Wellbeing, job satisfaction and commitment among Australian community health workers: the relationship with working conditions

The Australian community health sector has undergone extensive organisational reform in recent times, and, in the push to enhance efficiencies and contain costs, there are indications that these changes may have undermined the wellbeing of community health personnel and their ability to provide high quality illness-prevention services. The aim of this study was to examine the working environments experienced by community health service employees and identify conditions that are predictive of employee stress. The study was guided by a tailored version of the demand-control-support model, whereby the generic components of the model had been augmented by more situation-specific stressors. The results of multiple regression analyses indicated that job control, and, to a lesser extent, social support, were closely associated with the outcome variables (psychological health, job satisfaction and organisational commitment). The more situation-specific stressors also accounted for significant proportions of explained variance. Overall, the results suggest that working conditions, particularly job control, social support and specific job stressors, offer valuable opportunities for protecting and enhancingthe wellbeing of community health service personnel.

Perspectives of a nurse, a social-worker and a psychiatrist, regarding patient assessment in acute inpatient psychiatry settings : a case study approach

This case study explores what informs and organizes the assessment of patients, as undertaken by a nurse, a social worker and a psychiatrist in public, metropolitan, acute mental health service settings. The research data are the transcripts of in-depth interviews with three experienced practitioners, one from each of the three disciplines. The analysis draws on Foucauldian concepts: discourse as constructed through practices of discipline and the gaze. We explored examples of taken-for-granted assessment practices and their interplay with discourse. The findings suggest that participating practitioners use language in assessment in ways that support the powerful discourses of the professional disciplines. The competing discourse of management, associated with industry and economics, is evident in hospital admission processes, dictating the times and places of assessment. Professional and management discourses both effectively marginalize the perspective of another player in assessment, the patient.

International perspectives on psychosocial working conditions, mental health, and stress of dairy farm operators

Dairy farm operators-farmers, workers, and family members-are faced with many demands and stressors in their daily work and these appear to be shared across countries and cultures. Dairy operators experience high psychosocial demands with respect to a hard work and production ethos, economic influences, and social and environmental responsibility. Furthermore, both traditional and industrial farms are highly dependent on external conditions, such as weather, fluctuating markets, and regulations from government authorities. Possible external stressors include disease outbreaks, taxes related to dairy production, and recent negative societal attitudes to farming in general. Dairy farm operators may have very few or no opportunities to influence and control these external conditions, demands, and expectations. High work demands and expectations coupled with low control and lack of social support can lead to a poor psychosocial work environment, with increased stress levels, ill mental health, depression, and, in the worst cases, suicide. Internationally, farmers with ill mental health have different health service options depending on their location. Regardless of location, it is initially the responsibility of the individual farmer and farm family to handle mental health and stress, which can be of short- or long-term duration. This paper reviews the literature on the topics of psychosocial working conditions, mental health, stress, depression, and suicide among dairy farm operators, farm workers, and farm family members in an international perspective.

Associations between Australian early childhood educators’ mental health and working conditions: A cross-sectional study

© 2015, Early Childhood Australia Inc. All rights reserved. EARLY CHILDHOOD EDUCATION and care quality relies on educator capacity; however, working conditions may compromise educators’ mental health. This study examines associations between family day care (FDC) educators’ mental health and working conditions to inform workplace mental health promotion. Three hundred and sixty-six FDC educators completed an online or written survey. In addition to this, regression analyses were used to examine relationships between educator mental health and working conditions. Although many FDC educators had low psychological distress and moderate mental wellbeing, 41.7 per cent reported psychological distress. Most educators’ ‘efforts’ and ‘rewards’ were unbalanced (effort–reward imbalance [ERI] ratio) and showed high ‘overcommitment’ to work. Effort and overcommitment were significantly related to increased odds of psychological distress, whereas social support was associated with higher mental wellbeing. The ERI ratio had the strongest associations with educator psychological distress and mental wellbeing. As many working conditions associated with educator mental health are modifiable, this study highlights opportunities for workplace mental health promotion in FDC.

Provision of control measures for exposure of the hands to wet-working conditions in Australian workplaces

Objective: To analyze the occupational and demographic characteristics for workers participating in the Australian National Hazard Exposure Worker Surveillance (NHEWS) Survey, who reported the provision of various types of workplace control measures for exposure of the hands to wet-working conditions, and to identify the barriers for the provision of controls. Methods: Computer-assisted telephone interviews were conducted with 4500 workers in 2008. Workers were asked about the types of control measures provided to them in the workplace for exposure of the hands to liquids. Results: Workplace size was the strongest predictor for the provision of control measures. Compared to workplaces with fewer than five employees, workers in workplaces with 200 or more employees were more likely to report provision of gloves, barrier creams and moisturizers, labeling and warning, and ongoing training and education about skin care. Conclusion: Smaller workplaces have poorer access to control measures to mitigate exposure to wet work.

Job stress in the law enforcement sector: comparing the linear, non-linear and interaction effects of working conditions

This study addresses a gap in much of the research involving stress among high-risk occupations by investigating the effects of linear, non-linear and interaction models in a law enforcement organization that has undertaken a series of efficiency-driven organizational reforms. The results of a survey involving 2085 police officers indicated that the demand-control-support model provided good utility in predicting an officer's satisfaction, commitment and well-being. In particular, social support and job control were closely associated with all three outcome variables. Although the demand × control/support interactions were not identified in the data, there was some support for the curvilinear effects of job demands. The results have implications for the organizational conditions that need to be addressed in contemporary policing environments where new public management strategies have had widespread affects on the social and organizational context in which policing takes place.

