The Life Course Determinants of Vulnerability in Late Careers

Late career is often seen as a more vulnerable life-stage in the labour market, in which workers may experience a deterioration in job quality. Using a life course perspective and longitudinal data, this article analyses the vulnerability associated with late career by focusing on four occupational dimensions: working-time, career continuity, retirement timing and income change. The research is carried out using data from Switzerland, a country where the age profile of the labour force is an increasing issue. The paper also adopts a cumulative disadvantage perspective to examine the impact of previous work and family life experiences on work life vulnerability at older age. Our data come from the Survey of Health, Ageing and Retirement in Europe (SHARELIFE). The paper uses cluster analysis, sequence analysis and ordered logistic regression. Results show that women with previous family responsibilities resulting in long-term unemployment or caring, often with health complications, are more likely to be vulnerable to deterioration in job quality in late career. This suggests that experiences in the last period of the working life may be just as gendered as earlier periods.

Symptoms of chronic stress at work in NGO workers

Working in a NGO often involves providing life saving resources (food, medicine, equipment, water, etc) to needy populations around the globe. Such duty requires highly dedicated employees and humanitarian workers are said to face a hign degree of pressure in their daily work. Despite the evidence of taxing work demands, and a high potential for stress related problems, very few studies on occupational chronic stress have specifically looked at NGO workers. Assuming that "field stress" can relay to workers at headquarters, we carried out an exploratory study about occupational health among employees of a NGO's headquarters. We sent a questionnaire to all employees (N=130) of a NGO headquarters located in Switzerland. We used the TST questionnaire (French version of the Langner's questionnaire on psychiatric symptoms) to identify cases with potential mental health problems. We also included in the questionnaire some items about motivation, acknowledgment, work-life balance, job demand, and autonomy. A total of 75 employees answered our questionnaire (57% response rate). 44% of our sample were men (n=33) and 56% were women (n=42). The mean age was of 40 years (SD=7.6). 56% were working at the headquarters of the NGO in questions as of 2 years or less. Not surprisingly, a majority of respondents reported to be highly motivated (74%) and the meaning of work was important for 80% of them. However, 35% indicated having problems in conciliating their private and professional life. Most frequent reported symptoms included feeling "weak all over" (81%), having "trouble getting asleep often" (35%), "clogging in nose" (35%), feeling "nervous often" (33%), and "memory not all right" (33%). The score for psychiatric symptoms was high in 8 (11%) employees whose health might therefore be at risk. In comparison, other sudies showed that this proportion was 9% for French teachers and 16% for sales personnel1. Results show that symptoms of mental health problems do occur among NGO workers. Some of these symptoms are known to be linked to occupational stress. Chronic stress manifests itself first in non-specific symptoms (e.g. fatigue) and later in specific pathologies. This could explain the relatively low proportion of cases with a high score in Langner's scale than was expected. Therefore, we hypothesize a healthy worker effect. The fact that our sample is 40 years old in average, and that the turnover is quite high can also support this hypothesis. Further research is needed in order to better understand occupational stress in this specific population. An upcoming study will investigate the role of organizational factors associated with health complaints. Therefore, a longitudinal survey including quantitative and qualitative methods is appropriate.

The Articulation of Different Life Domains among Female Senior Managers and Their Subjective Well-Being : Focusing on Meaning Constructions in Everyday Life

Work-life issues have become a major concern across Western societies with the objective to promote women's careers and well-being. However, despite growing attempts to increase the number of women in senior management positions in European countries, such as Switzerland, they remain highly underrepresented. Inspired from the cultural approach in psychology, this article focuses on these women's concrete everyday life to understand how they articulate different life domains and how this influences their subjective well-being. A narrative approach based on reflexivity is adopted to analyze women's activity. Results show meaning intertwinements between life priorities that are often conflicting. Two psychological functions are identified: the feeling of control and the letting go of control. Each of these contributes to women's subjective well-being through the use of diversified supports, but their structuring roles appear only in relation to one another. Results are discussed in the light of existing literature and of their implications.

Le médecin de famille de demain [Tomorrow's family doctor].

