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Background: The integration of information systems in health care and social welfare organizations has brought significant changes in patient and client care. This integration is expected to offer numerous benefits, but simultaneously the implementation of health information systems and client information systems can also introduce added stress due to the increased time and effort required by professionals., Objective: This study aimed to examine whether professional groups and the factors that contribute to successful implementation (participation in information systems development and satisfaction with software providers' development work) are associated with the well-being of health care and social welfare professionals., Methods: Data were obtained from 3 national cross-sectional surveys (n=9240), which were carried out among Finnish health care and social welfare professionals (registered nurses, physicians, and social welfare professionals) in 2020-2021. Self-rated stress and stress related to information systems were used as indicators of well-being. Analyses were conducted using linear and logistic regression analysis., Results: Registered nurses were more likely to experience self-rated stress than physicians (odds ratio [OR] -0.47; P>.001) and social welfare professionals (OR -0.68; P<.001). They also had a higher likelihood of stress related to information systems than physicians (b=-.11; P<.001). Stress related to information systems was less prevalent among professionals who did not participate in information systems development work (b=-.14; P<.001). Higher satisfaction with software providers' development work was associated with a lower likelihood of self-rated stress (OR -0.23; P<.001) and stress related to information systems (b=-.36 P<.001). When comparing the professional groups, we found that physicians who were satisfied with software providers' development work had a significantly lower likelihood of stress related to information systems (b=-.12; P<.001) compared with registered nurses and social welfare professionals., Conclusions: Organizations can enhance the well-being of professionals and improve the successful implementation of information systems by actively soliciting and incorporating professional feedback, dedicating time for information systems development, fostering collaboration with software providers, and addressing the unique needs of different professional groups., (© Janna Nadav, Anu-Marja Kaihlanen, Sari Kujala, Ilmo Keskimäki, Johanna Viitanen, Samuel Salovaara, Petra Saukkonen, Jukka Vänskä, Tuulikki Vehko, Tarja Heponiemi. Originally published in JMIR Medical Informatics (https://medinform.jmir.org).)

Background: Work-related stress is a psychosocial risk factor linked to a higher risk of cardiovascular disease. However, the association between work-related stress and cardiovascular health (CVH) is not well established. We estimated the association between work-related stress and CVH in a multiethnic sample of adults free of cardiovascular disease at baseline., Methods and Results: We performed a cross-sectional analysis of 3579 community-based men and women, aged 45 to 84 years, of the Multi-Ethnic Study of Atherosclerosis from data collected between 2000 and 2002. Work-related stress (yes/no) was assessed by a self-administered questionnaire. CVH was measured by the American Heart Association's Life's Simple 7 metrics (smoking, physical activity, body mass index, diet, total cholesterol, blood pressure, and blood glucose). Each metric contributed 0, 1, or 2 points if in the poor, intermediate, or ideal range, respectively. The aggregated CVH score was 0 to 14 points and categorized as inadequate (0-8 points), average (9-10 points), and optimal (11-14 points). Polytomous logistic regression was used to estimate the association between work-related stress and CVH, adjusting for sociodemographic factors. The mean±SD age was 57±8 years, and 48% were women. Work-related stress was reported by 20% of participants. In fully adjusted models, participants with work-related stress had lower odds of having average (adjusted odds ratio [OR], 0.75 [95% CI, 0.62-0.92]) and optimal (adjusted OR, 0.73 [95% CI, 0.58-0.92]) CVH scores compared with participants without work-related stress., Conclusions: Work-related stress was associated with unfavorable CVH. These findings underscore the importance of workplace psychological well-being and suggest the need for studies on interventions that may reduce work-related stress and promote CVH.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prominent cause of chronic liver disease, and occupational stress may serve as a potential risk factor. This study aims to assess the association between occupational stress trajectories and incident MASLD among Chinese female nurses., Methods: We conducted a prospective longitudinal study using data from the Nurse' Health Cohort Study, involving 1,113 female nurses, free of MASLD at baseline (2018). Occupational stress was measured using the Chinese Nurse Job Stress Scale at four time points. Group-based trajectory modeling was used to identify distinct stress trajectories. Through doctors' diagnoses, we assessed incident MASLD over a subsequent 6-year period from 2019 to 2024. Cox proportional hazards regression models evaluated the association of stress trajectories and MASLD risk, adjusting for demographics, work-related factors, and medical conditions., Results: During follow-up, 256 nurses reported incident physician-diagnosed MASLD. Three occupational stress trajectories were identified: moderate decreasing (36.4%), moderate stable (55.9%), and moderate increasing (7.7%). Participants in the moderate increasing stress trajectory had a significantly higher risk of developing MASLD (adjusted HR: 3.14, 95% CI: 2.19-4.49, p < .001) compared to those in the moderate stable trajectory. This association between stress trajectory and MASLD risk was not modified by age or BMI (p interaction >0.50)., Conclusions and Relevance: The study concludes that increasing stress levels over time are associated with a higher incidence of MASLD. These findings underscore the importance of stress management interventions in reducing the risk of MASLD progression. Further research is needed to explore the underlying mechanisms and to develop targeted strategies for stress reduction in clinical settings., Competing Interests: Declarations Ethics approval and consent to participate All experiments were performed in accordance with relevant guidelines and regulations (such as the Declaration of Helsinki). The present study was approved by the institutional review board at Shengjing Hospital of China Medical University (2018PS09K). Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

The COVID-19 epidemic not only impacted China's economy but also induced periodic anxiety among employees, especially during its peak. Even as governmental controls relaxed, enterprises seemed unaffected externally. However, beneath the surface, the lingering effects on employee mental health persisted. Many faced dual stressors concerning their job and personal well-being due to the epidemic, heightening work-related anxieties. This research, a year after China resumed work, delves into the psychological stress influencing this sustained anxiety. A survey of 516 employees helped test the hypothesis using a multiple regression model. Findings indicated heightened continuous work anxiety due to the epidemic, particularly in hard-hit areas. However, individual resilience, organizational, and social support were found to mitigate these effects. The study underscores the sustained psychological aftermath of the epidemic on employees, urging health authorities to address it.

Background: Occupational safety hazards include physical, chemical, ergonomic, biological, and psychological hazards. Technological innovation in screening for occupational stress, especially among female workers, is needed to improve their health and productivity., Objective: This research is being conducted to obtain a prediction model of work stress through a questionnaire instrument that includes stressors and symptoms based on the transactional model, as well as measurement of work stress through a mobile app that can be used anywhere., Methods: The research is conducted in 3 stages: qualitative research, quantitative research (cross-sectional), and mobile app development. Data were collected from companies located in Jakarta, Indonesia. The sample was chosen based on purposive sampling. For the quantitative research (n=430), logistic regression analysis was used., Results: We are developing a work stress screening instrument for female workers, which includes stressors and symptoms based on the transactional model, in the form of a digital platform so that female workers can undertake the examination anywhere without interfering with working hours or home duties. This research was funded in January 2024 and qualitative data collection began in February 2024. Quantitative data were obtained in March 2024; the number of respondents in the qualitative stage was 6, and in the quantitative stage it was 430. The work stress screening app is in the development stage and will be launched at the same time as the data collection is performed so we can examine the respondents' perspectives on the use of the app., Conclusions: This study analyzes the prediction of work stress to help female workers screen for work stress. Workers who are detected as experiencing work stress will be educated using an algorithm programmed in the app., International Registered Report Identifier (irrid): PRR1-10.2196/55874., (©Dini Widianti, Zwasta Pribadi Mahardhika, Robiana Modjo. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 14.11.2024.)

Introduction: The impairment of mental health among veterinary professionals has raised public awareness in recent years. The driving forces include a serious gap in veterinary services - with less available veterinary colleagues, especially in rural areas - and a general lack of veterinary graduates. This article presents the results of our first Swiss survey on psychological well-being in the veterinary profession. Our results are viewed both in the current context and in the context of developments that have already taken place in other medical disciplines. Results indicate higher levels of stress in veterinarians working as clinicians, in female colleagues, in veterinarians of younger age and veterinarians under employment. In the meantime, larger surveys such as the Vétos Entraide (https://vetos-entraide.com) were established in France and projects such as the Happy Vet project (https://happyvetproject.org) were launched in Switzerland for eg. the burnout prevention in the profession. However, the topic of «mental health» remains highly relevant in veterinary medicine and requires further research and measures, which should consider the identified predisposing factors, such as age and gender.

