Stress and health outcomes: The mediating role of negative affectivity in female health care workers.

The current study explored the interrelationships among occupational stress, family stress, poor physical health, and psychological distress and examined the mediating role of negative affectivity (NA) in the stress and health process. A cross-sectional, nonexperimental design was used and a convenience sample of 271 female health care workers was recruited from northeastern Ohio. Data were collected with a self-reported questionnaire, scanned using Teleform Software, and electronically transferred to the SPSS format. Data analyses were performed in three separate phases: preliminary, measurement model, and structural model analyses (using structural equation modeling). Results suggested that occupational stress had a significant effect on psychological distress, and family stress had a significant impact on both poor physical health and psychological distress. NA partially mediated the effect of occupational stress on psychological distress. The effects of family stress on poor physical health and psychological distress were also partially mediated through NA. The indirect to total effect ratios were 30%, 17.15%, and 28%, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Severity of homelessness and adverse birth outcomes.

Predictors and the prevalence of adverse birth outcomes among 237 homeless women interviewed at 78 shelters and meal programs in Los Angeles in 1997 were assessed. It was hypothesized that they would report worse outcomes than national norms, that African Americans would report the worst outcomes because of their greater risk in the general population, and that homelessness severity would independently predict poorer outcomes beyond its association with other adverse conditions. Other predictors included reproductive history, behavioral and health-related variables, psychological trauma and distress, ethnicity, and income. African Americans and Hispanics reported worse outcomes than are found nationally, and African Americans reported the worst outcomes. In a predictive structural equation model, severity of homelessness significantly predicted low birth weight and preterm births beyond its relationship with prenatal care and other risk factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vocational interests of male and female social workers.

For a sample of 496 male social workers, a key was constructed for the Strong VIB that differentiated them from a Men-in-General group with only 16% overlap. A key for female social workers (N = 464) differentiated them from Women-in-General with only 29% overlap. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Job satisfaction variables among female clerical workers.

34 female clerical workers ranked 10 job characteristics in order of importance for self, importance for same sex, and importance for opposite sex. The 10 job characteristics were taken from F. Herzberg, B. Mausner, and B. Snyderman (see 34:3) and represented 5 motivators and 5 hygienes. Results of these rankings were compared with results obtained in 2 similar studies which used college females to rank the same 10 job characteristics. Results of this comparison show a basic difference between the 2 different female groups with the college females ranking motivators significantly higher for self than the female clerical workers. This difference is explained in terms of the college females' greater need for self-actualization and greater anticipation of opportunities for advancement, higher responsibilities, and the other motivators. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiological reactions to telework in female and male white-collar workers.

Information technology has created greater flexibility and mobility for employees, such as teleworkers. However, research on stress and health is limited. This study investigated psychophysiological arousal in 26 highly educated white-collar workers (12 women and 14 men) while (a) working at the office, (b) working at home (telework), and (c) relaxing at home. Blood pressure was significantly higher during work at the office than when teleworking at home, and men had significantly elevated epinephrine levels in the evening after telework at home. It was assumed that the lower cardiovascular arousal during telework is due to different work tasks and that elevated epinephrine levels in men after telework are caused by continued work after normal working hours. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Customer-Related Social Stressors and Burnout.

Although almost all literature on burnout implicitly assumes that burnout is primarily caused by stressful employee-customer interactions, only a few studies have addressed this empirically. A principal-components analysis of a newly developed instrument assessing various forms of customer-related social stressors (CSS) in 3 different service jobs (N = 591) revealed 4 themes of CSS: disproportionate customer expectations, customer verbal aggression, disliked customers, and ambiguous customer expectations. These 4 CSS predict burnout beyond a variety of control variables. Contrary to other predictors of burnout analyzed in previous studies, the amount of variance explained in exhaustion (14%) by the 4 CSS scales is not higher than for personal accomplishment (14%) and is considerably lower than for depersonalization (23%). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unhealthy aggression: Intermittent explosive disorder and adverse physical health outcomes.

