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Background: Numerous studies indicated that workers in the health sector suffer from work stress, hassles, and mental health problems associated with COVID-19, which negatively affect the completion of their job tasks. These studies pointed out the need to search for mechanisms that enable workers to cope with job stress effectively., Objectives: This study investigated psychological flow, mental immunity, and job performance levels among the mental health workforce in Saudi Arabia. It also tried to reveal the psychological flow (PF) and mental immunity (MI) predictability of job performance (JP)., Method: A correlational survey design was employed. The study sample consisted of 120 mental health care practitioners (therapists, psychologists, counselors)who lived in Saudi Arabia. Sixty-four were men, 56 were women, and their ages ranged between 27 and 48 (36.32±6.43). The researchers developed three measurements of psychological flow, mental immunity, and job performance. After testing their validity and reliability, these measures were applied to the study participants., Results: The results found median levels of psychological flow, mental immunity, and job performance among mental health care practitioners. Also, the results revealed that psychological flow and mental immunity were statistically significant predictors of job performance. The psychological flow variable contributed (38.70%) and mental immunity (54.80%) to the variance in job performance of mental health care practitioners., Conclusion: The current study indicated that psychological flow and mental immunity significantly influenced the job performance of mental health care practitioners. These findings pointed out that human resource management in mental health care institutions in Saudi Arabia must search for procedures that achieve a state of flow and mental immunity for workers to make their jobs more meaningful. Also, these findings indicated the importance of planning interventions to enhance mental health care practitioners' psychological flow, mental immunity, and job performance to help them cope with work stress effectively and protect them from symptoms of burnout., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Al Eid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Correctional officers (COs) are exposed to emotional and physical harm by the nature of their work. Operational stress can lead to burnout and influence absences and COs work performance., Objectives: This study aimed to evaluate the association between work-related stress and burnout adjusted by potential confounding variables (age, sex, correctional facility, type of correctional facility, distance to work, and absenteeism)., Methods: The sample of this cross-sectional study was made up of 799 prison officials. The self-administered questionnaire consisted of four instruments: demographic data, Health and Job Performance Questionnaire, Police Operational Stress Questionnaire, and Maslach Burnout Inventory. The questionnaires were completed online and in person., Results: A high proportion of COs reported high operational stress and burnout levels. Fatigue was the highest mean value from all stressors, with 5.89. COs reported high levels of emotional exhaustion and depersonalization. They also reported low levels of personal accomplishment. Furthermore, COs with high stress levels are approximately eight times more likely to experience burnout., Conclusion: These findings suggest that COs in Puerto Rico exposed to stress are more vulnerable to present burnout. The findings suggest that evidence-based interventions and programs should be implemented to help prevent and reduce operational stress and burnout among COs., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Laureano-Morales et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