Background: Healthcare workers have an increased risk of depression and anxiety, and medical staff have faced a wide variety of challenges, especially during the COVID-19-pandemic. The aim of the VOICE study was to investigate risk and protective factors for workplace-related stress experience and mental health., Method: A multicentre, web-based and prospective survey (VOICE study) was initiated in the spring of 2020 by a network of five psychosomatic university clinics (Erlangen, Ulm, Bonn, Cologne and Dresden). More than 25,000 respondents took part in the study at five measurement points., Results: Of 3678 employees examined in a hospital setting during the first wave of the pandemic, 17.4% and 17.8% of physicians, 21.6% and 19.0% of nurses and 23.0% and 20.1% of medical-technical assistants (MTA) were affected by symptoms of depression and anxiety, respectively, to a clinically relevant extent. The most important risk factors for depressive and anxiety symptoms were insufficient relaxation during leisure time, increased alcohol consumption, lower trust in colleagues in difficult work situations and increased fear of becoming ill with COVID-19. Predictors for increased post-traumatic symptoms were increased generalized anxiety and depression as well as increased fear of infecting family members. Sense of coherence, social support, optimism and reward level acted as protective factors., Discussion: The psychological effects of workplace-related stress during the pandemic were found to be significant. Therefore, regular mental health screening and prevention programmes for healthcare workers are indicated., (© 2024. The Author(s).)

Study Design: Cross-sectional study., Objectives: Suboptimal health status (SHS) is a third state between health and disease. Long-term being SHS will be detrimental to one's ability development. Previous studies have demonstrated the associations of lifestyle behaviors or work stress with SHS, but few studies have comprehensively analyzed the underlying factors and mechanisms between the three. This study aimed to investigate whether lifestyle behaviors mediated the relationship between self-perceived work stress and SHS., Methods: A total of 4238 urban workers, who participated in a cross-sectional survey conducted from December 2018 to October 2019, were included. A general linear model was used to explore the associations between lifestyle behaviors and self-perceived work stress with SHS after adjusting for demographic variables. Structural equation modeling was performed to examine the mediation by lifestyle behaviors., Results: The mean transformed scores of physical, mental, and social SHS were 70.98, 67.17, and 61.72, respectively. Unhealthy lifestyle behaviors and high self-perceived work stress positively affected SHS (P < 0.001). Self-perceived work stress imposed negative effects on physical SHS (β = -0.228, P < 0.001), mental SHS (β = -0.237, P < 0.001), and social SHS (β = -0.092, P < 0.001). The indirect effects of self-perceived work stress on physical SHS (β = -0.139, 95% CI: -0.178 to -0.106), mental SHS (β = -0.106, 95% CI: -0.134 to -0.082), and social SHS (β = -0.121, 95% CI: -0.154 to -0.092) were statistically significant., Conclusions: Lifestyle behaviors and self-perceived work stress were significantly associated with SHS among Chinese urban workers. The mediating effects of unhealthy lifestyle behaviors were found in the relationship between high self-perceived work stress and SHS. Future longitudinal research may verify these associations and elucidate the underlying mechanisms., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: Previous studies have shown that job strain is associated with low birthweight (LBW), preterm birth (PTB), and small for gestational age (SGA). We conducted a scoping review and meta-analysis to assess the association between job strain and adverse pregnancy outcomes., Methods: A literature search was performed on PubMed. We included English-language studies that examined the association between job strain (based on the Karasek demand-control model) and pregnancy outcomes. We excluded letters, posters, reviews, and qualitative studies. Random effects meta-analysis was performed. Heterogeneity was assessed using τ 2 and I 2 statistics. Potential bias was assessed using standard funnel plots. Asymmetry was evaluated by Egger's test. Leave-one-out analysis was performed for sensitivity analyses., Results: Three eligible studies were found for LBW, seven for PTB, and four for SGA. The number of subjects ranged from 135 to 4889, and the prevalence of high job strain ranged from 6.64% to 33.9%. The pooled odds ratio and 95% confidence interval (CI) for LBW, PTB, and SGA were 1.23 (95% CI: 0.97, 1.56), 1.10 (95% CI: 1.00, 1.22), and 1.16 (95% CI: 0.97, 1.39) respectively, indicating modest associations. Heterogeneity for LBW and PTB may not be important but may be moderate for SGA. No publication bias was detected for LBW and PTB, but possible publication bias exists for SGA., Conclusion: We found a modest association between job strain and PTB. Since job strain is only one of the many aspects of an unhealthy work environment, interventions that improve working conditions more broadly are needed., (© 2024 Wiley Periodicals LLC.)

Purpose: The aim of this study was to assess the stress level and depression among orthopaedic surgeons in Saudi Arabia. In addition, to evaluate orthopedic training programs related factors that might have a critical role in the development of depression among orthopaedic surgeons., Methods: The study adopted a cross-sectional study design. Two validated questionnaires were utilized, the Patient Health Questionnaire 9 (PHQ-9) and the Perceived Stress Scale (PSS-10) for assessing depressive symptoms and stress levels. Data was collected by sending the survey to the Saudi Commission for Health Specialties so they could be distributed throughout all registered orthopaedic surgeons., Results: The study sample consisted of 325 participants. The results revealed that the severity of depression varied across the different groups. As per the PHQ-9 criteria, 74 (22.8%) were initially diagnosed with major depression. Among assistant consultants, 39.5% reported severe depression, while 34.9% reported mild depression. Consultants predominantly reported moderate perceived stress (82.9%) with a notable proportion experiencing high perceived stress (12.4%). Assistant consultants showed a balanced distribution, with 93.0% reporting moderate perceived stress and 4.7% reporting high perceived stress. Demographic variables gender, relationship status and having children revealed statistically significant relationship with PHQ-9 scores (p-value < 0.05) but not with PSS-10 scores., Conclusion: The study highlights pressing need to address mental health concerns within orthopaedic surgeons. To address these challenges, healthcare institutions should implement comprehensive mental health support programs offering resources for stress management, counseling services, and peer support groups., (© 2024. The Author(s).)

Moral distress has been identified as an occupational hazard for clinicians caring for vulnerable populations. The aim of this systematic review was (i) to summarize the literature reporting on prevalence of, and factors related to, moral distress among nurses within acute mental health settings, and (ii) to examine the efficacy of interventions designed to address moral distress among nurses within this clinical setting. A comprehensive literature search was conducted in October 2022 utilizing Nursing & Allied Health, Embase, CINAHL, PsychInfo, and PubMed databases to identify eligible studies published in English from January 2000 to October 2022. Ten studies met inclusion criteria. Four quantitative studies assessed moral distress among nurses in acute mental health settings and examined relationships between moral distress and other psychological and work-related variables. Six qualitative studies explored the phenomenon of moral distress as experienced by nurses working in acute mental health settings. The quantitative studies assessed moral distress using the Moral Distress Scale for Psychiatric Nurses (MDS-P) or the Work-Related Moral Stress Questionnaire. These studies identified relationships between moral distress and emotional exhaustion, depersonalization, cynicism, poorer job satisfaction, less sense of coherence, poorer moral climate, and less experience of moral support. Qualitative studies revealed factors associated with moral distress, including lack of action, poor conduct by colleagues, time pressures, professional, policy and legal implications, aggression, and patient safety. No interventions targeting moral distress among nurses in acute mental health settings were identified. Overall, this review identified that moral distress is prevalent among nurses working in acute mental health settings and is associated with poorer outcomes for nurses, patients, and organizations. Research is urgently needed to develop and test evidence-based interventions to address moral distress among mental health nurses and to evaluate individual and system-level intervention effects on nurses, clinical care, and patient outcomes., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abstract: We investigated the association between job stress, as assessed by the effort-reward imbalance model, and the incidence of chronic low back pain (CLBP) over a 4-year period. A total of 1733 participants from the ELSA-Brasil Musculoskeletal cohort, who were free from LBP at baseline (2012-2014), were included. Episodes of LBP in the past 30 days, intensity, and the presence of disability were investigated in annual telephone follow-ups (2015-2018). Chronic LBP was defined as episodes of LBP lasting >3 months with at least moderate intensity. We analyzed the incidence of at least one episode of CLBP (yes/no), the number of CLBP episodes (0, 1, ≥2), and CLBP severity/disability (absent, nondisabling, severe/disabling). The association between these outcomes and tertiles of the effort-to-reward ratio, as well as each dimension of the effort-reward imbalance model, was investigated using multinomial logistic and Poisson regression models adjusting for sociodemographic and occupational variables. The cumulative incidence of CLBP over 4 years was 24.8%. High effort-reward imbalance increased the chances of experiencing multiple CLBP episodes and severe/disabling CLBP by 67% (95% confidence interval [CI]: 1.12-2.47) and 70% (95% CI: 1.14-2.53), respectively. High overcommitment increased the incidence of CLBP by 23% (95% CI: 1.01-1.50) and the chances of multiple CLBP episodes and severe/disabling CLBP by 67% (95% CI: 1.11-2.50) and 57% (95% CI: 1.05-2.34), respectively. These results indicate that exposure to job stress is associated with a higher incidence, a greater number of episodes, and increased severity of CLBP over a 4-year period. If this association is causal, measures aimed at reducing exposure to job stress are likely to alleviate the burden of CLBP., (Copyright © 2024 International Association for the Study of Pain.)

