Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study.

International audience

Psychosocial, musculoskeletal and somatoform comorbidity in patients with chronic low back pain: original results from the Dutch Transition Project

International audience

Evolution of psychosocial factors at work in a French region

International audience

Laparoscopic adjustable gastric banding in adolescents: Results at two years including psychosocial aspects

International audience

Home and group-based implementation of the "Growing Up Happily in the Family" program in at-risk psychosocial contexts

"Growing Up Happily in the Family" is a program to prevent child maltreatment targeted at parents of children aged 0-5 years old in at-risk psychosocial contexts. The program is delivered via either a group-based or a home-visit format. The objective of this study was to evaluate the impact of various implementation components in the home and group versions on changes in parental attitudes about child development and education. At-risk and non at-risk parents participated in the group-based (196 participants in 26 groups) and home-visit (95 participants) versions of the program delivered through local social services. We analyzed program adherence, adaptations, participant responsiveness, quality of delivery, and implementation barriers as predictors of changes in parental attitudes. The results showed that greater program adherence, better quality of delivery and participant responsiveness, and positive climate predicted changes in parental attitudes in both formats. Therefore, it is important to take into account the quality of the implementation process when testing the effectiveness of early group-based and home-visit interventions in at-risk families.

"Family Education and Support" program for families at psychosocial risk: the role of implementation process

This paper analyses the implementation characteristics of the Family Education and Support program, a theory-driven, needs-based, and evidence-based positive parenting program originally developed for the Andalusian family preservation services. The implementation process of 34 trials of the FAF program with 155 participants was analyzed. Cluster analyses were also performed to explore variability in implementation conditions from a comprehensive perspective. Results showed different implementation profiles that moderated the FAF effectiveness (namely lengthier interventions, higher program fidelity, and practitioners' positive perceptions and satisfaction with the program). The relevance of examining implementation process across several trials is discussed in order to distinguish core and non-core FAF components, as well as the need for combining faithful and adaptable implementations that guarantee the ecologic validity of evidence-based positive parenting programs.

Psychosocial stressors perceived in the process of social reintegration and compliance time remaining in prison sentence

Introduction: This study shows the results obtained from evaluating the main psychosocial stressors perceived in the process of social reintegration and their relation to a remaining sentence time in prison. Material and methods: A questionnaire based on an ad hoc design was administered, using a Likert scale, with a total of 383 inmates serving sentences in southeast Spain. Results: Findings show that inmates with a remaining sentence period of more than one year, like those who had served more than a year of their sentence, showed greater concern about possible economic difficulties. Conclusions: The psychosocial stressors studied might provide relevant information to facilitate the process of social reintegration after the completion of a prison sentence.

Morbidity and temporary cycles for the outpatient service at Universidad Estatal a Distancia in Costa Rica

No data has apparently been published on morbidity and outpatient service of faculty and staff of a distance university.  This report presents such data from the Universidad Estatal a Distancia (Costa Rican State University for Distance Education). The participants in this study were the employees who were outpatients between January 15, 2004 and December 15, 2006.  Instead of using a sample, the entire population was studied with a total of 1,526 medical records. Procedure: During the first stage all of the medical records were read and the morbidity data was tabulated.  Subsequently, this information was statistically analyzed using Statgraphics Centurion XV. The main findings were that 50% of the patients used the outpatient service only once during the study period and that most of them were between 20 and 50 years of age.  The days with the most consultations were Mondays, Tuesdays, and Wednesdays.  The number of consultations was relatively stable throughout the year, with a slight increase in June. The three main causes for visiting the service were: upper respiratory tract diseases, muscular-skeletal disorders, and irritated digestive system problems. Main conclusions: Most of the consultations were from the departments with the more faculty and staff members; however, some departments had extremely high or low consultation rates per capita, maybe due to factors such as pathologies that require periodic control, geographical proximity, and psycho-social issues of patients who create a vicious circle due to the somatization of such problems.  The hypothesis that this population’s morbidity rate would differ from the national average because of its high educational level was rejected.  Nevertheless, the hypothesis that there are weekly and yearly cycles was maintained.