The profession of family doctor will undergo profound changes in the coming decade due to external, political, demographic and societal developments. Changes will also occur from within the profession affecting its content and its functioning. Other influences, in addition to generational developments (reduced working hours, feminisation, revaluation of the work-life balance), will come from collaboration with new professions, news structures as well as technical and human progress. In this transitional period it is important to uphold core values of family medicine, in particular coordination, continuity of care and the global approach to patients. In training future family doctors we must both prepare them for new skills and roles, and continue to share the core values with them.

Burnout and associated factors in employees of a Swiss teaching hospital

Background Working in a teaching hospital is a highly stressful occupation, which can lead to burnout. The consequences of burnout in health professionals can be very serious, both for themselves and patients. The aim of this cross-sectional study was to assess the extent of burnout and associated factors in hospital employees. Methods In the Fall of 2007, all employees of a Swiss teaching hospital were invited to complete a job satisfaction survey. It included the work-related burnout scale (scored 0-100) of the Copenhagen Burnout Inventory (CBI-French version), measuring the degree of physical and psychological fatigue and exhaustion perceived as related to the person's work; a high degree of burnout was defined as a score _50. Logistic regression analyses were used to determine factors associated with a high degree of burnout. Results A total of 4575 individuals returned the questionnaire (response rate 54%). Of them, 1503 (33%) had a high degree of burnout. The rate of burnout was higher among women (34.3% versus 30.5%, P = 0.012) and respondents younger than 40 years (37.7% versus 28.6%, P < 0.001). Executives were less prone to burnout than employees (27.1% versus 33.9%, P < 0.0019). Rates of burnout differed by profession: nurses and physicians had higher rates than administrative and logistic staff (42.8% and 37.4% versus 25.6% and 20.9%, respectively P < 0.001). Burnout was inversely associated with job satisfaction. In multivariate analysis, factors associated with burnout were overall dissatisfaction (OR 3.23; 95% CI 2.66-3.91), dissatisfaction with workload (OR 2.09; 95% CI 1.74-2.51) and work-life balance (OR 2.25; 95% CI 1.83-2.77), being a woman (OR 1.56; 95% CI 1.28-1.90), working fulltime (OR 1.41; 95% CI 1.08-1.85) and working as a nurse, a physician or in the psychosocial sector. Conclusions One-third of respondents, mostly nurses and physicians, experienced burnout and had lower levels of job satisfaction. The factors associated with burnout may help to tailor programmes aiming at reducing burnout at both the individual and organizational level within the hospital.

L'insertion sociale plurielle des femmes cadres supérieurs en Suisse : contribution à l'étude du bien-être subjectif au quotidien : approche qualitative intégrative

