Vilhelm Borg

The second version of the Copenhagen Psychosocial Questionnaire

Aims: The aim of the present paper is to present the development of the second version of the Copenhagen Psychosocial Questionnaire (COPSOQ II). Methods: The development of COPSOQ II took place in five main steps: (1) We considered practical experience from the use of COPSOQ I, in particular feedback from workplace studies where the questionnaire had been used; (2) All scales concerning workplace factors in COPSOQ I were analyzed for differential item functioning (DIF) with regard to gender, age and occupational status; (3) A test version of COPSOQ II including new scales and items was developed and tested in a representative sample of working Danes between 20 and 59 years of age. In all, 3,517 Danish employees participated in the study. The overall response rate was 60.4%; (4) Based on psychometric analyses, the final questionnaire was developed; and (5) Criteria-related validity of the new scales was tested. Results: The development of COPSOQ II resulted in a questionnaire with 41 scales and 127 items. New scales on values at the workplace were introduced including scales on Trust, Justice and Social inclusiveness. Scales on Variation, Work pace, Recognition, Work-family conflicts and items on offensive behaviour were also added. New scales regarding health symptoms included: Burnout, Stress, Sleeping troubles and Depressive symptoms. In general, the new scales showed good criteria validity. All in all, 57% of the items of COPSOQ I were retained in COPSOQ II. Conclusions: The COPSOQ I concept has been further developed and new validated scales have been included.

Social class and self-rated health: can the gradient be explained by differences in life style or work environment?

The purpose of the present paper is to describe differences in work environment and life style factors between social classes in Denmark and to investigate to what extent these factors can explain social class differences with regard to changes in self-rated health (SRH) over a 5 year period. We used data from a prospective study of a random sample of 5001 Danish employees, 18-59 years of age, interviewed at baseline in 1990 and again in 1995. At baseline we found higher prevalence in the lower classes of repetitive work, low skill discretion, low influence at work, high job insecurity, and ergonomic, physical, chemical, and climatic exposures. High psychological demands and conflicts at work were more prevalent in the higher classes. With regard to life style factors, we found more obese people and more smokers among the lower classes. The proportion with poor SRH increased with decreasing social class at baseline. The follow-up analyses showed a clear association between social class and worsening of SRH: The lower the social class, the higher the proportion with deterioration of SRH. There was no social gradient with regard to improved SRH over time. Approximately two thirds of the social gradient with regard to worsening of SRH could be explained by the work environment and life style factors. The largest contribution came from the work environment factors.

Socioeconomic status and psychosocial work environment: results from a Danish national study.

Objective: The aim of this study was to analyse the associations between socioeconomic status (SES) and a number of psychosocial work environment factors with a potential impact on inequality in health. Methods: A representative sample of 1,684 adult Danish employees fi lled in a standardized questionnaire or were interviewed by telephone. The response rate was 62%. The population was divided into four levels of SES (I to IV). The psychosocial work environment was described with 19 scales. Results: Quantitative, cognitive, and emotional job demands and a number of dimensions related to active and developmental work showed higher levels among high SES individuals. Job insecurity was highest among women with low SES. Dimensions describing interpersonal relations, social support, and leadership showed no clear associations with SES. Conclusions: Prevention aiming at improving health and reducing inequality in health should focus on the dimensions of active and developmental work: infl uence at work, possibilities for development, degrees of freedom, and meaning of work. Furthermore, job insecurity should be reduced.

The distinction between work pace and working hours in the measurement of quantitative demands at work

During recent years many researchers have criticized the widely used scales on psychological job demands. For instance, they comment that in most cases different types of demand seem to be mixed in one measure. In this paper we analyse the scale on quantitative job demands in the recently developed Copenhagen Psychosocial Questionnaire (COPSOQ), with special emphasis on Differential Item Functioning (DIF). DIF refers to basic differences between groups of respondents, which may affect how they respond to questionnaire items. The data material for our study comprised a representative sample of Danish employees. The respondents were categorized into 32 specific jobs according to the International Standard Classification of Occupations (ISCO 1968). We analysed DIF with respect to the respondents’ jobs with logistic regression analyses. These analyses showed that the items used in the original demand scale functioned very differently for different jobs in the population. The conclusion is that scales on quantitative demands are very sensitive to the choice of specific items. If many items on fast work pace and tempo are included in a scale, a number of blue-collar jobs will be identified as high-demand jobs. If, on the other hand, many questions on long working hours and overtime are included, the use of the scale will result in an entirely different picture. This issue has so far received little attention in occupational health psychology. The results have wide theoretical and methodological implications for research on quantitative job demands.

