Is a single item stress measure independently associated with subsequent severe injury: a prospective cohort study of 16,385 forest industry employees

Background: A previous review showed that high stress increases the risk of occupational injury by three- to five-fold. However, most of the prior studies have relied on short follow-ups. In this prospective cohort study we examined the effect of stress on recorded hospitalised injuries in an 8-year follow-up.
Methods: A total of 16,385 employees of a Finnish forest company responded to the questionnaire. Perceived stress was measured with a validated single-item measure, and analysed in relation recorded hospitalised injuries from 1986 to 2008. We used Cox proportional hazard regression models to examine the prospective associations between work stress, injuries and confounding factors.
Results: Highly stressed participants were approximately 40% more likely to be hospitalised due to injury over the follow-up period than participants with low stress. This association remained significant after adjustment for age, gender, marital status, occupational status, educational level, and physical work environment.
Conclusions: High stress is associated with an increased risk of severe injury.

La réaction de stress physiologique à la violence au travail

Directeur(s) de thèse : Alain Marchand. M. Sc. Université de Montréal 2015. Comprend un résumé en anglais et en français. Disponible en format Adobe PDF.

Cuidar dos cuidadores : o (des)envolvimento da espiritualidade na prevenção de quadros de stress e burnout

A Humanidade anda cansada, esgotado. Um cansaço que é a soma do fardo de cada um e também parte do fardo de outros. E a Humanidade busca explicações para este cansaço. E quer aliviá-lo. E quer minimizá-lo. Mas busca muito mais que isso. Trata-se, enfim, de buscar não o remédio mas o sentido da própria existência, as respostas adedentro, ou seja, bem no interior do ser humano. O presente trabalho pretende ser uma reflexão – compreender para agir - sobre a busca da dimensão da espiritualidade como possível resposta na prevenção de quadros de stress e burnout. Quem trabalho na área da assistência e na relação de ajuda contínua com pessoas em situação de extrema fragilidade sabe que se não houver um cuidado na reposição de energias, com muita facilidade a pessoa chega a um estado de cansaço e a qualquer momento o turboadrenalina pode queimar. No âmbito da gestão de unidades sociais e bem-estar, cuidar dos cuidadores é a maior e mais nobre missão de qualquer Instituição. Pois, que serviços seriam vivenciados sem as pessoas que formam o corpo e, por isso, a vida de uma Instituição? O caminho da nossa reflexão é orientado para a Comunidade Vida e Paz, como espaço relacional que quer e procura ser um espaço de renovação de vidas – das pessoas sem abrigo – onde, amparadas por um conjunto de Cuidadores, cujo olhar se orienta num trabalho de unificação da pessoa, são imbuídos por uma espiritualidade que se quer colaborante na missão de dignificar cada pessoa e devolvê-la à sua condição original. A pessoa, cada pessoa, é a soma de si, da relação com outros e da relação com o transcendente. Na missão de cuidar, pode a espiritualidade ser ausente? Desta, retiramos um sentido coerente da existência, a verdade do dom e da dádiva e, por isso, uma vida feliz.

Implications of a theoretical framework on stress and burnout for the development of graduate nursing education curricula

This study had two purposes: (a) to develop a theoretical framework integrating and synthesizing findings of prior research regarding stress and burnout among critical care nurses (CCRNs), and (b) to validate the theoretical framework with an empirical study to assure a theory/research based teaching-learning process for graduate courses preparing nursing clinical specialists and administrators.^ The methods used to test the theoretical framework included: (a) adopting instruments with reported validity, (b) conducting a pilot study, (c) revising instruments using results of the pilot study and following concurrence of a panel of experts, and (d) establishing correlations within predetermined parameters. The reliability of the tool was determined through the use of Cronbach's Alpha Coefficient with a resulting range from.68 to.88 for all measures.^ The findings supported all the research hypotheses. Correlations were established at r =.23 for statistically significant alphas at the.01 level and r =.16 for alphas.05. The conclusions indicated three areas of strong correlation among the theoretical variables: (a) work environment stressor antecedents and specific stressor events were correlated significantly with subjective work stress and burnout; (b) subjective work stress (perceived work related stress) was a function of the work environment stressor antecedents and specific stressor events, and (c) emotional exhaustion, the first phase of burnout, was confirmed to be related to stressor antecedents and specific stressor events. This dimension was found to be a function of the work environment stressor antecedents, modified by the individual characteristics of work and non-work related social support, non-work daily stress, and the number of hours worked per week. The implications of the study for nursing graduate curricula, nursing practice and nursing education were discussed. Recommendations for further research were enumerated. ^

