Women's occupational health: a critical review and discussion of current issues

Action to improve women's occupational health has been slowed by a notion that women's jobs are safe and that any health problems identified among women workers can be attributed to unfitness for the job or unnecessary complaining. With increasing numbers of women in the labor force, the effects of work on women's health have recently started to interest health care providers, health and safety representatives and researchers. We begin our summary of their discoveries with a discussion of women's place in the workplace and its implications for occupational health, followed by a brief review of some gender-insensitive data-gathering techniques. We have then chosen to concentrate on the following four areas: methods and data collection; directing attention to women's occupational health problems; musculoskeletal disease; mental and emotional stress. We conclude by pointing out some neglected occupational groups and health issues.     

Integrating mental health services into primary medical care

Primary care clinicians occupy a strategic position in relation to the emotional problems of their patients. Integrating mental health and primary medical services promotes available, coordinated, accessible, and less stigmatizing treatment by recognizing an indivisibility of the total person in illness and in health. Federal efforts to encourage Health Maintenance Organization (HMO) development as part of a national health program prompts serious attention to organizational arrangements for developing such an integrated program for medical-mental health care. We have found a team collaborative model in which mental health providers are members of a primary care team to be useful and promising. Supportive services are provided on a continuing basis through patterned relationships. Shared responsibility for patient care between physicians, nurse practitioners, physician assistants, and mental health workers provides built-in peer review and encourages intrateam consultation.     

Treatment of open tibial fracture with Ender nail

This study was designed to examine the burnout symptoms among nurses in different settings, differing by specialty, age, gender, number of years on the job, and place of work, in the People's Republic of China. A total of 1,100 nurses completed the Maslach Burnout Inventory. Burnout symptoms in nurses were related to setting, specialty, age, gender, place of work, and number of years on the job. The findings suggest that the physical features in clinics and in obstetrics and gynecology departments should be improved and that social and public health support systems, as well as stress management skills, should be offered to new nurses in order to improve their ability to cope with stress and to improve the quality of care for patients.     

Psychosocial safety climate: Development of the PSC-12.

Psychosocial risks in the workplace have the potential for causing psychological and social harm that contributes toward the mental health disability burden. Psychosocial risks are influenced by macrolevel factors such as the psychosocial safety climate within the organization. This paper concerns the development and evaluation of a short instrument to measure psychosocial safety climate (PSC). PSC is conceived as an up-stream resource, and concerns senior management values and attitudes toward care and practices in relation to employee psychosocial well being. In a pilot sample (N = 78) we used an iterative procedure incorporating regression analysis to reduce 26 items down to a parsimonious 12 item, four-factor scale (PSC-12). The PSC-12 was then assessed using confirmatory factor analysis and the scale validated in a second representative sample of Australian workers (N = 398). The PSC-12 showed expected relationships with psychosocial risk factors (e.g., job demands, job resources), worker engagement and health, and work related outcomes (e.g., job satisfaction). We further confirmed the invariance of the factor coefficients and factor covariance across the two multioccupational samples using multigroup analysis. In a third organizational study (N = 16 teams, 106 health care workers) we found that PSC showed group like psychometric properties, and team level PSC was associated with individual level psychological distress and work engagement. PSC showed incremental value beyond a physical safety measure. The results provide initial indications that the PSC-12 can be used across a range of occupations, and within organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emergency medical services for children: Beyond lights and sirens.

This article describes the history of emergency medical services for children and identifies important mental health issues. It discusses the roles of psychologists in such services, including intervening with children and their families during times of crisis, helping others who are providing the physical care of children to mitigate rather than exacerbate children's emotional distress, and attending to the emotional needs of health care providers who treat children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of job satisfaction, sources of stress and psychological symptoms among general practitioners in Leeds

BACKGROUND: The past seven years have seen rapid changes in general practice in the United Kingdom (UK), commencing with the 1990 contract. During the same period, concern about the health and morale of general practitioners (GPs) has increased and a recruitment crisis has developed. AIM: To determine levels of psychological symptoms, job satisfaction, and subjective ill health in GPs and their relationship to practice characteristics, and to compare levels of job satisfaction since the introduction of the 1990 GP contract with those found before 1990. METHOD: Postal questionnaire survey of all GP principals on the Leeds Health Authority list. The main outcome measures included quantitative measures of practice characteristics, job satisfaction, mental health (General Health Questionnaire), and general physical health. Qualitative statements about work conditions, job satisfaction, and mental health were collected. RESULTS: A total of 285/406 GPs (70%) returned the questionnaires. One hundred and forty-eight (52%) scored 3 or more on the General Health Questionnaire (GHQ-12), which indicates a high level of psychological symptoms. One hundred and sixty GPs (56%) felt that work had affected their recent physical health. Significant associations were found between GHQ-12 scores, total job satisfaction scores, and GPs' perceptions that work had affected their physical health. Problems with physical and mental health were associated with several aspects of workload, including list size, number of sessions worked per week, amount of time spent on call, and use of deputizing services. In the qualitative part of the survey, GPs reported overwork and excessive hours, paperwork and administration, recent National Health Service (NHS) changes, and the 1990 GP contract as the most stressful aspects of their work. CONCLUSIONS: Fifty-two per cent of GPs in Leeds who responded showed high levels of psychological symptoms. Job satisfaction was lower than in a national survey conducted in 1987, and GPs expressed the least satisfaction with their hours, recognition for their work, and rates of pay. Nearly 60% felt that their physical health had been affected by their work. These results point to a need to improve working conditions in primary care and for further research to determine the effect of any such changes.     

