Search

Micro- and small-sized enterprises (MSE), and small- and medium-sized enterprises (SME) in Germany are often burdened with high levels of psychosocial stressors at work. The IMPROVEjob intervention was originally developed for general practice teams, and aims to promote job satisfaction and reduce psychosocial stressors in the context of workplace health management (WHM). This qualitative study identified challenges and transfer options regarding the transfer of the IMPROVEjob intervention to other MSE/SME settings. Based on previous study results, a comprehensive, qualitative inter- and transdisciplinary approach was developed and conducted between July 2020 and June 2021, also including single interviews and focus group discussion with eleven experts from MSE/SME settings. Data analysis was carried out using a rapid analysis approach. The experts discussed psychosocial topics and didactic formats of the original IMPROVEjob intervention. A lack of access to information on managing work-related psychosocial stressors and inadequate recognition of the importance of psychosocial stressors in the workplace among managers and employees, seemed to be the highest barriers regarding the transfer of the intervention into other MSE/SME settings. The transfer of the IMPROVEjob intervention to other MSE/SME settings requires an adapted intervention format, comprising targeted offers with easy access to information on managing work-related psychosocial stressors and improving WHM in MSE/SME settings.

Background: Work-privacy conflict (WPC) has become an important issue for medical professionals. The cluster-randomized controlled IMPROVEjob study aimed at improving job satisfaction (primary outcome), with additional outcomes such as examining the work-privacy conflict in German general practice personnel. Using baseline data of this study, the relationship between work-privacy conflict and job satisfaction (JS) was analyzed. In addition, factors associated with higher WPC were identified. Methods: At baseline, 366 participants (general practitioners (GPs) in leadership positions, employed general practitioners, and practice assistants) from 60 German practices completed a questionnaire addressing socio-demographic data and job characteristics. Standardized scales from the German version of the COPSOQ III requested data concerning job satisfaction and work-privacy conflict. Both scores range from 0 (lowest) to 100 (highest). Multilevel analysis accounted for the clustered data. Statistical analyses were performed using IBM SPSS and RStudio software, with a significance level set at p < 0.05. Results: Job satisfaction was 77.16 (mean value; SD = 14.30) among GPs in leadership positions (n = 84), 79.61 (SD = 12.85) in employed GPs (n = 28), and 72.58 (SD = 14.42) in practice assistants (n = 254). Mean values for the WPC-scale were higher for professionals with more responsibilities: GPs in leadership positions scored highest with 64.03 (SD = 29.96), followed by employed physicians (M = 45.54, SD =30.28), and practice assistants (M = 32.67, SD = 27.41). General practitioners and practice assistants working full-time reported significantly higher work-privacy conflict than those working part-time (p < 0.05). In a multilevel analysis, work-privacy conflict was significantly associated with job satisfaction (p < 0.001). A multiple regression analysis identified working hours, as well as and being a practice owner or an employed physician as factors significantly influencing WPC. Discussion: WPC was high among general practice leaders and practice personnel working full-time. Future interventions to support practice personnel should focus on reducing WPC, as there is good evidence of its effects on job satisfaction.