We aimed to explore the experiences, needs, and mental health impact of family members of healthcare workers (HCWs) before and during the COVID-19 pandemic. Eleven quantitative and nine qualitative studies were included in this review. Based on the narrative synthesis, we identified five outcomes: 'Mental health outcomes', 'Family relationships, 'Coping skills and resilience', 'Quality of life and social life', and 'Practical outcomes'. Our findings indicated that there was a high risk to the mental health and well-being of families of healthcare workers both before and during the pandemic. However, with the COVID-19 pandemic, some experiences and mental health issues of families were worsened. There was also a negative association between working long hours/shift work and family relationships/communication, family social life, and joint activities, and family members taking on more domestic responsibilities. Families tended to use both positive and negative coping strategies to deal with their loved one's job stress. Organisations and support services working with people in health care work should consider widening support to families where possible. With this understanding, HCWs and their families could be supported more effectively in clinical and organisational settings. Trial registration: Systematic Review Registration Number: CRD42022310729. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022310729., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Tekin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Burnout, characterised by emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (PA), is caused by chronic workplace stress. Though widely reported in doctors, variability in definitions and assessment methods render comparisons between studies challenging. Furthermore, traditional methods of reporting burnout can be misleading, focusing more on individuals than on the workplace. Various scores from Maslach Burnout inventory (MBI) have been previously reported as 'burnout', inflating reported prevalence. Recent research suggests using latent profile analysis (LPA), to explore the continuum from engagement to burnout, as distinct patterns of working life may contribute to different profiles., Aims: To examine the prevalence of latent burnout profiles (LBP) amongst Irish hospital doctors., Methods: LBP categorisation of MBI was applied to responses from 1610 hospital doctors from a national survey. Effort-Reward Imbalance (ERI) questionnaire and work ability score were used to measure work stress and work ability., Results: In line with LBP categorisation, the respondents were classified as follow: 23% (N = 364) Engaged; 21% (N = 332) Burnout (High EE and DP), Overextended (N = 476, 30%); 22% (N = 355) Ineffective (low PA score), 5% (N = 83) Disengaged (high DP scores). Consultants were more likely to be classified as Engaged than trainees. Those classified as Burnout were younger. Females were more likely to be classified as Overextended. Work stress was associated with Overextended, Disengaged and Burnout profiles. Insufficient workability was associated with Burnout profile., Conclusions: The use of LPA provides more nuanced exploration of the phenomenon which can be correlated with workplace features, pointing to potential interventions., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Haire et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study explores the dynamics of work pressure and decision-making effectiveness among university department heads within the context of Middle Eastern higher education. It aims to address a significant gap in the literature by answering five key questions: (1) What level of work pressure do department heads face as perceived by faculty members? (2) Does work pressure vary based on gender or years of experience? (3) How effective are department heads in decision-making? (4) Are there differences in decision-making effectiveness related to gender, university affiliation, or experience? (5) Is there a correlation between work pressure and decision-making effectiveness? A quantitative correlational research design was employed, gathering data from a questionnaire distributed to 205 faculty members. Correlational descriptive analysis revealed that department heads are subjected to high levels of work pressure but maintain a high level of decision-making effectiveness. However, significant differences in decision-making effectiveness were noted, with female faculty members performing better regardless of university affiliation or experience. A pronounced correlation was found between the intensity of work pressure and decision-making efficacy. The study underscores that department heads are under considerable work pressure, which could affect their productivity and, crucially, their decision-making processes. Universities are encouraged to take proactive steps to mitigate these pressures and promote a supportive, low-stress environment. Future research could extend this work by employing qualitative methods, including interviews and observations., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Al-Zoubi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The present study investigated how life stress and sleep disturbance impact depressive symptoms among Chinese (N = 185) and Japanese (N = 464) workers. Based on a hypothesis that sleep disturbance can cause depression, a statistical model is established, expecting that work-related life stress indirectly increases depressive symptoms by worsening sleep disturbance rather than initiating depression directly. The study also examined the buffering effects of social support on depression. The extent of depressive symptoms, sleep disturbance symptoms (insomnia, hypersomnia, and nightmare), work-related stressors, and available social support were measured. The result revealed that the extent of depression was equivalent for both groups, but the Chinese reported more stress, less social support, and more severe sleep disturbance symptoms than the Japanese. Despite those differences, the statistical model fitted both groups well, suggesting that addressing sleep disturbance at the earliest opportunity can effectively prevent depression onset for workers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Matsuda, Kikutani. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The COVID-19 pandemic is the most significant worldwide health catastrophe, with massive impacts observed particularly among the healthcare workers. Stress among healthcare workers is a significant and pervasive issue that can have profound implications for both the well-being of healthcare professionals and the quality of patient care. This study aimed to determine the prevalence of stress related to the COVID-19 pandemic and the associated factors among the healthcare workers (HCWs)., Methods: A retrospective cross-sectional study was conducted involving 533 HCWs in Kota Setar District Health Office. Related data was collected between January and June 2021. Stress was measured using the Depression Anxiety Depression Scale 21 (DASS-21). Other variables included in this study were sociodemographic and employment factors. The associated factors and predictors were determined by employing chi-square test and multivariate logistic models., Results: COVID-19 related stress was reported at 10.5%. HCWs who work at the district health offices and those with degree or higher qualifications had 2.3 (AOR = 2.310, 95% CI: 1.177-4.535) and 3 (AOR = 2.899, 95% CI: 1.613-5.211) higher odds of experiencing stress compared to those working in the clinics and had lower qualifications (diploma or less)., Conclusions: The mental wellbeing of the HCWs participated in this study had been affected negatively by the COVID-19 pandemic, resulting in one in 10th of the HCWs were experiencing stress during the COVID-19 pandemic, with higher risk observed among those working at the district health office and HCWs with higher qualifications or ranking. This is expected since COVID-19 was a new and unprecedented outbreak associated with massive number of mortalities that requires active contact tracing and surveillance which commonly conducted at district health office level. Active intervention needed to cope with the overwhelming stress and working condition to ensure effective rehabilitation are in place and quality of work were not jeopardized., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Itam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Workplace events play a significant role in shaping the performance of employees and organizations. Negative events, in particular, require careful attention due to their severe impact on employee wellbeing and performance. Workplace bullying and incivility are two negative events that can cause significant harm to employees and contribute to poor performance. This study examines the effects of workplace bullying and incivility on employee performance in the presence of perceived psychological wellbeing (PWB), with the moderating role of perceived organizational support (POS) considered for both independent variables and employee performance (EP). The study focuses on female nurses working in the healthcare sector of Azad Jammu and Kashmir. The results of the study indicate that workplace bullying and incivility have adverse effects on employee performance and that PWB mediates these relationships. Moreover, perceived organizational support moderates the relationship between both predictors and the employee performance criterion. In conclusion, the findings of this study highlight the importance of creating a positive and supportive work environment to mitigate the negative effects of workplace bullying and incivility on employee performance., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Mehmood et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Many workers are experiencing the downsides of being exposed to an overload of information and communication technology (ICT), highlighting the need for resources to cope with the resulting technostress. This article offers a novel cross-level perspective on technostress by examining how the context of the welfare state influences the relationship between income and technostress. Showing that individuals with higher income experience less technostress, this study argues that the welfare state represents an additional coping resource, in particular in the form of unemployment benefits. Since unemployment benefits insure income earners in the case of job loss, the negative effect of income on technostress should increase with higher levels of unemployment generosity. In line with these expectations, empirical results based on original survey data collected in collaboration with the OECD show that the impact of income on technostress varies across welfare state contexts. Implications for public health and policymakers are being discussed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Lauterbach et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Physicians suffering from burnout are more likely to develop depression, substance dependence, and cardiovascular diseases, which can affect their practices. Stigmatization is a barrier to seeking treatment. This study aimed to understand the complex links between burnout among medical doctors and the perceived stigma., Methods and Findings: Online questionnaires were sent to medical doctors working in five different departments of the Geneva University Hospital. The Maslach Burnout Inventory (MBI) was used to assess burnout. The Stigma of Occupational Stress Scale in Doctors (SOSS-D) was used to measure the three stigma dimensions. Three hundred and eight physicians participated in the survey (response rate: 34%). Physicians with burnout (47%) were more likely to hold stigmatized views. Emotional exhaustion was moderately correlated with perceived structural stigma (r = 0.37, P < .001) and weakly correlated with perceived stigma (r = 0.25, P = 0.011). Depersonalization was weakly correlated with personal stigma (r = 0.23, P = 0.04) and perceived other stigma (r = 0.25, P = 0.018)., Conclusion: These results suggest the need to adjust for existing burnout and stigma management. Further research needs to be conducted on how high burnout and stigmatization impact collective burnout, stigmatization, and treatment delay., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Favre et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Increasing and changing demands for academic teachers worldwide are leading to different consequences, some of which are negative, such as physical and mental health impairment. With the job demands-resources model and the transactional model of occupational stress adopted as a theoretical framework, a cross-sectional study among Polish academic teachers was conducted. The aim of the study is to identify the role of vital personal resources understood as selected health-promoting behaviours, such as (1) stress-coping strategies, (2) sleep hygiene, and (3) using annual vacation leave, in the process of the regeneration. In a cross-sectional survey, the following variables have been assessed: 1) work-related stress using the Psychosocial Risk Scale, 2) occupational burnout using the Oldenburg Burnout Inventory (OLBI), 3) chronic fatigue using the Polish adaptation of the Checklist Individual Strength (CIS), and selected health behaviours of academic teachers 4) stress-coping strategies with the help of the Polish version of Mini-COPE and 5) rest: the amount of sleep and vacation days devoted to rest using a short questionnaire designed by the authors. The sample (N = 340) was comprised of academic teachers employed at Polish higher education institutions who have experienced changes in the work environment in recent years. We conducted a multiple regression analysis to determine the relationships among stress, burnout, and chronic fatigue, looking at coping strategies and rest as a moderator. The results indicate that there is a strong relationship between stress resulting from an excessively demanding work environment on the one hand and occupational burnout and chronic fatigue on the other. At the same time, selected health behaviours of academic teachers only slightly moderate the analyzed relationship. Avoidance strategies strengthen the relationship between stress and its negative consequences, while rest and-to a limited extent-the amount of sleep only slightly contribute to weakening the analyzed relationship., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Springer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In these times of successive lockdown periods due to the health crisis induced by COVID-19, this paper investigates how the usages of collaborative and communication digital tools (groupware, workflow, instant messaging and web conference) are related to the evolution of teleworkers' subjective well-being (job satisfaction, job stress) and job productivity comparing during and before the first lockdown in spring 2020. Using a sample of 438 employees working for firms located in Luxembourg, this analysis enables, first, to highlight different profiles of teleworkers regarding the evolution of usages of these tools during the lockdown compared to before and the frequency of use during. Second, the analysis highlights that these profiles are linked to the evolution of job satisfaction, job stress and job productivity. Our main results show that (1) the profile that generates an increase in job productivity is the one with a combined mastered daily or weekly use of all of the four studied digital tools but at the expense of job satisfaction. On the contrary, (2) the use of the four digital tools both before and during the lockdown, associated with an increase in the frequency of use, appears to generate too much information flow to deal with and teleworkers may suffer from information overload that increases their stress and reduces their job satisfaction and job productivity. (3) The habit of using the four tools on a daily basis before the lockdown appears to protect teleworkers from most of the adverse effects, except for an increase in their job stress. Our results have theoretical and managerial implications for the future of the digitally transformed home office., Competing Interests: The authors have declared that no competing interests exist. The author’s acknowledgements are the following: This research is carried out within the framework of the DIGITUP project ‘Digital Up-skilling in a telework environment’ supported by the Luxembourg National Research Fund (COVID-19/2020-1/14736055/DIGITUP/Martin). The authors thank various seminar and conference audiences for helpful comments. We thank the Luxembourg National Research Fund (FNR), LISER and the University of Luxembourg for sponsoring and providing access to the ‘COVID-19 Socio-Economic Impacts (SEI) survey’.

