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Background: Middle managers have not received enough attention within the healthcare field, and little is known how stressful factors in their work environment coupled with a lack of adequate sleep are related to musculoskeletal pain. The aim of this study was to examine the correlation between stressful factors in the work environment, lack of adequate sleep, and pain/discomfort in three body areas. Methods: Questionnaire was sent electronically to all female nursing unit managers (NUM) in Iceland through the outcome-survey system. The response rate was 80.9%. Results: NUM who had high pain/discomfort in the neck area also had very high pain/discomfort in the shoulder area and pain in the lower back. The results also revealed positive a medium-strong correlation between mental and physical exhaustion at the end of the workday and musculoskeletal pain. Stress in daily work, mental strain at work, and being under time-pressures had hardly any correlation with pain/discomfort in the three body parts. Adequate sleep had a significant negative correlation with all stressful factors in the work environment and all three body parts under review. Conclusion: The results will hopefully lead to a better consideration of stressful factors in the work environment, sleep, and musculoskeletal pain in middle managers., Funding: This study was funded partly by The Icelandic Nurses’ Association—Science Fund.

Publisher's version (útgefin grein), Objective To assess the association between stress related disorders and subsequent risk of cardiovascular disease. Design Population based, sibling controlled cohort study. Setting Population of Sweden. Participants 136 637 patients in the Swedish National Patient Register with stress related disorders, including post-traumatic stress disorder (PTSD), acute stress reaction, adjustment disorder, and other stress reactions, from 1987 to 2013; 171 314 unaffected full siblings of these patients; and 1 366 370 matched unexposed people from the general population. Main outcome measures Primary diagnosis of incident cardiovascular disease-any or specific subtypes (ischaemic heart disease, cerebrovascular disease, emboli/thrombosis, hypertensive diseases, heart failure, arrhythmia/conduction disorder, and fatal cardiovascular disease)-and 16 individual diagnoses of cardiovascular disease. Hazard ratios for cardiovascular disease were derived from Cox models, after controlling for multiple confounders. Results During up to 27 years of follow-up, the crude incidence rate of any cardiovascular disease was 10.5, 8.4, and 6.9 per 1000 person years among exposed patients, their unaffected full siblings, and the matched unexposed individuals, respectively. In sibling based comparisons, the hazard ratio for any cardiovascular disease was 1.64 (95% confidence interval 1.45 to 1.84), with the highest subtype specific hazard ratio observed for heart failure (6.95, 1.88 to 25.68), during the first year after the diagnosis of any stress related disorder. Beyond one year, the hazard ratios became lower (overall 1.29, 1.24 to 1.34), ranging from 1.12 (1.04 to 1.21) for arrhythmia to 2.02 (1.45 to 2.82) for artery thrombosis/embolus. Stress related disorders were more strongly associated with early onset cardiovascular diseases (hazard ratio 1.40 (1.32 to 1.49) for attained age, The study was supported by Grant of Excellence, Icelandic Research Fund (grant No 163362-051 to UAV), and ERC Consolidator Grant (StressGene, grant No 726413 to UAV); by the Karolinska Institutet (Senior Researcher Award and Strategic Research Area in Epidemiology to FF); and by the Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework (grant No 340-2013-5867 to CA).

Publisher's version (útgefin grein), Purpose: Postpartum psychosis is a rare but severe complication following childbirth, with unknown etiology. This study investigated whether the death of a close family member — a source of severe stress — the year before or during pregnancy was associated with an increased risk of psychotic illness in the postpartum period among women without and with a history of psychiatric disorder. Methods: We studied live births in Denmark during 1978-2008 and births in Sweden during 1973-2006 (n=5,246,978). Information on death of women’s relatives and partners and sociodemographic, health-, and pregnancy-related factors was obtained through linkage with nationwide registries. Results: The death of a close relative the year before or during pregnancy was not associated with psychotic illness during the first 90 days postpartum among women without (adjusted HR 1.02, 95% CI 0.76-1.37) or with a history of psychiatric disorder (HR 0.96, 95% CI 0.74-1.25). Similarly, there was no association between bereavement and risk of postpartum psychosis according to the timing of the loss (the year before or during pregnancy), the relative’s cause of death (natural or unnatural), or the woman’s relationship to the deceased (parent/sibling or partner/older child). Conclusions: Death of a close relative, one of the most severe sources of stress, before or during pregnancy was not associated with postpartum psychosis. Therefore, these data do not support the hypothesis that severely stressful life events, such as bereavement around the time of pregnancy, are associated with postpartum psychosis. © 2019 Warselius et al., This work was supported by the Swedish Society of Medicine (grant SLS588081 to KDL), Karolinska Institutet Research Foundation (grant 2016fobi50733 to KDL), Swedish Council for Working Life and Social Research (grant 2015-00837 to KDL), Danish Council for Independent Research (grant DFF-6110-00019 to JL), Karen Elise Jensens Fond (grant 2016 to JL), Nordic Cancer Union (grants 176673, 186200, and R217-A13234-18-S65 to JL), Novo Nordisk Fonden (grant NNF18OC0052029 to JL), TrygFonden (grants 904414 and 15199 to CO), and the Lundbeck Foundation (grant R155-2012-11280 to MV). The funders were not involved in the design of the study, analyses, interpretation of the results, writing of the manuscript, or decision to submit the manuscript for publication.