Objective: To examine the relationship between Intermittent Explosive Disorder (IED; a psychiatric diagnosis characterized by episodes of affective aggression) and adverse physical health outcomes. Design: A large epidemiological sample drawn from the Collaborative Psychiatric Epidemiological Surveys (N = 10,366), was used to compare participants with a lifetime diagnosis of IED (n = 929) to those without any history of IED (n = 9,437) on demographic variables (age, education, gender, race) common risk factors (smoking status, body mass index, substance use disorders, past accident or injury requiring treatment, major depression) and the presence of 12 adverse health outcomes. Main Outcome Measures: History of heart attacks, coronary heart disease, hypertension, stroke, lung disease, diabetes, cancer, arthritis, back/neck pain, ulcer, headaches, and other chronic pain. Results: Logistic regression analysis controlling for demographic and other risk factors indicated that IED was associated with 9 of the 12 adverse physical health outcomes (coronary heart disease, hypertension, stroke, diabetes, arthritis, back/neck pain, ulcer, headaches, and other chronic pain). Only cancer, heart attacks, and lung disease were not significantly related to IED. Conclusion: IED may be a risk factor for several significant adverse physical health outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactions of workers to male and female mental patient job applicants.

48 female department store workers in Exp I evaluated a female confederate unfavorably when she was tense, but whether or not she had been mentally ill made no difference to them. In Exp II 48 male hospital employees rejected a male confederate both when he was tense and when he had a history of mental illness. In Exp III 44 female hospital workers met another female confederate, and the results were virtually identical to those of Exp I. It is concluded that either the sex of the Ss and/or of the patient seems to be an important variable in the acceptance granted previous mental patients. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of job satisfaction and job dissatisfaction among female clerical workers.

Correlated degree of overall satisfaction, overall dissatisfaction, and overall satisfaction/dissatisfaction with measures of satisfaction/dissatisfaction with several aspects of the work situation for 160 female clerical workers. Tabulations were made of responses to open-ended questions concerning reasons for positive and negative feelings about the company. The results of these analyses offer no support for the 2-factor theory of job satisfaction, but are consistent with the traditional framework in which any variable can be both a "satisfier" and a "dissatisfier." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disorders of the back and spine in construction workers. Prevalence and prognostic value for disability

STUDY DESIGN: A cohort study on back-related morbidity and its impact on early retirement resulting from disability among employees in the construction industry. OBJECTIVE: To describe the prevalence of back-related morbidity according to different measures in various occupational groups and to assess the prognostic value of these measures for early retirement resulting from disability. METHODS: The results of occupational health examinations conducted in 1986-1988 among 4,958 employees of the German construction industry aged 40-64 years were analyzed. Active follow-up evaluation was carried out between October 1992 and July 1994 to ascertain employment status. RESULTS: Compared with that of white-collar employees, no excess risk for self-reported back pain or sciatica was seen for any of the manual professions. In contrast, the age-adjusted prevalence of clinical findings of the spine was elevated among all employees in manual professions, and the prevalence of a recorded diagnosis related to disorders of the back and spine (ICD-9 position 720-724) was elevated among bricklayers compared with white-collar employees. The relative risk of being granted a disability pension in the follow-up period was 1.6 (95% Confidence Interval [Cl], 1.3-2.1) for persons reporting back pain or sciatica, 1.8 (95% Cl, 1.4-2.2) for persons with an abnormal clinical finding of the spine, and 1.5 (95% Cl, 1.2-1.8) for persons with a recorded medical diagnosis related to disorders of the back or spine (ICD-9 720-724). CONCLUSION: Patterns of morbidity varied according to the evaluated morbidity measure. All three measures qualified as significant predictors of disability and helped to identify high-risk occupations and high-risk employees.     

Promoting health, promoting women: the construction of female and professional identities in the discourse of community health workers

Community health worker (CHW) programs are implemented in the third world and among racial minorities in the U.S. by public health professionals with the goal of improving people's access to basic health services. There is a shared view that women's roles as mothers make them effective CHWs because most health practices are located within the realm of the family. The objective of this paper is to inquire how and what concepts of woman are constructed and promoted in CHW programs. Viewing CHW as a discourse, I examine literature on CHWs using a critical feminist perspective and insights from narrative and rhetorical analyses. I argue that CHW positions women living in the third world and non-white Hispanic women in the U.S. as the "other" woman. The natural attributes of this other woman include mother, care giver, oppressed, child-like, and victim of patriarchy, religion, poverty, and diseases. These attributes are used to define categories of the female such as "the third world woman" and "Hispanic woman". These categories, in turn, define two unnamed opposite categories: "the first world woman" and "the public health professional". I conclude that CHW is a colonizing discourse and that public health professionals and feminists need to practice reflexivity.     