Purpose: Though individuals with depression and those with poor working conditions are more likely to be on long-term sickness absence (LTSA), less is known about how working conditions may modify the associations between depression status and LTSA. This study aims to examine the association between depression and LTSA among Swedish workers with different levels of job strain and its individual components (job demands and job control)., Methods: All Swedish workers 30 - 60 years old (N = 3,065,258) were studied in 2005. At baseline (2005-2010), workers were categorized as: without depression, being prescribed antidepressants, and being in inpatient/outpatient care. Job strain was measured using a Swedish Job Exposure Matrix, and data on LTSA were obtained from 2011 to 2021. The association between depression and LTSA was assessed using Cox proportional-hazards regression stratified by categories of job strain., Results: Compared to workers without depression, workers with depression had higher risk of LTSA across all job strain levels. Depression was associated with the highest hazards of LTSA in active jobs, but a similar population attributable fraction (PAF) was found across categories of job strain, indicating similarities between the different categories., Conclusion: There was evidence of a moderating effect of job strain in the relationship between depression and LTSA, but also evidence that this was due to differences in baseline depression prevalence in the different job strain categories. Future research is needed to determine alternative factors which could be relevant for reducing LTSA among those who have already developed depression., (© 2024. The Author(s).)

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.)

Objectives: Prevalence of work-related musculoskeletal disorders (WRMSDs) among general dental practitioners and orthodontists is approximated to range between 64% and 93%. Etiology of WRMSDs in the mentally and physically demanding occupation remains unclear, for which reason the aim of the study was to clarify the interplay of physical, psychological, and mental factors on WRMSDs., Method and Materials: Of 94 orthodontists and 187 general dental practitioners (mean age = 35 years) questioned using an online survey, 84% reported persisting tension or pain in the back, neck, or shoulders. While 71% of females were employed (29% self-employed), only 39% of male participants were employed. Cluster analysis was used to characterize dental practitioners according to their movement profile and the moderating effect of stress on certain WRMSDs., Results: Three movement profiles of general dental practitioners and orthodontists were significantly predictive of WRMSD. The minority could be characterized as healthy (n = 45), whereas twice as many reported nearly twice as much pain (n = 90). Stress proved to be a strong, significant moderator of WRMSDs in relation to sex, employment status, and body mass index., Conclusion: The prevalence of WRMSDs found was alarming. Given the feminization of dentistry, and that being female, stressed, and an employee (rather than self-employed) is a significant predictor of WRMSDs, this represents a danger to the German health system.

Objectives: Sleep quality is a critical concern among healthcare professionals, yet the role of uncertainty stress has been inadequately explored. This study aims to explore the associations between sleep quality and uncertainty stress among healthcare professionals working in Chinese hospitals., Design: Cross-sectional survey., Setting: Data were collected via a cross-sectional survey administered to healthcare professionals across three Chinese provinces from 29 September 2022 to 18 January 2023., Participants: A total of 1902 participants contributed valid responses for analysis., Primary Outcome Measure: Sleep quality., Results: Out of 1902 respondents, 26.4% reported uncertainty stress and 50.5% experienced insomnia. Binary logistic regression analysis revealed that higher uncertainty stress significantly predicted poor sleep quality (OR=3.89; 95% CI 3.06, 4.95; p<0.001) while controlling for sociodemographic characteristics. Furthermore, linear regression analysis confirmed the similar relationship between uncertainty stress and sleep quality ( β =3.10; 95% CI 2.67, 3.52; p<0.001)., Conclusions: The study highlights a significant association between uncertainty stress and impaired sleep quality among Chinese healthcare professionals. These findings suggest the necessity for targeted strategies to mitigate uncertainty stress, which may potentially promote better sleep and overall well-being in healthcare settings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID-19 pandemic. An in-depth understanding of healthcare workers' (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs' concerns during the COVID-19 pandemic-expressed in real time during an active mental health crisis., Design: This study involved analysis of data from 'Shout', a text message-based, UK-wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudorandom sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 to March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose-built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with subthemes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication., Results: Three themes emerged from the data: (1) poor mental health, subthemes-(a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. (2) Negative work experiences, subthemes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and (d) abuse at work. (3) The impact of the COVID-19 pandemic, subthemes: (a) additional work pressure and (b) isolation and risk., Conclusion: This study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Moral injury has emerged as a construct of interest in healthcare workers' (HCW) occupational stress and health. We conducted one of the first multidisciplinary, longitudinal studies evaluating the relationship between exposure to potentially morally injurious events (PMIEs), burnout, and turnover intentions. HCWs (N = 473) completed surveys in May of 2020 (T1) and again in May of 2021 (T2). Generalized Linear Models (robust Poisson regression) were used to test relative risk of turnover intentions, and burnout at T2 associated with PMIE exposure, controlling for T1 covariates. At T1, 17.67% reported they had participated in a PMIE, 41.44% reported they witnessed a PMIE and 76.61% reported feeling betrayed by healthcare or a public health organization. In models including all T1 PMIE exposures and covariates, T2 turnover intentions were increased for those who witnessed a PMIE at T1 (Relative Risk [RR] = 1.66, 95% Confidence Interval [CI] 1.17-2.34) but not those that participated or felt betrayed. T2 burnout was increased for those who participated in PMIE at T1 (RR = 1.38, 95%CI 1.03-1.85) but not those that witnessed or felt betrayed. PMIE exposure is highly prevalent among HCWs, with specific PMIEs associated with turnover intentions and burnout. Organizational interventions to reduce and facilitate recovery from moral injury should account for differences in the type of PMIE exposures that occur in healthcare work environments., (© 2024. The Author(s).)

Purpose: This study mainly focused on the long-term effect of different risk exposure levels and prior anti-epidemic experience of healthcare workers in mitigating COVID-19 on their work stress in the post-COVID era., Design/methodology/approach: The study sample included 359 physicians, 619 nurses, 229 technicians and 212 administrators, for a total of 1,419 healthcare workers working in the Lanzhou area during the investigation. Data were analyzed by multivariate regression models., Findings: Our findings indicated that the interaction between pandemic effect mitigation experience and high-risk exposure significantly affected healthcare workers in the post-COVID era by increasing their work stress ( p  < 0.001) and reducing their rest time ( p  < 0.001). Healthcare workers may have experienced worse outcomes in the long term if they had higher levels of risk exposure and more experience in fighting epidemics. Furthermore, poor mental health ( p  < 0.001) and prior experience with SARS ( p  < 0.001) further amplified these adverse effects. However, surprisingly, we did not observe any effect of prior anti-epidemic experience or high-risk exposure on the mental health of healthcare workers in the post-COVID era ( p  > 0.1)., Research Limitations/implications: The adverse impact of COVID-19 may have left long-lasting effects on Health professionals (HPs), particularly those with high Risk exposure (RE) and more mitigation experience. Poor Mental health (MH) and previous experience in mitigating previous similar outbreaks (such as SARS) are risk factors that should be considered. Support programs must be designed and promoted to help HPs respond and improve their performance., Originality/value: Our study presents compelling evidence that the COVID-19 pandemic will have long-term detrimental effects on the work stress of healthcare workers., (© Emerald Publishing Limited.)

Background: Since the outbreak of the Coronavirus Disease 2019 (COVID-19), front-line nurses have faced not only daily work stress but also a high risk of infection and excessive workload, leading to unsatisfactory professional quality of life (ProQOL). This study aimed to explore whether self-compassion (SC) and benefit finding (BF) play a chain mediating role between work stress and ProQOL among Chinese nurses during the COVID-19 pandemic., Methods: From March to April 2022, a sample of 13,936 Chinese nurses was recruited through snowball sampling. Demographic information, work stress, SC, BF, and ProQOL were assessed. The SPSS 25.0 software and Amos 24.0 software were used for statistical analysis. The bootstrap method was employed to construct and examine the chain mediating structural equation model., Results: The ProQOL level of Chinese nurses during the COVID-19 pandemic was moderate. The overall fit indices for the compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) models were satisfactory (χ²/df = 2.486, 3.256, 2.553, RMSEA = 0.011, 0.014, 0.011, the GFI, AGFI, NFI, and CFI values were all above 0.90). Work stress had direct effects on CS, BO, and STS (β=-0.171, 0.334, 0.222, P < 0.001), and also indirectly affected these outcomes through SC (point estimate=-0.010, 0.021, 0.024, P < 0.001), BF (point estimate=-0.033, 0.015, - 0.011, P < 0.001), as well as their chain mediating effect (point estimate=-0.015, 0.006, - 0.005, P < 0.001)., Conclusions: Our study suggests that SC and BF partially mediated the association between work stress and ProQOL in Chinese nurses during the COVID-19 pandemic. Training on SC and BF may be crucial components of interventions aimed at improving ProQOL., (© 2024. The Author(s).)

