Steffen Torp

The impact of psychosocial work factors on musculoskeletal pain : a prospective study

A prospective cohort study investigated how psychosocial work factors predict musculoskeletal pain. A total of 721 workers at 226 automobile repair garages answered two questionnaires distributed with a 1-year interval. The predictor variables were psychological demands, decision authority, social support, and management support. The outcome variables were neck pain, low back pain, and an index of pain from seven different parts of the body in the past 30 days. The best predictors were low decision authority and management support. Low decision authority predicted neck pain, low back pain, and total musculoskeletal pain when adjusted for the effect of the respective musculoskeletal pain measured in the first survey, for age, and for gender. Low management support predicted both low back pain and general musculoskeletal pain. The study indicates that psychosocial factors at work may predict musculoskeletal pain.

A pilot study of how information and communication technology may contribute to health promotion among elderly spousal carers in Norway

The objective of this pilot Norwegian intervention study was to explore whether use of information and communication technology (ICT) by informal carers of frail elderly people living at home would enable them to gain more knowledge about chronic illness, caring and coping, establish an informal support network and reduce stress and related mental health problems. Potential participants were close relatives of an elderly person with a diagnosis of a chronic illness dwelling in the same household who wished to continue caring for their relative at home, were 60 years of age or older, had been caring for less than 2 years, were a computer novice and had Norwegian as their first language. Nineteen elderly spousal carers participated in the study from two municipalities in eastern Norway. The project commenced in January 2004 and consisted of a multimethod evaluation model. Outcomes measured included carers social contacts (measured by the Family and Friendship Contacts scale); burden of care (measured by the Relative Stress scale); and knowledge about chronic disease and caring, stress and mental health and use of ICT (examined via a composite carer questionnaire). These quantitative data were collected immediately prior to the study and at 12 months. Qualitative data were also collected via focus group interviews with participant carers at 7 months. At follow-up, quantitative measures did not reveal any reduction in carer stress or mental health problems. However, carers reported extensive use of the ICT service, more social contacts and increased support and less need for information about chronic illness and caring. Contact with and support from other carers with similar experiences was particularly valued by participants. The intervention also enhanced contacts with family and friends outside the carer network. Thus, it can be seen that ICT has the potential to contribute to health promotion among elderly spousal carers.

Worksite adjustments and work ability among employed cancer survivors

ObjectivesThis study was conducted to determine how many cancer survivors (CSs) make worksite adjustments and what kinds of adjustments they make. Changes in work ability among employed CSs were explored, and clinical, sociodemographic, and work-related factors associated with the current total work ability were studied.MethodsCSs of the ten most common invasive types of cancer for men and women in Norway completed a mailed questionnaire 15–39xa0months after being diagnosed with cancer. Included in the analyses were all participants who worked both at the time of diagnosis and at the time of the survey and who had not changed their labor force status since diagnosis (nu2009=u2009563). The current total work ability was compared to the lifetime best (0–10 score).ResultsTwenty-six percent of the employed CSs had made adjustments at work, and the most common adjustment was changing the number of work hours per week. Despite the fact that 31% and 23% reported reduced physical and mental work abilities, respectively, more than 90% of the CSs reported that they coped well with their work demands. The mean total work ability score was high (8.6) among both men and women. Being self-employed and working part-time at the time of diagnosis showed significant negative correlations with total work ability, while a favorable psychosocial work environment showed a significant positive correlation. CSs with low work ability were more often in contact with the occupational health service and also made more worksite adjustments than others.ConclusionThe prospects of future work life seem optimistic for Norwegian employed CSs who return to work relatively soon after primary treatment.

Work engagement: a practical measure for workplace health promotion?

The objectives of this study were to investigate whether psychological job demands, personal control and social support affect the negative health measure of depression differently than the positive measure of work engagement and to investigate whether work engagement mediates the effects of job demands and resources on the level of depression. We discuss the implications of using engagement as an outcome measure in workplace health promotion. We performed a cross-sectional questionnaire study among a general working population in Norway (n = 605). In the multivariate analysis, high psychological job demands as well as high control and social support correlated significantly with high work engagement. High demands as well as low control and social support correlated significantly with high levels of depression. When we included engagement as an independent variable together with demands, control and social support in the multivariate analysis, the positive correlation between demands and depression remained as well as the significant correlations between the level of depression and control and social support became non-significant. This indicates that engagement mediates the effects of control and social support on the level of depression. Encouraging enterprises to improve engagement in addition to focusing on preventing diseases may be worthwhile in workplace health promotion. Promoting engagement may have more positive organizational effects than a more traditional disease prevention focus, because engagement is contagious and closely related to good work performance and motivation.

How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, managers invol...

Sick leave patterns among 5-year cancer survivors: a registry-based retrospective cohort study.

