Occupational Medicine-Oxford最新文献

Background: International studies have revealed that numerous challenges (e.g. job demands) and opportunities (e.g. job resources as protective factors) affect the well-being of healthcare workers.

Aims: Building on the job demands-resources theory, we explored how job-related demands and the role of inclusive leadership as a job resource influenced the well-being of junior doctors during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: A cross-sectional web survey was conducted in July 2022 for 82 junior doctors who had experienced the 3-year COVID-19 pandemic. The survey captured their perceived physical, psychological and COVID-19-related job demands and the inclusive leadership behaviours exhibited by their clinical unit supervisors as job resources. Data were also collected on junior doctors' experiences of burnout, compassion satisfaction and occupational commitment as variables of job outcomes. Hierarchical linear regression analysis was applied to explore the relationships between the variables.

Results: Physical and COVID-19-related job demands were associated with increased burnout among junior doctors. Inclusive leadership as a job resource was associated with junior doctors' reduced burnout and increased compassion satisfaction and buffered the negative effects of psychological demands on their compassion satisfaction. Only COVID-19-related job demands were associated with junior doctors' occupational commitment.

Conclusions: Our study highlights the critical effects of COVID-19-related job demands on junior doctors' burnout and occupational commitment. Inclusive leadership behaviours exhibited by clinical unit supervisors are a valuable job resource, which can be incorporated as one of the competencies training for medical staff.

Background: Working from home (WFH) is becoming more common, but little is known about how it specifically affects neuro-divergent workers' psychological and occupational well-being.

Aims: This review aimed to explore the experiences of neuro-divergent staff WFH, including the challenges they face; the potential benefits of homeworking for this specific population and the support systems they require.

Methods: We searched six electronic databases, as well as reference lists of included papers, one preprint server and Google, for literature on neuro-divergent workers' experiences of WFH. Results were synthesized using thematic analysis.

Results: We reviewed 25 studies (mostly based on data collected during the coronavirus disease 2019 pandemic), finding very little research statistically analysing the impact of WFH on well-being or productivity, or comparing the impact of WFH across neuro-divergent and neuro-typical populations. The (mostly qualitative) findings showed that neuro-divergent participants described various benefits and challenges of the sensory environment at home; the reduction of commuting; increased flexibility and lack of routine when homeworking; the reduction of 'masking' behaviours; lack of in-person social contact and increased use of technology.

Conclusions: The findings emphasize the importance of not assuming a one-size-fits-all approach to homeworking and suggest managers should be mindful of workers' individual preferences for working whilst ensuring that all employees are appropriately supported. The results can inform future research and provide insights for employers to help them create more inclusive work environments.

Background: Cholecystectomy, a type of surgery commonly performed globally, has possible mutual effects on the socioeconomic conditions of different countries due to various postoperative recovery times.

Aims: This study evaluated the medical and socioeconomic factors affecting delayed return-to-work (RTW) time after elective cholecystectomy.

Methods: This retrospective study analysed patients who underwent elective cholecystectomy for benign gallbladder diseases from January 2022 to April 2023. The patients' medical and socioeconomic data were collected to investigate the clinical and socioeconomic factors correlated with RTW time of >30 days after surgery.

Results: This study included 180 consecutive patients. Significant correlations were found between delayed RTW time (>30 days) and age (odds ratio [OR]: 1.059, 95% confidence interval [CI] 1.008-1.113, P = 0.024), lack of medical insurance (OR: 2.935, 95% CI 1.189-7.249, P = 0.02) and high-intensity labour jobs (OR: 3.649, 95% CI 1.495-8.909, P = 0.004). Patients without medical insurance (26.6 versus 18.9 days) and those with high-intensity labour jobs (23.9 versus 18.8 days) had a higher mean RTW time than those with insurance and a less-intense labour job (P < 0.001).

Conclusions: After cholecystectomy, older age, lack of medical insurance and high-intensity labour job were correlated with a delayed RTW time. Informing patients about their expected RTW time after surgery can help reduce costs.

Background: The veterinary workplace carries a high risk of staff accidents and injuries, yet there is scant research exploring it in comparison with other comparable fields, such as human medicine.

Aims: To understand how veterinary professionals define injuries and to understand what injuries they do, or do not, deem reportable.

Methods: A cross-sectional survey comprising demographic questions and open-text questions was shared with veterinary practice staff across the UK. Data were analysed descriptively and using an inductive content analysis.

Results: There were 740 respondents, who were broadly representative of the veterinary profession. There were differences in how injuries were defined; for example, small animal veterinarians expected injuries to involve blood, while equine and production animal veterinarians were more likely to expect injuries to reduce their ability to perform work and require medical treatment. Many suggested that 'all' workplace injuries should be reported; however, 'minor' injuries were often overlooked, for example, needlestick injuries did not always meet the criteria of being an 'injury'. Injuries caused by staff themselves (e.g. trips) were less likely to be reported than injuries that could be blamed on an external factor (e.g. dog bite).