Background: Burnout is a syndrome of emotional exhaustion, low personal accomplishment and depersonalization experienced by a health professional and it is more common in nurses due to high workload and job stress that is mostly caused by working proximity to patients and taking care of them. Burnout compromises the provision of quality health care. Despite this, there is no information in Ethiopia on burnout among nurses in study area., Objectives: To determine the magnitude of burnout and associated factors among nurses working in public hospitals of Harari regional state and Dire Dawa administration, eastern Ethiopia, February 1-29, 2020., Methods: Institutional based quantitative cross-sectional study was employed from February 1-29 among 412 randomly selected nurses who have been working in hospitals for the last 6 months. Simple random sampling method was employed and data was collected by self-administered, standardized, reliable and valid, questionnaire (Maslachs Burnout Inventory- Human Services Survey). Data was entered into EpiData Version 3.1 and exported to statistical package for social science version 20 for analysis. All covariate with P-value less than 0.25 in bivariable analysis were candidate for multivariable analysis. Level of statistical significance was declared at p-value < 0.05., Results: Among 412 nurses taking part in this study, 183(44.4%) of nurses with 95% CI, had experienced burnout. Married marital status [AOR:2.3,95%CI:(1.2-4.3)], poor current health status [AOR:4.8, 95% CI:(1.1-21.4)] and fair current health status [AOR:12, 95% CI:(4.5-32)], working greater than eight hour per-day[AOR:0.52, 95%CI:(0.29-0.92)], intention to leave a job [AOR:0.48,95%CI:(0.2-0.88), being working in emergency room [AOR:0.3,95%CI:(0.1-0.98)] and using a different medication related to work related health problems were factors associated with nurses' burnout., Conclusion: The nurses' burnout in this study is high and it is attributed by marriage, perceiving health status as poor and fair, whereas, having the intention to leave job, being working in emergency room and using a medication in relation to work related health problems reduced risk of developing burnout. So, the concerned bodies should provide trainings which focus on stress copying mechanisms and assertiveness program., Competing Interests: No

Translators face hectic daily schedules with deadlines they must duly meet. As trainees they receive tuition on how to work swiftly to meet them efficiently. But despite the prominent role of time pressure, its effects on the translation process are still scarcely researched. Studies point to the higher occurrence of errors under stringent time constraints. Most of these studies use key-logging or eye-tracking techniques to identify the problems encountered. But no attempt has yet been made to measure the physiological effects of time pressure in English-to-Spanish translation and their interplay with trainees' psychological state. The present study researches the influence of time pressure on translation by exploring trainees' physiological response (i.e., salivary cortisol) and psychological traits (i.e., self-esteem and anxiety). 33 Spanish translation trainees translated 3 English literary texts under different time pressure conditions: Text 1 (no time limit), Text 2 (10 minutes), Text 3 (5 minutes). Regression analysis results showed that higher cortisol levels during preparation predicted higher number of meaning errors in Text 1 and lower number of translated words in Text 2 and 3. Besides, higher trait anxiety emerged as predictor of lower number of translated words, but higher accuracy under extreme time constraints and in the absence of time pressure. Higher self-esteem correlated with lower levels of anxiety and lower levels of cortisol during preparation and recovery, suggesting that it may act as a protective factor against stress. And yet, the regression analysis showed that higher self-esteem predicted lower meaning and total accuracy under extreme time pressure. Besides, in our correlation analysis self-esteem was positively related to the number of translated words in Text 2 and 3. Results suggest that even if self-esteem could be a protective factor against stress, it may also have a negative effect on task performance mediated by overconfidence., Competing Interests: The authors have declared that no competing interests exist.

Intensive care unit healthcare workers (ICU HCW) are at risk of mental health issues during emerging disease outbreaks. A study of ICU HCW from France revealed symptoms of anxiety and depression in 50.4% and 30.4% of workers at the peak of the first wave of the pandemic. The level of COVID-19 exposure of these ICU HCW was very high. In Canada, ICU HCW experienced variable exposure to COVID-19 during the first wave of the pandemic, with some hospitals seeing large numbers of patients while others saw few or none. In this study we examined the relationship between COVID-19 exposure and mental health in Canadian ICU HCW. We conducted a cross-sectional cohort study of Canadian ICU HCW in April 2020, during the acceleration phase of the first wave of the pandemic. Psychosocial distress was assessed using the 12-item General Health Questionnaire (GHQ-12). Participants were asked about sources of stress as well as about exposure to COVID-19 patients and availability of personal protective equipment (PPE). Factors associated with clinically-relevant psychosocial distress were identified. Responses were received from 310 Canadian ICU HCW affiliated with more than 30 institutions. Of these, 64.5% scored ≥ 3 points on the GHQ-12 questionnaire, indicating clinically-relevant psychosocial distress. The frequency of psychosocial distress was highest amongst registered nurses (75.7%) and lowest amongst physicians (49.4%). It was also higher amongst females (64.9%) than males (47.6%). Although PPE availability was good (> 80% of participants reported adequate availability), there was significant anxiety with respect to PPE availability, with respect to the risk of being infected with COVID-19, and with respect to the risk of transmitting COVID-19 to others. In multivariable regression analysis, Anxiety with respect to being infected with COVID-19 (OR 1.53, CI 1.31-1.81) was the strongest positive predictor of clinically-relevant psychosocial distress while the Number of shifts with COVID-19 exposure (OR 0.86, CI 0.75-0.95) was the strongest negative predictor. In summary, clinically-relevant psychosocial distress was identified amongst a majority of ICU HCW during the acceleration phase of the first wave of the COVID-19 pandemic, including those with minimal or no exposure to COVID-19. Strategies to support mental health amongst ICU HCW are required across the entire healthcare system., Competing Interests: The authors declare that no competing interests exist.

Introduction: Health care professionals are at higher risk of developing stress-related problems during outbreaks, due to the overwhelming clinical workload, fear of contagion, and inadequate protective gears. So, in order to monitoring mental health issues and to understand the factors evidence-based interventions is important. Therefore, this study was aimed to assess perceived stress and associated factors among health care professionals working in the context of COVID-19, Southern Ethiopia., Methods: Institution based cross-sectional study was conducted among 798 health care professionals from the 1st May to 1st June 2020. The study participants were selected using simple random sampling technique after allocating a proportion to each health institute based on the size of health care professionals. A pre-tested and structured interviewer-administered questionnaire using KOBO collect survey tool was used to collect data. A total score of >20 points was considered as the cut off for experiencing perceived stress based on perceived stress scale. Both bivariable and multivariable logistic regression analysis were performed to identify associated factors. The level of statistical significance was set at a p-value of less than 0.05 in multivariable logistic regression., Result: Nearly two-thirds 61.8% (95% CI: 58.4%, 65.2%) of HCPs had perceived stress. Not having COVID-19 updated information (AOR = 2.41, 95% CI: 1.31, 4.43), not at all confident on coping with stress (AOR = 9.94, 95% CI:3.74, 26.41), somewhat confident in coping with stress (AOR = 4.69, 95% CI:2.81, 7.84), moderately confident on coping with stress (AOR = 2.36, 95% CI: 1.46, 3.82), and not getting along well with people (AOR = 4.88, 95% CI: 1.42, 16.72) were positively association with perceived stress. However, feeling overwhelmed by the demand of everyday life (AOR = 0.52 95% CI: 0.35, 0.77) and worrying about what other people think about them (AOR = 0.48, 95% CI: 0.24, 0.81) were negatively associated with perceived stress., Conclusion: COVID-19 update, confidence in coping with stress, getting along with people, worrying about what other people think about them, and feeling overwhelmed by the demand of everyday life were factors significantly associated with perceived stress. The provision of COVID-19 update to HCPs along with wider strategies to support their psychological wellbeing is vital., Competing Interests: The authors have declared that no competing interests exist.

