H.M. Hasselhorn

Work-Home Conflict in the European Nursing Profession

Abstract This study investigated predictors of the work-home conflict among registered nurses (n = 27,603) in eight European countries. Two scales were used to assess work-family conflict (WFC) and family-work conflict (FWC). Based on a distinction of time- and strain-based and individual factors for WFC, bivariate correlations and multiple linear regression analysis were computed. The relationship between WFC and intention to leave the nursing profession was also analyzed. Quantitative demands indicating intensity of work, regularity of working time, and being, pressured to work overtime were the, dominating predictors for WFC, explaining 13-23% of the observed variance. The association between WFC and intention to leave the nursing profession was pronounced in all countries except one. Most European countries lack qualified nurses. Attempts to retain nurses in their profession should take, into consideration the WFC, the regularity of working time in particular, and overtime issues.

Effort-reward imbalance among nurses in stable countries and in countries in transition.

Abstract The effort-reward imbalance (ERI) model was used to analyze burnout and intention to leave the nursing profession (ITL) in nurses (n = 21,229) in seven European countries, as part of the NEXT-Study. Data were gathered using the short form of the ERI questionnaire. Burnout was assessed using the Copenhagen Burnout Inventory. Multivariate logistic regression all alysiscontrolled for age and gender. ERI was very high in Poland, Germany, Italy, and Slovakia. High ERI was associated with burnout. Odds ratios (ORs) ranged from 2.6 to 13.2 for ERI and from 3.0 to 5.5 for overcommitment (OC). Nurses with high ERI also had high ORs for ITL (2.6–5.7). The association of OC and ITL was weaker (1.1–1.7). The strong and consistent associations of ERI model results with psychological health and with ITL support the relevance of the model for examining different outcome levels. Nurses in transitional countries, as expected, experienced high ERI. High ERI in stable countries suggests that their economic sectors, particl1larlyhealth care, may be in transition.

Psychosocial work environment and intention to leave the nursing profession: Results from the longitudinal Chinese NEXT study.

Aims: A shortage of nurses happens not only in developed countries, but also in developing countries, such as in China, but the nurse turnover here makes the situation worse. Why do Chinese nurses want to leave the nursing profession? Our hypothesis is that unfavourable psychosocial work environment could predict nurses’ intention to leave (ITL). Methods: Collaborating with the EU NEXT study (Nurses’ Early eXit sTudy), the longitudinal study was conducted in China, and the psychosocial work environment was measured with the Copenhagen Psychosocial Questionnaire (COPSOQ). A total of 3,088 registered female nurses working in hospitals were eligible for the baseline analyses by multivariate logistic regression, and 1,521 for the one-year follow-up analyses by multivariate Poisson regression. Results: A wide range of psychosocial factors at work — in particular, increased emotional demands, decreased meaning of work, decreased commitment to the workplace, and decreased job satisfaction — were associated with ITL in both baseline analyses and prospective analyses after adjusting for numerous confounders. Conclusions: The findings suggest that unfavourable psychosocial work environment predicts ITL in Chinese nurses. Improvements in the psychosocial work environment may be helpful in retention of the nursing workforce.

Cohort profile: The lidA Cohort Study—a German Cohort Study on Work, Age, Health and Work Participation

The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx).

The Copenhagen Psychosocial Questionnaire in Germany: From the validation of the instrument to the formation of a job-specific database of psychosocial factors at work

The German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) was established and tested in a sample of 2561 employees in order to: (a) assess the questionnaires’ psychometric properties; and (b) develop an appropriate instrument to use in the assessment of psychosocial risk factors. A shortened version of the instrument was developed, reducing the number of items from 141 to 87. With this, a database has been established since 2005. In a cooperation model between science (Freiburg Research Centre of Occupational and Social Medicine) and companies or organizations, new COPSOQ data are added to the dynamically growing database with profession-specific profiles of psychosocial factors at work. In return, companies can compare their results with job-related data in the database, facilitating the interpretation of their results and the implementation of improvement measures. The COPSOQ database has reached >25,000 respondents. Ongoing projects will expand the German COPSOQ database and include representative samples. Furthermore, a job exposure matrix for psychosocial factors at work will be constructed in 2009. Finally, in several projects, a first assessment has been followed by efforts to improve the problematic areas of psychosocial working conditions.

Factors influencing immunity against diphtheria in adults

In about 50% of all adult Germans, serological immunity to diphtheria is lacking even though a vaccination history exists in most cases. In this study, the factors contributing to diphtheria immunity, up to 43 years after the last diphtheria vaccination, were analysed. Serum samples were taken from 287 adults whose complete vaccination history was available, and who had received a standard primary vaccination. The sera were tested by tissue culture neutralization assay for diphtheria antitoxin levels. The time lapse since the last diphtheria vaccination proved to be the most important factor influencing the protection rate. Secondly, the factor last vaccination within the first 3 years of life and, finally, female gender were found to correlate significantly with a low protection rate. No direct effect could be established for age, number of previous vaccinations, occupational contact with patients or travel within any endemic region during the last 10 years. Since diphtheritic infection can occur among previously vaccinated persons, the immunity gap observed among adults should be closed by regular diphtheria boosters. Special attention should be paid to the three groups mentioned. Further investigation is required to determine whether or not a single booster vaccination is sufficient to provide long-term protection for those in the risk groups indicated above.