The Worsening of the employment and work conditions and its relationship to the self-perceived health in European working population. Relevance and effects of the latest socioeconomic crisis

The recent crisis of the capitalistic economic system has altered the working conditions and occupations in the European Union. The recession situation has accelerated trends and has brought transformations that have been observed before. Changes have not looked the same way in all the countries of the Union. The social occupation norms, labour relations models and the type of global welfare provision can help underline some of these inequalities. Poor working conditions can expose workers to situations of great risk. This is one of the basic assumptions of the theoretical models and analytical studies of the approach to the psychosocial work environment. Changes in working conditions of the population seems to be important to explain in the worst health states. To observe these features in the current period of economic recession it has made a comparative study of trend through the possibilities of the European Working Conditions Survey in the 2005 and 2010 editions. It has also set different multivariate logistic regression models to explore potential partnerships with the worst conditions of employment and work. It seems that the economic crisis has intensified changes in working conditions and highlighted the effects of those conditions on the poor health of the working population. This conclusion can’t be extended for all EU countries; some differences were observed in terms of global welfare models.

Equilíbrios Difíceis: stress laboral, equilíbrio trabalho/família e diferenças de género entre os colaboradores de uma empresa de tecnologias da informação

O stress é não apenas inerente para o ser humano, como indispensável para a sua sobrevivência. À medida que as sociedades humanas evoluíram, assim também se alteraram as principais fontes de stress. Actualmente o stress organizacional é uma das principais áreas de investigação, bem como as suas relações com a família e a vida pessoal. Em foco estão ainda as variáveis individuais que servem como moderadoras da experiência de stress, como o coping e o suporte social. Neste trabalho procurou-se conhecer os níveis de stress experienciados pelos colaboradores da Cisco Systems Lda, identificando diferenças de género e entre os tipos de trabalho. Pretendeu-se ainda relacionar o stress no trabalho com o equilíbrio trabalho/família, equlíbrio vida pessoal/trabalho, suporte social e coping. Através de um estudo não experimental transversal, descritivo/descritivo correlacional, com 42 sujeitos, utilizando o PMI – Pressure Management Indicator, foi possível identificar quatro factores, com α a partir de 0,531 para as variáveis moderadoras ate 0,904 para as variáveis stressoras. Os trabalhadores da amostra trabalham em média 49,7 horas por semana, apontando como principal razão “para que o trabalho seja feito”; 31,7% consideram estar a sofrer de pressão negativa iniciada há mais de 3 meses. Estão muito satisfeitos com a organização, mas sentem pressão devido ao volume de trabalho, ao relacionamento interpessoal e às dificuldades em desligar do trabalho quando em casa, fazendo uso de estratégias focadas no problema e de suporte social. Existem diferenças estatisticamente significativas entre homens e mulheres nas subescalas “Estado de espírito” e “Nível de confiança”, indicando níveis mais altos de segurança e satisfação com o seu estado mental para o grupo dos homens. No que respeita aos tipos de trabalho, foi possível identificar diferenças entre as categorias Sénior gerência/profissional e Manual/hábil nas subescalas “Nível de energia”, “Volume de trabalho” e “Equilíbrio vida/trabalho”. Existe correlação positiva entre as variáveis stressoras e a subescala “Equilíbrio trabalho/família” (r=0,890; p<0,000) e entre as variáveis stressoras e a escala de Coping (r=0,748; p<0,000), sugerindo