User needs gathering for the design of information and communications technology-supported occupational stress management intervention: A quantitative study.

Introduction: The software industry is considered a growing industry with a high propensity to cause stress reactions among employees due to its demanding and technology-driven nature. There are convincing shreds of evidence that information and communications technology (ICT) interventions can effectively solve stress-related disorders. However, several identified constraints have hindered its potential benefits, such as poor adherence, lack of engagement, high attrition and lack of personalisation. Objective: The study presented in this article aims to gather the user needs of software employees in Sri Lanka to identify design ideas for an ICT-supported intervention for occupational stress management (ICTSMI) in the software industry. Materials and methods: The study followed a quantitative approach using an online questionnaire in which three key areas were investigated: (1) stressors, (2) coping strategies and (3) design preferences. A total of 408 valid responses were collected and analysed using SPSS software. Results: Findings revealed that the majority of software employees were with a moderate level of stress. They perceived work stressors and role stressors as common causes of stress. The most frequently used coping strategy was to seek social support, followed by digital activities and sports and physical exercises. The male and female design preferences varied to a greater extent but only slightly varied based on their job category. However, findings suggested the necessity of further elicitation of user needs to support the design process.

Managing workplace health promotion in municipal organizations: The perspective of senior managers.

BACKGROUND: Previous research indicates that companies manage workplace health in various ways, but more in-depth empirical knowledge of how workplace health promotion (WHP) is managed in public sector organizations is needed. OBJECTIVE: The aim of this study was to explore how WHP is managed and incorporated into the general management system in two large Swedish municipal organizations. METHODS: A qualitative descriptive approach was used. Fourteen senior managers were purposefully selected and interviewed using semi-structured interviews. Documents were used as supplementary data. All data were analysed using qualitative content analysis. RESULTS: The management of WHP was described as a set of components that together contribute to the organization's capacity for WHP. The informants described WHP as dominated by fitness programmes and as following a problem-solving cycle, in which the annual employee survey emerged as an important managerial tool. Achieving feasible WHP measures and appropriate follow-ups were described as challenges. The provision of leadership competence for WHP and use of supportive resources were described as additional components. CONCLUSIONS: The WHP management approach needs to be broadened to include work environment and organizational factors. Further integration with occupational health and safety and the general management system in the organizations is also needed.

Emergency department nurses' experiences of occupational stress: A qualitative study from a public hospital in Bangkok, Thailand.

BACKGROUND: Occupational stress has been a health-related issue among nurses for many decades. Emergency department nurses are frequently confronted with occupational stress in their workplace; in particular, they encounter stressful situations and unpredictable events. These encounters could make them feel more stressed than nurses in other departments. Research considering occupational stress from the perspective of Thai emergency department nurses is limited. OBJECTIVE: This study aimed to explore nurses' perceptions of occupational stress in an emergency department. METHODS: A qualitative approach was used to gain an understanding of nurses' experiences and perceptions regarding stress in their workplace. Semi-structured interviews were used for data collection. Twenty-one emergency department nurses working in a public hospital in Thailand were interviewed, and the data were analyzed using content analysis. RESULTS: The findings comprised three themes: (1) perceived stress, (2) consequences of stress, and (3) stress management. CONCLUSIONS: The results of this study can be used by hospital management to help them adopt effective strategies, such as support programs involving co-workers/supervisors, to decrease occupational stress among emergency department nurses. Future research that explores each of the themes found in this study could offer a more comprehensive understanding of nurses' occupational stress in the emergency department.

The relationship of chronic and momentary work stress to cardiac reactivity in female managers: feasibility of a smart phone-assisted assessment system.

OBJECTIVES: To evaluate a wireless smart phone-assisted (SPA) system that assesses ongoing heart rate (HR) and HR-triggered participant reports of momentary stress when HR is elevated during daily life. This SPA system was used to determine the independent and interactive roles of chronic and momentary work stress on HR reactivity among female managers. METHODS: A sample of 40 female managers reported their chronic work stress and wore the SPA system during a regular workday. They provided multiple reports of their momentary stress, both when triggered by increased HR and at random times. Relationships among chronic stress, momentary stress, and HR were analyzed with hierarchical linear modeling. RESULTS: Both chronic work stress (b = 0.08, standard error [SE] = 0.03, p = .003) and momentary work stress (b = 1.25, SE = 0.62, p = .052) independently predicted greater HR reactivity, adjusting for baseline HR, age, smoking, caffeine, alcohol use, and momentary physical activity levels. More importantly, chronic and momentary stress significantly interacted (b = 1.00, SE = 0.04, p = .036); high momentary stress predicted elevated HR only in the context of high chronic stress. CONCLUSIONS: Female managers who experience chronic work stress displayed elevated cardiac reactivity during momentary stress at work. The joint assessment of chronic stress and momentary stress and their relationship to physiological functioning during work clarifies the potential health risks associated with work stress. Moreover, this wireless SPA system captures the immediate subjective context of individuals when physiological arousal occurs, which may lead to tailored stress management programs in the workplace.