RESUME« L'insertion sociale plurielle des femmes cadres supérieurs en Suisse. Contribution à l'étude du bien-être subjectif au quotidien. Approche intégrative qualitative. »Depuis une quarantaine d'années, nombreux sont les travaux qui étudient les relations entre les différents milieux de vie au quotidien et, plus particulièrement, l'impact de leurs articulations singulières sur la santé. Nous y identifions deux axes principaux : l'un aborde ce phénomène selon une perspective de « conflit travail-famille » en termes de « stress », l'autre se focalise davantage sur la promotion du « bien-être » au travers d'une approche d'« équilibre travail-vie ». Or, l'ensemble de ces recherches considère comme «pathogènes» les désajustements, les contradictions et les tensions vécus au quotidien. Selon cette tendance, le « bien-être » apparaît comme un état d'équilibre ultime indépendant du contexte de vie du sujet. Toutefois, peu de recherches portent sur la dimension située du bien-être dans son rapport à l'activité concrète au sein des milieux deNotre étude s'intéresse à cette question auprès des femmes cadres supérieurs, selon une perspective critique et développementale en psychologie de la santé (Lyons & Chamberlain, 2006 ; Santiago-Delefosse, 2002,2011 ; Malrieu, 1989 ; Vygotski, 1985). En effet, cette population constitue un terrain privilégié pour comprendre le sens donné à l'activité à partir des contraintes, responsabilités et demandes perçues dans des contextes parfois contradictoires, et pour analyser le rôle de ces derniers dans un bien-être subjectif.En cohérence avec notre positionnement théorique, nous avons mené des entretiens qualitatifs focalisés sur l'activité quotidienne auprès de 20 femmes, et ceci en deux temps (T1-T2) (40 entretiens). Les résultats issus des analyses du contenu des discours permettent de définir le vécu de l'articulation des milieux de vie chez nos participantes, selon trois axes à la fois interdépendants et autonomes. Chaque axe se définit par une série de supports spécifiques jouant un rôle structurant dans leur bien-être subjectif. Ainsi, le premier axe se caractérise par des supports de maîtrise subjective, ainsi que par l'appropriation de contraintes sociales et corporelles, selon un rythme de l'activité soutenu. Le deuxième s'accompagne de supports qui favorisent la prise de distance au travers du relâchement du rythme et du lâcher prise de la maîtrise, par la création d'espaces personnels et sociaux « pour soi ». Enfin, le troisième porte sur le positionnement de soi par rapport à autrui en termes de « personnalisation ».Construits en rapport à la corporéité et à autrui au sein de contextes spécifiques, ces différents supports prennent leur sens au sein d'un système de pratiques global, unique pour chaque femme. Selon cette conception critique, le bien-être subjectif chez les femmes cadres se définit comme le fruit d'un processus mouvant issu des tensions vécues entre les trois axes de l'articulation des milieux de vie. Il est par conséquent social, corporel et psychologique.Nos résultats ouvrent des perspectives de recherche et d'intervention, notamment en santé et travail. Ces ouvertures sont orientées vers une approche intégrative en psychologie de la santé, c'est-à-dire, de la prise en compte dans des questions de santé et de bien-être du processus de construction du sujet en relation à son insertion sociale plurielle.ABSTRACT« Plural social participation among women senior managers in Switzerland. Contribution to the study of subjective well-being in everyday life. An integrative and qualitativeapproach.»For the last forty years, a large body of literature has studied the relationships between different social realms in everyday life and, more particularly, the impact of their singular intertwinements with health. We identify two main trends : The first one focuses on this phenomenon through the « work-family conflict » perspective in terms of « stress » whilst the second one is more concerned by the promotion of « well-being » through a « work-life balance » approach. However, both of these trends consider disadjustments, contradictions and tensions in everyday life as « pathogenic ». According to this conception, « well- being » appears as an ultimate state of balance which is indépendant from the subject's life context. Nevertheless, few studies have examined the situated dimension of well-being in its link to concrete activity in social realms.Our research is concerned with this issue among women senior managers from a critical and developmental perspective in Health Psychology (Lyons & Chamberlain, 2006 ; Santiago-Delefosse, 2002, 2011 ; Malrieu, 1989 ; Vygotski, 1985). In fact, this population represents a favourable field so as to study : how the meaning of daily activity is constructed accross different and often conflictive social realms ; to understand the many ways in which this population deals with perceived constraints, responsibilities and requests, and to analyse the role of situated plural activity in subjective well-being.Consitent with our theoretical framework, we have designed a qualitative method. We have conducted two-time (T1-T2) interviews with 20 women by focusing on their daily activity (40 interviews). The Thematic Content Analysis reveals that four different social realms are articulated among our participants through three main axes, which are at the same time interdependent and autonomous. Each one of these axis is defined by a certain number of specific supports that play an important role in these women's subjective well- being. The first axis is concerned by several supports that signify a « feeling of control » along with the appropriation of social and body constraints by means of a rapid pace of activity. The second one regards the use of supports that contribute to « put things into perspective » by means of the slowing down of the pace of activity and through letting go of the feeling of control. This mechanism includes the creation of personal and social spaces of « one's own ». The third axis is defined by the positioning of the self in regard to others through a process of « personnalization ».Developed in specific contexts through the intertwinnements between the body and social others, supports belonging to these axes acquire significance and meaning on the basis of their relationship to a global system of activities of which they are part. However, this articulation is uniquely defined for each participant. According to this critical approach, subjective well-being among women senior managers emerges as a meaningful and changing process, situated in a plural social context. This is, it appears as the result of conflictual interactions defining the three different axis that we have identified. Subjective well-being is hence a social, embodied and psychological phenomena that is closely linked to the articulation of different social realms. Our findings open new research and practice perspectives, especially concerning health and work issues. These perspectives convey an integrative approach in Health Psychology by considering health and well-being by taking into account the process of construction of the subject in regard to his or her plural social participation.