Background: Occupational stress is associated with adverse outcomes for medical professionals and patients. In our cross-sectional study with 136 general practices, 26.4% of 550 practice assistants showed high chronic stress. As machine learning strategies offer the opportunity to improve understanding of chronic stress by exploiting complex interactions between variables, we used data from our previous study to derive the best analytic model for chronic stress: four common machine learning (ML) approaches are compared to a classical statistical procedure., Methods: We applied four machine learning classifiers (random forest, support vector machine, K-nearest neighbors', and artificial neural network) and logistic regression as standard approach to analyze factors contributing to chronic stress in practice assistants. Chronic stress had been measured by the standardized, self-administered TICS-SSCS questionnaire. The performance of these models was compared in terms of predictive accuracy based on the 'operating area under the curve' (AUC), sensitivity, and positive predictive value., Findings: Compared to the standard logistic regression model (AUC 0.636, 95% CI 0.490-0.674), all machine learning models improved prediction: random forest +20.8% (AUC 0.844, 95% CI 0.684-0.843), artificial neural network +12.4% (AUC 0.760, 95% CI 0.605-0.777), support vector machine +15.1% (AUC 0.787, 95% CI 0.634-0.802), and K-nearest neighbours +7.1% (AUC 0.707, 95% CI 0.556-0.735). As best prediction model, random forest showed a sensitivity of 99% and a positive predictive value of 79%. Using the variable frequencies at the decision nodes of the random forest model, the following five work characteristics influence chronic stress: too much work, high demand to concentrate, time pressure, complicated tasks, and insufficient support by practice leaders., Conclusions: Regarding chronic stress prediction, machine learning classifiers, especially random forest, provided more accurate prediction compared to classical logistic regression. Interventions to reduce chronic stress in practice personnel should primarily address the identified workplace characteristics., Competing Interests: The authors have declared that no competing interests exist.

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49-2.95), nurse (OR 1.38; 95% CI 1.04-1.84), and 'other clinical' (OR 2.02; 95% CI 1.45-2.82); being redeployed (OR 1.27; 95% CI 1.02-1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98-2.99), anxiety (OR 4.87; 95% CI 3.92-6.06) and depression (OR 4.06; 95% CI 3.04-5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51-0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22-0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers., Competing Interests: JK has received an educational grant from Johnson and Johnson. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: The ongoing COVID-19 pandemic has caused rapid changes in the healthcare system. Workforce reorganization, reduced standard of care and a lack of personal protection equipment (PPE) for health care workers were among the concerns raised in the first wave of the pandemic. Our aim was to explore the experiences, distress and burden among Norwegian neurologists during the first weeks of the pandemic., Methods: Hospital-based neurologists in Norway (n = 400) were invited to a web-based survey in April 2020. The study focused on patient management, organizational changes and personal stress during the first weeks of the pandemic lockdown. Work-home interface stress was assessed by the Cooper Job Stress Questionnaire., Results: In total, 135 neurologists participated. Seventy-three% experienced a change in their personal work situation, and 67% examined patients with suspected COVID-19 infection and neurological disease. Changed access to resources, and the perception that medical follow-up was unsatisfactory, were associated with a high degree of burden and stress. Neurologists were also worried about the potential lack of PPE and the fear of spreading SARS CoV-2 to close family members. The mean score of work-home interface stress was 2.8 with no significant differences between gender or specialist status. Reduced standard of care was reported for all neurological conditions, and in particular for non-emergency treatments., Conclusion: The vast majority of neurologists in Norway experienced a change in their personal work situation during the first phase of the pandemic. The fear of becoming infected and ill was not a major contributor to burden and stress., Competing Interests: BWS has received speaking fees from Novartis, unrelated to the present work. ECS has received speaking fees from Bayer and Novartis, unrelated to the present work. AMS,ESK, KWF and SHJ report no conflicts of interest. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Background: The SARS-CoV-2 virus has spread rapidly around the globe since December 2019 creating much uncertainty among medical staff. Due to close patient contact, medical assistants are at increased risk of an infection. Several studies have investigated psychological consequences of the SARS-CoV-2 pandemic on medical staff, yet studies in the outpatient setting are scarce and studies addressing medical assistants are lacking. This study aimed to investigate pandemic-related stressors, attitudes, and work outcomes among medical assistants and to identify possible determinants., Methods: The population under study were medical assistants across entire Germany. A self-devised online questionnaire was published between April 7th, 2020, and April 14th. including questions on pandemic-related stressors, attitudes and work outcomes. Additionally, symptoms of depression and anxiety disorder were measured by PHQ-2 and GAD-2, respectively. Logistic regression was performed to identify possible determinants., Results: 2150 medical assistants provided complete data (98.0% female, mean age 37.6 years). Major stressors were uncertainty about the temporal scope of the pandemic (95.1% agreement), about how to act correctly (77.5%), feelings of not being allowed to let patients down (75.9%), uncertainty about one's financial situation (67.4%) and about contact persons for further information (67.1%). One third (29.9%) of the study population screened positively for depression and 42.6% for anxiety disorder. Feeling burdened by one's financial situation was significantly associated with working in specialist practices (1.32 [1.08-1.62]), caring for children (1.51 [1.22-1.87]), depression (1.28 [1.01-1.62]), and anxiety disorder (1.93 [1.55-2.39]). Feeling burdened by thoughts about virus contraction at work was also significantly associated with working in specialist practices (1.33 [1.07-1.64]), caring for children (1.33 [1.07-1.66]), depression (1.54 [1.18-2.00]), and anxiety (4.71 [3.71-5.98])., Conclusions: This study provides novel evidence regarding major SARS-CoV-2 pandemic-related stressors among medical assistants and suggests need for special support for medical assistants caring for children and working in specialist practices., Competing Interests: The authors have declared that no competing interests exist.

Migrant workers may experience higher burdens of occupational injury and illness compared to native-born workers, which may be due to the differential exposure to occupational hazards, differential vulnerability to exposure-associated health impacts, or both. This study aims to assess if the relationships between psychosocial job characteristics and mental health vary by migrant status in Australia (differential vulnerability). A total of 8969 persons from wave 14 (2014-2015) of the Household Income and Labour Dynamics in Australia Survey were included in the analysis. Psychosocial job characteristics included skill discretion, decision authority and job insecurity. Mental health was assessed via a Mental Health Inventory-5 score (MHI-5), with a higher score indicating better mental health. Migrant status was defined by (i) country of birth (COB), (ii) the combination of COB and English/Non-English dominant language of COB and (iii) the combination of COB and years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age and educational attainment. Migrant status was analysed as an effect modifier of the relationships between psychosocial job characteristics and mental health. Skill discretion and decision authority were positively associated with the MHI-5 score while job insecurity was negatively associated with the MHI-5 score. We found no statistical evidence of migrant status acting as an effect modifier of the psychosocial job characteristic-MHI-5 relationships. With respect to psychosocial job characteristic-mental health relationships, these results suggest that differential exposure to job stressors is a more important mechanism than differential vulnerability for generating occupational health inequities between migrants and native-born workers in Australia., Competing Interests: The authors have declared that no competing interests exist.

