Shannon L. Wagner

Modifiable workplace risk factors contributing to workplace absence across health conditions: A stakeholder-centered best-evidence synthesis of systematic reviews

BACKGROUND A challenge facing stakeholders is the identification and translation of relevant high quality research to inform policy and practice. This study engaged academic and community stakeholders in conducting a best evidence-synthesis to enhance knowledge use. OBJECTIVES To identify modifiable workplace disability risk and protective factors across common health conditions impacting work-related absence. METHODS We searched MEDLINE, Embase, CINHAL, The Cochrane Library, PsycINFO, BusinessSourceComplete, and ABI/Inform from 2000 to 2011. Systematic reviews that employed quantitative, qualitative, or mixed methods of work-focused population were considered for inclusion. Two or more independent reviewers reviewed titles only, titles and abstracts, and/or full articles when assessing eligibility for inclusion. Selected articles underwent methodological screening. RESULTS The search strategy, expert input and grey literature identified 2,467 unique records from which 142 full text articles underwent comprehensive review. Twenty-seven systematic reviews met eligibility criteria. Modifiable work factors found to have consistent evidence across two or more health conditions included lack of social support, increased physical demands at work, job strain, lack of supervisory support, increased psychological demands, low job satisfaction, low worker control of job, and poor leadership quality. CONCLUSIONS The active engagement of stakeholders led to greater understanding of relevance of the study findings for community stakeholders and appreciation of the mutual benefits of collaboration.

Mental Health Implications of Fire Service Membership

The primary goal of the current study was to add to the literature regarding mental health implications of fire service membership. Paid-professional firefighters (n = 94) were compared with workers from non-emergency-service occupations (n = 91) with respect to posttraumatic symptomatology as well as other symptoms of mental illness. The results suggested that firefighters self-reported greater posttraumatic symptomatology than comparison participants as measured by the Impact of Events Scale—Revised. In addition, the firefighters reported more distress on several subscales of the Symptom Checklist 90—Revised. Specifically, firefighters scored higher than the non-emergency-service participants on self-reported interpersonal sensitivity, anxiety, hostility, and psychoticism. Contrary to the original hypotheses, no links were evident between years of service and posttraumatic/mental health symptoms. Overall, this project suggests that firefighters are at substantially higher risk for traumatic stress symptoms as compared with other workers who do not work within the emergency services. In addition, it is suggested that previous reports of additional mental health symptoms experienced by firefighters may actually be more consistent with secondary reports of posttraumatic symptomatology. A secondary goal of this study was to provide exploratory data regarding potential links between firefighters’ mental health and self-reported personality characteristics. These data suggest that neuroticism may play a special role in the prediction of posttraumatic symptomatology for firefighters.

Occupational Stress in the Multicultural Workplace

Occupational stress is a well researched topic leading to the development of strong, viable models of workplace stress. However, there is a gap in the literature with respect to the applicability of this research to specific cultural groups, in particular those of immigrant status. The present paper reviews the extant literature regarding occupational stress from a multicultural perspective, evaluates the usefulness for existing models in the multicultural context, and discusses current issues with respect to increasing multiculturalism in the work environment. The authors conclude that workforce diversity is emerging as a pressing issue of organizational life and consequently, that future research needs to continue investigating whether current knowledge regarding workplace stress is fitting with the multicultural diversity of the present-day working population.

Investigating the “Rescue Personality”:

Mitchell and Bray use the term rescue personality as a way of describing characteristics of individuals who serve in the emergency services and describe emergency service workers as inner-directed, action oriented, obsessed with high standards of performance, traditional, socially conservative, easily bored, and highly dedicated.This rescue personality has provided an important foundation for the controversial Critical Incident Stress Management model; however, little empirical evidence is available demonstrating its existence.Previous literature has primarily considered emergency service personality characteristics as predictors of posttraumatic symptoms and/or effective job performance. Consequently, a gap in the literature exists with respect to research investigating the existence of a particular personality type for emergency service workers, as compared with those working in nonemergency occupations. The present project compared a group of paid professional firefighters (n = 94) with a comparison gr...

Physician-stakeholder collaboration in Disability Management: A Canadian perspective on guidelines and expectations

Purpose. The physician plays a vital role in Disability Management; unfortunately, there is an apparent lack of clarity with respect to the functions included in this role. The present article reviews the collaborative nature of the physician-stakeholder relationship giving attention to types of expectations, current Canadian guidelines and future challenges. Conclusion. The authors conclude that although challenging and complex, the physicians performance in Disability Management can be optimized through improved communication and collaboration with stakeholders.