The Influence of Neurocognitive Impairment, Alcohol and other Drug (AOD) Use, and Psychosocial Factors on Antiretroviral Treatment Adherence, Service Utilization and Viral Load Among HIV-Seropositive Adults

Among people living with HIV (PLWH), adherence to antiretroviral therapy (ART) can be affected by problems of neurocognitive (NC) impairment, stress, alcohol and other drug (AOD) abuse, and other barriers. The aims of this research were to: (1) examine factors associated with NC impairment, (2) explore relationships between psychosocial variables with ART adherence and viral load (VL), and (3) evaluate the efficacy of an evidence-based intervention in improving ART adherence, increasing service utilization, and decreasing VL. The first study (n=370) was cross sectional and used structural equation modeling to test whether AOD use, years living with HIV, and time from HIV diagnosis to seeking care were associated with poorer NC functioning. The second study (n=246) used similar methods to test the hypothesis that stress, barriers to adherence, NC impairment, poor social support, and AOD use were related to lower VL mediated by ART adherence. The third study (n=243) evaluated an evidence-based, eight-session program to improve ART adherence, reduce VL, and increase service utilization in a randomized controlled trial. Study participants were PLWH living in South Florida, 18 to 60 years old, with a history of alcohol abuse enrolled from January 2009 through November 2012. Secondary analysis of available data showed: (1) scores on interference with executive functioning increased by 0.32 for each day of marijuana use and 1.18 for each year living with HIV, but no association was found between alcohol use and NC functioning; (2) each barrier to adherence was associated with a 10% decrease in adherence to ART and a 0.42 unit increase in VL (log10) and the relationship between barriers and VL was partially mediated by ART adherence; (3) participants in the evidence-based program were more likely than the comparison group to report an undetectable VL (OR=2.25, p Psychosocial factors affect VL, but ART adherence is essential in achieving an undetectable VL in PLWH.

Préférences musicales alternatives et ajustement psychosocial à la fin de l’adolescence : une approche développementale semi-paramétrique

Essai doctoral présenté à la Faculté des études supérieures en vue de l'obtention du grade de Docteur en psychologie (D. Psy,), option clinique

Adolescent’s subjective perceptions of chronic disease and related psychosocial factors: Highlights from an outpatient context study

Background: Adolescents with chronic disease (CD) can be more vulnerable to adverse psychosocial outcomes. This study aims: 1) to identify differences in psychosocial variables (health-related quality of life, psychosomatic complaints, resilience, self-regulation and social support) among adolescents who feel that CD affects or does not affect school/peers connectedness (measured by self-reported participation in school and social activities); and 2) to assess the extent to which psychosocial variables are associated with connectedness in school and peer domains. Methods: A cross-sectional study was conducted in 135 adolescents with CD (51.9% boys), average age of 14 ± 1. 5 years old (SD = 1.5). Socio-demographic, clinical, and psychosocial variables were assessed, using a self-reported questionnaire, which included the Chronic Conditions Short Questionnaire, KIDSCREEN-10 Index, Symptoms Check-List, Healthy Kids Resilience Assessment Module Scale, Adolescent Self-Regulatory Inventory, and Satisfaction with Social Support Scale. Descriptive statistics, GLM-Univariate ANCOVA and Logistic Regression were performed using the IBM Statistical Package for Social Sciences (SPSS), version 22.0. The significance level was set at p < 0.05. Results: Thirteen to eighteen percent of the adolescents felt that CD affected participation at school (PSCH) and participation in leisure time with friends (PLTF). These adolescents presented lower results for all psychosocial study variables, when compared with adolescents who did not feel affected in both areas of participation. From the studied psychosocial variables, the most important ones associated with PSCH (after controlling for age, gender, diagnosis, and education level of father/mother) were self-regulation and psychosomatic health. Concerning the PLTF, social support was the sole variable explaining such association. Conclusions: The present study pointed out the association between psychosocial variables; and living with a CD and school/peers connectedness. The need to focus on the assessment of the effects of a CD on adolescents’ lives and contexts is suggested, as well as on the identification of vulnerable adolescents. Such identification could help to facilitate the maximization of social participation of adolescents with CD, and to plan interventions centered on providing support and opportunities for a healthy youth development. For that purpose, a complex and multifactorial approach that includes clinicians, schools, family, and peers may be proposed.