Attitudes Toward Organizational Change among Public Middle Managers

Positive attitudes toward change (PATC) are an important current issue in public organizations facing profound financial and managerial reforms. This study aims to identify social and organizational antecedents of PATC. The investigated population is composed of middle managers working in Swiss public hospitals (N = 720), which are currently being confronted by major reforms. Partial mediation effects of organizational commitment (OC) in the relationships between independent variables and PATC are also controlled. The findings show that perceived social support (work relationships with colleagues and supervisors) as well as perceived organizational support (employee voice and participation, information and communication, work-life balance) are positively and significantly related to PATC. Stress perception is shown to have a negative impact on PATC. This article provides valuable contributions with respect to antecedents of attitudes toward change in a population of public middle managers.

Work and health : remodelling perspectives of working life research, as proposed by Järvholm et al. (2009)

Järvholm and Co-workers (2009) proposed a conceptual model for research on working life. Models are powerful communication and decision tools. This model is strongly unidirectional and does not cover the mentioned interactions in the arguments.With help of a genealogy of work and of health it is shown that work and health are interactive and have to be analysed on the background of society.Key words: research model, work, health, occupational health, society, interaction, discussion paperRemodellierung der von Järvholm et al. (2009) vorgeschlagenen Forschungsperspektiven in Arbeit und GesundheitJärvholm und Kollegen stellten 2009 ein konzeptionelles Modell für die Forschung im Bereich Arbeit und Gesundheit vor. Modelle stellen kraftvolle Kommunikations- und Entscheidungsinstrumente dar. Die Einflussfaktoren im Modell verlaufen jedoch nur in einer Richtung und bilden die interaktiven Argumente im Text nicht ab. Mit Hilfe einer Genealogie der Begriffe Arbeit und Gesundheit wird aufgezeigt, dass Arbeit und Gesundheit sich gegenseitig beeinflussen und nur vor dem Hintergrund der jeweiligen gesellschaftlichen Kontextfaktoren zu analysieren sind.Introduction : After an interesting introduction about the objectives of research on working life, Järvholm and Co-workers (2009) manage to define a conceptual model for working life research out of a small survey of Occupational Safety and Health (OSH) definitions. The strong point of their model is the entity 'working life' including personal development, as well as career paths and aging. Yet, the model Järvholm et al. (2009) propose is strangely unidirectional; the arrows point from the population to working life, from there to health and to disease, as well as to productivity and economic resources. The diagram only shows one feed-back loop: between economic resources and health. We all know that having a chronic disease condition influences work and working capacity. Economic resources have a strong influence on work, too. Having personal economic resources will influence the kind of work someone accepts and facilitate access to continuous professional education. A third observation is that society is not present in the model, although this is less the case in the arguments. In fact, there is an incomprehensible gap between the arguments brought forth by Järvholm and co-workers and their reductionist model.Switzerland has a very low coverage of occupational health specialists. Switzerland is a long way from fulfilling the WHO's recommendations on workers' access to OSH services as described in its Global plan of action. The Institute for Work and Health (IST) in Lausanne is the only organisation which covers the major domains of OSH research that are occupational medicine, occupational hygiene, ergonomic and psychosocial research. As the country's sole occupational health institution we are forced to reflect the objectives of working life research so as not to waste the scare resources available.I will set out below a much shortened genealogy of work and of health, with the aim of extending Järvholm et al's (2009) analyses on the perspectives of working life research in two directions. Firstly towards the interactive nature of work and health and the integration of society, and secondly towards the question of what working life means or where working life could be situated.Work, as we know it today - paid work regulated by a contract as the basis for sustaining life and as a base for social rights - was born in modern era. Therefore I will start my genealogy in the pre-modern era, focus on the important changes that occurred during industrial revolution and the modern era and end in 2010 taking into account the enormous transformations of the past 20-30 years. I will put aside some 810 years of advances in science and technology that have expanded the world's limits and human understanding, and restrict my genealogy to work and to health/body implicating also the societal realm. [Author]