Background: Teachers experienced increased stressors and stress during the initial onset of the COVID-19 pandemic. While many educators returned to in-person instruction in the 2021-2022 school year, they faced changing job demands and stressors which has important implications for educator well-being. We sought to understand the stressors and health impacts faced by U.S. educators in the 2021-2022 school year, two years following the acute phase of the pandemic., Methods: Thirty-four certified educators based in Connecticut, USA participated in four virtual focus groups in February 2022. A semi-structured focus group script, designed by the research team and guided by the job demands-resources model, was administered to understand stressors and stress impacts. Data were transcribed and analyzed using the constant comparative method to identify themes and sub-themes. Themes were summarized based on how many participants mentioned them., Results: Analysis of the qualitative data yielded three themes concerning the well-being impacts of stress: physical health and health behaviors, psychological health, and relationships and social well-being behaviors. The majority of educators indicated impacts in these domains with 76% indicating impacts on physical health and health behaviors (e.g. poor sleep, physical exhaustion, lack of exercise, unhealthy eating), 62% indicating impacts on psychological health (e.g. emotional exhaustion, anxiety, negative self-evaluation); and 68% indicating impacts on relationships social well-being behaviors (e.g. connections with family or friends, connections with others, relationships with coworkers). The majority (94%) of educators indicated that stressors from the school or district with the majority (91%) citing stressors related to protocols/expectations (e.g. excessive or increased demands, insufficient or decreased resources) and some (38%) administrators. Over half (62%) indicated personal stressors including personal/home life (41%), high personal expectations (18%), and income (18%). Some (35%) indicated either the pandemic (26%) or safety concerns (9%) were stressors. Some (24%) cited students' parents as a stressor and a few indicated community (12%), students (12%), and state or national level (9%) stressors., Conclusion: Educator well-being continued to be impacted in the post-pandemic era. Targeted interventions are needed to reduce school and district-related demands and to address stress-related educator well-being., (© 2024. The Author(s).)

Goals: To describe the exposure to psychosocial risks at work and the consumption of psychotropic drugs and opioids among women working as cleaners; and to analyse the association between their exposure to psychosocial risks and drug use., Methods: Observational cross-sectional study based on an online survey (collected during April and May 2021) from the wage-earning population in Spain. In this study, only women working in manual occupations were included (n=3430). Working conditions and drug consumption of cleaning workers were compared with those of other manual workers through bivariate analysis. The adjusted prevalence ratios and the corresponding 95% CIs were estimated using Poisson regression models with robust variance., Results: Cleaning workers were older and had more problems making ends meet than other manual workers and were significantly more exposed to low possibilities for development (85.2 (95% CI 81.8 to 88.0)), high strain (51.9 (95% CI 47.3 to 55.9)) and low social support from colleagues (72.0 (95% CI 68.1 to 75.7)) and supervisors (61.7 (95% CI 57.3 to 65.6)). They also scored higher prevalence rates for the use of tranquillisers (37.7 (95% CI 32.0 to 43.3)) and opioids (33.3 (95% CI 27.9 to 38.6)) consumption indicators. This consumption was associated significantly with high strain exposure and high insecurity over working conditions., Discussion: Under the umbrella of the 2012 labour reform, cleaning companies shift the pressure and burden they have on ordinary cleaning staff in the form of low wages and precarious working conditions. Our results imply that addressing adverse working conditions, mainly high strain and insecurity over working conditions, may significantly contribute to reducing the gender and social inequalities among cleaning workers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Research shows that front-line nurses' workload and stress levels increased during the coronavirus disease 2019 (COVID-19) pandemic, however, there is little research of these factors in relation to nurse managers. Previous research undertaken in Austria found that some nurse managers working in nursing homes undertook clinical as well as managerial functions during the pandemic, a double burden that could have increased their stress levels and have had adverse psychological, physical and social consequences., Aim: To investigate the effects of the COVID-19 pandemic on nurse managers' workload, perceptions of teamwork and stress levels, and the physical, psychological and social consequences of working during the pandemic., Method: A cross-sectional design was used. Respondents (n=238) were sent an online questionnaire during the second wave of the pandemic (which in Austria was November 2020 to March 2021) containing questions on demographics and fear of infection, their current workload compared with pre-pandemic workload, their perceptions of the influence of the pandemic on teamwork, their levels of stress measured using the Perceived Stress Scale (PSS), and the physical, psychological and social consequences of working during the pandemic., Results: Most respondents (95%) had to undertake more or much more work than usual during the pandemic, while just over half (52%) perceived that the influence of the pandemic on teamwork had been positive throughout or partially positive. Overall, the respondents' level of stress was moderate, as measured by the PSS. Around 28% of respondents were afraid of infecting someone other than themselves, notably their families, employees and patients. Fear for themselves, their families and their patients or residents were commonly reported psychological consequences of working during the pandemic, while confusion due to information overload was the second most commonly reported psychological consequence., Conclusion: Comparing results with previous research is difficult due to the lack of research of nurse managers' experiences of the pandemic. Fear appears to have been a major issue for nurse managers during the pandemic, particularly in relation to infection and information overload. This emphasises the need for healthcare organisations to focus on the mental health and well-being of nurse managers, as well as front-line staff, during and after crisis situations such as a pandemic. Organisations may consider reworking and adopting already-established COVID-19 regulations, schedules and local guidelines, particularly in terms of communication and infection control, which could help to reduce nurse managers' fear in future crisis situations., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Correctional workers (CWs) endure several operational stressors (e.g., exposures to potentially psychologically traumatic events) and organisational stressors (e.g., shift work, staff shortages), which are associated with positive screens for mental disorders and self-reports of suicidal behaviours and thus urgently warrant further inquiry. The Canadian Provincial and Territorial Correctional Worker Mental Health and Well-Being Study (CWMH) used an online survey to collect data from Canadian correctional service organisations across all 13 provinces and territories. This national Canadian study investigates suicidal behaviours among CWs across diverse occupational roles and provincial and territorial jurisdictions (n = 3740, 50.1% female). The results estimated prevalence proportions for self-reported past-year and lifetime suicidal thoughts, planning, and attempts across the 13 Canadian provincial and territorial correctional systems, with the exceptions of past-year suicidal planning in Alberta, Newfoundland and Labrador, New Brunswick, and Yukon where jurisdictional considerations and requests precluded the inclusion of select questions. Substantial proportions of participants reported past-year or lifetime suicidal ideation (i.e., 9.1%, 29.2%, respectively), planning (i.e., 4.1%, 14.7%, respectively), or attempts (i.e., 0.8%, 7.2%, respectively). Sociodemographic variables (i.e., sex, age, marital status, total years of service, occupational category) were associated with past-year and lifetime suicidal behaviours. Findings provide opportunities for future research and can inform tailored efforts by clinicians, service providers, and organisational leaders to support proactive interventions and treatments, including supporting the partners and families of CWs, fostering social support networks, and improving access to timely mental health treatment., (© 2024 The Author(s). Stress and Health published by John Wiley & Sons Ltd.)

Job strain is a major concern in the workplace. Work-related stress is an increasing challenge worldwide as it is the leading cause of long-term sickness absences, disability pensions and lower productivity. Rarely studied simultaneously, both leisure-time physical activity (LTPA) and physical fitness (PF), which comprises cardiorespiratory fitness (CRF) and muscular fitness (MF), may have potential in preventing and managing job strain. The current study aimed to investigate whether LTPA, CRF and MF predict perceived job strain. In addition, the study examines reverse associations, that is, whether job strain predicts LTPA, CRF and MF. We used longitudinal population-based data from a Northern Finland birth cohort of 1966 (n = 5363) to analyse LTPA, CRF and MF as well as job strain and its components, job demands and job control, at age 31 years (1997) and 46 years (2012). Leisure-time physical activity was measured with a self-reported questionnaire whereas CRF and MF were measured as part of clinical examination. Linear regression analyses were used to analyse the data. In both men (n = 2548) and women (n = 2815), higher baseline MF predicted lower job strain and job demands 15 years later. In women, higher baseline total LTPA predicted higher job demands, whereas in men, higher CRF predicted lower job strain and higher job control. These associations remained significant, also when adjusted for education and occupational status. In the analyses on reverse associations, higher job control and higher job demands were linked to higher leisure-time moderate-to-vigorous physical activity (MVPA) and total LTPA 15 years later among both men and women, except for the association between job demands and total LTPA among women. These associations remained significant after adjustment for education and occupational status, except for the association of job control with MVPA and total LTPA among men. The association of higher job demands and total LTPA became significant in women. We conclude that LTPA and PF seem beneficial in preventing and managing job strain., (© 2024 The Author(s). Stress and Health published by John Wiley & Sons Ltd.)