The influence of age on the distribution of self-rated health, burnout and their associations with psychosocial work conditions

OBJECTIVE Self-rated health (SRH) and burnout are commonly used health indicators. This study was designed to examine the age-specific patterns of SRH and burnout and their correlations with self-reported disease symptoms, and to investigate the moderating effects of age on the associations of psychosocial work conditions with these two health measures. METHODS Study subjects were 20,454 male and 16,875 female employees from 2 representative surveys conducted in 2007 and 2010 in Taiwan. SRH was assessed by a single item and burnout was assessed by the general burnout subscale of the Copenhagen Burnout Inventory (CBI). Psychosocial work conditions including working hours, psychological and physical job demands, job control, job insecurity and workplace justice were assessed by a validated questionnaire. RESULTS Older workers were at higher risk for poor SRH which was correlated with the presence of multiple disease symptoms. In contrast, employees aged 30-40 years had higher burnout which was strongly correlated with emotional disturbance. Among all the examined work factors, low workplace justice was found to be the most predominant predictor for poor SRH and high burnout, and the associations were more profound in younger workers than in older workers. CONCLUSION SRH and burnout were differentially related to age, and there were evidences of moderating effects of age on the associations between psychosocial work conditions and health. Researchers and health practitioners should pay attention to the influence of age when using the measures of SRH and burnout as indicators to detect health risk in association with adverse psychosocial work conditions.

Foxes as indicators for TBE endemicity — a comparative serological investigation

Summary Besides humans, many animals can be infected by the tick-borne encephaltitis virus (TBEV) — with or without developing clinical signs of inflammable neurological disorder — and thus, they may serve as indicators for TBE endemicity. Game animals like deer, wild boar, and the fox are usually strongly infested with ticks. In contrast to other animals, foxes are known to live in habitats with only a small radius (about 7 to 10 km, rarely up to 50 km). In this way, a fox normally represents the place where it is found, and the local rate of anti-TBEV-seropositive foxes may indicate the TBE endemicity in that very region. In order to investigate various geographic regions in view of the possible occurrence of TBE, sera of foxes in different areas were collected and tested for antibodies against TBEV by ELISA. Six regions with different TBE incidences were studied: southwestern Germany (n = 79 foxes, seroprevalence 34.2%), eastern Black Forest Area (n = 153 foxes, seroprevalence 9.8%), Odenwald (n = 50 foxes, seroprevalence 10.0%), Taunus (n = 50 foxes, seroprevalence 2.0%), Brandenburg (n = 86 foxes, seroprevalence 0%), northeastern France (n = 55 foxes, seroprevalence 1.8%). The comparative descriptive analysis showed that the anti-TBEV seroprevalence in foxes reflected well the TBE incidences in different regions. Thus, foxes may be used to screen for TBE endemicity in various geographic areas. As in many districts fox sera are collected for rabies control, longitudinal investigations on TBE endemicity may be based on those samples. Additionally, species which are easier to access (e. g., cows or goats) may be used as sentinel system in areas with pastures and grazing flocks.

The Demand-Control-Support model and intent to leave across six European countries: The role of employment opportunities

Abstract In this paper, the explanatory power of the Demand-Control-Support (DCS) model for intent to leave (ITL) a job was tested, with employment opportunities (EO) taken into consideration. It was hypothesized that, when employment opportunities are low, the explanatory power of the DCS model for ITL is low because workers have no possibility of finding a new job despite the stressful characteristics of their current one. Analyses were performed on 16,052 female nurses from six European countries who were participating in the Nurses’ Early Exit Study (NEXT). A countrys unemployment rate and perceived employment opportunities were measures of EO. The results of multivariate regression analyses revealed that (controlling, among other things, for type of work contract) demands were related to ITL irrespective of EO. However, control and social support were more strongly related to ITL: (1) in countries with low (versus high) unemployment rate, and (2) among individuals with high (versus low) perceived employment opportunities. The DCS model, in its additive version (the main effects of the three dimensions), had better explanatory power for ITL in low unemployment rate countries only. The results suggest that employment opportunities may influence the explanatory power of the DCS model in relation not only to intent to leave but also to other outcomes.

Psychosocial Work Environment and Intention to Leave the Nursing Profession: A Cross-National Prospective Study of Eight Countries

Many countries throughout the world are facing a serious nursing shortage, and retention of nurses also is a challenge. The aim of this study was to compare the predictive contribution of a broad spectrum of psychosocial work factors, including job strain, effort-reward imbalance, and alternative employment opportunity, to the probability of intention to leave the nursing profession. A total of 7,990 registered female nurses working in hospitals in eight countries (Germany, Italy, France, the Netherlands, Belgium, Poland, Slovakia, and China) were included in the one-year prospective study. A standardized questionnaire on job strain, effort-reward imbalance, employment opportunity, and intention to leave the nursing profession was used in the survey. Multilevel logistic regression modeling was used to analyze the data. Results showed that an imbalance between high effort and low reward (in particular, poor promotion prospects) and good employment opportunity at baseline were independently associated with a new intention to leave the nursing profession at follow-up. However, job strain appeared to have relatively less explanatory power. Findings suggest that interventions to improve the psychosocial work environment, especially the reciprocity experienced between effort and reward, may be effective in improving retention of nurses and tackling the international nursing shortage.