Emotional flexibility advancement has been found to be highly effective in clinical settings to treat, for example, depression, anxiety, and chronic pain. Developing these skills in the working context has also shown very encouraging results in public sector settings. Also, a few studies have revealed effectiveness in a private sector setting, but no studies have yet looked at the effectiveness of developing these skills amongst high-paced, high-demanding, and highly-educated knowledge workers. In this pilot training intervention study, we report evidence that emotional flexibility can be developed in this context. We conducted an experiment with treatment and control groups, with only the treatment group receiving an emotional flexibility training. Emotional flexibility improved significantly for the treatment group, whereas the improvements were minimal or negative for the control group. Furthermore, we reveal that General self-efficacy improved amongst treatment group participants (and not for control group participants), and that this is associated with emotional flexibility. Finally, we show that the improvements were higher for participants starting from a lower baseline., Competing Interests: The 1st author is a part-time employee of the organization where the research was performed and a part-time affiliated researcher at three Universities. The 4th author is an employee of the same organization and invited the research as part of an employee well-being program. None of the other authors are part of this organization and served as academic researchers. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Introduction: Poor mental and sleep health negatively affects work performance, turnover intention, and information retention. We examined the impact of waiting job in upscale restaurants on the sleep health of waiters., Materials and Methods: This was a descriptive study which collected cross-sectional data from waiters of upscale restaurants, using PSQI and DASS-21 questionnaires. Descriptive and inferential statistics comprising mean, frequency, percentage, chi-square, and logistic regression were adopted in presenting the results., Results: Sleep quality was poor among 74% of the waiters. The predictors of sleep quality were sex (p = 0.002), role at restaurant (p = 0.004), non-prescription drug use (p<0.001), depression (p<0.001), anxiety (p<0.001), and stress (p<0.001). The prevalence of anxiety, depression, and stress among the waiters was 52.3%, 38.3%, and 34.4% respectively. Stationed (AOR = 4.72, 95%CI = 1.7-812.53, p = 0.002) and supervising (AOR = 3.08, 95%CI = 1.25-7.57, p = 0.014) waiters were more likely to have good sleep quality than headwaiters. Waiters who had depression, anxiety, and stress were, however, 8% (AOR = 0.92, 95%CI = 0.46-1.85, p = 0.819), 28% (AOR = 0.72, 95%CI = 0.38-1.36, p = 0.315), and 49% (AOR = 0.51, 95%CI = 0.24-1.07, p = 0.073) less likely to have a good sleep quality than those who respectively did not have depression, anxiety, and stress., Conclusions: Sleep quality was poor among most of the waiters. If this persists, Ghana may not be able to meet the Sustainable Development Goal 3.4 target of promoting mental health and wellbeing. To improve sleep quality and accelerate progress towards achievement of the SDG target, there should be increased collaboration among stakeholders in the health and hospitality industries to develop innovative interventions to reduce poor sleep quality among workers., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Practice assistants represent a highly relevant occupational group in Germany and one of the most popular training professions in Germany. Despite this, most research in the health care sector has focused on secondary care settings, but has not addressed practice assistants in primary care. Knowledge about practice assistants' workplace-related stressors and resources is particularly scarce. This cross-sectional study addresses the mental workload of practice assistants working in primary care practices., Methods: Practice assistants from a network of 185 German primary care practices were invited to participate in this cross-sectional study. The standardized `Short Questionnaire for Workplace Analysis' (German: Kurzfragebogen zur Arbeitsanalyse) was used to assess practice assistants´ mental workload. It addresses eleven workplace factors in 26 items: versatility, completeness of task, scope of action, social support, cooperation, qualitative work demands, quantitative work demands, work disruptions, workplace environment, information and participation, and benefits. Sociodemographic and work characteristics were also obtained. A descriptive analysis was performed for sociodemographic data and "Short Questionnaire for Workplace Analysis" factors. The one-sided t-test and Cohen´s d were calculated for a comparison with data from 23 professional groups (n = 8,121)., Results: A total of 550 practice assistants from 130 practices participated. The majority of practice assistants was female (99.3%) and worked full-time (66.5%) in group practices (50.6%). Compared to the other professional groups, practice assistants reported higher values for the factor social support (4.0 versus 3.7 [d 0.44; p<0.001]), information and participation (3.6 versus 3.3 [d 0.38; p<0.001] as well as work disruptions (2.7 vs. 2.4 [d 0.42; p<0.001]), while practice assistants showed lower values regarding scope of action (3.4 versus 3.8 [d 0.43; p<0.001])., Conclusions: Our study identified social support and participation within primary care practices as protective factors for mental workload, while work disruptions and scope of action were perceived as stressors., Competing Interests: The authors have declared that no competing interests exist.

Women can play a pivotal role in the progress and sustainability of the world if they are empowered through education and employment opportunities in Science, technology, innovation and through changing the social stereotypes that restrain them in certain workplaces. In the literature, few recently published studies exist that document the challenges faced by female scientists in their workplaces. The purpose of this study was to understand the challenges and coping strategies faced by female scientists around the world today, in order to contribute to their improved performance. A multi-centre electronic cross-sectional survey across 55 countries was conducted to profile female scientists and to identify the challenges that they experience throughout their career as well as the coping mechanisms that they use to overcome the barriers. A total of 263 female scientists from different countries across the world participated in our study and most participants were from the South East Asian Region. Most female scientists in our study belong to the middle and junior level career category and earning around 1250 USD per month. Most of the scientists reported availability of maternity leave at their workplace but less than a third reported presence of a creche at work. Workplace sexual harassment was reported by 24% of the study population. Work related stress (71.5%) and work life imbalance (46%) are also major challenges faced by female scientists. Self-confidence, dedication and hard work are the most commonly adopted coping strategy. Flexible work timings, woman-friendly management policies, fair appraisal and mentorship appear to reduce the work-related stress and improve work-life balance among female scientists. In conclusion, female scientists face numerous challenges, which can greatly affect both their individual and career growth. Intrinsic (personal) and extrinsic (institutional) factors are important for improving female scientists' wellbeing and productivity., Competing Interests: The authors have declared that no competing interests exist.

Background: There is literature scarcity relating to burnout and other work stresses in relation to Chinese nursing-workforce performance., Objectives: To assess the relationship between self-esteem versus burnout; and effort-reward ratio versus favorability to the work environment, among Chinese nurses., Methods: We employed four validated questionnaires in the assessment burnout, self-esteem, effort-reward ratio, and favorability of nursing workplace; Maslach-Burnout Inventory (MBI), Rosenberg's self-esteem (RS), Effort-Reward imbalance (ERI) and Work-Environment Scale questionnaires (WES). Linear and ordinal regression models were utilized to assess the relationships between the variables. Analyses were conducted by using SPSS at a 95% level of significance., Results: We assessed 487 (Mean age: 38.8±7.1 years) nurses from three hospitals. Higher self-esteem was associated with a lower level of emotional exhaustion (Unstandardized coefficient: -0.579, p-Value<0.001); and a lower level of depersonalization (Unstandardized coefficient: -0.212, p-Value = 0.001). The relationship between self-esteem and personal achievement did not reach statistical significance. A higher effort-reward ratio was associated with less likelihood that nurses would consider their work environment favorable (Logit estimate of -0.832, p-Value = 0.014)., Conclusion: Lower self-esteem is associated with increased burnout. A higher effort-reward ratio is associated with an enhanced perception work environment as unfavorable. We recommend psychosocial intervention programs and amendments in nursing policies to improve effort-reward imbalance among Chinese nurses., Competing Interests: The authors have declared that no competing interests exist.

Background: Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator., Methods: A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory., Results: The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW., Conclusions: The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED., Competing Interests: The authors have declared that no competing interests exist.