Conclusions: Collectively, the data suggest a wide-ranging perception of risk of injury in practice, with some harms seen as 'everyday norms'. Veterinary practices should interpret their injury statistics with a high degree of caution. They should explore the microcultures within their practices relating to worker perception of risk, injury and barriers to reporting.

Background: Healthcare professionals (HCPs) are expected to identify and respond to domestic abuse (DA) among their patients. Although research suggests that a high proportion of HCPs are affected by DA, the impact of their experiences has been under-researched.

Aims: To assess UK HCPs' experiences of DA and develop a broad understanding of its impact on work and HCPs' support needs.

Methods: An online cross-sectional survey was promoted via multiple professional channels (October to December 2022). We adopted convenience sampling and analysed data descriptively.

Results: Among the 192 HCP survivors who responded, all abuse subtypes-psychological, sexual, economic and physical-were common. Ninety per cent of abusers were male (ex)partners. Eighty-five per cent reported abusers directly interfered with their work and 92% reported their work and career were affected. Almost all reported physical and mental health consequences. Eighty-nine per cent reported their own experiences shaped their responses to patient survivors. On average, per year, HCP survivors reported they had 13 sick days, 5 days' leave, 10 days' lateness and 6 days' early departure due to DA. Only 20% reported their workplace had a staff DA policy, and over 50% were unsure what workplace support mechanisms were available. Just over half disclosed at work; concerns that others would question their fitness to practice were common. Twenty-two per cent reported aspects of work, for example, long hours, stopped them from seeking support outside work.

Conclusions: HCPs face unique barriers to DA disclosure and support-seeking and may benefit from tailored support from specialists who understand both DA and the healthcare context.

Background: Every year, 2.3 million people worldwide succumb to work-related accidents and illnesses. The primary industries have long been acknowledged with elevated accident risks. Recent levels and trends of injury and associated fatalities in these sectors are uncertain. An enhanced understanding of these risks in these industries is required for effective injury prevention in the future.

Aims: This study aimed to describe registered fatalities in the primary industries worldwide, exploring potential disparities between countries and identifying trends in injury rates.

Methods: Data were obtained on fatal occupational injuries per 100,000 workers in farming, fishing and forestry for the years 2010-2015 from the International Labour Organization ILO-STAT database. Descriptive statistics and mixed-model regression analyses were conducted. Fatal occupational injuries in upper- and middle-income countries were compared.

Results: The study incorporated data from 32 countries: 21 from Europe. America had the highest mean occupational fatality injury rate (76.9). The highest recorded rates for individual countries occurred in Colombia in 2014 (265.2) and Lithuania in 2015 (75.0), and the lowest in Greece in 2012 (0.2). Significant variation in injury rates was evident among the countries. There was no trend in the incidence of fatal injuries from 2010 to 2015, neither for all countries, nor Europe. Middle-income countries had higher occupational fatality injury rate than upper-income countries.

Conclusions: The occupational fatality injury rate exhibited considerable variation, ranging from 0.9 to 265.2, and the injury rate was lowest in upper-income countries. There was no trend in the figures 2010-2015.

Background: While the number of female medical graduates continues to increase, only a few pursue an orthopaedic career. This is related to challenges regarding pregnancy and the peripartum period during orthopaedic training.

Aims: To evaluate fertility, pregnancy-related complications and attitudes towards female orthopaedic surgeons in Israel.

Methods: An electronic anonymous 34-question electronic web-based survey was sent to all Israeli female orthopaedic surgeons. Participation was voluntary. Questions were formulated to determine demographics, obstetrics medical history, teratogenic exposure, medical leave and breastfeeding parameters along with attitude towards pregnancy.

Results: Twenty-six orthopaedic surgeons complied with the survey, 68% of all registered female orthopaedic surgeons. Participants age was 39.5 (±8.8). The average number of children for a female orthopaedic surgeon was 2.2 (±1.4), with an average of 1.3 (±1.1) deliveries during residency. The average age for a first child was 31.1 (±3.7) years. Four surgeons required fertility treatments and six had abortions. Thirty-eight per cent experienced pregnancy complications. Most surgeons were exposed to radiation and bone cement during pregnancy. The average duration of maternity leave was 19.4 (±9.9) weeks and return to work was associated with cessation of breastfeeding. Seventy-six per cent of surgeons felt that pregnancy had negatively influenced their training, and 12% reported negative attitudes from colleagues and supervisors.

Conclusions: Orthopaedic surgeons in Israel experience a delay in childbirth and higher rates of pregnancy complications. Most feel that their training is harmed by pregnancy. Programme directors should design a personalized support programme for female surgeons during pregnancy and the peripartum period.