Study Question: What is the prevalence of occupational stress, somatization, and burnout reported by UK and US, embryologists and the impact of work conditions on these well-being outcomes?, Summary Answer: Surveyed UK and US embryologists reported moderate perceived stress, low somatic symptom severity, high levels of burnout, and overall stressful work conditions, but with differences that could be due to country-specific occupational and employment characteristics., What Is Known Already?: Spanish, UK, US, and international surveys have identified high levels of occupational stress, somatization, burnout, and occupational health issues among embryologists. These issues have been attributed to embryologists' occupational challenges and work conditions., Study Design, Size, Duration: A cross-sectional web-based survey was sent to 253 embryologists working in UK ART/IVF clinics and 487 embryologists working in US ART/IVF clinics., Participants/materials, Setting, Methods: Participants self-reported their stress levels, somatization, burnout, and work conditions. Proportions across the Perceived Stress Scale (PSS), Patient Health Questionnaire (PHQ-15), Maslach Burnout Inventory-General Survey (MBI-GS), a single-item work unit grade (A-F), and customized occupational and sociodemographic questionnaires were calculated using descriptive statistics. Welch's t-test was utilized to compare PSS and PHQ-15 scores between groups. Risk ratios were calculated using log-binomial regression for all models except for levels of anxiety related to performing cryostorage tasks, for which Poisson models were used., Main Results and the Role of Chance: In total, 50.6% (128) of the embryologists in the UK and 50.1% (244) in the US completed the survey. Both groups self-reported moderate PSS and low PHQ-15 scores, although fewer UK embryologists scored high on the MBI cynicism dimension than their US colleagues (43% UK vs 60% US embryologists, P < 0.05). The UK and US embryologists did not differ on the MBI exhaustion dimension with both scoring high for exhaustion (59% UK vs 62% US). Although 81% and 80% of UK and US embryologists, respectively, reported working overtime, more embryologists in the UK reported being adequately compensated. Increasing levels of anxiety-related to cryostorage showed a dose-dependent increased risk of burnout on at least two MBI-GS dimensions only in the UK group, and, a dose-dependent likelihood of higher PSS and PHQ-15 scores in both groups., Limitations, Reasons for Caution: Since the two groups were surveyed 9 months apart and were self-reporting, the study is limited by the differences in responsibilities, scheduling, and workload specific to the time of year., Wider Implications of the Findings: Work-related health issues and occupational challenges shared by UK and US embryologists could be addressed by organizational enhancements and technology. Lower levels of stress and burnout among UK embryologists might be due to the HFEA-provided structure/certainty., Study Funding/competing Interest(s): This study was supported without any external funding by TMRW Life Sciences Inc., which is developing and commercializing an automated platform for embryology. M.G.C. and M.S.L. are full-time employees and stockholders/shareholders with TMRW Life Sciences, and A.M. of Novavax, Inc. was an employee of TMRW Life Sciences. G.P. is a consultant for TMRW Life Sciences. The remaining authors declare no conflict of interest., Trial Registration Number: NCT05326802; NCT05708963., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology.)

Objective: This study investigates anxiety risk and work-related factors among platform workers. The recent growth in the platform industry is a worldwide trend, with delivery workers in Korea representing typical platform workers., Methods: This cross-sectional study used the 6th Korean Working Conditions Survey to assess anxiety risk among 532 delivery workers compared to general employees. It identified associations between work-related factors and anxiety, including job demands and autonomy, legal protection, and emotional labor., Results: Delivery workers exhibited significantly higher anxiety (odds ratio [OR] = 1.67 95% confidence interval [CI] = 1.23-2.28) and work-related anxiety (OR = 2.17 95% CI = 1.48-3.18) risk than the general workforce, and a significantly higher risk of having unfavorable work environment factors. Their anxiety risk was significantly associated with work-related factors, such as long shifts, quick return, time pressure, job stress, absence of union, work-family conflict, and emotional labor., Conclusions: This study identified high levels of anxiety among Korean delivery workers and associated occupational factors. It highlights the importance for industry and government interventions to enhance mental health support, mitigate poor employment conditions, and ensure legal safeguards., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: The purpose of this study was to identify the factors influencing pediatric nurses' job stress, including their level of fatigue and partnerships with the parents of patients. This investigation aimed to findings of this study may lead to the development of strategies to reduce pediatric nurse's job stress., Design and Methods: Participants were recruited from pediatric, pediatric intensive care, and neonatal intensive care units across seven general hospitals. Eligibility requires a minimum of 6 months of experience in pediatric nursing. The sample size was determined using the G*power program, considering various variables, including age, marital status, presence of children, and work-related characteristics, leading to a final sample size of 135, adjusted for a 10% dropout rate. Data collection was conducted through self-report questionnaires, and analysis involved frequency, percentage, mean, standard deviation, t-tests, ANOVA, and stepwise multiple regression, using SPSS Statistics 27.0., Results: This study confirmed a significant correlation between pediatric nurses' fatigue and job stress, with higher levels of fatigue associated with increased job stress. Stepwise regression analysis showed that fatigue and age were significant predictors of job stress among pediatric nurses, explaining 23% of the variance. However, detailed analysis showed that younger nurses had lower job stress scores compared to older nurses. This result suggests that more experienced nurses may experience higher job stress due to increased responsibilities and emotional burdens., Practice Implications: This study identified the need for effective strategies to manage fatigue and reduce job stress among pediatric nurses during the COVID-19 pandemic. Younger nurses, particularly those under 25 and between 26 and 30 years old, experience lower job stress compared to older nurses. Comprehensive support systems should be developed, including workload management, emotional support, and programs to enhance partnerships between nurses and parents. These strategies can improve job satisfaction and the quality of care provided to young patients. Additionally, they ensure a more resilient and effective healthcare workforce during pandemics and similar crises., (© 2024 Wiley Periodicals LLC.)

Objective: This study aimed to explore the relationship between workplace discrimination and psychological distress across 9 years using data from the Midlife in the Unites States study., Methods: Workplace discrimination was measured with a validated six-item scale at baseline with three categories (low, intermediate, and high), and psychological distress was measured with the Kessler 6 scale at baseline and follow-up. In total, 1,546 workers were analyzed by linear regression., Results: High levels of workplace discrimination were significantly associated with increased psychological distress at follow-up (crude β = 0.633; 95% CI, 0.307-0.959). After adjusting for demographic factors, socioeconomic status, and health-related behaviors, associations were slightly attenuated (fully adjusted β = 0.447; 95% CI, 0.115-0.780)., Conclusions: High workplace discrimination was longitudinally associated with higher levels of psychological distress. Organizations should actively prevent discrimination, which may improve workers' mental health consequently., Competing Interests: Li, Keller, and Guardiano have no relationships/conditions/circumstances that present potential conflict of interest., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Background: Prior pandemic research has focused on physicians and nurses who provide direct patient care. Literature on the experiences of nonnurse/physician clinicians and nonclinical health care professionals is sparse., Methods: An observational, cross-sectional study was conducted over threetime points to examine the impact of COVID-19 on clinical and nonclinical healthcare professionals ( n = 464)., Findings: There were no significant differences in distress across survey waves, except for anger ( p = .046). No significant differences in distress scores were found between job types. Multiple linear regression results varied. Both the threat and interrupted plans scores were significant predictors of distress. Resources available to healthcare providers (HCPs) were underutilized in all three waves., Conclusions: Healthcare professionals' distress increases with exposure. Integrating self-care resources for staff may mitigate the impact and maintain a healthy work environment., Application to Practice: Occupational health providers should incorporate these findings when developing opportunities to address the needs of health care professionals in the workplace., Competing Interests: Conflict of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study compared the stress, anxiety and depression levels in employees working in the health, education and security sectors. The study also investigated the effect of psychological resilience on stress, anxiety, and depression levels and whether the stress, anxiety, depression and psychological resilience levels of employees differ according to occupational and demographic variables. In this cross-sectional study, 1222 employees participated, comprising 50.8% from the health sector, 37.7% from education, and 11.5% from security. Data were collected using the Stress, Anxiety, and Depression Scale-21 and the Brief Resilience Scale. The study revealed varying rates of severe stress (49.1%), anxiety (74.0%), and depression (53.2%) among participants. Health employees experienced higher stress (52.1%), anxiety (77.0%), and depression (58%) rates compared to those in education (46.4%, 72.4%, and 48.4%) and security sectors (44.3%, 66.4%, and 48.5%). Health employees exhibited higher stress, anxiety, and depression levels, signifying a significant difference. Furthermore, the research identified psychological resilience as a crucial predictor of stress, anxiety, and depression. Additionally, these mental health issues were more prevalent among younger individuals with less work experience, females, private sector employees, singles, and those without children. The findings of the study showed that the level of stress, anxiety and depression was high in employees working in all three sectors (health, education and security), but mental problems were more common in health employees. The fact that psychological resilience is a significant predictor of stress, anxiety and depression levels indicates that this factor should be taken into account., (© 2024 The Author(s). Stress and Health published by John Wiley & Sons Ltd.)