Modifiable worker risk factors contributing to workplace absence: A stakeholder-centred best-evidence synthesis of systematic reviews

BACKGROUND A challenge facing stakeholders is the identification and translation of relevant high quality research to inform policy and practice. This study engaged academic and community stakeholders in conducting a best evidence-synthesis to identify modifiable risk and protective worker factors across health conditions impacting work-related absence. OBJECTIVES To identify modifiable worker disability risk and protective factors across common health conditions impacting work-related absence. METHODS We searched Medline, Embase, CINHAL, The Cochrane Library, PsycINFO, BusinessSourceComplete, and ABI/Inform from 2000 to 2011. Quantitative, qualitative, or mixed methods systematic reviews of work-focused population were considered for inclusion. Two or more reviewers independently reviewed articles for inclusion and methodological screening. RESULTS The search strategy, expert input and grey literature identified 2,467 unique records. One hundred and forty-two full text articles underwent comprehensive review. Twenty-four systematic reviews met eligibility criteria. Modifiable worker factors found to have consistent evidence across two or more health conditions included emotional distress, negative enduring psychology/personality factors, negative health and disability perception, decreased physical activity, lack of family support, poor general health, increased functional disability, increased pain, increased fatigue and lack of motivation to return to work. CONCLUSIONS Systematic reviews are limited by availability of high quality studies, lack of consistency of methodological screening and reporting, and variability of outcome measures used.

Adolescent-Parent Verbal Conflict The Roles of Conversational Styles and Disgust Emotions

A total of 94 adolescents (M age = 14.2 years) participated in 20-minute hypothetical conflict discussions with either their mothers or fathers (24 daughter-mother, 22 son-mother, 25 daughter-father, 23 son-father dyads). Audiotaped conversations were coded for speakers’ conversational style (overlaps between turns, simultaneous speech, and successful interruptions) and hostile emotional expressions (i.e., disgust/contempt). Adolescents used a conversational style that included more overlaps, simultaneous speech and successful interruptions than their parents, with the greatest differences in styles found for adolescents and their mothers. Adolescents’ and parents’ conversational styles and expressions of disgust were analyzed in modeling procedures in an attempt to predict selfreported perceptions of adolescent-parent conflict. Results revealed that adolescents’ rates of disgust were positively predicted from both the degree of difference in the adolescent’s and parent’s conversational styles and from the parent’s rates of disgust expressions. In turn, adolescents’ expressions of disgust were found to positively predict adolescents’ perceptions of levels of relationship conflict with their parents.

Effects of Traumatic Stress on Firefighters' World Assumptions:

Male firefighters (n = 94) were compared with male workers (n = 91) from a variety of blue-collar, non—emergency service occupations. Responses on the World Assumptions Scale were examined in combination with the Impact of Events Scale—Revised and the Symptom Checklist-90. Initial hypotheses suggested that firefighters would report disrupted world assumptions and that these disrupted assumptions would be linked with greater mental health symptomatology. Results revealed that firefighters were not different from controls on world assumptions and that world assumptions were unrelated to years of service. These results suggest that the psychological reactions of workers exposed to high levels of job-related traumatic stress may not be consistent with that described in previous literature regarding primary victims. Consequently, it is suggested that more research is needed that specifically addresses psychological outcomes for firefighters and other high-trauma occupations. The findings also suggest that benevolence may be particularly important in relation to mental health in firefighters and that this belief may be useful in the prevention of posttraumatic symptomatology.

Higher cortisol is associated with poorer executive functioning in preschool children: The role of parenting stress, parent coping and quality of daycare

Child executive functions (cognitive flexibility, inhibitory control, working memory) are key to success in school. Cortisol, the primary stress hormone, is known to affect cognition; however, there is limited information about how child cortisol levels, parenting factors and child care context relate to executive functions in young children. The aim of this study was to examine relationships between child cortisol, parenting stress, parent coping, and daycare quality in relation to executive functions in children aged 3–5 years. We hypothesized that (1) poorer executive functioning would be related to higher child cortisol and higher parenting stress, and (2) positive daycare quality and positive parent coping style would buffer the effects of child cortisol and parenting stress on executive functions. A total of 101 children (53 girls, 48 boys, mean age 4.24 years ±0.74) with complete data on all measures were included. Three saliva samples to measure cortisol were collected at the child’s daycare/preschool in one morning. Parents completed the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P), Parenting Stress Index (PSI), and Ways of Coping Questionnaire (WCQ). The Early Childhood Environment Rating Scale – Revised (ECERS-R) was used to measure the quality of daycare. It was found that children with poorer executive functioning had higher levels of salivary cortisol, and their parents reported higher parenting stress. However, parent coping style and quality of daycare did not modulate these relationships. Identifying ways to promote child executive functioning is an important direction for improving school readiness.

Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews

Background: Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. Objective: To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. Results: The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. Conclusion: There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.