Metabolic syndrome (MetS) is a worldwide health concern related to cardiovascular disease. Stress at work increases the risk for MetS, whereas physical activity and cardiorespiratory fitness (CF) have been shown to be potential buffers against stress. The aim of this study was to test the stress-buffering effects of physical activity and CF on the relationship between work stress and MetS. In a prospective study, we followed 97 police officers (mean age = 39.7 years; mean body mass index = 25.74 kg/m2) over one year and assessed MetS, as defined by the National Cholesterol Education Program Adult Treatment Panel III. Stress at work was measured with the Job Content Questionnaire, as well as the Effort-Reward Imbalance Questionnaire. Physical activity was assessed objectively via 7-day accelerometry. CF was assessed with the Åstrand bicycle ergometer test. Hierarchical linear regression models were carried out to predict MetS at follow-up (mean overall MetS score = 1.22), after controlling for baseline levels and sociodemographic background (mean overall MetS score = 1.19). Higher CF levels were significantly associated with lower MetS risk at follow-up (β = -.38). By contrast, no main effects were found for physical activity and work stress. However, high effort and demand were significantly correlated with increased blood pressure (effort: r = .23 for systolic blood pressure; r = .21 for diastolic blood pressure) and waist circumference (effort: r = .26; demand: r = .23). Moreover, no significant interaction effects occurred between work stress and CF/physical activity. The results emphasize the importance of high levels of CF in the prevention of MetS in police officers. Accordingly, provision of regular training opportunities and repeated CF testing should be considered as a strategy in overall corporate health promotion., Competing Interests: The authors have declared that no competing interests exist.

Stress has become an inherent aspect of the nursing profession. Chronically experienced work stress can lead to burnout. Although situational stressors show a significant influence on burnout, their power to predict the complete syndrome is rather limited. After all, stressors only exist "in the eye of the beholder". This study aimed to explore how individual vulnerability factors such as core-self evaluations and coping, contribute to burnout in relation to situational stressors within a population of hospital nurses. Cross-sectional data was collected in 2014, using five validated self-report instruments: Dutch Core Self Evaluations Scale, Nursing Work Index Revised, Utrecht Coping List, Ruminative Response Scale, and Utrecht Burnout Scale. 219 of the 250 questionnaires were returned. Core-self evaluations, situational factors and coping each contributed significantly to the predictive capacity of the models of the separate burnout dimensions. Core-self evaluations was significantly related to emotional exhaustion. It was suggested that Core-self evaluations might be placed at the initiation of the loss cycle. However, further research is warranted., Competing Interests: The authors have declared that no competing interests exist.

The average length of hospital stay in the psychiatric ward is longer, and the risk of patient-to-nurse violence is higher than that in other departments. Therefore, psychiatric nurses' work environment may differ from that of other nurses. The factors related to psychiatric nurses' self-efficacy may also differ from those of general workers or other nurses. Mental health care that considers the characteristics of psychiatric nurses requires exploration of self-efficacy unique to psychiatric nurses. This cross-sectional study aimed to explore the distinct factors related to psychiatric nurses' self-efficacy. The developed 24 items related to improvement in self-efficacy and 25 items related to decrease in self-efficacy were examined. The Generalized Self-Efficacy Scale was used to measure the validity of the factors. To extract the factors of self-efficacy, data from 132 nurses and assistant nurses who provided informed consent were analyzed, and the reliability and validity of the factors were calculated. The factors associated with improvement in self-efficacy were "Positive reactions by patients," "Ability to positively change nurse-patient relationship," and "Practicability of appropriate nursing." The factors associated with decrease in self-efficacy were "Uncertainty in psychiatric nursing" and "Nurses' role loss." The Cronbach's α for all factors exceeded .70. Of the five factors, four had significant weak-to-moderate correlations with the Japanese version of the Generalized Self-Efficacy Scale; therefore, the validity was quantitatively confirmed with four factors. Interventions based on these four factors may improve psychiatric nurses' self-efficacy. Additionally, it is possible that this tool assesses the unique facets of self-efficacy rather than psychiatric nurses' general self-efficacy. Interventions to improve psychiatric nurses' self-efficacy based on the characteristics of psychiatry are needed., Competing Interests: The authors have declared that no competing interests exist.

Providing direct health and social care services for people who exhibit behaviours that challenge can be a highly stressful occupation. Existing literature has suggested that there is a need to develop further theoretical understanding of how work related stress can be reduced in professions that consist of providing care for people who exhibit behaviours that challenge. The aim for this study was to use a Classic Grounded Theory approach to develop a theoretical framework to illustrate a common issue that could influence work related stress levels experienced when managing behaviours that challenge in health and social care settings. A series of focus groups and 1:1 semi-structured interviews were conducted to explore the articulated experiences of 47 health/social care professionals who provide care for people who exhibit behaviours that challenge. This led to the development of Therapeutic Engagement Stress Theory (TEST), which illustrates that the perceived capacity to therapeutically engage with people who exhibit behaviours that challenge is an issue that can influence the levels of stress experienced by health/social care professionals. TEST provides a framework that could be applied to identify specific factors that inhibit staff to successfully deliver caring interventions for people who exhibit behaviours that challenge, and also inform bespoke support mechanisms to reduce stress in health/social care professionals., Competing Interests: The authors have declared that no competing interests exist.

Objectives: The purpose of this study was to assess the relationships among the following elements: unhealthy work indicators (job stress and emotional exhaustion at work), the decision to drive (or not), and driving crashes suffered by Spanish workers., Methods: For this cross-sectional study, a full sample of 1,200 Spanish drivers (44% women and 56% men) was used, their mean age being 42.8 years. They answered a questionnaire divided into three sections: demographic and driving-related data; burnout, job stress, and life stress; and self-reported road behaviors and driving safety indicators., Results: Overall, 41.6% of drivers reported emotional exhaustion at work. Furthermore, 80.2% of the participants showing substantial signs of job stress or exhaustion had experienced one or more important stressful life events during the previous year. Job stress was associated with the number of driving crashes suffered along the last 3 years. Also, and especially in situations where drivers admit not feeling well enough to drive, job stress and emotional exhaustion seem to be independent from the decision to drive, and from perceiving these variables as potential impairers of driving performance., Conclusions: First of all, this study showed a high prevalence of job stress and emotional exhaustion symptoms experienced at work by Spanish workers. Moreover, significant relationships were found among self-rated driving performance, workplace stress and burnout indicators, which suggests that job stress and emotional exhaustion levels may, indeed, impair driving performance, but they do not influence the decision to drive or not. In other words, even when they are significantly affected by job stress or emotional exhaustion at work, most Spanish drivers still drive., Competing Interests: The authors have declared that no competing interests exist.

Objective: The Job Demands and Control model classifies job types as active, passive, low-strain or high-strain, based on a combination of job demands and control. While studies have shown high-strain jobs to have adverse consequences for health and work participation, prognostic factors for the four job types have been less explored. The aim of this study was to assess the associations between sociodemographic factors and job descriptors and being in high-strain, low-strain, active and passive jobs., Methods: The WIRUS Screening study targeted Norwegian employees in private and public enterprises. In this study, associations with job types among 4,487 employees were investigated with binary logistic regression analyses, adjusting for sociodemographic and job-related variables., Results: In fully adjusted models, high-strain job was associated with female gender; lower education; shift work; and doing work outside the workplace. Low-strain job was associated with opposite scores on the same variables, and with lower job position. Active job was associated with lower age; female gender; higher levels of education; higher job position level; shift work; and not doing work outside the workplace. Passive job was associated with opposite scores on the same variables., Conclusions: The study corroborates the role gender and education have for experiencing the job, and expands on existing knowledge on the role of job position and irregular working hours and spaces. By identifying factors associated with job types, the prevention of health problems and work disability may become be more targeted., Competing Interests: The authors have declared that no competing interests exist.