Management of safety climate and the psychosocial work environment – new challenges for occupational health and safety professionals?

Introduction: The work environment and Occupational Health and Safety (OHS) practice have changed over the last number of years. A holistic OHS approach has been recommended by the authorities in this field (e.g. World Health Organisation (WHO), European Agency for Safety and Health at Work (EU-OSHA) and the International Labour Organisation (ILO)). This involves a unified action engaging elements of the physical and psychosocial workplace with greater focus on prevention and promotion of health and wellbeing. The health and safety practitioner (HSP) has been recognised as one of the main agents for implementation of OHS. Within an organisation they act as a leader of change and a professional who shapes health and safety while safeguarding the wellbeing of individuals at work. Additionally, safety climate (SC) has been developed as an essential concept for OHS of an organisation, its productivity and the wellbeing of its workforce. Scholars and practitioners have recognised the great need for further empirical evidence on the HSP’s role in a changing work environment that increasingly requires the use of preventative measures and the assessment and management of psychosocial work-related risks. This doctoral research brings together the different concepts used in OHS and Public Health including SC, Psychosocial workplace risks, Health Promotion and OHS performance. The associations between these concepts are analysed bearing in mind the WHO Healthy Workplace Framework and three of its main components (physical and psychosocial work environment and health resources). This thesis aims to establish a deeper understanding of the practice and management of OHS in Ireland and the UK, exploring the role of HSPs (employed in diverse sectors of activity) and of SC in the OHS of organisations. Methods: One systematic review and three cross-sectional research studies were performed. The systematic review focussed on the evidence compiled for the association of SC with accidents and injuries at work, clarifying this concept’s definition and its most relevant dimensions. The second article (chapter 3) explored the association of SC with accidents and injuries in a sample of workers (n=367) from a pharmaceutical industry and compared permanent with non-permanent workers. Associations of safety climate with employment status and with self-reported occupational accidents/injuries were studied through logistic regression modelling. The third and fourth papers in this thesis investigated the main tasks performed by HSPs, their perceptions of SC, health climate (HC), psychosocial risk factors and health outcomes as well as work efficacy. Validated questionnaires were applied to a sample of HSPs in Ireland and UK, members of the Institute of Occupational Safety and Health (n=1444). Chi-square analysis and logistic regression were used to assess the association between HSPs work characteristics and their involvement in the management of Psychosocial Risk Factors, Safety Culture and Health Promotion (paper 3). Multiple linear regression analysis was used to determine the association between SC, HC, psychosocial risk factors and health outcomes (general health and mental wellbeing) and self-efficacy. Results: As shown in the systematic review, scientific evidence is unable to establish the widely assumed causal link between SC and accidents and injuries. Nevertheless, the current results suggested that, particularly, the organisational dimensions of SC were associated with accidents and injuries and that SC is linked to health, wellbeing and safety performance in the organisation. According to the present research, contingent workers had lower SC perceptions but showed a lower accident/injury rate than their permanent colleagues. The associations of safety climate with accidents/injuries had opposite directions for the two types of workers as for permanent employees it showed an inverse relationship while for temporary workers, although not significant, a positive association was found. This thesis’ findings showed that HSPs are, to a very small degree, included in activities related to psychosocial risk management and assessment, to a moderate degree, involved in HP activities and, to a large degree, engaged in the management of safety culture in organisations. In the final research study, SC and HC were linked to job demands-control-support (JDCS), health, wellbeing and efficacy. JDCS were also associated with all three outcomes under study. Results also showed the contribution of psychosocial risk factors to the association of SC and HC with all the studied outcomes. These associations had rarely been recorded previously. Discussion & Conclusions: Health and safety climate showed a significant association with health, wellbeing and efficacy - a relationship which affects working conditions and the health and wellbeing of the workforce. This demonstrates the link of both SC and HC with the OHS and the general strength or viability of organisations. A division was noticed between the area of “health” and “safety” in the workplace and in the approach to the physical and psychosocial work environment. These findings highlighted the current challenge in ensuring a holistic and multidisciplinary approach for prevention of hazards and for an integrated OHS management. HSPs have shown to be a pivotal agent in the shaping and development of OHS in organisations. However, as observed in this thesis, the role of these professionals is still far from the recommended involvement in the management of psychosocial risk factors and could have a more complete engagement in other areas of OHS such as health promotion. Additionally, a strong culture of health and safety with supportive management and buy-in from all stakeholders is essential to achieve the ideal unified and prevention-focussed approach to OHS as recommended by the WHO, EU-OSHA and ILO.