How does service workers’ behavior affect their health? Service climate as a moderator in the service behavior–health relationships.

To address the question of whether providing high-quality service deteriorates or benefits workers’ health, a contingency model was tested that focused on service climate as a moderator. This interacts with service behavior to affect workers’ perceptions of emotional exhaustion, hence their physical and mental health. Findings of this study with 328 nurses from 66 nursing units indicated that congruent conditions of service climate and behaviors benefited workers’ health, whereas incongruent conditions affected it adversely. The findings are discussed in light of stress, and emotion–work perspectives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Role of Acceptance and Job Control in Mental Health, Job Satisfaction, and Work Performance.

Acceptance, the willingness to experience thoughts, feelings, and physiological sensations without having to control them or let them determine one's actions, is a major individual determinant of mental health and behavioral effectiveness in a more recent theory of psychopathology. This 2-wave panel study examined the ability of acceptance also to explain mental health, job satisfaction, and performance in the work domain. The authors hypothesized that acceptance would predict these 3 outcomes 1 year later in a sample of customer service center workers in the United Kingdom (N = 412). Results indicated that acceptance predicted mental health and an objective measure of performance over and above job control, negative affectivity, and locus of control. These beneficial effects of having more job control were enhanced when people had higher levels of acceptance. The authors discuss the theoretical and practical relevance of this individual characteristic to occupational health and performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Workers' perceptions of how jobs affect health: A social ecological perspective.

A national sample of 2,048 workers was asked to rate the impact of their job on their physical and mental health. Ordered logistic regression analyses based on social ecology theory showed that the workers' responses were significantly correlated with objective and subjective features of their jobs, in addition to personality characteristics. Workers who had higher levels of perceived constraints and neuroticism, worked nights or overtime, or reported serious ongoing stress at work or higher job pressure reported more negative effects. Respondents who had a higher level of extraversion, were self-employed, or worked part time or reported greater decision latitude or use of skills on the job reported more positive effects. These findings suggest that malleable features of the work environment are associated with perceived effects of work on health, even after controlling for personality traits and other sources of reporting bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Job strain, social support and mental health: a study on the male heavy manufacturing workers

OBJECT: The aim of this study is to explore the influence of work experience on workers' psychological function. Specifically, the researchers will examine the effect of job demand, decision latitude, job strain, and social support at worksite on the mental health status of male heavy manufacturing workers. METHOD: By purposive sampling, from October 1994 to March 1995, the present investigators implemented a self-administered questionnaire survey on the workers in southern Taiwan. The Karasek job strain model and its measure were embedded in the questionnaire to evaluate workers' perceptions of their job conditions. In addition, Chinese Health Questionnaire (CHQ) was utilized to evaluate the workers' status of mental health. RESULT: Totally, 1,117 workers were selected for this survey. An unviriate analysis showed the younger the workers, the lower their monthly income, and the newer their employment, were more likely to be classified as high risk in mental health status. The workers with more decision latitude and higher social support would be better in mental health status. In addition, it also showed that workers under high job strain were more likely to be in poor mental health status. Result from multivariate logistic regression showed those who served longer, had more decision automony, and had higher social support, were less likely to be in poor mental health status. Instead, those who sustained high job strain were more likely to be in poor mental health status. DISCUSSION: The implication from those findings for the implementation of health promotion program. would be raised, and the limitation of this inference would also be discussed.     

Professional psychology in state correctional institutions: Present status and alternate futures.

Current (1978) and projected (1985) patterns for the employment of psychologists and other mental health personnel in state correctional institutions are compared to professional and judicial standards for mental health manpower. Professional standards posited by the American Correctional Association see the psychologist and social worker as the principal agents of mental health care in the nation's prisons. Against these standards, severe shortages of psychologists are observed in the prisons, and an increase in the psychological work force of 245% will be required for prisons by 1985. Judicial standards set forth in the Pugh v. Locke decision of 1976 place emphasis in mental health care delivery on subprofessionals and paraprofessionals. Against these standards, a current shortage in the psychological work force is of negligible magnitude, and an increase of only 36% is required against 1985 projections. Speculations are offered about future mental health staffing needs under varying sets of judicial and legislative decisions. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Combined somatic and psychiatric care—Effects on personnel treating drug addicts with infectious diseases.