Millistjórnendur eru í krefjandi hlutverki og upplifa sig oft eins og milli steins og sleggju. Þeir gegna þungavigtarhlutverki en störf þeirra einkennast af miklu vinnuálagi og streitu. Þó hafa þeir fengið fremur litla athygli í stjórnendafræðum, einkum innan heilbrigðisþjónustunnar. Við vitum til dæmis lítið um áhrif þessa krefjandi starfs á heilsu þeirra, til dæmis hvort streituvaldandi þættir í starfsumhverfinu tengjast stoðkerfisverkjum og svefni. Tilgangur þessarar rannsóknar var að skoða þessi tengsl. Um er að ræða lýsandi þversniðsrannsókn þar sem gögnum var safnað með forprófuðum spurningalista sem sendur var rafrænt á 137 hjúkrunardeildarstjóra í gegnum Outcome-kannanakerfið. Svarhlutfall var 80,9%. Lýsandi tölfræði og ályktunartölfræði var notuð við úrvinnslu gagna. Niðurstöður sýndu skýr tengsl streituvaldandi þátta í starfsumhverfi, stoðkerfisverkja og ófullnægjandi svefns eftir að stjórnað var fyrir áhrifum af aldri, hjúskaparstöðu og fjölda stöðugilda í hjúkrun á deild. Streituvaldandi þættir í starfsumhverfinu og svefn höfðu tengsl við styrkleika stoðkerfisverkja á hálssvæði og herðum og svefn hafði tengsl við styrkleika verkja í neðri hluta baks. Meiri streita þýddi meiri stoðkerfisverki á hálssvæði og í herðum að teknu tilliti til svefns. Ófullnægjandi svefn þýddi aftur meiri stoðkerfisverki frá öllum þremur líkamssvæðunum að teknu tilliti til streituvaldandi þátta. Saman skýrðu streituvaldandi þættir í starfsumhverfinu og ófullnægjandi svefn, að teknu tilliti til aldurs, hjúskaparstöðu og fjölda stöðugilda við hjúkrun á deild, 17% af heildarbreytileika í styrkleika stoðkerfisverkja á hálssvæði, 21% í herðum og 14% í neðri hluta baks. Fram kom marktæk samvirkni milli streituvaldandi þátta í starfsumhverfinu og svefns varðandi styrkleika stoðkerfisverkja á hálssvæði. Niðurstöður þessarar rannsóknar verða vonandi til þess að hugað verði betur að streituvaldandi þáttum í starfsumhverfi millistjórnenda svefni og stoðkerfisverkjum þeirra., Middle managers have demanding roles and often experience themselves between a rock and a hard place, and their jobs are characterized by a heavy workload and stress. They have not received adequate attention in management science, in particular within healthcare. We know, for example, little about how stressful factors in the work environment are related to musculoskeletal pain and sleep. The purpose of this study was to examine this relationship. This is a descriptive cross-sectional study in which data was collected by a questionnaire which was sent electronically to 137 nursing managers through the Outcome-survey system. The response rate was 80.9%. Descriptive statistics and inferential statistics were used for statistical analysis. The results showed a clear link between stressful factors in the work environment and insufficient sleep, after controlling for the effects of age, marital status and the number of staff in the nursing unit. Stressful factors in the work environment and sleep affected the intensity of pain in the neck and shoulder area, and sleep correlated with the intensity of pain in the lower back. Taking sleep into account, more stress meant more pain in the neck and shoulder area. Taking into account stressful factors, insufficient sleep meant more pain in all three body regions. Together, stressful factors in the work environment and insufficient sleep explained 17% of the total variation in the intensity of pain in the neck area, 21% in the shoulder area, and 14% in the lower back, taking into account age, marital status and the number of staff in the nursing unit. There was a statistically significant interaction between stressful factors in the work environment and sleep regarding the intensity of musculoskeletal pain in the neck area. The results of this study will hopefully lead to better consideration of stressful factors in the work environment, sleep and musculoskeletal pain of middle managers., Ritrýnt tímarit