For four decades, theories of job demand-control have proposed that higher occupational status groups have lower health risks due to the stress accompanying jobs featuring high demands but high control. This research examines whether Flexible Work Arrangements (FWAs) can improve the health prospects of a range of workers by giving greater control over work time arrangements. Our setting is Australia, where FWAs were introduced in 2009. In line with these early studies alongside studies of work-life balance, we expected to observe that workers with access to control over daily work times could better control the activities outside of work that influence chronic disease. Using a practice sociology approach, we compared the accounts of twenty-eight workers in blue and white collar industries with differing degrees of work time flexibility. The findings do not contradict early theories describing occupational differences of job demand-control dynamics and their relationship to health risks. However, this study suggests that a) time demands and strains have increased for a broad sweep of workers since the 1980s, b) the greater control of higher occupational status groups has been eroded by the high performance movement, which has attracted less scrutiny than FWAs, and c) more workers are forced to adapt their daily lives, including their approach to health, to accommodate their job demands. Job insecurity further impedes preventative health practices adoption. What might appear to be worker-controlled flexibility can-under the pressures of job insecurity and performance expectations without time limits-transform into health-eroding unpredictability. The answer however is not greater flexibility in the absence of limits on the well-documented precursors of work stress: long hours, job insecurity and intensity-related exhaustion. While there have been welcome developments in job demand-control-health conceptualizations, they typically ignore the out-of-work temporal demands that workers face and which compound on-the-job demands. Redesign of the temporalities of working life within worksites need to be accompanied by society-level policies which address caring responsibilities, gender equality as well as broad labour market conditions., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Precarious employment is associated with poor health. Among employees in precarious employment, those with multiple jobs may face additional health risks, e.g. due to combining work schedules and job roles. Our research question is: do differences in health exist between multiple and single job holders in precarious employment?, Methods: Participants in the Netherlands Working Conditions Survey 2012 aged 25-64 years who were not employed through the Act on Social Work Provision and who had a precarious job were included. To select employees in precarious employment (n = 3,609), latent class analysis was performed, based on variables based on indicators described by Van Aerden. Differences in general self-perceived health, burnout complaints, musculoskeletal health, and sickness absence between multiple and single job holders were studied cross-sectionally using logistic regression analyses., Results: No significant differences were found between multiple and single job holders in precarious employment for self-perceived health (OR = 0.9; 95%CI = 0.7-1.3), burnout complaints (OR = 0.9; 95%CI = 0.7-1.2), and musculoskeletal health (OR = 1.1; 95%CI = 0.8-1.5). In crude analyses, multiple job holders experienced less sickness absence than single job holders (OR = 0.7; 95%CI = 0.5-0.9). In adjusted analyses, this difference was no longer statistically significant (OR = 0.8; 95%CI = 0.6-1.0)., Conclusions: Despite potential health risks related to multiple job holding, we did not find health differences between multiple and single job holders in precarious employment in the Netherlands. More longitudinal research is necessary to provide recommendations for policy makers regarding multiple job holders in precarious employment., Competing Interests: The authors have declared that no competing interests exist.

Background: This study reports on physicians' experiences with chronic pain management. For over a decade prescription opioids have been a primary treatment for chronic pain in North America. However, the current opioid epidemic has complicated long-standing practices for chronic pain management which historically involved prescribing pain medication. Caring for patients with chronic pain occurs within a context in which a growing proportion of patients suffer from chronic rather than acute conditions alongside rising social inequities., Methods: Our team undertook an ethnographic approach known as institutional ethnography in the province of Ontario, Canada in order to explore the social organization of chronic pain management from the standpoint of primary care physicians. This paper reports on a subset of this study data, specifically interviews with 19 primary care clinicians and 8 nurses supplemented by 40 hours of observations. The clinicians in our sample were largely primary care physicians and nurses working in urban, rural and Northern settings., Findings: In their reflections on providing care for patients with chronic pain, many providers describe being most challenged by the work involved in helping patients who also struggled with poverty, mental health and addiction. These frustrations were often complicated by concerns that they could lose their license for inappropriate prescribing, thus shifting their work from providing treatment and care to policing their patients for malingering and opioid abuse., Interpretation: Our findings show that care providers find the treatment of patients with chronic pain-especially those patients also experiencing poverty-to be challenging at best, and at worst frustrating and overwhelming. In many instances, their narratives suggested experiences of depersonalization, loss of job satisfaction and emotional exhaustion in relation to providing care for these patients, key dimensions of burnout. In essence, the work that they performed in relation to their patients' social rather than medical needs seems to contribute to these experiences. Their experiences were further exacerbated by the fact that restricting and reducing opioid dosing in patients with chronic pain has become a major focus of care provision., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Long-term sick leave and disabilities due to common mental disorders are challenging for society, employers, and individuals. Hence, we wanted to investigate whether psychosocial work environments experienced by employees undergoing treatment for such disorders was associated with return to work., Methods: At the start of treatment, 164 patients responded to questionnaires concerning their psychosocial work environment (the Job Demand-Control-Support model and the Effort-Reward Imbalance model), symptoms (The Clinical Outcomes in Routine Evaluation Outcome Measure) and ability to work (Work Ability Index). In addition, the respondents reported whether they were working or on sick leave at the start and end of their courses of treatment. Their therapists provided information about diagnoses., Results: Return to work was associated with control of decisions, support from colleagues, esteem, and job promotion opportunities as measured at the start of treatment. In multivariate analyses, control over decisions and job promotion opportunities continued to predict return to work when adjusted for symptoms, current work ability, and expected future work ability., Discussion: The working conditions that predicted return to work are considered to facilitate work performance and to be sources of motivation, job satisfaction, and job commitment. Consequently, it is important to examine whether this patient group has a favorable working environment and consider changes in the workplace if the environment is not favorable., Competing Interests: The authors BL, OS and MV are employees of Lovisenberg Hospital in Oslo, where the data were collected. TR declares that he has no competing interests.

Introduction: Worldwide, there are between 50-67 million migrant domestic workers, the majority of whom are women. In many countries, provisions are not in place to protect female migrant domestic workers. These women may be at risk of occupational and social stressors, including exploitation and abuse, which may negatively impact on their quality of life, including psychological health. Research examining the occupational, social, and psychological needs of FMDWs from a public health perspective is critical to guide the development of policies which ensure wellbeing, prevent abuse, and align with international priorities to improve population health. Though there have been a number of high-profile incidents of exploitation and abuse, there has been limited research on the stressors experienced by these communities, their perceived impact, or coping mechanisms., Materials and Methods: Thematic analysis was used to analyse qualitative free-text written responses collected as part of a cross-sectional survey on the relationship between social and occupational stressors and the health and quality of life of FMDWs in Singapore. Responses correspond to open-ended questions in the qualitative component of the survey examining three domains: causes of stress, coping strategies, and what people can do to help with stress., Results: Responses from 182 FMDWs were analysed. Key themes were identified around causes of stress (including 'work and agency', 'the pervasiveness of financial need', and 'family and obligation'), coping strategies, and social support. Each theme describes key factors which contribute to the occupational and social stressors experienced and reported by FMDWs., Discussion: This research highlights the stressors FMDWs in Singapore experience, as well as key coping mechanisms. There is a clear need for policies which facilitate FMDWs' ability to utilise these coping resources, and which protect against coercive or exploitative employment conditions. Strategies are also needed to monitor and evaluate policies intended to protect FMDWs, and to strengthen the implementation of global frameworks targeted at improving workplace conditions and workers' rights., Competing Interests: The authors have declared that no competing interests exist.