"I just kept running and running until I hit the wall": working men seeking care due to stress-related problems.

BACKGROUND: Stress problems are major public health problems. OBJECTIVE: To gain an increased understanding of how working men seeking care due to minor mental dysfunctions related to stress recognize their symptoms, what triggers them, and how this impacts their everyday life. PARTICIPANTS: Fourteen men of working age, consecutively seeking care due to minor mental dysfunctions indicating stress problems, at two clinics in the Stockholm area in Sweden during 2009 and 2010. METHODS: A qualitative methodology was chosen, and interviews were performed and analyzed using qualitative content analysis. RESULTS: In the manifest content, categories such as difficulties in setting limits, low social support, high work demands, and mental and physical dysfunctions were identified. Three themes finally emerged (latent content) and indicated that in this group of informants there are stressors both within the individual himself, in working life, and a lack of recovery. CONCLUSIONS: Based on our findings it would be possible to implement measures to prevent stress-related problems by promoting coping strategies on an individual level, encouraging social networks, and regular physical exercise. By implementing work policies and workplace modifications, and also providing individual support at the workplace, supervisors and human resources managers could prevent, or modify stress problems among employees.

Older people living at home: associations between falls and health complaints in men and women.

AIMS AND OBJECTIVES: To investigate the associations between self-reported falls and health complaints, among persons aged 75 years and older living at home, and to investigate gender differences in the associations. BACKGROUND: There are several studies concerned with risk factors for falling, and others related to health complaints, but not many with associations between falls and health complaints. There are some inconsistent data of incidence and gender-related differences in falling. DESIGN: Case-control community-based study. METHODS: In total, 1243 persons living in two municipal districts in Sweden answered a questionnaire. Odds ratios (OR) and regression models with 95% confidence interval (CI) were used to determine the associations between self-reported falls and different health complaints. RESULTS: The adjusted (multivariate) linear regression showed that urinary incontinence, self-rated health and tiredness were significantly associated with falls for both men and women living at home. The gender-related differences in falling were associated with the variables such as self-rated health for men and tiredness and pain in the hands, elbows, legs or knees for women. CONCLUSION: An association is evident between falls and urinary incontinence, poor self-rated health and tiredness for older persons living at home. Gender differences in falls show an association with poor self-rated health, tiredness and pain in the hands, elbows, legs or knees. RELEVANCE TO CLINICAL PRACTICE: As older people are expected to live in their own homes as long as possible, more knowledge is required about what determines the risk of falling. Nurses in community care are recommended to use assessment tools that include urinary incontinence in order to detect the risk of falling.

Health, sleep, and professional career in female white-collar workers back to work after long-term sick-listing due to minor mental disorders.

AIMS: This study is a 3-year follow up of female white-collar workers, who were on long-term sick leave in 2004 due to stress-related and minor mental disorders. The aim is to show what promotes return-to-work (RTW) and the impact of a long period of sickness absence on professional career. METHODS: The study includes a cohort of 233 women who were currently on medically certified sick leave lasting ≥90 days in 2004. A postal questionnaire was sent out after 34 months, regarding self-rated health, quality of sleep, sick-listing status, occupational status, etc. RESULTS: After 34 months, 69% of the women had fully returned to working life. One of the most salient findings is that almost half of those had changed jobs and more than a third were in a new profession. Those who were back in working life rated less negative consequences of the long-term sick-listing on their professional career and their quality of sleep was better (OR 2.90, 95% CI 1.50-5.60 "sleeping all night"). Self-rated health did not show significant association with RTW (OR 2.83, 95% CI 0.91-8.77). Those who had returned to working life reported more control over their lives (OR 1.98, 95% CI 1.01-3.88). CONCLUSIONS: The findings imply that, in work health promotion and rehabilitation and efforts to prevent sickness absence due to stress-related disorders, important factors to be considered are job mobility, changes in present work, improved sleep, and control over one's own life.

Assistant nurses working in care of older people: associations with sustainable work ability.

