Sheila T. Fitzgerald

Workplace violence: prevalence and risk factors in the safe at work study.

Objective: Nurses face one of the highest rates of reported workplace violence (WPV). This research examined the prevalence of WPV and demographic, work-related, and adult and childhood abuse histories as risk factors for WPV among 2166 nurses/nursing personnel across four health care institutions in one US metropolitan area. Methods: Using data from an online cross-sectional survey, multivariate logistic regression was utilized to determine risk factors for physical and psychological WPV. Results: Almost one-third (30%) of nurses/nursing personnel experienced WPV (19.4% physical, 19.9% psychological). Risk factors included being a nurse, white, male, working in the emergency department, older age, longer employment, childhood abuse, and intimate partner violence. Conclusions: Adult and childhood abuse histories have not been considered in previous large-scale investigations, but were significant risk factors along with other previously identified risk factors for WPV.

Return to work after percutaneous transluminal coronary angioplasty

A prospective study of 82 patients employed in the 6-month period before percutaneous transluminal coronary angioplasty (PTCA) was performed to determine the patterns of lag time in work resumption and the factors associated with early return to work. One month after PTCA, 59% of patients had resumed work whereas 87% were employed 6 months after PTCA. Patients who had a myocardial infarction in the month before PTCA, as well as those with less than 12 years of education, blue collar jobs and low levels of self-efficacy (self-confidence) for return to work had a lower probability of work resumption at every point in the 24 weeks of follow-up. Cox proportional hazards analysis revealed the psychosocial construct, self-efficacy, to be the strongest predictor of return to work 1 month after PTCA, independent of having a recent myocardial infarction, disease severity, age, job classification, gender and physician advice (p = 0.0006). Kaplan-Meier analysis for return to work after PTCA confirmed that patients with high self-efficacy estimates obtained just before hospital discharge after PTCA resumed employment earlier than those with low self-efficacy levels (p = 0.0001). The same relation was observed in those patients with and without a myocardial infarction in the month before PTCA, p = 0.0022 and 0.0012 respectively. These findings suggest that although PTCA is considered relatively safe and minimally invasive by physicians, patients may still lack confidence in their ability to return to work even when physically capable of doing so.

Functional status after coronary artery bypass grafting and percutaneous transluminal coronary angioplasty

Two cohorts of consecutive patients of comparable age with similar preprocedure cardiac function who underwent either coronary artery bypass grafting (CABG; n = 106) or percutaneous transluminal coronary angioplasty (PTCA; n = 64) were entered into a prospective comparison study examining functional status and return to work during the first year of recovery. Patients were evaluated using standardized functional status instruments for activities of daily living, work performance, social activity, mental health and quality of social interaction at 1, 6 and 12 months after the procedure. Within the CABG group, statistically significant improvements of functional status on every subscale were noted over the 1-year follow-up. Patients undergoing PTCA demonstrated significant improvement in all dimensions except for the quality of interaction at 1 year as compared with baseline. When the 2 groups were compared, the PTCA group demonstrated greater participation than the CABG group in routine daily physical and social activities at 1 and 6 months, but this apparent advantage disappeared by 1 year. Measures of psychological functioning were better after CABG than after PTCA. A reduction in the number of those with employment occurred in both the CABG and PTCA groups, independent of physical functional status measures, which improved in both groups after the procedures. For those with employment, the CABG group reported the greatest improvement in work performance.

The impact of urinary incontinence in working women: A study in a production facility

ABSTRACT Objectives: The objectives of this study were to identify the impact of self-reported UI on working women, to describe urine loss symptoms, strategies used to control urine loss, and help-seeking behavior among full-time women working in a rural production facility. Methods: A cross-sectional survey design was used and questionnaires were distributed to 500 women (response rate, 54%). Items elicited information on demographics, health, parity, symptoms and duration of urine loss, strategies to manage urine loss, effects of UI on work activities, level of knowledge about UI and treatment options, perceived importance of getting professional help, and actual help seeking behavior. Results: Twenty-nine percent (n = 78) reported UI at least monthly. Incontinent women were older (44.8 years vs. 38.1 years) than continent women (t = −5.22, p < .001) and incontinent women had a significantly higher average body mass index (BMI) than continent women (t = −4.3, p < .001). More women reported urine loss with coughing, lifting, bending, and when hands were in water, and were more likely to use pads at work to control urine loss. Few women had reported UI to a health care provider (36%) and most wanted more information about UI (85%). Conclusions: UI is a prevalent problem for working women. Workplace programs designed to assist women with prevention, treatment, and management of UI are crucial.

Urinary incontinence. Impact on working women.

