Alicia Kurowski

Occupation-differential construct validity of the Job Content Questionnaire (JCQ) psychological job demands scale with physical job demands items: a mixed methods research.

The construct validity of the Job Content Questionnaire (JCQ) psychological demands scale in relationship to physical demands has been inconsistent. This study aims to test quantitatively and qualitatively whether the scale validity differs by occupation. Hierarchical clustering analyses of 10 JCQ psychological and physical demands items were conducted in 61 occupations from two datasets: one of non-faculty workers at a university in the United States (6 occupations with 208 total workers) and the other of a Belgian working population (55 occupations with 13,039 total workers). The psychological and physical demands items overlapped in 13 of 61 occupation-stratified clustering analyses. Most of the overlaps occurred in physically-demanding occupations and involved the two psychological demands items, ‘work fast’ and ‘work hard’. Generally, the scale reliability was low in such occupations. Additionally, interviews with eight university workers revealed that workers interpreted the two psychological demands items differently by the nature of their tasks. The scale validity was occupation-differential. Practitioner Summary: The JCQ psychological job demands scale as a job demand measure has been used worldwide in many studies. This study indicates that the wordings of the ‘work fast’ and ‘work hard’ items of the scale need to be reworded enough to differentiate mental and physical job demands as intended, ‘psychological.’

The impact of workplace factors on filing of workers’ compensation claims among nursing home workers

BackgroundInjuries reported to workers’ compensation (WC) system are often used to estimate incidence of health outcomes and evaluate interventions in musculoskeletal epidemiology studies. However, WC claims represent a relatively small subset of all musculoskeletal disorders among employed individuals, and perhaps not a representative subset. This study determined the influence of workplace and individual factors on filing of workers’ compensation claims by nursing home employees with back pain.MethodsSurveys were conducted in 18 skilled nursing facilities in four U.S. states. Self-administered questionnaires obtained information on demographic characteristics, working environment, and health behaviors/status. Employees who reported low back pain at least once in four questionnaire surveys were included. WC claims from the same facilities were obtained from the employer’s workers compensation insurer and matched by employee name. The dichotomous dependent variable was filing of back-related worker’s compensation claim. Association with predictors of interest, including pain severity, physical job demand, job strain, social support, schedule control, and safety climate, was assessed using multivariate regression modeling. Individual characteristics were tested as potential confounders.ResultsPain severity level was significantly associated with filing low-back related claims (odds ratio (OR) = 1.49, 95% CI = 1.18 – 1.87). Higher physical demands at work (OR = 1.07, 95% CI = 1.01 – 1.14) also increased the likelihood of claim filing. Higher job strain (OR = 0.83, 95% CI = 0.73 – 0.94), social support at work (OR = 0.90, 95% CI = 0.82 – 0.99), and education (OR = 0.79, 95% CI = 0.71 – 0.89) decreased the likelihood of claim filing.ConclusionsThe results suggest that the WC system captured the most severe occupational injuries. Workplace factors had additional influence on workers’ decision to file claims, after adjusting for low back pain severity. Education was correlated with worker’s socioeconomic status; its influence on claim filing is difficult to interpret because of the possible mixed effects of working conditions, self-efficacy, and content knowledge.

Differences among nursing homes in outcomes of a safe resident handling program.

A large nursing home corporation implemented a safe resident handling program (SRHP) in 2004-2007. We evaluated its efficacy over a 2-year period by examining differences among 5 centers in program outcomes and potential predictors of those differences. We observed nursing assistants (NAs), recording activities and body postures at 60-second intervals on personal digital assistants at baseline and at 3-month, 12-month, and 24-month follow-ups. The two outcomes computed were change in equipment use during resident handling and change in a physical workload index that estimated spinal loading due to body postures and handled loads. Potential explanatory factors were extracted from post-observation interviews, investigator surveys of the workforce, from administrative data, and employee satisfaction surveys. The facility with the most positive outcome measures was associated with many positive changes in explanatory factors and the facility with the fewest positive outcome measures experienced negative changes in the same factors. These findings suggest greater SRHP benefits where there was lower NA turnover and agency staffing; less time pressure; and better teamwork, staff communication, and supervisory support.

A Physical Workload Index to Evaluate a Safe Resident Handling Program for Nursing Home Personnel

Objective: The aim of this study was to obtain a comprehensive analysis of the physical workload of clinical staff in long-term care facilities, before and after a safe resident handling program (SRHP). Background: Ergonomic exposures of health care workers include manual handling of patients and many non-neutral postures. A comprehensive assessment requires the integration of loads from these varied exposures into a single metric. Method: The Postures, Activities, Tools, and Handling observational protocol, customized for health care, was used for direct observations of ergonomic exposures in clinical jobs at 12 nursing homes before the SRHP and 3, 12, 24, and 36 months afterward. Average compressive forces on the spine were estimated for observed combinations of body postures and manual handling and then weighted by frequencies of observed time for the combination. These values were summed to obtain a biomechanical index for nursing assistants and nurses across observation periods. Results: The physical workload index (PWI) was much higher for nursing assistants than for nurses and decreased more after 3 years (−24% versus −2.5%). Specifically during resident handling, the PWI for nursing assistants decreased by 41% of baseline value. Conclusion: Spinal loading was higher for nursing assistants than for nurses in long-term care centers. Both job groups experienced reductions in physical loading from the SRHP, especially the nursing assistants and especially while resident handling. Application: The PWI facilitates a comprehensive investigation of physical loading from both manual handling and non-neutral postures. It can be used in any work setting to identify high-risk tasks and determine whether reductions in one exposure are offset by increases in another.

Enhancing the Usability of a Mobile App for Process Evaluation in a Participatory Ergonomics Healthcare Intervention

Monitoring of workplace intervention processes in real-time can identify factors influencing intervention success or failure while they can still be modified if necessary. The aims of this study are to describe a process to assess and (where necessary) improve functionality and usability of a process evaluation mobile app. The app was developed for the research study “Safety and Health through Integrated, Facilitated Teams” (SHIFT), an evaluation of the CPH-NEW Healthy Workplace Participatory Program in public sector healthcare institutions. App users are members and co-facilitators of labor-management health and safety committees, internal program champions, other managers, and researchers. The app records four “functions:” meetings held, attendance and attendee feedback; project-related chats; and time spent on project activities. Post-meeting feedback surveys cover participant engagement, group dynamics, and usefulness of the intervention at each step. Pilot tests were conducted across combinations of device specifications to assess both functionality and usability. Functionality problems were fixed as they were documented. The average System Usability Scale scores for seven student testers were similar between the two interfaces: 72.9 for the mobile app and 72.5 for the website, both corresponding to “good” usability. Development of a mobile app requires substantial effort and personnel time which may not be apparent at the start of the project. Communication between researchers and the app developer was challenging at times. Conceptual and mental models of the specifications do not necessarily correspond due to differences in fields, experience, and priorities.