Work environment and changes in self-rated health: a five year follow-up study

A representative sample of 5001 Danish employees was followed for five years. The respondents were interviewed by telephone in 1990 and again in 1995. Social class, diseases, self-rated health (SRH), and a number of psychosocial and other work environment factors were assessed in 1990, and SRH was measured again in 1995. We analyzed predictors of changes in SRH from 1990 to 1995. After control for age, gender, and disease, the following factors predicted worsening of SRH among respondents with good SRH in 1990: repetitive work, high psychological demands, low social support, high job insecurity, and high ergonomic exposures. After further control for social class, the ORs for some of these factors were reduced, but they all remained significant. Only one of the work environment factors, ergonomic exposures, predicted improvements in SRH among those respondents who had poor SRH in 1990. Many studies have shown that SRH is a powerful independent predictor for total mortality. This is the first study showing that a number of work environment factors predict worsening of SRH over time. Copyright

Job demands, job resources and long‐term sickness absence in the Danish eldercare services: a prospective analysis of register‐based outcomes

AIM To investigate associations between psychosocial job demands, job resources and cases of registered long-term sickness absence among nursing staff in the eldercare services. BACKGROUND Research has shown that psychosocial work environment exposures predict sickness absence in healthcare settings. However, only few studies have longitudinally investigated associations between specific job demands and job resources and risk of long-term sickness absence. METHODS Questionnaire data were collected in 2004 and 2005 among all employees in the eldercare services in 35 Danish municipalities and were followed in a National register on payment of sickness absence compensation for a 1-year follow-up period (N = 7921). Three psychosocial job demands - emotional demands, quantitative demands and role conflicts - and three job resources - influence, quality of leadership and team climate - were investigated to predict risk of sickness absence for eight or more consecutive weeks in the follow-up period. Data were analysed using Cox proportional hazards model. RESULTS A percentage of 6·5 of the respondents were absent for eight or more consecutive weeks during follow-up. The analyses showed that emotional demands, role conflicts, influence, quality of leadership and team climate were significantly associated with risk of long-term sickness absence. In an analysis with mutual adjustment for all job demands and job resources, influence constituted the strongest predictor of long-term sickness absence (negative association). CONCLUSIONS Job demands and job resources are significantly associated with risk of long-term sickness absence. Interventions aimed at improving the psychosocial work environment may, therefore, contribute towards preventing long-term sickness absence in the eldercare services.

One-year prospective study on the effect of workplace bullying on long-term sickness absence

AIMS To examine the effect of workplace bullying on long-term sickness absence using a prospective design. BACKGROUND Although bullying has been identified as a serious problem in the health care sector, little attention has been given to the possible effect of workplace bullying on long-term sickness absence and its implications. METHODS The sample consisted of 9949 employees (78.1% response rate) working in the elderly-care sector in 36 Danish municipalities. Long-term sickness absence was measured by linking a survey on work and health to the national register on social transfer payments. RESULTS Among the 1171 employees that were bullied at work in the past 12 months, 1.8% were frequently bullied and 7.3% were occasionally bullied. The risk of long-term sickness absence was higher for those frequently bullied even after adjusting for psychosocial work characteristics [rate ratio (RR) = 1.92, confidence interval (CI): 1.29-2.84; P < 0.05]. CONCLUSION This is the first prospective study that explored the effect of both frequent and occasional bullying on long-term sickness absence among health care employees. The effect of frequent bullying on long-term sickness absence was independent of the psychosocial work characteristics. IMPLICATIONS FOR NURSING MANAGEMENT Workplace bullying might impact negatively the quality of care and patients safety.