Objective: To characterize the burden and social distribution of occupational psychosocial exposures in the United States (US)., Methods: We merged 2022 US employment and demographic data from the Current Population Survey (CPS) with occupational characteristic data from the Occupational Information Network (O*NET), wage data from the Occupational Employment and Wage Statistics Survey, and hours worked from the CPS, to estimate the number and proportion of US workers at risk of exposure to 19 psychosocial hazards. We additionally estimated the number and proportion of US workers over- or underrepresented in exposure burden., Results: Of the exposures examined, US workers were most commonly employed in occupations with high time pressure (67.5 million US workers exposed; 43.2% US workers exposed), high emotional labor (57.1 million; 36.6%), and low wages (47.8 million; 30.6%). The burden of exposures was uneven across sociodemographic strata, attributable to occupational segregation. The full data set is available online at https://deohs.washington.edu/us-exposure-burden., Conclusions: Work-related psychosocial exposures are ubiquitous and should be considered in occupational and public health research, policy, and interventions to reduce the burden of disease and health inequities in the United States., (© 2024 Wiley Periodicals LLC.)

Background: Neurosurgeons may resort to caffeine, alcohol, and various drugs to maintain peak performance as they grapple with work demands and escalated stress. The prevalence of this controversial strategy remains largely unexplored., Methods: An anonymous survey of 23 questions formulated by our research group was distributed through personal contacts and neurosurgical societies. Inquiries revolved around the use of medications and other substances for job-related reasons. Data were analyzed via regression and descriptive statistics in python., Results: In total, 215 neurosurgeons (43 residents) were included, with 213 disclosing their gender (94 females). Out of all, 9.3% were <30, 38.1% were 30-39, 44.6% were 40-59, and 7.9% were >60 years old. Most (70.7%) practiced in Europe, 18.6% in Asia, 6.5% in North and South America, and the rest in Africa or Australia. While 132 participants stated they consume caffeine to manage challenging schedules, drugs for cognitive and mood enhancement were utilized by 18 and 35 respectively. Alcohol was employed for stress relief by 28 with 4 reporting as heavy drinkers. Drugs posed a solution to sleep disorders for 82, and helped 8 others in strengthening their hand dexterity. Notably, 12 of those claiming drug use initiated it in medical school. Exercise, self-care activities, and relational support were the main alternatives sought. Ultimately, most responders recommended extending mental health assistance and raising awareness about drug use., Conclusions: Reflecting on our results on job-associated drug use by neurosurgeons, we propose the judicious use of pharmacological or nonpharmacological adjuncts, alongside the prioritization of neurosurgeons' well-being., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: We investigated the impact of engaging in side jobs on turnover and its interaction with psychological distress among Japanese employees., Methods: A prospective cohort study was conducted using a questionnaire-based survey. We investigated 2783 full-time employees in companies permitting side jobs. Multiple logistic regression analyses were used to examine the relationship between side jobs and turnover, and its relationship stratified by psychological distress., Results: Employees engaging in side jobs had higher odds ratios (ORs) for turnover after adjusting for covariates, including psychological distress (OR, 1.54; 95% confidence interval, 1.22 to 1.93). Among those under psychological distress, ORs for turnover were significantly higher (OR, 1.96; 95% confidence interval, 1.39 to 2.76). Conversely, in employees without distress, no significant difference was observed., Conclusions: Side job engagement correlates with higher turnover, particularly among employees under psychological distress., Competing Interests: Conflicts of interest: T.N. reports personal fees from BackTech Inc., EWEL Inc., and Sompo Health Support Inc., outside the submitted work. K.M. reports research grants from Daido Life Insurance Company and Komatsu Ltd.; scholarship grants from AORC, BackTech Inc., Daido Life Insurance Company, EWEL Inc., iSEQ. Inc., JMA Research Institute Inc., Mediva Inc., SMS Co., Ltd., Sompo Health Support Inc., and T-PEC Corporation; and personal fees from BackTech Inc. and Sompo Health Support Inc., outside the submitted work. The other authors declare no conflicts of interest associated with this manuscript., (Copyright © 2024 American College of Occupational and Environmental Medicine.)

Objectives: This scoping review maps the literature on psychosocial distress and coping among nursing assistants (CNAs) in long-term care facilities (LTC) during the COVID-19 pandemic onto the Social Ecological Model (SEM) of Occupational Stress., Methods: Searches yielded 862 unique studies. Inclusion criteria were sample CNAs or equivalent in LTC; includes psychosocial variable; and collect data from February 2020-. A multi-phasic, meta-synthesis was used to synthesize qualitative data., Results: We identified 20 studies (13 quantitative, 7 qualitative) conducted between March 2020 and December 2021 from 14 countries. Prevalence rates were reported for perceived stress (31-33%; n  = 1 study), post-traumatic stress (42%; n  = 1), anxiety (53%; n  = 1), depression (15-59%; n  = 2), suicidal thoughts (11-15%; n  = 1), and everyday emotional burnout (28%; n  = 1). Qualitative studies identified factors contributing to psychosocial distress and coping at each SEM level (i.e. individual, microsystem, organization, and peri-/extra-organizational). Quantitative studies primarily measured factors relating to psychosocial distress and coping at the individual and organizational levels., Conclusions & Clinical Implications: This review identifies specific targets for intervention for psychosocial distress among CNAs in LTC at multiple levels, including job clarity; workload; facility culture; community relations; and policy. These intervention targets remain relevant to the LTC industry beyond the context of the COVID-19 pandemic.

This cross-sectional study investigates the association between long working hours, short sleep duration, and mental health among Japanese physicians. We enrolled 232 Japanese physicians. We used the Brief Job Stress Questionnaire to assess high-stress status, and the Japanese version of the Center for Epidemiologic Studies Depression scale to assess depressive status. Daily sleep duration (DSD) and weekly working hours (WWHs) were collected using a self-administered questionnaire. Multivariable-adjusted logistic regression analysis was performed to examine the association of the combined categories of DSD and WWHs with high-stress and depressive status. Compared to physicians with WWHs <80 h and DSD ≥6 h, the multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of high-stress status for those with WWHs ≥80 and DSD ≥6, WWHs <80 and DSD <6, and WWHs ≥80 and DSD <6 were 2.76 (0.97-7.87), 3.36 (1.53-7.40), and 3.92 (1.52-10.14), respectively. The respective ORs (CIs) of depressive status were 1.82 (0.42-7.81), 4.03 (1.41-11.53), and 4.69 (1.33-16.62). The results showed that regardless of working long hours or not, physicians with DSD <6 h had significantly higher stress and depressive status, suggesting that not only regulating long working hours but also ensuring adequate sleep duration is important for preventing physicians' mental health.

Background: A favorable clinical environment and nurse motivation are both essential for achieving high-quality patient outcomes and organizational performance in healthcare systems, which can be highly distressing for nurses. The purpose of this study was thus to determine the associations among and influences of psychological distress, work environment quality, and motivation on one another., Methods: This was a cross-sectional, descriptive-correlational study conducted with a total sample of 204 nurses in two public tertiary hospitals. We used an online survey to collect nurses' responses, which comprised the Kessler Psychological Distress Scale-6, Brief Nurses' Practice Environment Scale, and Multidimensional Work Motivation Scale. We ran the necessary statistical analyses in SPSS version 28., Results: We found that nurses' psychological distress, work environment quality, and motivation were moderate. A significant, positive, and moderate relationship existed between psychological distress and work environment quality, while nurses' educational level was statistically different with their motivation level. In the regression, only the nationality, current position, and work environment variables significantly influenced psychological distress. The hospital type also significantly influenced work environment quality. No variable was found to influence nurses' motivation level, though., Conclusions: We concluded that nurses' work environment quality and motivation are interconnected with the psychological stress they experience at work. Monitoring nurses' work environment quality, motivation levels, and psychological distress is thus vital to ensure better patient care., Competing Interests: The authors declare there are no competing interests., (©2024 Alharbi et al.)