Préférences musicales alternatives et ajustement psychosocial à la fin de l’adolescence : une approche développementale semi-paramétrique

Essai doctoral présenté à la Faculté des études supérieures en vue de l'obtention du grade de Docteur en psychologie (D. Psy,), option clinique

Comment les superviseurs agissent-ils pour améliorer l’environnement psychosocial des employés ? Risques visés, leviers et obstacles rencontrés

Au cours des dernières décennies, le monde du travail a subi de grands bouleversements qui se manifestent aujourd’hui par une augmentation des problèmes de santé psychologique en milieu de travail. Pour prévenir les problèmes de santé mentale au travail, il est désormais reconnu que les interventions préventives visant à modifier l’organisation du travail et, par la même occasion, les différentes contraintes de l’environnement psychosocial (EPS) de travail sont les plus efficaces. Dans le cadre de ces interventions organisationnelles, les superviseurs jouent un rôle crucial pour agir en prévention auprès des employés, notamment en raison de leur position centrale au sein de la hiérarchie organisationnelle. Leurs comportements ainsi que leurs actions peuvent donc avoir un impact aussi bien positif que négatif sur l’environnement psychosocial de leurs subordonnés. Toutefois, les superviseurs sont également soumis à des conditions de travail difficiles, telles qu’une charge de travail élevée ou de longues heures de travail consécutives, par exemple. Face à un tel paradoxe, il est pertinent d’approfondir les connaissances concernant ce qu’il leur est possible de faire pour améliorer l’EPS de leurs subordonnés et comment ils s’y prennent. Ainsi, le présent mémoire cherche à répondre à la question de recherche suivante : Comment les superviseurs agissent-ils pour améliorer l’EPS du travail des employés? Cette étude vise à documenter les risques visés par les actions entreprises par les superviseurs ainsi que les leviers et les obstacles qu’ils rencontrent. Afin de comprendre comment les déterminants de l’ensemble du milieu de travail influencent l’action des superviseurs sur l’EPS des employés, les résultats de cette recherche, provenant de quatre entretiens collectifs tenus dans deux municipalités de tailles différentes et impliquées dans la démarche « Entreprise en santé », ont été examinés sous l’angle du modèle théorique de l’activité réelle de travail, utilisé en ergonomie. Un répertoire de 33 types d’actions favorables à l’amélioration de l’EPS des employés a été obtenu, permettant de comprendre comment les superviseurs opérationnalisent les principes de prévention. La latitude décisionnelle est d’ailleurs le facteur de risque sur lequel le plus de participants ont rapporté au moins une action. En tout, 23 leviers ainsi que 34 obstacles ont été rapportés. L’utilisation de la marge de manoeuvre par les superviseurs est ressortie comme un moyen important de pallier leur manque de latitude décisionnelle formelle. Pour conclure, cette étude met en évidence que les interventions organisationnelles visant la prévention en santé mentale doivent être adaptées au contexte organisationnel (climat organisationnel, changements à l’organisation du travail, ressources et contraintes des acteurs). Il a aussi été constaté que les superviseurs récupèrent les occasions de changement à l’organisation du travail pour y intégrer leurs objectifs de gestion des risques à la santé mentale, même s’ils ont été initiés dans un autre but (souvent pour des motifs économiques). Notre étude met également en lumière que pour agir positivement sur l’EPS des employés, les superviseurs doivent avoir de la latitude décisionnelle ainsi que de la marge de manoeuvre, être soutenus et formés adéquatement.