Work-related violence as a predictor of fatigue: A 5-year follow-up of the Danish Work Environment Cohort Study

The main purpose of this study was to analyse work-related violence as a predictor of fatigue. In 1990 and 1995, 5001 Danish employees (a representative sample of the Danish workforce) were interviewed by telephone. The response rates were 90% in 1990 and 84% in 1995. The interviews included questions on fatigue and violence in 1990 and the SF-36 Vitality Scale (energy level and fatigue) in 1995. We found an association between exposure to work-related violence (both actual and threatened) in 1990 and fatigue in 1995. Employees who had been subjected to work-related violence in 1990 were approximately three times as likely to be fatigued in 1995 as non-exposed respondents. Violence predicted fatigue independently of a number of covariates, such as gender and age, social support, interpersonal conflict, type of contact at work with people other than colleagues, fatigue at baseline, and social class. We also found that exposure to violence in 1990 strongly predicted exposure to violence in 1995. Fatigue may result in a lower quality of life, a reduced ability to cope with the workload, and it may also reduce commitment towards clients. This may have an impact on the workplace and co-workers, who may have to cope with a higher workload. (Abstract Adapted from Source: Work & Stress, 2003. Copyright

Muscle activity and cardiovascular response during computer-mouse work with and without memory demands

Computer-mouse work is characterized by repetitive movements combined with mental demands. The present purpose was to study how the body responded to simulated Computer Aided Design (CAD) work without memory demand and when a high short-term memory demand was introduced. Nine female subjects repetitively performed a task which involved 15 s of elevation of the right index and middle fingers followed by 6 s of rest. Every second time the fingers rested, the left index finger was required to type a six-figure number, either ‘123456’ (without memory demand) or a random number shown half a minute before (with memory demand). After 7 min of performing the task without memory demand, the memory demand was introduced and continued for 1 h. Introduction of memory demand resulted in increased heart rate (77 ← 84 beats/min), blood pressure (systolic 129 ← 140 mmHg; diastolic 72 ← 79 mmHg) and forearm extensor muscle activity (wrist, 2.7 ← 4.5% EMGmax; finger, 5.6 ← 7.5% EMGmax) and finger flexor muscle activity (0.7 1.2% EMGmax) indicating increased co-contraction. Hereafter, muscle activity and cardiovascular response tended to decrease. Self-reported stress and rating of perceived exertion (RPE) for the right shoulder increased throughout the period. Two additional sub-studies were inlcuded, which focused on adaptation to the physical load, showing a decrease in muscle activity and arousal, and reintroduction of the memory load, showing a lower response as compared to the initial response. The practical consequences of the findings suggest that job content should have variable mental demands.

Bullying at work and onset of a major depressive episode among Danish female eldercare workers

OBJECTIVE The aim of this study was to analyze whether exposure to workplace bullying among 5701 female employees in the Danish eldercare sector increases the risk of onset of a major depressive episode (MDE). METHODS Participants received questionnaires in 2004-2005 and again in 2006-2007. MDE was assessed with the Major Depression Inventory. We examined baseline bullying as a predictor of onset of MDE at follow-up using multiple logistic regression. We further conducted a cross-sectional analysis at the time of follow-up among participants who at baseline were free of bullying, MDE, and signs of reduced psychological health. Finally, we analyzed reciprocal effects, by using baseline bullying and baseline MDE as predictors for bullying and MDE at follow-up. RESULTS Onset rates of MDE in the groups of no, occasional, and frequent bullying were 1.5%, 3.4%, and 11.3%, respectively. Odds ratios (OR) for onset of MDE were 2.22 [95% confidence interval (95% CI) 1.31-3.76] for occasional bullying and OR 8.45 (95% CI 4.04-17.70) for frequent bullying, after adjustment for covariates. In the cross-sectional analysis, OR were 6.29 (95% CI 2.52-15.68) for occasional bullying and 20.96 (95% CI 5.80-75.80) for frequent bullying. In the analyses on reciprocal effects, both baseline bullying [occasional: OR 2.12 (95% CI 1.29-3.48) and frequent: OR 6.39 (95% CI 3.10-13.17)] and baseline MDE [OR 7.18 (95% CI 3.60-14.30] predicted MDE at follow-up. However, only baseline bullying [occasional: OR 7.44 (95% CI 5.94-9.31) and frequent: OR 11.91 (95% CI 7.56-18.77)] but not baseline MDE [OR 0.93 (95% CI 0.47-1.84)] predicted bullying at follow-up. CONCLUSIONS Workplace bullying increased the risk of MDE among female eldercare workers. MDE did not predict risk of bullying. Eliminating bullying at work may be an important contribution to the prevention of MDE.