Community violence exposure, adverse childhood experiences, and posttraumatic distress among urban development workers.

The current study examines community violence exposure among 284 urban community development workers located in five U.S. cities. Adulthood exposure to community violence, history of adverse childhood experiences (ACEs), and current symptoms of posttraumatic distress (PTSD) were assessed to test the hypothesis that a personal history of ACEs moderates the relationship between community violence exposure and PTSD symptom severity. Seventy-five percent of urban development workers reported direct community violence victimization, 71% reported a history of at least one ACE, and 14% of the sample met probable diagnostic criteria for PTSD. A multiple regression analysis confirmed that ACEs and indirect adulthood community violence exposure were significantly positively related to the severity of PTSD symptoms. These variables accounted for a small amount of variance in PTSD. Direct exposure to community violence and the interaction between ACEs and community violence did not contribute significant variance to the model. The implications and limitations are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reexploration for bleeding is a risk factor for adverse outcomes after cardiac operations

OBJECTIVE: Although previous studies have included early reexploration for bleeding as a risk factor in analyzing adverse outcomes after cardiac operations, reexploration for bleeding has not been systematically examined as a multivariate risk factor for increased morbidity and mortality after cardiac surgery. Furthermore, multivariate predictors of the need for reexploration have not been identified. Accordingly, we performed a retrospective analysis of 6100 patients requiring cardiopulmonary bypass from January 1, 1986, to December 31, 1993. METHODS: Eighty-five patients who had ventricular assist devices were excluded from further analysis because of the prevalence of bleeding and the significant morbidity and mortality associated with placement of a ventricular assist device, unrelated to reexploration. In the remaining 6015 patients, potential adverse outcomes analyzed included operative mortality, mediastinitis, stroke, renal failure, adult respiratory distress syndrome, prolonged mechanical ventilation, sepsis, atrial arrhythmias, and ventricular arrhythmias. To control for the confounding effects of other risk factors, we performed a multivariate logistic regression analysis. Potential covariates considered in the logistic model included age, sex, race, history of reoperation, urgency of the operation, congestive heart failure, prior myocardial infarction, renal failure, diabetes, hypertension, chronic obstructive pulmonary disease or stroke, and the bypass and crossclamp time. RESULTS: The overall incidence of reexploration was 4.2% (253/6015). Four independent risk factors--increased patient age (p < 0.001), preoperative renal insufficiency (p = 0.02), operation other than coronary bypass (p < 0.001), and prolonged bypass time (p = 0.0.3)--were identified as predictors of the need for reexploration. The preoperative use of aspirin, heparin, or thrombolytic agents and the bleeding time were not identified as predictors. Reexploration for bleeding was identified as a strong independent risk factor for operative mortality (p = 0.005), renal failure (p < 0.0001), prolonged mechanical ventilation (p < 0.0001), adult respiratory distress syndrome (p = 0.03), sepsis (p < 0.0001), and atrial arrhythmias (p = 0.006). CONCLUSION: These data indicate that meticulous attention to surgical hemostasis and possibly application of recently developed modalities designed to facilitate perioperative correction of coagulopathy could improve outcomes after cardiac operations.     

Coping with workplace stress: A multiple-group comparison of female managers and clerical workers.

This study cross-validated and refined a causal model of workplace stress (B. C. Long, S. E. Kahn, & R. W. Schutz, 1992). Multivariate analysis of variance and multiple-group structural equation modeling were used to contrast female clerical workers (n?=?214) with the original sample of managerial women (n?=?249). Consistent with the effects of social roles, clerical workers had fewer coping resources, appraised the stress event as less controllable, experienced more work demands and less support, used relatively less engagement coping, and were more distressed and less satisfied than managers. Moreover, the personality disposition of agentic traits had a stronger influence on coping strategies for clerical workers than for managers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Job strain and ambulatory blood pressure among female white-collar workers