Until recently, the impact of urinary incontinence (UI) on working women, a population generally characterized as healthy, has not been the focus of research. Women employed full time at a large university center participated in a cross sectional survey about UI. Of the 1,113 women surveyed, age 18 and older, 21 % (n = 232) reported UI at least monthly. Incontinent women were significantly older and had a higher body mass index than continent women. Using disposable products, limiting fluids, avoiding caffeinated beverages, using voiding schedules, and keeping extra clothes or underwear were strategies used to manage UI at work. Responses to an open ended question related to the impact of UI on working life included: interference with sleep and resulting fatigue at work, embarrassment, alteration of concentration, and emotional distress. Implications for nurses are discussed in relation to assessment, education, and management of UI in the occupational setting.

Urinary Incontinence in Working Women: A Comparison Study

OBJECTIVES To compare the findings of two surveys concerning the nature of urinary incontinence and management strategies used by full-time employed working women. METHODS The first study was conducted in an urban academic setting with a survey distributed to 2000 women. The second study was conducted with 500 women in a rural pottery manufacturing facility. RESULTS Twenty-one percent of the women working in an academic setting (group A) and 29% (p = 0.002) of the women working in a manufacturing setting (group B) reported being incontinent of urine at least monthly. More women in group B reported antecedents mixed incontinence (i.e., antecedent to both stress and urge incontinence). More women in group B also used panty liners to manage urine loss (p = 0.003), whereas more women in group A used voiding schedules (p = 0.008) and pelvic muscle exercises (p = 0.04). More women in group A reported that they did not know if their incontinence could improve (40% vs. 1%, p = 0.00). The majority in both groups said that getting treatment was of no or little importance, yet, overwhelmingly, most women (group A 81%; group B 86%) wanted more information about incontinence. CONCLUSIONS Incontinence is a prevalent condition in working women. Discrepancies exist in the nature of the urine loss and strategies used to manage incontinence. Treatment also differs for those women who report urine loss to healthcare providers. Most women want to learn more about incontinence. Secondary prevention strategies need to be tailored and tested to meet symptoms and concerns for women in different work settings.

The Relationship Between Religious Coping Style and Anxiety over Breast Cancer in African American Women

In this study, we investigated the relationship between religious coping style and anxiety related to breast cancer and the use of mammography in a sample of African American women. We also assessed the relationship of breast cancer anxiety to related variables such as church affiliation and attendance, church teachings on health, and acceptance of those teachings.

Early pulmonary response to allergen is attenuated during acute emotional stress in females with asthma

Some asthma patients and physicians who treat asthma have reported that stress worsens their disease. It has also recently been shown that chronic stressful life events increase airway inflammation 6–24 h after inhalation of antigen in patients with allergic asthma. However, there is no data regarding the effect of an acute stressor on the airway constriction that occurs within minutes of antigen inhalation (early pulmonary response) in this same population. The aim of this study was to examine this effect in eight females with allergic asthma. Each subject was challenged with increasing concentrations of inhaled allergen on a control visit (no stress) and on a stress visit, when they were asked to verbally recount an emotionally stressful situation between each concentration. Systolic (SP) and diastolic (DP) blood pressure, cardiac frequency (fc) and forced expiratory volume in one second (FEV1) were measured on both visits. SP, DP and fc were statistically increased on the stress visit as compared to control. Per cent decrease in FEV1 at the same last dose of allergen was significantly less on the stress visit (11.2±7.0%) compared to control (15.0±8.7%). These findings suggest that the early pulmonary response to inhaled allergen is attenuated while verbally reexperiencing an acute emotional stressor in females with allergic asthma.

Anger in Young Black and White Workers: Effects of Job Control, Dissatisfaction, and Support

This cross-sectional study tested the hypothesis that characteristics of work that contribute to job strain also increase anger in young service-sector workers. A new measure of anger directed at coworkers, supervisors, and customers was regressed on job strain indices (job control, coworker and supervisor support, dissatisfaction) in models that controlled for dispositional negative affect and work status. Results in a sample of 230 young Black and White men and women revealed that low levels of job control and social support, and high levels of job dissatisfaction, were independently associated with increased work-related anger. Moreover, social support moderated the impact of low job control on anger directed at coworkers. Findings indicate that anger experienced at work may be an early marker of job stress, which has been prospectively related to cardiovascular disease.

Early Antecedents of Adult Work Stress: Social-Emotional Competence and Anger in Adolescence

We hypothesized that youth with elevated coronary heart disease (CHD) risk who exhibit diminished social-emotional competence and frequent anger in adolescence experience increased occupational stress after becoming adults. Perceived job control and support from coworkers in 57 young Black and White men and women were regressed on measures of social problem-solving skill (SPS) and anger arousal (AR) obtained 5 years earlier when participants were in high school. In models controlling for grade point average (GPA), SPS and GPA independently predicted coworker support in adulthood; anger in high school predicted diminished job control. These findings suggest that occupational stress may have identifiable social-emotional antecedents early in life.