Although we spend much of our waking hours working, the emotional experience of work, versus non-work, remains unclear. While the large literature on work stress suggests that work generally is aversive, some seminal theory and findings portray working as salubrious and perhaps as an escape from home life. Here, we examine the subjective experience of work (versus non-work) by conducting a quantitative review of 59 primary studies that assessed affect on working days. Meta-analyses of within-day studies indicated that there was no difference in positive affect (PA) between work versus non-work domains. Negative affect (NA) was higher for work than non-work, although the magnitude of difference was small (i.e., .22 SD, an effect size comparable to that of the difference in NA between different leisure activities like watching TV versus playing board games). Moderator analyses revealed that PA was relatively higher at work and NA relatively lower when affect was measured using "real-time" measurement (e.g., Experience Sampling Methodology) versus measured using the Day Reconstruction Method (i.e., real-time reports reveal a more favorable view of work as compared to recall/DRM reports). Additional findings from moderator analyses included significant differences in main effect sizes as a function of the specific affect, and, for PA, as a function of the age of the sample and the time of day when the non-work measurements were taken. Results for the other possible moderators including job complexity and affect intensity were not statistically significant., Competing Interests: The authors have declared that no competing interests exist.

This research examined the psychometric properties and construct validity of the Short Grit Scale (Grit-S) in Chinese insurance employees (N = 2,363; 37% males; mean age = 35.14). Exploratory factor analysis and confirmatory factor analysis (CFA) were used to determine the factor structure of the Grit-S. The resulting model was tested by multi-group CFA for the factorial invariance of the Grit-S across genders and age groups. Results showed that the Grit-S could be best explained by a two-factor model containing consistency of interest (α = .70) and perseverance of effort (α = .75). The factor model was equivalent across genders and age groups. The scores of the Grit-S were significantly correlated with external criteria variables including mental wellbeing and job performance. Overall, our findings suggested that the Grit-S can be a promising assessment of the grit trait in Chinese employees., Competing Interests: The authors have declared that no competing interests exist.

The purpose of the study was to examine the relationship between perceived occupational stress and psychological well-being among secondary school heads in Khyber Pakhtunkhwa. A sample of 402 secondary school heads (male n = 260, female n = 142) was selected through multistage sampling technique. A descriptive, quantitative and correlative research design was used. For gathering information from the participants, two standardized tools i.e., "Occupational Stress Index (OSI)" and "Ryff's Psychological Wellbeing Scale (RPWB)" were used for measuring perceived occupational stress and psychological well-being respectively. For statistical analysis, mean, standard deviation, Pearson's product-moment correlation and multiple regression were employed. The findings revealed that there is a strong negative correlation between perceived occupational stress and psychological well-being. Furthermore, moderate negative correlation was found between all the sub-scales of perceived occupational stress and psychological well-being. All the subscales of occupational stress except low status were found significant predictors and have negative effect on psychological well-being of secondary school heads. So, it was suggested that Elementary & Secondary Education Department Khyber Pakhtunkhwa should have a collaboration with policy makers to formulate a comprehensive strategy for stress reduction management for secondary school heads so that they may develop good psychological well-being and perform their duties effectively., Competing Interests: The authors have declared that no competing interests exist.

Objective: In the workplace depression and suicide are serious mental health problems. A lack of knowledge and mental health skills along with the stigma toward mental health problems often results in delays in seeking professional help. Interventions targeting not only persons with mental health problems but also people around the individual are warranted in order to encourage supporting behavior within entire workplace. In the present study, we investigated the efficacy of our newly developed educational training program in the management with depression and suicidal risk in the workplace as a single-arm pilot trial., Methods: The program is a two-hour (2-h) training course for employees based on the Mental Health First Aid (MHFA) program which aims to increase public mental health literacy. We conducted this program at a company workplace among 91 employees, and ultimately 83 participants completed the self-rated questionnaires. Changes in confidence and practical skills in early intervention of depression and suicide-prevention, and stigma toward mental health problems were evaluated using self-rated questionnaires at 3 time-points; pre-program, immediately post-program, and 1 month after the program., Results: Confidence and practical skills were significantly improved even 1 month after the program, and stigma reduced just after the program., Conclusions: Our pilot study suggests that the program has a positive impact on encouraging employees to support their co-workers with mental health problems, and is applicable for busy workers due to its short duration. A single-arm design, evaluation using self-rated questionnaire and short-term follow up period are the main limitations of the present study. Hence, future research is required to validate the effects of this program with control groups, and also to assess long-term effectiveness and objective changes such as absenteeism and sick leave., Trial Registration: UMIN Clinical Trials Registry (UMIN-CTR) R000023258., Competing Interests: Miyako Hirashima and Shion Ueno are employed by TOTO Ltd. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

Objective: To explore work-related psychosocial stressors among people of Chinese, Vietnamese and Arabic-speaking backgrounds currently working in Australia., Methods: In 2015, a telephone survey of 585 Vietnamese, Chinese and Arabic-speaking workers asked about workplace bullying, ethnic discrimination, job complexity, degree of control, security and fairness of payment along with demographic and employment information. Estimates of job-related psychosocial stressors were derived and regression analyses used to identify significant associations., Results: At least one workplace stressor was reported by 83% of the workers in the study. Education was significantly associated with experiencing any psychosocial stressor and also with the total number of stressors. Workers aged 45 years and older were more likely to be bullied or experience racial discrimination compared with younger workers of any ethnicity. There was a greater likelihood of reporting low control over a job when the interview was conducted in a language other than English and the workers were either Chinese or Arabic. Workers on a fixed-term contract, independent of ethnicity were more likely to report a job with low security. Overall psychosocial job quality decreased with education and was associated with occupation type which interacted with ethnicity and gender., Conclusions: The results suggest that job-related psychosocial stressors are widespread but not uniform across ethnic groups. Further research into what drives differences in work experience for migrant groups would provide information to guide both employers and migrants in ways to reduce workplace psychosocial stressors., Competing Interests: The authors have declared that no competing interests exist.

There was little information concerning the combined effect of occupational psychosocial hazards such as long working hours, high job stress, and high fatigue on the risk of cardiovascular and cerebrovascular diseases (CVD). The aim of this study was to investigate the interaction among occupational psychosocial hazards and the impact of metabolic syndrome (MetS) on the risk of CVD among bus drivers. The Taiwan Bus Driver Cohort Study involving 1014 professional drivers was established in 2005 and comprehensively studied. The interactions among occupational psychosocial hazards and the impact of MetS on the risk of CVD were measured. A working pattern questionnaire, job stress questionnaires, the Swedish occupational fatigue inventory, the stress satisfaction offset score, biochemical measurements, and physical examinations were used to assess psychosocial hazards and the presence of metabolic syndrome. There were 707 eligible bus drivers with a mean age of 43.5years old. During the 8-years of follow-up, 77 drivers were diagnosed with CVD. Long working hours, high job stress, and high fatigue were associated with an increased risk of cardiovascular disease incidence in the multivariate analysis. There were synergistic effects among long working hours, high job stress, and high fatigue only in drivers with MetS. A combination of long working hours, high job stress, and high fatigue increased the risk of developing CVD in bus drivers with MetS., Competing Interests: The authors have declared that no competing interests exist.