Work factors as predictors of sickness absence: a three month prospective study of nurses’ aides

Abstract

Aims: To identify the work factors that predict sickness absence in nurses' aides. Methods: The sample comprised 5563 Norwegian nurses' aides, not on leave because of illness or pregnancy when they completed a mailed questionnaire in 1999. Of these, 4931 (88.6%) completed a second questionnaire three months later. The outcome measure was the three month incidence proportion of certified sickness absence (>3 days), as assessed by self reports at follow up. Results: Perceived lack of encouraging and supportive culture in the work unit (odds ratio (OR) 1.73; 95% confidence interval (CI) 1.28 to 2.34), working in psychiatric and paediatric wards, having injured the neck in an accident, and health complaints were associated with higher risk of sickness absence, after adjustments for a series of physical, psychological, and organisational work factors, personal engagement in the work unit, demographic characteristics, and daily consumption of cigarettes. Having untraditional jobs (for nurses' aides) (OR 0.53; 95% CI 0.36 to 0.77), and engaging in aerobics or gym were associated with a lower risk of sickness absence. Conclusions: The study suggests that the three month effects of work factors on rates of certified sickness absence are modest in nurses' aides. The most important work factor, in terms of predicting sickness absence, seems to be perceived lack of encouraging and supportive culture in the work unit.S ickness absence represents a major problem in Western societies.1 The nurses' aides, the main providers of practical patient care in the health service, are one of the occupational groups that exhibit the highest absence rates. 2The reasons for sickness absence are complex.1 3 The causes of an illness may be numerous, and an ill person's ability to work and decision to be absent from work are determined not only by the severity of the health problem, but by a series of social, psychological, and physical factors. It seems likely that working conditions may contribute to illness, and, in case of illness, influence the perception of work ability and the decision to be absent from work. Nurses' aides have to cope with a series of physical and psychological demands at work, including mechanical exposures and frequent social encounters. 5The impact of these challenges on rates of sickness absence remains to a large extent unclear. The relation between work factors and the occurrence of sickness absence has been investigated in many studies. However, the results from studies of civil servants, [6][7][8][9][10][11] 38 have been reported to be associated with rates of sickness absence. However, in many of these studies, the results may have been confounded by socioeconomic and cultural differences between nurses' aides and other groups of healthcare workers, such as registered nurses. In several studies, only a few work factors were explored at a time; as work factors may be correlated, the identified associations may in fact be due to the effects of unmeasured work factors. The effects of positive challenges in the ...

Psychological symptoms and subsequent sickness absence

“…The HADS depression scale correlates 0.49 with the 4DSQ depression scale but 0.67 with the 4DSQ distress scale, illustrating the distress component in the HADS depression scale (Terluin et al 2006). Eriksen et al (2003) studied prospectively the occurrence of SA longer than 3 days in a cohort of nurses' aides, during a period of 3 months. In a multivariate model, pain and fatigue were among the most powerful predictors with odds ratios (ORs) of 1.41 (for a little pain), 1.82 (for rather intense pain), 2.43 (for intense pain), and 1.73 (for always fatigued).…”

“…Some studies looked at interview-based psychiatric disorders (Kessler and Frank 1997;Dewa and Lin 2000;Kouzis and Eaton 1994;Suija et al 2009;Kruijshaar et al 2003;Broadhead et al 1990;Jenkins 1985;Laitinen-Krispijn and Bijl 2000), others at questionnaire-based psychological symptoms (Hilton et al 2008;Bültmann et al 2005Bültmann et al , 2006Virtanen et al 2007;Kivimäki et al 2001;Bourbonnais and Mondor 2001;Andrea et al 2003;Väänänen et al 2003; Lexis et al 2009;Duijts et al 2006;Eriksen et al 2003;Janssen et al 2003;Ahola et al 2008;Borritz et al 2006;Kivimäki et al 2007;Krantz and Ostergren 2002). The symptom predictors studied were distress (Hilton et al 2008;Bültmann et al 2005;Virtanen et al 2007;Kivimäki et al 2001;Bourbonnais and Mondor 2001;Andrea et al 2003;Väänänen et al 2003), depression (Bültmann et al 2006; Lexis et al 2009;Duijts et al 2006;Eriksen et al 2003), fatigue (Bültmann et al 2005;Andrea et al 2003;Duijts et al 2006;Eriksen et al 2003;…”

“…The symptom predictors studied were distress (Hilton et al 2008;Bültmann et al 2005;Virtanen et al 2007;Kivimäki et al 2001;Bourbonnais and Mondor 2001;Andrea et al 2003;Väänänen et al 2003), depression (Bültmann et al 2006; Lexis et al 2009;Duijts et al 2006;Eriksen et al 2003), fatigue (Bültmann et al 2005;Andrea et al 2003;Duijts et al 2006;Eriksen et al 2003;Janssen et al 2003), burnout (Bourbonnais and Mondor 2001;Duijts et al 2006;Ahola et al 2008;Borritz et al 2006) and psychosomatic symptoms (Väänänen et al 2003;Eriksen et al 2003;Kivimäki et al 2007;Krantz and Ostergren 2002). Some studies reported on SA as a dichotomous (yes/no) outcome (Kouzis and Eaton 1994;Laitinen-Krispijn and Bijl 2000;Bültmann et al 2005;Eriksen et al 2003;Ahola et al 2008;Krantz and Ostergren 2002), others reported on the frequency of SA spells (Kivimäki et al 2001(Kivimäki et al , 2007Väänänen et al 2003;Duijts et al 2006) or the total number of SA days (Kessler and Frank 1997;Dewa and Lin 2000;Suija et al 2009;Kruijshaar et al 2003;Broadhead et al 1990;…”

“…Few studies analyzed SA both in terms of frequency and duration as recommended by Hensing et al (1998). SA was either established by self-report (Hilton et al 2008;Kessler and Frank 1997;Dewa and Lin 2000;Kouzis and Eaton 1994;Suija et al 2009;Kruijshaar et al 2003;Broadhead et al 1990;Jenkins 1985;Laitinen-Krispijn and Bijl 2000;Eriksen et al 2003;Borritz et al 2006) or by organizational absence records (Bültmann et al 2005(Bültmann et al , 2006Virtanen et al 2007;Kivimäki et al 2001Kivimäki et al , 2007Bourbonnais and Mondor 2001;Andrea et al 2003;Väänänen et al 2003;Lexis et al 2009;Duijts et al 2006;Janssen et al 2003;Ahola et al 2008;Krantz and Ostergren 2002). Not all studies have taken into account possible confounding or effect modification by other factors.…”

“…depression). Only one study merged various symptoms in a single predictive model to partial out the unique impact of certain types of symptoms on the outcome of SA (Eriksen et al 2003). In addition, none of the studies that we know of studied anxiety symptoms as determinant of SA and only a few studies paid attention to the differential effect of various severity levels of the symptoms studied (Bült-mann et al 2006;Lexis et al 2009;Ahola et al 2008), the severity threshold at which psychological symptoms start to impact on SA.…”