que níveis de stress elevados interferem com a vida familiar e conduzem a maior utilização das estratégias de coping. Apesar das políticas de recursos humanos da empresa no sentido de promover a conciliação entre trabalho e vida pessoal e familiar, há ainda margem para intervir e melhorar. / Stress is not only inherent to the human being, it’s essential to survival. As the humans societies evolved, so did the major sources of stress. These days, organizational stress is one of the main areas of research, as it is it’s relation with family and personal life. Under the spotlight are also individual variables that moderate the stress experience, such as coping and social support. With this paper, we intended to know the levels of stress experienced by the workers of Cisco Systems Lda, identifying gender and work type differences. We were also intending to relate work stress with home/work balance, life/work balance, social support and coping. Using a cross sectional correlational study, with n=42, using the PMI, we were able to identify four factors, with α starting on 0,531 for moderator variables to 0,904 for stressor variables. The workers on this sample work an average of 49,7 hours per week, naming “to get the job done” as the main reason for it. 31,7% consider to be suffering from negative pressure that started more than 3 months ago. They are very satisfied with the organization, but feel pressure due to workload, interpersonal relationship and the difficulties in switching off from work when at home. They use mostly Problem focus strategies and social support.There are statically significative differences between men and women in the subscales “State of mind” and “Confidence level”, which indicate higher levels of security and satisfaction with their state of mind for men. Regarding work types, we were able to identify differences between senior Management and Manual categories on subscales “Energy level”, “Workload” and “Life/work balance”. There is a positive correlation between stressor variables and the subscales “Home/work balance” (r=0,890; p<0,000) and between stressor variables and Coping scale (r=0,748; p<0,000), suggesting that high levels of stress interfere with family life and lead to higher use of coping mechanisms. Despite the company’s human resources policies to promote the balance between work and personal and family life, there is still place to intervene and improve.

Labour stress in nursing

Based on evidence found during the empirical study we can affirm that the nursing profession is affected by work stress. Objective: Evaluate stress and engagement levels among nurses in health units in Portugal and Spain and describe the stress-generating factors among the surveyed nurses. Methods: A comparative study on a transversal level. Sample of 867 nurses (504 Portuguese, 363 Spanish), female 83.6 % (78.6 % in Portugal, 90.6 % in Spain) and average age of 37. 77.2 % of the Portuguese and 39.4 % of the Spanish nurses work on average 40 hours per week. 60.6 % and 57.7 % of the Spanish and Portuguese respectively have exercised their profession for 10 years. Pamela Gray-Toft’s Nurs- ing Stress Scale (1981) [1] and Schaufeli & Bakker’s Utrecht Work En- gagement Scale (2003) [2] were used. Results: Globally, Portuguese nurses experience higher stress levels although the difference with Spanish nurses is not statistically significant. There are statistically significant differences between Portugal and Spain in “Lack of help from colleagues” and also in the psychological domain in general. Concerning Engagement, there are statistically significant differences in the three dimensions, the p-value of the Student t-test was under 5 %, highlighting that Spanish nurses are more vigorous, dedicated and absorbed by their work. Conclusions: Portuguese nurses perceive more psychological stress and mention having less help from colleagues. Spanish nurses feel more vigorous, dedicated and absorbed by their work.

