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Background: Negative nurse work environments have been associated with nurse bullying and poor nurse health. However, few studies have examined the influence of nurse bullying on actual patient outcomes. Purpose: The purpose of the study was to examine the association between nurse-reported bullying and documented nursing-sensitive patient outcomes. Methods: Nurses (n = 432) in a large US hospital responded to a survey on workplace bullying. Unit-level data for 5 adverse patient events and nurse staffing were acquired from the National Database of Nursing Quality Indicators. Generalized linear models were used to examine the association between bullying and adverse patient events. A Bayesian regression analysis was used to confirm the findings. Results: After controlling for nurse staffing and qualification, nurse-reported bullying was significantly associated with the incidence of central-line-associated bloodstream infections (P < .001). Conclusions: Interventions to address bullying, a malleable aspect of the nurse practice environment, may help to reduce adverse patient events. [ABSTRACT FROM AUTHOR]

Objective: Increasingly, workers in the service, welfare, and health care sectors suffer adverse effects (ie, depression, burnout, etc) of "low-energy syndromes." Less is known about energy-based outcomes among knowledge workers. This study aimed to identify determinants of self-rated energy in knowledge workers and examine how these determinants change over time. Methods: In collaboration with a large union and employer federation, 317 knowledge workers in Sweden responded to the health and productivity survey three times. Results: At each assessment, worry, satisfaction with eating habits, and work-effectiveness were predictive of energy levels; however, only work-effectiveness covaried with energy over time. Conclusions: This study suggests that perceived work-effectiveness is an important factor in preventing knowledge workers from experiencing "low-energy syndromes." Lifestyle factors also play a role. Therefore, multifaceted interventions for increasing energy are needed. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the mediating effects of organizational efficiency on organizational climate, occupational stress, and employee mental health. A total of 5316 employees who responded to a survey were the subject of the study. Results of the study suggest the significance for employers to improve both the psychosocial work environment and organizational efficiency that may contribute to decreased employee stress and improved mental well-being.

The article focuses on subjective health complaints (SHCs) of employees at various jobs, and their relation with job satisfaction and work environment. According to the World Health Organization, health is a state of complete physical, mental, and social well-being, and not just the absence of disease. It is stated that SHCs are the major cause of sickness leave, which results in loss of working days, and sickness compensation. It is mentioned that a majority of health complaints are due to musculoskeletal pain, tiredness, and gastrointestinal complaints, and very few employees with SHCs seek health care. It is stated that organizational stress is the main cause of health complaints among workers, and job satisfaction is important for promoting employee health.

Objective: To study whether knowledge about psychosocial work indicators and a structured method to implement changes based on such knowledge comprise an effective management tool for enhancing organizational as well as employee health and well-being. Methods: White- collar employees representing 22 different work units were assessed before and after a 1-year intervention program. Subjective ratings on health and work environment, biologic markers, absenteeism, and productivity were measured. Results: Significant improvements in performance feedback, participatory management, employeeship, skills development, efficiency, leadership, employee well-being, and work-related exhaustion were identified. The restorative hormone testosterone increased during the intervention and changes correlated with increased overall organizational well-being Absenteeism decreased and productivity improved. Conclusions: Fact-based psychosocial workplace interventions are suggested to be an important process for enhancing employee well-being as well as organizational performance. [ABSTRACT FROM AUTHOR]

Sickness absenteeism caused by musculoskeletal disorders (MSDs) is a persistent and costly occupational health challenge. In a prospective controlled trial, we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management. Patients with physician-diagnosed MSDs were randomized either to the intervention group or the reference group offered the traditional case management routines. Participants filled out a comprehensive questionnaire at the initiation of the study and after 6 months. In addition, administrative data were collected at 0, 6, and 12 months after the initiation of the project. For the entire 12-month period, the total mean number of sick days for the intervention group was 144.9 (SEM 11.8) days/person as compared to 197.9 (14.0) days in the reference group (P < 0.01). Compared with the reference group, employees in the intervention group significantly more often received a complete rehabilitation investigation (84% versus 27%). The time for doing this was reduced by half (59.4 (5.2) days versus 126.8 (19.2), P < .01). The odds ratio for returning to work in the intervention group was 2.5 (95% confidence interval 1.2-5.1) as compared with the reference group. The direct cost savings were USD 1195 per case, yielding a direct benefit-to-cost ratio of 6.8. It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability. Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial. [ABSTRACT FROM AUTHOR]