PurposeThe aims of this study were to observe the sick leave rates of cancer survivors for five consecutive years following a first lifetime diagnosis of invasive cancer and to identify socio-demographic and clinical predictors of sick leave taken in the fifth year after diagnosis.MethodsThis registry study comprised 2,008 Norwegian individuals (18–61xa0years old) with their first lifetime diagnosis of invasive cancer in 1999 and alive in 2004 and a cancer-free control group (nu2009=u20093,240) matched by sex, age, educational level, and employment status in 1998. Sick leave was defined as at least one sick leave period >16xa0days within the year in question.ResultsA total of 75xa0% of the long-term cancer survivors (LTCSs) took sick leave within the first 12xa0months after their diagnosis. The sick leave rate stabilized at a slightly higher level in the following 4xa0years compared to the year before diagnosis, with approximately 23xa0% of the male and 31xa0% of the female LTCSs taking sick leave. Being single with children, having low education, working in health and social work sector, or having taken sick leave the year before diagnosis (1998) predicted the sick leave taken 5xa0years after diagnosis (2004) among LTCSs. Compared to the controls, LTCSs with rectal, lymphogenic, breast, or “other” types of cancer had significantly higher sick leave rates 5xa0years after diagnosis. Socio-demographic factors explained more of the variance in sick leave than did clinical factors.ConclusionEmployed LTCSs struggle with their ability to work 5xa0years after diagnosis. More research is needed to identify factors that would promote LTCSs’ health and ability.Implications for cancer survivorsA socioeconomic and work environmental perspective seems necessary for achieving effective occupational rehabilitation and preventing sick leave among LTCSs.

Change in employment status of 5-year cancer survivors

AIMSnTo follow the employment status of 5-year cancer survivors for 5 years after diagnosis with their first lifetime invasive cancer and to identify socio-demographic, work-related and cancer-related predictors of employment status after 5 years.nnnMETHODSnThis prospective registry study concerned all 3278 people in Norway (18-61 years old) diagnosed with their first lifetime invasive cancer in 1999 and alive in 2004 and a cancer-free control group (n = 6368) matched by sex, age, educational level and employment status in 1998.nnnRESULTSnThe employment rate among male cancer survivors declined steadily every year, from 94% the year before diagnosis (1998) to 77% 5 years after diagnosis (2004). This change did not differ significantly from that of male controls. The employment rate of female survivors also declined steadily, from 87% (1998) to 69% (2004). This decline was greater than that among female controls, and in 2004 survivors had a significantly lower employment rate. For both men and women, the significant pre-diagnosis predictors of being employed in 2004 concerned higher socio-economic position. For both sexes, lung cancer survivors had the highest decline in employment rate, and male skin cancer survivors had a lower decline in employment rate than controls. Socio-demographic and work-related factors explained more of the variance in employment status than did cancer diagnosis.nnnCONCLUSIONnThe employment rate among 5-year cancer survivors did not change significantly except for female survivors. Low socio-economic position is a risk factor for decline in employment rate and should be focused on to prevent cancer-related inequity.

A comparative study of cancer patients with short and long sick-leave after primary treatment

Abstract Background. Sick-leave after primary cancer treatment has hardly been studied. This study compares Norwegian cancer patients (CPs) with shorter (≤8 months) and longer (≥9 months) sick-leave after primary cancer treatment. Our aim was to characterize factors associated with these two types of sick-leave in order to identify possible factors for interventions by which long-term sick-leaves may be avoided. Methods. A mailed questionnaire was completed by a sample of Norwegian CPs 15 to 39 months after primary treatment of the ten most common invasive types of cancer. The groups with shorter (n=359) and longer (n=481) sick-leaves (SSL vs LSL) were compared with each other by self-reported information as to socio-demographic and cancer-related variables, health, quality of life, work ability, work situation and supportive interventions. Results. The LSL consisted of 78% females, and 76% of them had breast or gynaecological cancer. A higher proportion of patients with low level of education, economical problems, treated with chemotherapy, hormones and multimodal treatment belonged to LSL compared to SSL. Significantly more LSL had recurrences of cancer, co-morbidity, regular use of medication, and poorer self-rated health, quality of life and work ability. Compared to SSL, more LSL reported needs for and offers of supportive care such as physiotherapy, physical activities and psychosocial support. A multivariate regression analysis showed that reduced work ability, changes in employment due to cancer, lack of support from supervisors at work, and having had combined treatment were significantly associated with being LSL. Conclusions. Longer sick-leave after primary cancer treatment is associated with combined cancer treatment, lack of support from supervisors and reduced overall work ability. Interventions and counselling related to the work place and reduced work ability could be of value for prevention of long-term sick-leaves.

The impact of social and organizational factors on workers' use of personal protective equipment: a multilevel approach.

Objective: On the basis of the job demands-control-support model by Karasek and Theorell, we investigated how social and organizational factors influence workers’ use of personal protective equipment (PPE). Methods: A cross-sectional study was performed among 1420 workers in 203 motor vehicle-repair garages. Multilevel modeling was performed to account for the hierarchical structure of the data. Results: Social and management support correlated positively with PPE use at the worker level. Low demands measured at the garage level and having a health and safety management system at the garage also correlated with active use of PPE. An interaction effect between social support and garage-level demands was observed. Conclusions: In addition to health information and provision of PPE, focusing on social and organizational factors seems necessary to get more workers to comply with the instructions on PPE use.

The influence of individual and contextual work factors on workers’ compliance with health and safety routines

This study investigated the relationships between workers compliance with health and safety (H&S) routines and instructions adopted in the company (dependent variable) and psychological demands, decision authority, social support, management support, unionization and H&S management system (independent variables). A cross-sectional questionnaire study was performed among 1051 workers and the managers of 102 small- and medium-sized motor vehicle repair garages. Multilevel modeling was performed to account for the hierarchical structure of the data. At the worker level, high compliance with H&S routines correlated significantly with both social support and H&S-related management support. At the garage level, mean management support and a well-developed H&S management system correlated significantly with high workers compliance. Changing both the individual and contextual factors in the work environment may thus increase workers participation in H&S activities.