Occupational Medicine-Oxford最新文献

Background: Individuals with severe mental illness experience greater unemployment and barriers to workforce re-entry. However, less is known about additional indicators of employment stability for individuals across mental illness severity.

Aims: This study aims to examine associations between mental illness severity, use and adequacy of mental health treatment, and indicators of employment stability.

Methods: In this repeated cross-sectional study, 2010-2019 data from the U.S. National Survey of Drug Use and Health were used to construct multivariate logistic regression models predicting the odds of part-time employment, past-year work interruption, number of past-year employers, and past-month health-related work absence by mental illness severity and adequacy of mental health treatment.

Results: Compared to individuals with no mental illness, those with any and severe mental illness had significantly higher odds of part-time employment (adjusted odds ratios [AORs] = 1.51 and 2.16, 95% confidence intervals [CIs] 1.4-1.6 and 2.0-2.3), multiple past-year employers (AORs = 1.78 and 2.34, CIs 1.7-1.9 and 2.1-2.6), past-year work interruption (AORs = 1.69 and 2.20, CIs 1.6-1.8 and 2.1-2.4), and >7 days of past-month work absence (AORs = 2.51 and 3.82, CIs 2.3-2.8 and 3.3-4.5). Among respondents with mental illness, perceived inadequacy of mental treatment predicted higher odds of all adverse employment outcomes.

Conclusions: Compared to those with no mental illness, individuals with mental illness of any severity have higher odds of employment instability. Policy and programmatic support aimed at addressing the needs of individuals with mental illness, including access to adequate mental health treatment, are needed to facilitate continued, competitive employment.

Background: There is growing interest in understanding neurodevelopmental disorders such as Attention-deficit/hyperactivity disorder (ADHD) among doctors. However, the current understanding of ADHD and its association with mental well-being in doctors is limited.

Aims: This study investigated the significance of ADHD among doctors with mental health difficulties accessing a national mental health service for doctors in England.

Methods: Electronic records from 2877 doctors seeking mental health care through the National Health Service Practitioner Health service were analysed. Demographic data, psychopathology scales (PHQ-9 for depression, GAD-7 for anxiety, Core-10 for psychological well-being) and ADHD screening using ADHD Self-Report Scale (ASRS) were examined. Analyses were conducted to explore associations between ADHD screening, demographic variables and co-existing mental health disorders.

Results: The study revealed that over one-third (35%) of doctors in this study sample screened positive for ADHD using the ASRS questionnaire. The male-to-female ratio for screened positive was 1.1:1. The number of doctors screening positive for ADHD reduced with age. A substantial portion of doctors who screened positive for ADHD also exhibited symptoms of co-existing mental health disorders such as anxiety and depression.

Conclusions: This study highlights that assessments for ADHD among doctors presenting with mental health difficulties can be important and relevant. Validated screening tools can be used in this process. The high rate of psychopathology among those who screened positive for ADHD in this study sample indicates the need for detailed assessments to understand the complex dynamic of ADHD symptoms and psychiatric disorders. Recognizing ADHD is important as treatments are different to other psychiatric disorders.

Background: Poor mental health is highly prevalent among schoolteachers. Different occupational, contextual and personal factors have been identified as sources of their psychological distress.

Aims: To explore the association of classroom-level variables with teachers' mental health over the course of an academic year.

Methods: This study included 80 primary schoolteachers and 2075 pupils from the STARS trial conducted in England, which explored the impact of the Incredible Years Teacher Classroom Management programme. Linear regression models examined the relationships between classroom-level predictor variables and teachers' psychological distress, as measured by the Everyday Feeling Questionnaire, at 1 and 9 months into the school year. Predictor variables included classroom size and demographic composition, amount of teaching assistant support, and pupils' mental health, as measured by the Strengths and Difficulties Questionnaire and the Pupil Behaviour Questionnaire. Analyses were adjusted for teacher length of service and trial arm status.

Results: One month into the school year, fully adjusted analyses showed that having a classroom with a higher proportion of male pupils was associated with worse teacher mental health. None of the classroom-level stressors were associated with teacher mental health at 9 months.

Conclusions: Classroom gender balance was associated with teacher's mental health at the beginning but not at the end of the academic year. It is important to consider classroom-level variables when developing interventions and policies for teacher mental health.