Engagement and labour stress in nursing

Engagement is a useful concept in the profession of nursing as it focuses on the positive dimension of human behaviour and visualizes the work context as a positive situation. Evaluate the stress and engagement levels on Portuguese and Spanish nurses and analyse the factors related to the stress and engagement levels in the two sample groups. Comparative exploratory study in a quantitative paradigm. Sample of 867 nurses (504 Portuguese, 363 Spanish), female 83.6% (78.6% Portugal, 90.6% Spain) and average age of 37. Portuguese (77.2%) and Spanish nurses (39.4%), work on average 40 hours per week. 60.6% and 57.7% of the Spanish and Portuguese respectively exercise their profession for 10 years. Sociodemographic questionnaire, the Pamela Gray-Toft’s Nursing Stress Scale (1981) and Schaufeli & Bakker’s Utrecht Work Engagement Scale (2003) were used. In what concerns Engagement there are statistically signiicant differences in the three dimensions, the p-value of the t-Student test were under 5%, highlighting the Spanish nurses for being more vigorous, dedicated and absorbed by their work: vigour, dedication and absorption. The sample of Portuguese nurses experience higher stress levels although the difference with Spanish nurses isn’t statistically signiicant. There are statistically signiicant differences between Portugal and Spain in “Lack of help from colleagues” and also in the psychological domain in general. The Spanish nurses feel more vigorous, dedicated and absorbed by their work. The Portuguese nurses perceive more psychological stress and mention having less help from colleagues.

Vulnerabilidade ao stress, estratégias de coping e autoeficácia em professores portugueses

Neste trabalho, apresentamos uma investigação realizada com professores, no qual se procura determinar a vulnerabilidade ao stress ; identificar as principais fontes de stress ; estabelecer as principais estratégias de coping; analisar se as estratégias deste condicionam a presença de stress laboral; e reconhecer se a autoeficácia percebida é preditora desse tipo de stress . Trata-se duma investigação por questionário, do tipo correlacional, e a amostra é constituída por 54 professores do Ensino Básico público português. As respostas ao Questionário sociodemográfico e profissional; ao Questionário de Vulnerabilidade ao Stress — 23QVS (Serra, 2000); ao Questionário de Stress nos Professores — QSP (Gomes et al ., 2006; Gomes, 2007); ao Coping Job Scale — CJS de Latack (adaptação de Jesus & Pereira, 1994); e à Escala de Avaliação de Autoeficácia Geral (Ribeiro, 1995) revelam que 20,4% dos docentes são vulneráveis ao stress ; os comportamentos inadequados/indisciplina dos alunos são as principais fontes de stress ; as estratégias de controlo são as mais utilizadas pelos participantes para enfrentar o stress , seguidas das de escape e das de gestão de sintomas. Os professores não vulneráveis ao stress utilizam principalmente estratégias de controlo e apresentam níveis mais elevados de eficácia perante a adversidade, bem como de iniciativa e persistência em relação aos professores vulneráveis ao stress

Physical and environmental determinants

This chapter describes physical and environmental determinants of the health of Australians, providing a background to the development of successful public health activity. Health determinants are the biomedical, genetic, behavioural, socio-economic and environmental factors that impact on health and wellbeing. These determinants can be influenced by interventions and by resources and systems (AIHW 2006). Many factors combine to affect the health of individuals and communities. People’s circumstances and the environment determine whether the population is healthy or not. Factors such as where people live, the state of their environment, genetics, their education level and income, and their relationships with friends and family, all are likely to impact on their health. The determinants of population health reflect the context of people’s lives; however, people are very unlikely to be able to control many of these determinants (WHO 2007). This chapter and Chapter 6 illustrate how various determinants can relate to, and influence other determinants, as well as health and wellbeing. We believe it is particularly important to provide an understanding of determinants and their relationship to health and illness in order to provide a structure in which a broader conceptualisation of health can be placed. Determinants of health do not exist in isolation from one another. More frequently they work together in a complex system. What is clear to anyone who works in public health is that many factors impact on the health and wellbeing of people. For example, in the next chapter we discuss factors such as living and working conditions, social support, ethnicity and class, income, housing, work stress and the impact of education on the length and quality of people’s lives. In 1974, the influential ‘Lalonde Report’ (Lalonde 1974) described key factors that impact on health status. These factors included lifestyle, environment, human biology and health services. Taking a population health approach builds on the Lalonde Report, and recognises that a range of factors, such as living and working conditions and the distribution of wealth in society, interact to determine the health status of a population. Tackling health determinants has great potential to reduce the burden of disease and promote the health of the general population. In summary, we understand very clearly now that health is determined by the complex interactions between individual characteristics, social and economic factors and physical environments; the entire range of factors that impact on health must be addressed if we are to make significant gains in population health, and focussing interventions on the health of the population or significant sub-populations can achieve important health gains. In 2007, the Australian Government included in the list of National Health Priority Areas the following health issues: cancer control, injury prevention and control, cardiovascular health, diabetes mellitus, mental health, asthma, and arthritis and musculoskeletal conditions. The National Health Priority Areas set the agenda for the Commonwealth, States and Territories, Local Governments and not-for-profit organisations to place attention on those areas considered to be the major foci for action. Many of these health issues are discussed in this chapter and the following chapter.