Studies on the prevalence and factors of depression, and anxiety symptoms from a work-ascribed or causal perspective are not available and studies on the prevalence of occupational stress in Ethiopia are limited. Therefore, this study aimed to determine the prevalence of occupational depression, job anxiety, and occupational stress, and to identify their determinants in healthcare workers. We conducted a multicenter cross-sectional study in selected public hospitals in the Central and Southern Ethiopia from 16th January to 28th February 2023. We used stratified random sampling to select 9 public hospitals from three strata: primary, general and tertiary hospitals. We collected data using scales of perceived occupational stress, occupational depression inventory, and job anxiety. We performed a confirmatory factor analysis followed by determining the prevalence of those mental symptoms and identifying independent factors using multiple ordinal logistic regression. Among 1426 healthcare workers, the overall prevalence of occupational depressive, job anxiety, and occupational stress symptoms were 39.0%, 57.6%, and 68.0%, respectively. Females, medical specialists, participants with a history of disease or injury, those with low job dissatisfaction, higher sleeping disorder scores, higher life-threatening events (LTEs) scores, and longer working hours were more likely to report occupational depressive symptoms. Participants with poor perceived health significantly increased the odds of reporting job anxiety symptoms. Participants with low job satisfaction, a history of workplace verbal violence, higher scores for sleep disorders, and higher LTEs score had significantly greater odds of reporting both job anxiety and occupational stress symptoms. Younger participants were also more likely to report occupational stress symptoms. Our study highlights the need to prioritize workplace mental health interventions for healthcare workers. The study also suggested the need to address gender, educational level, job satisfaction, and sleep hygiene, develop coping mechanisms for LTEs, prevent workplace violence, and manage of working hours per week to enhance the mental well-being of healthcare workers in Ethiopia., (© 2024. The Author(s).)

Objectives: The study aimed to assess the mental health and well-being of Lithuanian healthcare workers by gathering demographic information, identifying common stressors affecting the work environment, evaluating mental health, and exploring directions for psychosocial care. Additionally, the research explored the prevalence of considering a career change among respondents., Material and Methods: The study included 1618 responders who completed an online survey in December 2021 - January 2022. Participants included in this study: physicians, nurses, residents and other healthcare workers. It evaluated their demographics, most common stressors affecting their work environment and mental health on the Depression, Anxiety and Stress Scale - 21 (DASS-21) scale. Lastly, all responders asked if they had considered changing their occupation to a non-medical job. Univariate analysis was performed using χ2 and Student's t test, and binary logistic regression evaluated career change predictors., Results: Career change was considered by 1081 (66.8%) responders. The main career change predictors were poor working conditions (OR 1.91, p < 0.001), direct contact with patients (OR 1.84, p < 0.001), lack of career perspectives (OR 1.95, p < 0.001), mobbing (OR 1.67, p = 0.001) and exhaustion (OR 1.51, p = 0.005). After evaluating DASS-21 scores, it was found that 23% of respondents had severe and extremely severe depression symptoms, 27.4% severe and extremely severe anxiety, and 21.4% had severe and extremely severe stress levels., Conclusions: Lithuanian healthcare workers are in high distress and have poor mental health. They are in need psychosocial assistance to avoid burnout and staff loss. Int J Occup Med Environ Health. 2024;37(3):287-99., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objectives: Both physical and psychosocial risk factors contributing to musculoskeletal disorders occur in the professional nursing group, and previous literature suggested that their interaction may increase the risk of musculoskeletal pain among nurses. The aim of the study was to examine perceived workload and stress as well as physical findings and musculoskeletal complaints in nurses., Material and Methods: The participants consisted of 42 female nurses, age range 23-60 years. They marked on a pain drawing the site/sites that was/were painful at the moment of testing, its duration and intensity. Thereafter they were examined using the movement and respiration domains from the Global Physiotherapy Examination (GPE). Furthermore, a subjective workload measure was made using the paper version of the National Aeronautics and Space Administration Task Load Index and stress was assessed using the Perceived Stress Questionnaire ., Results: Almost the entire study group declared that pain experienced in at least 1 location was chronic, i.e., had lasted ≥1 year (97%). The most frequent locations of pain were low back (22.4%) and cervical/head (21.6%) regions. In the GPE, most scores indicated restricted and reduced movement, with the subdomain flexibility having the highest deviation from the predefined standard. Furthermore, the results indicated hampered respiration, especially visible in standing position. Out of all workload scores, the highest was obtained for temporal demand. Perceived stress level was found to be moderate and significantly associated to chronic chest/ thoracic pain. Interestingly, the compression of thorax test positively correlated with mental (r = 0.42, p < 0.05) and physical demand (r = 0.35, p < 0.05), whereas the elbow drop test and temporal demand correlated negatively (r = -0.37, p < 0.05)., Conclusions: To sum up, the majority of nurses participating in this study had long-lasting pain and limited flexibility of the body and hampered respiration, which both may enhance intensity of experienced musculoskeletal pain. Int J Occup Med Environ Health. 2024;37(3):257-70., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Study Objective: The present study is aimed at providing an assessment of the changes in burnout, job strain, isostrain, sleepiness, and fatigue levels over time and identifying factors associated with these symptoms among healthcare workers in French emergency departments (EDs). Method: We conducted a prospective, multicenter study in four EDs and an emergency medical service. Participants completed questionnaires at inclusion and at 90 days to assess burnout, job strain, isostrain, sleepiness, and fatigue. Results : A total of 211 respondents (43.5%) completed the questionnaires at inclusion. At the beginning of the study, 84 (40.8%) participants presented symptoms of burnout, 86 (43.2%) had symptoms of job strain, and 58 (29.4%) of isostrain. Forty-two (20.1%) healthcare workers presented symptoms of sleepiness, and 8 (3.8%) had symptoms of fatigue. We found that symptoms of burnout were more frequent for healthcare workers with a previous psychiatric history (55.3% vs. 39.1%, p = 0.02) and were lower among participants who had at least one dependent child (33.1% vs. 48.3%, p = 0.013). Symptoms of job strain were higher among administrative staff compared to physicians (55.6% vs. 28.7%, p = 0.01) and among healthcare workers with managerial responsibilities compared to those without (45.6% vs. 28.8%, p = 0.015). Symptoms of isostrain were higher among administrative staff (42.3%) compared to paramedics (34.1%) and physicians (19.8%, p = 0.026). Conclusion: We identified that potential factors associated with the emergence of symptoms of burnout and job strain are suggested, underlining several areas of improvement for the prevention against mental health disorders in the specific population of ED healthcare workers. Trial Registration: ClinicalTrials.gov identifier: NCT04383886., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Marion Douplat et al.)

Objective: To understand the current status of occupational stress, occupational burn-out and sleep quality among ambulance drivers in Hengyang, China and to analyse the relationship between occupational stress, occupational burn-out and sleep quality of ambulance drivers., Design: A cross-sectional study., Setting: Prehospital emergency centre of third-class hospital in Hengyang, China., Participants: From October 2023 to December 2023, a cross-sectional survey was conducted, with 213 ambulance drivers from Hengyang, China, selected as participants., Methods: General demographic questionnaires, the Chinese Occupational Stress Inventory, the Maslach Burnout Inventory and the Pittsburgh Sleep Quality Index were used for data collection and analysis., Results: Occupational stress among ambulance drivers was positively correlated with occupational burn-out and sleep quality (r=0.528, 0.447, both p<0.01) while occupational burn-out was positively correlated with sleep quality (r=0.394, p<0.01). Occupational burn-out partially mediated the relationship between occupational stress and sleep quality among ambulance drivers, with a mediation effect value of 0.168, accounting for 26.09% of the total effect., Conclusion: The sleep quality of ambulance drivers in Hengyang, China is suboptimal, with occupational stress directly predicting sleep quality. Occupational burn-out plays a partial positive mediating role between occupational stress and sleep quality among ambulance drivers. Reducing occupational stress and burn-out is beneficial for improving the sleep quality of ambulance drivers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: Occupational stress is known to have detrimental effects on health care professionals worldwide. This study aimed to address a research gap by investigating sources and levels of occupational stress in U.K. audiologists., Method: A mixed-methods cross-sectional design and convenience sampling were utilized. The study used the Audiologist Occupational Stress Questionnaire (AOSQ) and an audiological working practices questionnaire. The study included 100 registered U.K. audiologists., Results: The research revealed that over a third of participants reported experiencing moderate or higher levels of occupational stress. Pediatric audiologists and those with a high daily patient load reported significantly higher stress scores than other specialties and those seeing fewer patients per day. Identified sources of stress for U.K. audiologists included clinical demands and time constraints, staffing issues, leadership in the workplace, and equipment availability. Reported impacts of stress encompassed mental health issues, fatigue, social life disruptions, and physical health concerns., Conclusions: The research validated the use of the AOSQ in a U.K. setting, and the findings provided insights into the sources and levels of occupational stress experienced by U.K. audiologists, supporting existing research on occupational stress in audiologists in other countries. The identification of consistent stress themes across the literature underscores the need for targeted support and interventions to ensure the well-being of audiologists and empower them in maintaining their pivotal role in health care.