Background: Diplomatic personnel face unique job demands due to their frequent relocations. There is some evidence that occupational stress contributes to poor well-being in this occupational group, but little research on the aspects of the job that are perceived to be particularly challenging.

Aims: This study aimed to explore diplomatic personnel's perceptions of their organization and their roles and to identify aspects of the job, which could cause stress and potentially affect well-being.

Methods: Semi-structured interviews were carried out with 24 employees of the Foreign, Commonwealth and Development Office between September 2021 and February 2022. Participants were asked to reflect on their experiences before the coronavirus disease 2019 pandemic. Thematic analysis was used to analyse data.

Results: Participants enjoyed many aspects of their work including the variety, travel opportunities and feeling that they made a difference. They also identified several stressors relating to job demands, overseas postings, family needs, frequent relocation, hardship posts, workplace relationships, (lack of) appreciation and acknowledgement, and organizational culture. Good relationships with colleagues and managers were perceived to be very important.

Conclusions: Findings suggest various ways in which diplomatic organizations can better support their personnel, highlighting workload management; cross-cultural training; providing appropriate support to both accompanying families and unaccompanied staff members; practical and psychological preparation for those in high-risk locations; encouraging positive workplace relationships; good management; increased autonomy and increased recognition for good work.

Background: Call-handlers and dispatchers (CHDs) working in specialized emergency and urgent communication centres are essential in supporting public safety and health. Evidence suggests that these professionals are at increased risk of mental health conditions, including post-traumatic stress disorder (PTSD), depression, anxiety and alcohol abuse among other conditions; however, reliable prevalence estimates remain undetermined.

Aims: We provide the estimated pooled prevalence for PTSD, depression, anxiety and hazardous drinking among emergency and urgent CHDs globally.

Methods: We searched 10 electronic databases, grey literature and the Annals of Emergency Dispatch and Response. Eligible studies reported original quantitative data and used validated self-reported measures on the prevalence of mental health conditions of interest (i.e. PTSD, depression, anxiety and alcohol use) within CHD professionals. Three reviewers independently screened results for eligibility. Prevalence estimates were pooled using random-effects meta-analyses.

Results: In total, 16 857 references were retrieved. From these, 183 full-text articles were assessed for eligibility, of which 37 articles were included in this systematic review, and 13 articles provided necessary quantitative information for meta-analyses. In total, 7759 CHDs were considered across nine different countries. The overall pooled prevalence for PTSD was 17.8% (95% confidence interval [CI] 12.4-24.0%), depression was 28.2% (95% CI 20.7-36.2%), anxiety was 17.2% (95% CI 6.6-31.5%) and hazardous drinking was 17.8% (95% CI 6.9-32.2%).

Conclusions: These findings indicate CHDs are at significant risk of mental health problems. Further quantitative and qualitative research is warranted to help understand the psychological risks of working as a CHD and guide appropriate psychological support.

Background: Several investigations have shown that residents are especially vulnerable to work stress, with the greatest relevance placed on psychosocial factors.

Aims: To investigate the relationship between psychosocial risk factors and general, mental and vitality perceived health and job satisfaction among residents in a teaching hospital for a preventive intervention program.

Methods: This is a retrospective cross-sectional study. Data on psychosocial factors (F-PSICO-INSHT-4.0), perceived general, mental and vitality health (36-item Short Form Survey questionnaire), and overall job satisfaction were collected from an anonymous, online survey (2018). Univariate and multivariate analysis was done.

Results: The survey was answered by 107 residents (31% response rate). Female residents had worse perceived mental health than males (P < 0.05). Residents showed a worsening of vitality from the second year to the residency end (P < 0.05). No gender or year of residency differences were found related to general health. Job satisfaction worsened during years of residency (P < 0.01), with no gender differences. The psychosocial factors identified as potential risk factors were workload, emotional demands, participation/supervision and role performance. Multivariate linear regression models showed that compensation and role clarity explain 18% of the variation in general health score (adjusted-R2 = 0.183); role clarity, emotional demands, interpersonal conflicts and difficulty at work the 32% of the variation in mental health outcome (adjusted-R2 = 0.315); and compensation, time pressure, gender and supervision the 32% of the variability of vitality outcome (adjusted-R2 = 0.320).

Conclusions: These findings highlight the importance of psychosocial risk factors in perceived health, and overall satisfaction in medical residents during their specialist training.