To evaluate the nutritional, metabolic and immune effects of dietary arginine, glutamine and omega-3 fatty acids (fish oil) supplementation in immunocompromised patients, we performed a prospective study on the effect of immune formula administered to 11 severe trauma patients (average ISS = 24), 10 burn patients (average % TBSA = 48) and 5 cancer patients. Daily calorie and protein administration were based on the patient's severity (Stress factor with the range of 35-50 kcal/kg/day and 1.5-2.5 g/kg/day, respectively) Starting with half concentration liquid immune formula through nasogastric tube by continuous drip at 30 ml/h and increasing to maximum level within 4 days. The additional energy and protein requirement will be given either by parenteral or oral nutritional support. Various nutritional, metabolic, immunologic and clinical parameters were observed on day 0 (baseline), day 3, 7, and 14. Analysis was performed by paired student-t test. Initial mean serum albumin and transferrin showed mild (trauma) to moderate (burn and cancer) degree of malnutrition. Significant improvement of nutritional parameters was seen at day 7 and 14 in trauma and burn patients. Significant increase of total lymphocyte count (day 7, P < 0.01), CD4 + count (day 7, p < 0.01), CD8 + count (day 7, p < 0.0005 & day 14, p < 0.05), complement C3 (day 7, p < 0.005 day 14, p < 0.01), IgG (day 7, and 14, p < 0.0005), IgA (day 7, p < 0.0005 & day 14, p < 0.05), in all patients. C-reactive protein decreased significantly on day 7 (p < 0.0005) and day 14 (p < 0.005). 3 cases of burn wound infection, one case of UTI and one case of sepsis were observed. Two cases of hyperglycemia in burn, 3 cases of hyperbilirubinemia in trauma, 10 cases of elevated LFT (5 trauma/5 burn), and one case of hyponatremia in cancer patients were observed. Two cases of nausea, 4 cases of vomiting, 5 cases of diarrhea (< 3 times/day), 2 cases of abdominal cramp, 1 case of distension were observed. The feeding of IMMUNE FORMULA was well tolerated and significant improvement was observed in nutritional and immunologic parameters as in other immunoenhancing diets. Further clinical trials of prospective double-blind randomized design are necessary to address the so that the necessity of using immunonutrition in critically ill patients will be clarified.     

Interpersonal conflict at work and psychological outcomes: Testing a model among young workers.

On the basis of A. P. Fiske's (1992) general theory of social relations, a model of interpersonal conflict at work was developed and tested in a sample of young workers. The model predicts that conflict with supervisors is predictive of organizationally relevant psychological outcomes (job satisfaction, organizational commitment, and turnover intentions), whereas conflict with coworkers is predictive of personally relevant psychological outcomes (depression, self-esteem, and somatic symptoms). Data were obtained from a sample of 319 individuals ages 16–19 yrs. Structural equation modeling results supported the hypothesized relations. Secondary regression analysis of 2 data sets from M. A. Donovan, F. Drasgow, and L. J. Munson (1998) provides initial support for the generalizability of the hypothesized model to older employees. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between negligent adverse events and the outcomes of medical-malpractice litigation

BACKGROUND: We have previously shown that in New York State the initiation of malpractice suits correlates poorly with the actual occurrence of adverse events (injuries resulting from medical treatment) and negligence. There is little information on the outcome of such lawsuits, however. To assess the ability of malpractice litigation to make accurate determinations, we studied 51 malpractice suits to identify factors that predict payment to plaintiffs. METHODS: Among malpractice claims that we reviewed independently in an earlier study, we identified 51 litigated claims and followed them over a 10-year period to determine whether the malpractice insurer had closed the case. We obtained detailed summaries of the cases from the insurers and reviewed the litigation files if the outcome of a case differed from the outcome predicted in our original review. RESULTS: Of the 51 malpractice cases, 46 had been closed as of December 31, 1995. Among these cases, 10 of 24 that we originally identified as involving no adverse event were settled for the plaintiffs (mean payment, $28,760), as were 6 of 13 cases classified as involving adverse events but no negligence (mean payment, $98,192) and 5 of 9 cases in which adverse events due to negligence were found in our assessment (mean payment, $66,944). Seven of eight claims involving permanent disability were settled for the plaintiffs (mean payment, $201,250). In a multivariate analysis, disability (permanent vs. temporary or none) was the only significant predictor of payment (P=0.03). There was no association between the occurrence of an adverse event due to negligence (P = 0.32) or an adverse event of any type (P=0.79) and payment. CONCLUSIONS: Among the malpractice claims we studied, the severity of the patient's disability, not the occurrence of an adverse event or an adverse event due to negligence, was predictive of payment to the plaintiff.