Leadership plays a key role in the well-being of military personnel, either contributing to health improvement or, conversely, becoming a source of stress. In the present study we propose that security providing leadership can reduce work stress in the military context. Furthermore, we suggest that security-providing leaders exert their positive influence on work stress by creating a psychological safety climate and preventing organizational dehumanization. A sample of 204 members (72.5% men) of the Spanish Air Force volunteered to participate in this empirical study and completed an online questionnaire and both the direct and indirect structural equation models were analyzed. Results show a negative relationship between security providing leadership and work stress. Additionally, organizational dehumanization and psychological safety climate act as mediators in this relationship. These results support this novel approach to leadership in the military context. They also offer new ways to create better organizational environments. By treating their subordinates in a personalized manner and supporting them, security-providing leaders can improve employees' perceptions of psychological safety climate and combat feelings of organizational dehumanization, which, in turn, can reduce work stress.

Aim: To describe and compare the prevalence of assaults and aggressive patient behavior among frontline staff in behavioral health (BH), medical-surgical (MS), and emergency department (ED) settings and examine the impact on staff health, work stress, work engagement, and intent to leave their position., Background: Patient verbal and physical assaults have significant staff consequences, including decreased work productivity, increased burnout, job dissatisfaction, absenteeism, turnover, and intentions to leave., Methods: Using a descriptive cross-sectional design, data were collected from a sample of 432 frontline staff working in ED, BH, and MS settings across 3 healthcare systems., Results: The majority of frontline staff (74%) reported experiencing verbal aggression often/frequently, significantly impacting their mental health, work engagement, stress levels, and intent to leave. All 3 specialty groups reported a significant increase in verbal/psychological assaults and physical assaults since the pandemic's onset., Conclusion: The COVID-19 pandemic had a significant impact on assaultive/aggressive behaviors. Nurse leaders must strategize on methods to decrease the normalization of violence against healthcare workers and support research aimed at evidence-based interventions to reduce such incidences of violence and ensure the well-being of healthcare workers., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Health care workers (HCW) experienced significant stress during the COVID-19 pandemic. This qualitative study describes how they contextualized the experience several years later., Methods: In August 2023, 1832 HCW at an academic medical center completed a confidential electronic survey; 443 of them responded to an open-ended question about their experiences during the pandemic. The statements were analyzed qualitatively, using a grounded theory approach to allow themes to emerge from the data., Results: Common themes included fear/anxiety (22%), burnout (15%), protecting family from risk (11%), lack of employer support (11%), fear of illness (8%), increased appreciation for life (8%), and exposure to death/illness (5%)., Conclusion: HCW experienced substantial stress during the pandemic. Mental health services and structural changes in the health care system are needed to protect HCW during future public health emergencies., Competing Interests: Conflict of interest: None declared., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Objectives . Studies have highlighted that healthcare workers are exposed to various forms of psychological distress. This study aimed to assess the psychological well-being of pharmacy staff during the COVID-19 pandemic and the associating factors. Methods . The cross-sectional study explored the psychological well-being of pharmacy staff during the COVID-19 pandemic. An adopted questionnaire was employed to collect quantitative data from January 1, 2021 to June 30, 2021. Results . A total of 515 respondents were recruited. Those who perceived good health status were 1.9 times more likely to have normal depression scores (relative risk ratio [RRR] = 0.53; B  = -0.64), and 2.4 times (RRR = 0.41; B  = -0.88) more likely to have normal stress scores. Those who were greatly affected by COVID-19 in their work were found to be 1.2 times (RRR = 1.20; B  = 0.18) more likely to have moderate anxiety scores and 1.44 times (RRR = 1.44; B  = 0.36) more likely to have severe depression scores. Respondents with higher work characteristic scores were more likely to have normal depression, stress and anxiety scores. Conclusions . Good health status perception and work characteristics appeared to be the factors affecting respondents' scores in all dimensions of psychological well-being. Hence, improving both domains will be key in improving overall psychological well-being.

Objective: This study aimed to investigate (i) the risk of work disability (>10-day sickness absence spell or disability pension) due to common mental disorders (CMD) among social workers compared with other health and social care, education, and non-human service professionals and (ii) whether the risk was mediated by job stress., Methods: A cohort of 16 306 public sector professionals in Finland was followed using survey data from baseline (2004 or if not available, 2008) on job stress [job strain or effort-reward imbalance (ERI)] and register data on work disability due to CMD from baseline through 2011. A Cox proportional hazards model was used to analyze the risk of work disability due to CMD between three occupation-pairs in a counterfactual setting, controlling for age, sex, job contract, body mass index, alcohol risk use, smoking, and physical inactivity., Results: Social workers' job stress was at higher level only when compared to education professionals. Thus, the mediation hypothesis was analyzed comparing social workers to education professionals. Social workers had a higher risk of work disability due to CMD compared with education professionals [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.58-2.74]. This HR was partly mediated by job strain (24%) and ERI (12%). Social workers had a higher risk of work disability than non-human service professionals (HR 1.54, 95% CI 1.13-2.09), but not compared with other health and social care professionals., Conclusions: Job stress partly mediated the excess risk of work disability among social workers only in comparison with education professionals.

Context/objective: Perceived job quality is a key indicator of sustainable work among persons with spinal cord injuries (PwSCI). This study aimed at (a) describing three indicators of perceived job quality ( i.e. job satisfaction, job performance, and work stress) among working PwSCI, and (b) identifying whether and how different person-job match dimensions ( i.e. interest congruence, demands-abilities fit, needs-supplies fit, and effort-reward imbalance) as well as sociodemographic and health-related factors ( e.g. age, sex, SCI-related characteristics, pain problems, and depressive symptoms) are associated with perceived job quality., Design: Cross-sectional, self-report survey., Setting: Community., Participants: 549 working-age PwSCI who participated in the 2017 community survey of the Swiss Spinal Cord Injury Cohort study and reported being engaged in paid work., Outcome Measures: Job satisfaction, job performance, and work stress., Results: Higher interest congruence, better needs-supplies fit and lower effort-reward imbalance, as well as female sex, were associated with higher job satisfaction, while higher effort-reward imbalance, poorer demands-abilities fit (underqualification), and - surprisingly - better needs-supplies fit were associated with higher work stress. Moreover, underqualification, worse needs-supplies fit as well as pain, depressive symptoms, and language region were associated with lower job performance., Conclusion: Integrating individuals in jobs that match their abilities, interests and needs, and which adequately reward their efforts may contribute to better job quality among PwSCI. Beyond that, common secondary health conditions and comorbidities such as pain and depressive symptoms should receive particular attention in interventions that aim to promote job quality and ultimately sustainable work in the SCI population.

The primary goal of the present study is to inspect the plausible job-related (i.e., challenge stressors and role blurring) and individual factors (i.e., fatigue and insomnia) that potentially lead to work-related cognitive failures among healthcare staff. Through the judgmental sampling technique, data was collected from healthcare personnel in Iran. The results revealed that challenge stressors in the form of time pressure, job responsibility, and work overload are significantly related to role blurring. Moreover, role blurring increases fatigue and insomnia among medical staff, and both insomnia and fatigue cause workplace cognitive failure. The results also confirm the mediation effect of role blurring in the association between challenge stressors, insomnia, and fatigue. According to the results, insomnia and fatigue similarly mediate the role blurring on workplace cognitive failure association. Theoretical implications, useful suggestions for practitioners, and prospective research avenues are debated in the study., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.