Infectious disease care, psychiatric care of drug addicts, and social care were combined in a ward for drug addicts with infectious diseases. The aim of this study was to evaluate the effects on the personnel (n?=?22). One ward with infectious disease care of HIV and AIDS patients (n?=?24) and another with nonsomatic care of drug addicts (n?=?18) were selected to make comparisons possible. The questionnaire concerned psychosocial work environment and health. The personnel at the new ward also participated in a semistructured interview. The personnel at the special ward experienced a significantly higher degree of emotional exhaustion and lack of ability to concentrate than the comparison groups. They also reported a higher degree of lack of clarity, more job strain, and more difficulties due to demands from patients. The combined care is probably associated with heavier psychological burdens than other forms of care. In spite of this, the personnel experienced their work as meaningful and mentally stimulating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing community capacity to treat post-deployment mental health problems: A public health initiative.

Meeting the mental health needs of Veterans returning from recent deployment requires the coordinated effort of partnerships across Department of Defense (DoD), Department of Veterans Affairs (VA), and state and local communities. Although the proportion of Veterans of Iraq and Afghanistan who have accessed VA health care has grown, the majority of these new combat Veterans have yet to present for VA care. The stigma associated with reporting a deployment-related mental health problem may be one factor in this, but access to treatment may also be an important concern among the one third of American Veterans who live in rural or highly rural areas. As these Veterans are more likely to present to a primary care, faith-based or mental health provider in their own community, partnerships between community providers, DoD, and VA are of critical importance in ensuring appropriate care, regardless of treatment setting. In an effort to improve services and access to services, especially to rural Veterans, an educational public health initiative was created to educate community providers about military culture, deployment-related mental health issues, VA resources, and evidence-based treatments. We describe the development, dissemination and evaluation of this initiative, as well as lessons learned for future similar endeavors. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Behavioral health in the pediatric primary care setting: Needs, barriers, and implications for psychologists.

Pediatric primary care providers (PPCPs) are increasingly being called on to assess children and adolescents for emotional and behavioral disorders, as well as to manage their care. The authors present the results of a survey of PPCPs regarding their comfort in assessing or diagnosing and treating or managing 19 emotional and behavioral problems, their expectations of how reasonable it is for PPCPs to assess and treat disorders, the actions they would take, barriers they face, and interest in developing formal relationships with mental health specialists. The authors discuss implications and opportunities for psychologists. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Academic Stress Among College Students: Comparison of American and International Students.

This study compared academic stressors and reactions to stressors between American and international students using Gadzella's Life Stress Inventory (B. M. Gadzella, 1991). Five categories of academic stressors (i.e., frustrations, conflicts, pressures, changes, and self-imposed) and four categories describing reactions to these stressors (i.e., physiological, emotional, behavioral, and cognitive) were examined. The sample consisted of 392 international and American students from 2 Midwestern universities. American students reported higher self-imposed stressors and greater behavioral reactions to stressors than international students. Respondent's status (American or international) and interaction of status and stressors emerged as the 2 strongest predictors of their behavioral, emotional, physiological, and cognitive reaction to stressors. Five stressors attained statistical significance in the regression model. The findings emphasize the need to recognize cultural differences in stress management. Implications for mental health providers in the university arena are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A within-subject longitudinal study of the effects of positive job experiences and generalized workplace harassment on well-being.

Drawing on the mobilization-minimization hypothesis, this research examines the influence of positive job experiences and generalized workplace harassment (GWH) on employee job stress and well-being over time, postulating declines in the adverse influence of GWH between Time 1 and 2 and less pronounced declines in the influence of positive job experiences over this same timeframe of approximately one year. A national sample of 1,167 workers polled via telephone at two time periods illustrates that negative job experiences weigh more heavily on mental health than do positive job experiences in the short-term. In the long-term, GWH's association with mental health and job stress was diminished. But its effects on job stress, and mental health, and physical health persist over one year, and, in the case of long-term mental health, GWH overshadows the positive mental health effects of positive job experiences. The research also argues for a reconceptualization of GWH and positive job experiences as formative latent variables on theoretical grounds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors associated with male workers' engagement in physical activity: white collar vs. blue collar workers

The purpose of this study was to identify factors associated with male workers' participation in different kinds of physical activity, noting differences between white collar and blue collar workers. This study examined the variables, perceived health status, self efficacy, perceived barriers, age, education, income, and job category (Pender, 1987) for their association with physical activity. Self efficacy and perceived health status were the cognitive-perceptual factors that predicted physical activity. Job category (e.g., blue collar vs. white collar) was found to be a highly significant predictor of physical activity. Comparing physical job requirements with the individual worker capacity can suggest to the occupational health nurse physical fitness programs that are most appropriate for individual workers.