The study evaluated the effect of a change of work site and organization on work environment and psychosocial parameters; the change involved health care personnel at a geriatric hospital. Another aim of this study was to evaluate the effects of a structured psychoeducational intervention program. The study found few changes in the indices of interest on the experimental and control wards. There were, however, significant improvements in social climate, goal quality, and independence of work on the control ward. The investigators postulated that too much external support hampers a group's ability to actively cope with change and might actually lower a group's ability and self-esteem. In order to achieve successful organizational change, psychosocial intervention programs for personnel must be performed by a well-informed, well-chosen, and experienced counsellor who is well tailored to the local organization. [ABSTRACT FROM AUTHOR]

Background: Possible health effects for employees of efforts to improve the psychosocial competence of managers have not been studied scientifically in the past.Objective: To explore how efforts to improve management will change the work environment and health of the employees.Methods: Managers of the experimental department in a large insurance corporation underwent 2-hour biweekly training sessions for 1 year-altogether, 60 hours. A control group of employees in other departments in the corporation not affected by the modification was followed with the same assessments. Morning blood samples for the assessment of serum cortisol were collected both at baseline and after 1 year in 155 participants in the experimental group and in 147 subjects in the control group. Liver enzymes and lipids were also assessed. In the questionnaire part of the 1-year follow-up study, there were 119 participants in the experimental group and 132 in the control group.Results: When repeated-measures ANOVA was used, a significant interaction effect was found for the level of serum cortisol; serum cortisol levels were decreased in the intervention group and were unchanged in the control group (ANOVA two-way interaction, p =.02; after exclusion of the managers, p =.005). A significant interaction effect was also observed for decision authority, with increased decision authority in the intervention group and, conversely, a decreased level in the control group (p =.001; after exclusion of managers, p =.02).Conclusions: The study indicates that a moderately intensive psychosocial manager program lasting for 1 year can be beneficial for the employees with regard to both lowered serum cortisol and improved authority over decisions. [ABSTRACT FROM AUTHOR]

Twenty patients with symptoms of “environmental illness” were subject to a controlled study of deep versus superficial acupuncture. The patients were evaluated by a detailed questionnaire concerning their occupational, environmental, and medical history. Blood samples were taken as well. Patients were randomized to deep or superficial acupuncture. Both groups improved significantly in key variables during and after treatment. There were no group differences. There were no changes in biological variables apart from a gradual and continuous increase in serum cortisol and a decrease in neuropeptide Y, which was somewhat more accentuated in those receiving deep acupuncture. This rise in cortisol may have contributed to decreased dermal symptoms among the participants. It is hypothesized that the positive treatment results observed are partly due to weakening of the conditioned response, linking bodily symptoms to environmental agents. To date, a number of different methods have been tried in the management of patients with environmental illness. However, only rarely have the treatments been evaluated in controlled studies. [ABSTRACT FROM AUTHOR]

Presents a psychophysiological study of the impact of a controlled stress-reduction program in advanced telecommunication systems design work. Identification of major stressors for telecommunications employees; Assessment of the impact of a controlled prospective stress-reduction program.

This study examined 47 office workers during a day of regular work in front of a video display unit (VDU) and a day of leisure in the same environment. The study investigated possible effects of VDU work on circulating melatonin and adrenocorticotropic hormone (ACTH) levels. Circulating melatonin levels decreased significantly during VDU work, whereas ACTH levels increased significantly. In contrast, melatonin and ACTH levels did not change significantly during a day of leisure. Mental strain during work was significantly and positively associated with circulating levels of ACTH but not melatonin. The results indicate that the VDU environment is associated with measurable changes in melatonin and ACTH levels. Mental strain might explain changes in ACTH levels, but specific factors that might contribute to changes in melatonin levels are unknown. These findings might be relevant to the recent debate about the possible influence that electromagnetic and VDU environments might have on electromagnetic sensitivity. [ABSTRACT FROM AUTHOR]