Zusammenfassung Hintergrund In der stationären kardiologischen Rehabilitation werden Patienten idealerweise nach psychosozialen Risikofaktoren gescreent und psychologisch betreut. Herzbezogene Ängste bei kardiologischen Erkrankungen können die Lebensqualität erheblich beeinträchtigen und sowohl die Prognose des Krankheitsverlaufs als auch die soziale und berufliche Teilhabe beeinflussen. Aufgrund der Diskrepanz zwischen der, in der Literatur berichteten, Prävalenz der Herzangst und dem, durch die Patienten in der Klinik Roderbirken geäußerten Bedarf an psychologischer Betreuung, vermuteten die Autoren, dass ein Teil der Patienten diesen Bedarf nicht selbständig äußert. Ziel der Studie war es, diese Patienten durch ein einfaches Screening-Instrument zu identifizieren, um ihnen eine adäquate psychologische Betreuung anzubieten und dadurch die Rehabilitationsziele, darunter den Erhalt der Erwerbsfähigkeit, zu sichern. Methode Die vorliegenden Daten wurden in einer monozentrischen Querschnittsstudie in der Rehabilitationsklinik Roderbirken, Leichlingen, NRW, erhoben. Die Patienten wurden einmalig mit einem standardisierten Fragebogen, bestehend aus dem Herzangstfragebogen, der Hospital Anxiety and Depression Scale und der Skala I des Screening-Instruments Beruf und Arbeit in der Rehabilitation befragt. Soziodemographische und klinische Daten wurden aus dem Kliniksystem ergänzt. Die Auswertung der Daten erfolgte mithilfe deskriptiv-statistischer und regressionsanalytischer Verfahren. Ein Ethikvotum liegt vor. Ergebnisse Nach Bereinigung des Datensatzes konnten 507 Patienten in die Analyse eingeschlossen werden (82,6% Männer, mittleres Alter gesamt 54,4±7,1 Jahre). Von diesen meldeten 40,0% einen Bedarf an psychologischer Betreuung an. Bei 15,7% aller Patienten lag eine Herzangst nach dem Herzangstfragebogen vor, von denen wiederum 59,0% einen Bedarf an psychologischer Betreuung anmeldeten. Es zeigte sich, dass insbesondere Patienten mit diagnostizierten psychischen Erkrankungen Betreuungsbedarf äußerten (57,6 vs. 0,7%; p Diskussion Die Ergebnisse der Selbstbeurteilungsfragebögen und die Betrachtung sozioökonomischer sowie klinischer Patientencharakteristika geben Hinweise auf ein Bedarfsprofil hinsichtlich des psychologischen Betreuungsbedarfs und eine negative subjektive Erwerbsprognose. Schlussfolgerung Ein Screening mit der Hospital Anxiety and Depression Scale ist geeignet, um die Identifizierung nicht geäußerter psychologischer Betreuungsbedarfe und damit die Zielerreichung der beruflichen Reintegration in der kardiologischen Rehabilitation zu unterstützen.

The psychosocial care of cardiac patients is becoming increasingly important. In inpatient cardiac rehabilitation, patients should be ideally screened for psychosocial risk factors and given psychological support. Heart-focused anxiety can significantly impair quality of life and subsequently influence prognosis of the course of the disease as well as social and occupational participation. Due to the difference between reported prevalence of heart-focused anxiety and the observed lower rate of patients expressing need for psychological support, the authors assumed that some patients do not express their need for psychological support. Therefore, aim of the study was to identify these patients through a simple screening instrument in order to offer them appropriate psychological support and consequently to maintain rehabilitation goals, including ability to work.We conducted a cross-sectional study at an inpatient cardiac rehabilitation center, Roderbirken, Leichlingen, Germany. Patients completed a standardised questionnaire, consisting of the Cardiac Anxiety Questionnaire, the Hospital Anxiety and Depression Scale and Scale I of the Screening Instrument Work and Occupation. Data were analyzed using descriptive statistics and logistic regression analysis. Ethical approval was obtained.Finally, 507 patients were included in the analysis (82.6% men, mean age 54.4±7.1 years). Of these, 40.0% expressed need for psychological support. Prevalence of heart-focused anxiety was 15.7%; among them significantly more patients expressed need for psychological support (59.0 vs. 41.0%; p0.05). Also patients with mental disorders expressed need for psychological support (57.6 vs. 0.7%; p0.05). Subjective assessment of early retirement was associated with heart-focused anxiety and with depressive symptoms (both p0.001) as well as education and employment status.Based on the results of the self-assessment instruments as well as the socioeconomic and clinical patient characteristics, possible indicators of subjective occupational prognosis can be derived.An screening through Hospital Anxiety and Depression Scale can facilitate target achievement of return to work in cardiac rehabilitation.In der stationären kardiologischen Rehabilitation werden Patienten idealerweise nach psychosozialen Risikofaktoren gescreent und psychologisch betreut. Herzbezogene Ängste bei kardiologischen Erkrankungen können die Lebensqualität erheblich beeinträchtigen und sowohl die Prognose des Krankheitsverlaufs als auch die soziale und berufliche Teilhabe beeinflussen. Aufgrund der Diskrepanz zwischen der, in der Literatur berichteten, Prävalenz der Herzangst und dem, durch die Patienten in der Klinik Roderbirken geäußerten Bedarf an psychologischer Betreuung, vermuteten die Autoren, dass ein Teil der Patienten diesen Bedarf nicht selbständig äußert. Ziel der Studie war es, diese Patienten durch ein einfaches Screening-Instrument zu identifizieren, um ihnen eine adäquate psychologische Betreuung anzubieten und dadurch die Rehabilitationsziele, darunter den Erhalt der Erwerbsfähigkeit, zu sichern.Die vorliegenden Daten wurden in einer monozentrischen Querschnittsstudie in der Rehabilitationsklinik Roderbirken, Leichlingen, NRW, erhoben. Die Patienten wurden einmalig mit einem standardisierten Fragebogen, bestehend aus dem Herzangstfragebogen, der Hospital Anxiety and Depression Scale und der Skala I des Screening-Instruments Beruf und Arbeit in der Rehabilitation befragt. Soziodemographische und klinische Daten wurden aus dem Kliniksystem ergänzt. Die Auswertung der Daten erfolgte mithilfe deskriptiv-statistischer und regressionsanalytischer Verfahren. Ein Ethikvotum liegt vor.Nach Bereinigung des Datensatzes konnten 507 Patienten in die Analyse eingeschlossen werden (82,6% Männer, mittleres Alter gesamt 54,4±7,1 Jahre). Von diesen meldeten 40,0% einen Bedarf an psychologischer Betreuung an. Bei 15,7% aller Patienten lag eine Herzangst nach dem Herzangstfragebogen vor, von denen wiederum 59,0% einen Bedarf an psychologischer Betreuung anmeldeten. Es zeigte sich, dass insbesondere Patienten mit diagnostizierten psychischen Erkrankungen Betreuungsbedarf äußerten (57,6 vs. 0,7%; p0,05). Die subjektive Erwerbsprognose war mit Herzangst und mit der Depressionssymptomatik nach Hospital Anxiety and Depression Scale assoziiert (je p0,001), des Weiteren mit der Ausbildung und dem beruflichen Status.Die Ergebnisse der Selbstbeurteilungsfragebögen und die Betrachtung sozioökonomischer sowie klinischer Patientencharakteristika geben Hinweise auf ein Bedarfsprofil hinsichtlich des psychologischen Betreuungsbedarfs und eine negative subjektive Erwerbsprognose.Ein Screening mit der Hospital Anxiety and Depression Scale ist geeignet, um die Identifizierung nicht geäußerter psychologischer Betreuungsbedarfe und damit die Zielerreichung der beruflichen Reintegration in der kardiologischen Rehabilitation zu unterstützen.