Psychosocial working conditions in a representative sample of working Australians 2001–2008: an analysis of changes in inequalities over time

Background A number of widely prevalent job stressors have been identified as modifiable risk factors for common mental and physical illnesses such as depression and cardiovascular disease, yet there has been relatively little study of population trends in exposure to job stressors over time. The aims of this paper were to assess: (1) overall time trends in job control and security and (2) whether disparities by sex, age, skill level and employment arrangement were changing over time in the Australian working population. Methods Job control and security were measured in eight annual waves (2000–2008) from the Australian nationally-representative Household Income and Labour Dynamics of Australia panel survey (n=13 188 unique individuals for control and n=13 182 for security). Observed and model-predicted time trends were generated. Models were generated using population-averaged longitudinal linear regression, with year fitted categorically. Changes in disparities over time by sex, age group, skill level and employment arrangement were tested as interactions between each of these stratifying variables and time. Results While significant disparities persisted for disadvantaged compared with advantaged groups, results suggested that inequalities in job control narrowed among young workers compared with older groups and for casual, fixed-term and self-employed compared with permanent workers. A slight narrowing of disparities over time in job security was noted for gender, age, employment arrangement and occupational skill level. Conclusions Despite the favourable findings of small reductions in disparities in job control and security, significant cross-sectional disparities persist. Policy and practice intervention to improve psychosocial working conditions for disadvantaged groups could reduce these persisting disparities and associated illness burdens.

Environmental contributions to social and mental health outcomes following pediatric stroke

Mental health and social outcomes following acquired brain injury (ABI) in children are often considered to be due to brain insult, but other factors, such as environment, may also play a role. We assessed mental health and social function in children with chronic illness, with and without stroke (a form of ABI), and typically developing (TD) controls to examine environmental influences on these outcomes. We recruited 36 children diagnosed with stroke, 15 with chronic asthma, and 43 TD controls. Children and parents completed questionnaires rating child mental health and social function and distal and proximal environment. TD children had significantly less internalizing and social problems than stroke and asthma groups, and engaged in more social activities than children with stroke. Poorer parent mental health predicted more internalizing and social problems and lower social participation. Family dysfunction was associated with internalizing problems. Lower parent education contributed to children's social function. Children with chronic illness are at elevated risk of poorer mental health and social function. Addition of brain insult leads to poorer social participation. Quality of home environment contributes to children's outcomes, suggesting that supporting parent and family function provides an opportunity to optimize child mental health and social outcomes.

Relationships between psychosocial working conditions and multiple employee performance measures

 The outcomes of the current study suggest employee performance should be taken into account when examining the effects of stress-related working conditions. Furthermore, the current study highlights the need to pay careful attention to the types of analyses that are undertaken in stressor-performance research and not to assume the relationship between stress-related working conditions and employee performance parallels the stressor-health literature.

Social determinants of health - why we continue to ignore them in the search for improved population health outcomes!

There is now unequivocal evidence that the health status of individuals and of whole communities is socially and economically determined, as are many other aspects of our lives. This suggests, as advocates of public health and population health approaches argue, that our efforts in managing our health and wellbeing should focus much more on early intervention and prevention programs than has been the case to date. However, although this ideology of social and economic determinism is generally accepted, practice does not reflect such values. Indeed, as increasing demand at the critical end of health service provision sees us spending more and more of our limited health care resources on acute and chronic illness, less resources are devoted to constructing and maintaining health-creating communities and environments. Paradoxically, while most of our leaders, academics and policy makers have themselves been nurtured in a sound understanding of cause and effect in the world, they are ignoring these fundamental premises in their approaches to the provision and management of health care. This paper explores some of the reasons why this might be the case and draws on key evidence to suggest that the time has come for us to think more ideologically in approaching health care in the future.

Working with family to promote health adolescent development

In recent years a sea change has occurred in thinking about interventions for families with adolescent children. A range of intervention strategies has been proposed, including parent education, adolescent education, family therapy, and community change. These associations arise, in part, from a higher likelihood sole-parent families will experience traumatic conflict around family breakdown, lack of supervision due to the parent's work pressures, and limited family income resulting in higher exposure to community risk factors, which demonstrated reduced parental drug use and improved family management, and the Strengthening Families Program, which demonstrated increased children's protective factors, reduced substance use in both adolescents and parents, and improved parenting behaviours are currently investigating the impact of an integrated multi-level secondary school intervention, resilient families, which incorporates communication training for students, an information night for parents, sequenced parent education groups, and brief family therapy.

Promoting the social and emotional health of primary school-aged children: reviewing the evidence base for school-based interventions

Schools are key settings for promoting the social and emotional health and well-being of children. This study investigated the effectiveness of interventions to improve the social and emotional well-being of primary school-aged children. The protocol development stage of the proposed systematic review identified related and comparable research reviews, indicating a more useful review of reviews. Eight reviews of intervention effectiveness covering 322 primary studies were reviewed. The majority examined classroom-based interventions. Greater effectiveness results from a sustained focus on the promotion of mental health, on self-esteem and coping outcomes within the broad school climate, and on replicating positive impacts rather than the prevention of mental health problems. Conclusions are limited by short duration of studies, lack of detail of interventions, identified outcomes and socio-demographic data, and the relationship between processes and outcomes. This study has clearly shown how crucial carefully designed studies are in understanding strategies with potential to impact on the mental health and well-being of children.