were analyzed separately for Major Cities and Others using the X2 test and the Mann-Whitney U test. Promoting and hindrance factors related to collaboration were assessed with Spearman's rank correlation coefficients and multiple logistic analysis. RESULTS: While the percentage of PHNs who felt the necessity of the collaboration was 96.8%0, those who actually collaborated with occupational health services was currently only 34.9% in Major Cities and 22.9% in Others. There were two types of collaboration. The first involved conferences of stakeholders, including PHNs, on common health problems in the community and participation rates were 24.5% for Major Cities and 25.8% for Others. The respective figures for the second type, in which health services were delivered to workplaces, were 56.3%0 and 52.2%0. The corresponding rates for promoting factors such as "Attend educational seminars concerning collaboration" (Major Cities 22.2%, Others 17.1% and "Work with existing PHNs who are motivated for collaboration" (Major Cities 9.7%, Others 13.9%) were low. On the other hand, "Discuss with superiors and colleagues about collaboration" was much more common (Major Cities 83.9%, Others 74.0%). The promoting factors significantly related to practice of collaboration were "Read the Collaboration Guidelines" and "Inclusion of collaboration with occupational health services into the municipal health plan" in Others. The significant hindrance factors were "Insufficient manpower" and "Non-residential workers are not recognized as being entitled to support." CONCLUSION: This study demonstrated the nation-wide current status concerning factors for collaboration for the first time. Based on these results separate for Major Cities and Others, countermeasures should now be considered.

Correlates of depressive symptoms among workers in small- and medium-scale manufacturing enterprises in Japan.

BACKGROUND: Although the relationship between job stress and depressive symptoms has been well documented among workers in large scale enterprises, the situation in small- and medium-scale enterprises (SMEs) is not fully understood. OBJECTIVES: To clarify the factors associated with depressive symptoms in SMEs in Japan. METHODS: 1,516 male and 738 female Japanese workers at SMEs were surveyed using a self-administered questionnaire. We applied hierarchical multiple linear regression with depressive symptoms (Center for Epidemiologic Studies Depressive Symptoms Scale) as the dependent variable, and (1) Individual, (2) Lifestyle, (3) Job stressors, and (4) SME unique factors as independent variables entered in 4 steps. Analyses were stratified by sex due to large differences in stress scores and demographic variables. RESULTS: Perceived lack of understanding from others with regard to health was the strongest factor associated with increased depressive symptoms (BETA=0.29 in males and 0.28 in females). Higher intragroup conflict (BETA=0.15 in males and 0.09 in females), perceived job future ambiguity (BETA=0.09 in males and 0.11 in females), higher quantitative workload (BETA=0.06 in males and 0.10 in females), and being an employer or a member of the employer's family (BETA=0.06 in males and 0.10 in females) were additional factors associated with high depressive symptoms. Economic concern, being single, cigarette smoking, shorter sleep duration, and skill underutilization were male specific, while younger age and lower social support at work were female specific factors significantly associated with increased depressive symptoms. CONCLUSIONS: These data suggest that poor mental health may be prevented by creating a workplace climate which focuses on the high value of the health of fellow workers.

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 and process evaluation of the participatory and action-oriented empowerment model facilitated by occupational health nurses for workplace health promotion in small and medium-sized enterprises.

The objective of this study is to develop an available empowerment model for workplace health promotion (WHP) in small and medium-sized enterprises (SMEs) and to evaluate its applicability and feasibility. Semi-structured interviews with employers and workers in SMEs were conducted to assess their actual requirements for support. The structure of our new empowerment model was discussed and established through several rounds of focus group meetings with occupational safety and health researchers and practitioners on the basis of results of our interviews. We developed a new participatory and action-oriented empowerment model based on needs for support of employers and workers in SMEs. This new model consists of three originally developed tools: an action checklist, an information guidebook, and a book of good practices. As the facilitators, occupational health nurses (OHNs) from health insurance associations were trained to empower employers and workers using these tools. Approximately 80 SMEs (with less than 300 employees) were invited to participate in the model project. With these tools and continued empowerment by OHNs, employers and workers were able to smoothly work on WHP. This newly developed participatory and action-oriented empowerment model that was facilitated by trained OHNs appears to be both applicable and feasible for WHP in SMEs in Japan.

[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.

Development of multi-dimensional action checklist for promoting new approaches in participatory occupational safety and health in small and medium-sized enterprises.

To meet diversified health needs in workplaces, especially in developed countries, occupational safety and health (OSH) activities should be extended. The objective of this study is to develop a new multi-dimensional action checklist that can support employers and workers in understanding a wide range of OSH activities and to promote participation in OSH in small and medium-sized enterprises (SMEs). The general structure of and specific items in the new action checklist were discussed in a focus group meeting with OSH specialists based upon the results of a literature review and our previous interviews with company employers and workers. To assure practicality and validity, several sessions were held to elicit the opinions of company members and, as a result, modifications were made. The new multi-dimensional action checklist was finally formulated consisting of 6 core areas, 9 technical areas, and 61 essential items. Each item was linked to a suitable section in the information guidebook that we developed concomitantly with the action checklist. Combined usage of the action checklist with the information guidebook would provide easily comprehended information and practical support. Intervention studies using this newly developed action checklist will clarify the effectiveness of the new approach to OSH in SMEs.