Background: A high prevalence of poor job satisfaction and high chronic stress is documented for general practitioners (GPs) and non-physician practice staff from various countries. The reasons are multifactorial and include deficits in leadership, communication and workflows. This publicly funded study evaluates the effectiveness of the newly developed participatory, interdisciplinary, and multimodal IMPROVEjob intervention on improving job satisfaction among GPs and practice personnel. Here, we report the baseline characteristics of the participating GPs and practice assistants, focusing on job satisfaction and perceived chronic stress. Methods: The IMPROVEjob study was performed as a cluster-randomised, controlled trial (cRCT) with German GP practices in the North Rhine Region. The IMPROVEjob intervention comprised two leadership workshops (one for practice leaders only; a second for leaders and practice assistants), a toolbox with supplemental printed and online material, and a nine-month implementation phase supported by IMPROVEjob facilitators. The intervention addressed issues of leadership, communication, and work processes. During study nurse visits, participants completed questionnaires at baseline and after nine months follow up. The primary outcome was the change in job satisfaction as measured by the respective scale of the validated German version of the Copenhagen Psychosocial Questionnaire (German COPSOQ, version 2018). Perceived chronic stress was measured using the Trier Inventory of Chronic Stress (TICS- SSCS). Results: Recruitment of 60 practices was successful: 21 were solo, 39 were group practices. At baseline, n = 84 practice owners, n = 28 employed physicians and n = 254 practice assistants were included. The mean age of all participants was 44.4 (SD = 12.8). At baseline, the job satisfaction score in the total sample was 74.19 of 100 (±14.45) and the perceived chronic stress score was 19.04 of 48 (±8.78). Practice assistants had a significantly lower job satisfaction than practice owners (p < 0.05) and employed physicians (p < 0.05). In the regression analysis, perceived chronic stress was negatively associated with job satisfaction (b= −0.606, SE b = 0.082, p < 0.001, ICC = 0.10). Discussion: The degree of job satisfaction was similar to those in other medical professionals published in studies, while perceived chronic stress was markedly higher compared to the general German population. These findings confirm the need for interventions to improve psychological wellbeing in GP practice personnel.

Work environment factors are highly correlated with employees’ health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.