Indicators of health have shown improvements in the Swedish working population during the past decades, but with the exception of low-skilled women. Earlier research has shown that assistant nurses belong to an occupational group, which has the lowest share of individuals with long-term health in the total Swedish workforce. Sick leave research has mostly focused on determining risk factors for the development of diseases and dysfunctions. In the process of acquiring knowledge about mechanisms for sick leave, it has become obvious that there is also a need to focus on what contributes to work ability. The aim in this study was to explore what promotes sustainable work ability in female assistant nurses working in care of older people. Associations between factors related to work, health, lifestyle and sustainable work ability were investigated in a cross-sectional nested case-control study in a cohort of 366 female assistant nurses. Data were collected in self-reports in a questionnaire. Odds ratios were calculated, and a multiple logistic regression analysis was performed with sustainable work ability as the dependent variable. Sustainable work ability was associated with good self-rated health, a BMI <30, ability to sleep well, recuperation, low stress level, support from family and friends, being over 25 years of age at birth of the first child, and control over one's own life in the ≥50 age group. In the logistic regression analysis, the significant associations were good self-rated health, being over 25 years of age at the birth of the first child and recuperation. In conclusion, the study showed that self-rated health and factors in private life are important for assistant nurse's sustainable work ability over time. The results from this study could be applied in health promotion work for employees in the care sector to strengthen and enhance sustainable work ability.

Understanding long-term sick leave in female white-collar workers with burnout and stress-related diagnoses: a qualitative study.

BACKGROUND: Sick leave rates in Sweden have been significant since the end of the 1990s. In this paper we focus on individual female white-collar workers and explore various factors and setting-based sources of ill health in working life and in private life, in order to understand impaired work ability, leading ultimately to long-term sick leave. METHODS: A qualitative methodology was chosen, and thematic, open-ended interviews were carried out with 16 women. The interviewees were strategically selected from a cohort of 300 women in full-time white-collar jobs in high-level positions, living in three urban areas in Sweden, and on long-term sick leave > or =90 days. A qualitative content analysis was carried out. RESULTS: The informants in the study were generally well educated, but a few had surprisingly little formal education considering their salary level and position on the labour market. The women were in professional positions more commonly held by men, either as specialists with some degree of managerial role or as executives with managerial responsibilities. Both external and internal stressors were identified. The analysis indicated that being in these gender-typed jobs could have induced sex discrimination and role conflicts. The women expressed strong agreement regarding success in working life, but emphasised the lack of competence matching in their present jobs. They also lacked the sense of having a rewarding job, saw leadership as weak, and disliked their present workplace and colleagues. Impaired health may have hindered them from changing jobs; conversely, their locked-in positions could have resulted in deterioration in their health status. The women displayed personal overcommitment, both at work and in private life, and had difficulties in setting limits. CONCLUSIONS: Factors in working life, as well as in private life, played an important role in the informants' deteriorated health and long-term sick leave. Job and workplace mismatching, problems in connection with company profitability, and poor leadership contributed to stress-related symptoms, resulting in reduced working capacity. On the basis of these findings, attention should be paid to identification of early indicators of exhaustion, and measures should be taken in work settings and in working life as a whole to promote retained work ability.

Understanding work ability: experiences of female assistant nurses in elderly care.

Few studies to date have investigated retained work ability. The aim of this explorative study was to describe female assistant nurses' experiences of high work attendance over the years The setting is a municipality in mid-Sweden that employs 466 female assistant nurses permanently within municipal elderly care. A qualitative methodology was chosen and thematic, open-ended, interviews were carried out with 12 female assistant nurses. The interviewees were selected from the 117 women who had taken the least amount of sick leave over the past five years, which meant no sick leave at all or no more than 5 days. The interviews were transcribed verbatim, and thereafter a content analysis was carried out. Three main themes connected with the aim of the study emerged from the interviews: "a desirable job, despite low status", "supportive social networks", and "coping ability". In order to strengthen work ability among female employees in elderly care, the findings indicate that it is crucial to support mobility in working life, and to promote social support and networks at the workplace and in private life, as well as a coping-oriented approach to health issues and social life.

Job mismatching, unequal opportunities and long-term sickness absence in female white-collar workers in Sweden.

AIM: To investigate associations between long-term sick-listing and factors at work and in family life. METHODS: Associations were investigated in a cross-sectional case-referent study. The study base included women in white-collar jobs, aged 30-55 years, living in three urban areas in Sweden between February 2004 and October 2004. A postal questionnaire was constructed with questions on occupational and family circumstances, and sent to 513 randomly selected female white-collar workers, of whom 233 had ongoing sick-leave of 90 days or more. The response rate was 81% (n = 413). RESULTS: Most of the women in this study were in managerial positions. The unadjusted associations showed that sick-listed women with children showed the highest estimates regarding reported long working hours, bullying, high mental strain, low control and low influence at work, and work-family imbalance. In a regression model, the strongest associations were: experiencing too high mental strain in work tasks (odds ratio (OR) = 2.57, 95% confidence interval (CI) = 2.09-3.15) and low control and influence at work (OR=2.17, 95% CI= 1.60-2.94). Sick-listed women reported an overall higher dissatisfaction with their workplace and working life. CONCLUSIONS: There seems to be a greater tendency for the sick-listed women in this study to experience low control and too high mental strain at work and to live in traditional family relationships with unequal opportunities. The women who were sick-listed were probably less able to cope with work stress and to find a balance between work and family life.