Coping resources, coping strategies and adaptation to organisational change : direct or buffering effects?

This study examined the effects of personal and social resources, coping strategies and appraised stress on employees' levels of anxiety and depression. In relation to the effects of resources and coping strategies, two different models were tested. The main effects model proposes that, irrespective of the level of stress, coping resources and coping strategies have direct effects on well-being. In contrast, the buffering model predicts that the buffering effects of coping resources and strategies are only evident at high levels of stress. One hundred lawyers completed a structured self-administered questionnaire that measured their personal and social resources, use of problem-focused and emotion-focused coping strategies, and appraisals of the stressfulness of the situation. Results revealed generally strong support for the main effects model in the prediction of employee levels of anxiety and depression. Lower levels of anxiety were linked to judgements of lower levels of organizational change, greater self-confidence, greater internality of control beliefs and less use of emotion-focused coping strategies. Lower levels of depression in employees were also linked to judgements of lower levels of organizational change, greater use of resources and less appraised stress. There was only limited support for the buffering effects model. Due to the small size of the sample, the findings need to be explored further in other contexts.

Residual stresses in rail-ends from the in-service insulated rail joints using neutron diffraction

Insulated rail joints (IRJs) are an integral part of the rail track signaling system and pose significant maintenance and replacement costs due to their low and fluctuating service lives. Failure occurs mainly in rail head region, bolt- holes of fishplates and web-holes of the rails. Propagation of cracks is influenced by the evolution of internal residual stresses in rails during rail manufacturing (hot-rolling, roller-straightening, and head-hardening process), and during service, particularly in heavy rail haul freight systems where loads are high. In this investigation, rail head accumulated residual stresses were analysed using neutron diffraction at the Australian Nuclear Science and Technology Organisation (ANSTO). Two ex-service two head-hardened rail joints damaged under different loading were examined and results were compared with those obtained from an unused rail joint reference sample in order to differentiate the stresses developed during rail manufacturing and stresses accumulated during rail service. Neutron diffraction analyses were carried out on the samples in longitudinal, transverse and vertical directions, and on 5mm thick sliceed samples cut by Electric Discharge Machining (EDM). For the rail joints from the service line, irrespective of loading conditions and in-service times, results revealed similar depth profiles of stress distribution. Evolution of residual stress fields in rails due to service was also accompanied by evidence of larger material flow based on reflected light and scanning electron microscopy studies. Stress evolution in the vicinity of rail ends was characterised by a compressive layer, approximately 5 mm deep, and a tension zone located approximately 5- 15mm below the surfaces. A significant variation of d0 with depth near the top surface was detected and was attributed to decarburization in the top layer induced by cold work. Stress distributions observed in longitudinal slices of the two different deformed rail samples were found to be similar. For the undeformed rail, the stress distributions obtained could be attributed to variations associated with thermo-mechanical history of the rail.