There is a void of studies concerning occupational health aspects from working with the most advanced forms of information technologies techniques such as are found in some of the world-renowned telecommunication systems development laboratories. However, many of these techniques will later be applied in the regular office environment. We wanted to identify some of the major stressors perceived by advanced telecommunication systems design employees and develop a valid and reliable instrument by which to monitor such stressors. We were also interested in assessing the impact of a controlled prospective stress-reduction program on perceived mental stress and specific psychophysiological parameters. A total of 116 employees were recruited. Sixty-one were offered to participate in one of three stress-reduction training programs (intervention group). The additional 50 functioned as a reference group. After a detailed baseline assessment, including a comprehensive questionnaire and psychophysiological measurements, new assessments were made at the end of the formal training program (+3 months) and after an additional 5-month period. Results reveal a significant improvement in the intervention group with regard to circulating levels of the stress-sensitive hormone prolactin as well as an attenuation in mental strain. Cardiovascular risk indicators were also improved. Circulating thrombocytes decreased in the intervention group. Type of stress-reduction programs chosen and intensity of participation did not significantly impact results. Coping style was not affected and no beneficial effects were observed with regard to the psychological characteristics of the work, eg intellectual discretion and control over work processes. The survey instrument is now being used in the continuous improvement of work processes and strategic leadership of occupational health issues. The results suggest that prior psychophysiological stress research, based on low- and medium-skill, rather repetitive kinds of jobs, may not be completely applicable to that of skilled professionals. The results indicate that cutting-edge telecommunication systems design employees suffer from significant amounts of mental strain. In addition, there are limited but measurable benefits from a stress-reduction program. More attention should be directed as to how to design healthy and productive work environments in workplaces using advanced information technologies. [ABSTRACT FROM AUTHOR]

This study tested psychological treatment of patients with "electric hypersensitivity." Seventeen patients were randomly assigned to a treatment group or a waiting-list control group in a pretest-posttest control group design. The patients were also taking part in double-blind provocation tests before and after the treatment. Subjective ratings of symptoms were registered and blood samples were taken and analyzed for "stress-related" variables, such as prolactin, cortisol, dehydroepiandrosterone, and cholesterol levels. The patients in the experimental group reduced their evaluations of the disability more than the control group did. This indicates that psychological treatment may be of value in this disease. However, none of the psychophysiological measures or the subjective reactions to the provocation test showed any significant between-group difference. The conclusion from the provocation test is that this group of alleged hypersensitive patients did not react to the electromagnetic fields. [ABSTRACT FROM AUTHOR]

Special Forces Police are called to the most dangerous situations that require skills and equipment beyond the training available to a patrol officer. We recruited a platoon of special forces (n = 18) and examined their basal and reactivity levels of cortisol in relation to occupational duties. Moreover, we measured the impact of a multiday program of intensive resilience and tactical training in improving cortisol responses to stressful situations. Participants were significantly more likely to exhibit basal cortisol levels higher than the civilian norms across all of the 5 days of intensive training. However, anticipatory cortisol, measured directly before exposure to critical incident scenarios, was significantly lower in Day 5 than in Day 1 of the training period. This study demonstrates that measuring cortisol is an objective method of examining training effects and possible long-term occupational health outcomes.

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

Postoperative services provide an excellent setting to study nursing work due to the patients' needing highly technical, yet highly comforting, care. The current study examined nursing work in postoperative services in an attempt to discern how nursing work is structured. Observations of nursing interactions in a 14-bed postoperative unit of a large Swedish university hospital found that nursing work in this setting is highly intensive and multidimensional. The need to provide nursing interactions that are caring and respectful of patients, while at the same time ensuring a high level of technical capacity, was obvious throughout all stages of patient stays in this unit. Furthermore, although each interaction is necessarily time-limited there is a caring relationship sustained with each patient. There is a pattern of caring that emerges that can be encapsulated as a "contingent routine." Nursing work cannot be broken down into "dimensions of caring." The work is high-pressure and involves, by necessity, multitasking. There are many dimensions of nursing care, but, usually, these are supplied simultaneously.