Falls in somatic and dementia wards at Community Care Units.

INTRODUCTION: Falls and fall injuries are common problems for patients at nursing homes in Sweden. Impaired cognitive function, a poor sense of orientation and a high intake of medicine, can lead to an increase in falls among older people. AIM: The objective of this study was to investigate the associations between falls and: fall risks, fractures, the use of physical restraints and the use of certain medications in somatic and dementia wards, respectively. METHOD: The study design is ecological, and aggregated data regarding falls, fall risk assessments, fractures, the use of physical restraints and medication were collected between 2000 and 2003. The Pearson correlation analysis and regression analyses were used to investigate associations between fall risks, medication, fractures, wheelchair-bound situations, bed rails and falls. RESULTS: The total number of reported fall incidents was 2651; of these, 737 incidents were registered in dementia wards and 1914 in somatic wards. Dementia wards and somatic wards differed regarding falls and fractures, as it was only in dementia wards that falls were associated with fractures. There was also a significant correlation between falls and assessed risk of falling, the use of certain medication, and physical restraints such as wheelchairs and bed rails in dementia wards. Falls at somatic wards were associated with the use of sleeping pills with benzodiazepines. CONCLUSION: For dementia wards there were associations between falls and fractures, physical restraints and the use of certain medications. Fractures were associated with the use of neuroleptics, sleeping pills and sleeping pills with benzodiazepines. At somatic wards, falls correlated with the use of sleeping pills with benzodiazepines, and with the use of wheelchairs and bed rails.

Falls and fall risk among nursing home residents.

AIM AND OBJECTIVES: The aim of this study was to identify risk factors for falls in older people living in nursing homes. BACKGROUND: Impaired cognitive function and a poor sense of orientation could lead to an increase in falls among those with impaired freedom of movement. Many accidents occur while an older person is walking or being moved. METHOD: The study was carried out over four years (2000-2003) and 21 nursing home units in five municipal homes for older people in Stockholm, Sweden, participated. A questionnaire was sent to staff nurses, including questions on fall risk assessments, falls, fractures, medication and freedom-restricting measures, such as wheelchairs with belts and bed rails. The data were aggregated and not patient-bound. The study covered 2,343 reported incidents. RESULTS: There was a significant correlation between falls and fractures (r = 0.365, p = 0.004), fall risk and use of wheelchairs (r = 0.406, p = 0.001, safety belts (r = 0.403, p = 0.001 and bed rails (r = 0.446, p = 0.000) and between the occurrence of fractures and the use of sleeping pills with benzodiazepines (r = 0.352, p = 0.005). Associations were also found between fall risk and the use of anti-depressants (r = 0.412, p = 0.001). CONCLUSION: In clinical practice, patient safety is very important. Preventative measures should focus on risk factors associated with individuals, including their environment. Wheelchairs with safety belts and bed rails did not eliminate falls but our results support the hypothesis that they might be protective when used selectively with less anti-depressants and sleeping pills, especially benzodiazepines.

Work and family: associations with long-term sick-listing in Swedish women - a case-control study.

BACKGROUND: The number of Swedish women who are long-term sick-listed is high, and twice as high as for men. Also the periods of sickness absence have on average been longer for women than for men. The objective of this study was to investigate the associations between factors in work- and family life and long-term sick-listing in Swedish women. METHODS: This case-control study included 283 women on long-term sick-listing > or =90 days, and 250 female referents, randomly chosen, living in five counties in Sweden. Bivariate and multivariate logistic regression analyses with odds ratios were calculated to estimate the associations between long-term sick-listing and factors related to occupational work and family life. RESULTS: Long-term sick-listing in women is associated with self-reported lack of competence for work tasks (OR 2.42 1.23-11.21 log reg), workplace dissatisfaction (OR 1.89 1.14-6.62 log reg), physical workload above capacity (1.78 1.50-5.94), too high mental strain in work tasks (1.61 1.08-5.01 log reg), number of employers during work life (OR 1.39 1.35-4.03 log reg), earlier part-time work (OR 1.39 1.18-4.03 log reg), and lack of influence on working hours (OR 1.35 1.47-3.86 log reg). A younger age at first child, number of children, and main responsibility for own children was also found to be associated with long-term sick-listing. Almost all of the sick-listed women (93%) wanted to return to working life, and 54% reported they could work immediately if adjustments at work or part-time work were possible. CONCLUSION: Factors in work and in family life could be important to consider to prevent women from being long-term sick-listed and promote their opportunities to remain in working life. Measures ought to be taken to improve their mobility in work life and control over decisions and actions regarding theirs lives.