| 1. |
- Arnetz, Bengt B., et al.
(författare)
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Examining self-reported and biological stress and near misses among Emergency Medicine residents : a single-centre cross-sectional assessment in the USA
- 2017
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 7:8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents.Design: Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses.Setting: The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA. Participants Residents in Emergency Medicine volunteered to participate. The sample consisted of 32 residents, with complete data on 28 subjects. Residents' supervising physicians assessed the clinical performance of each resident.Primary and secondary outcome measures: Participants' preshift and postshift stress, biological stress (salivary cortisol, plasma interleukin-6, tumour necrosis factor-alpha (TNF-alpha) and high-sensitivity C-reactive protein), residents' and supervisors' reports of near misses, number of critically ill and patients with trauma seen during the shift.Results: Residents' self-reported stress increased from an average preshift level of 2.79 of 10 (SD 1.81) to a postshift level of 5.82 (2.13) (p<0.001). Residents cared for an average of 2.32 (1.52) critically ill patients and 0.68 (1.06) patients with trauma. Residents reported a total of 7 near misses, compared with 11 reported by the supervising physicians. After controlling for baseline work-related exhaustion, residents that cared for more patients with trauma and had higher levels of TNF-a reported a higher frequency of near misses (R-2=0.72; p=0.001). Residents' preshift ratings of how stressful they expected the shift to be were related to the supervising physicians' ratings of residents' near misses during the shift.Conclusion: Residents' own ratings of near misses were associated with residents' TNF-alpha, a biomarker of systemic inflammation and the number of patients with trauma seen during the shift. In contrast, supervisor reports on residents' near misses were related only to the residents' preshift expectations of how stressful the shift would be.
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| 2. |
- Arnetz, Bengt B., et al.
(författare)
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Organizational Climate, Occupational Stress, and Employee Mental Health : Mediating Effects of Organizational Efficiency
- 2011
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 53:1, s. 34-42
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether the relationship between organizational climate and employee mental health is consistent (ie, invariant) or differs across four large hospitals, and whether organizational efficiency mediates this relationship. Methods: Participants (total N = 5316) completed validated measures of organizational climate variables (social climate, participatory management, goal clarity, and performance feedback), organizational efficiency, occupational stress, and mental health. Results: Path analysis best supported a model in which organizational efficiency partially mediated relationships between organizational climate, occupational stress, and mental health. Conclusions: Focusing on improving both the psychosocial work environment and organizational efficiency might contribute to decreased employee stress, improved mental well-being, and organizational performance.
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| 3. |
- Arnetz, Bengt B, et al.
(författare)
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Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees
- 2014
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 16:6, s. 1055-1061
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Tidskriftsartikel (refereegranskat)abstract
- Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10 %, respectively) than did the cumulative trauma index (7 and 3 %, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.
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| 4. |
- Arnetz, Bengt B, et al.
(författare)
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Spiritual values and practices in the workplace and employee stress and mental well-being
- 2013
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Ingår i: Journal of Management, Spirituality and Religion. - : International Association of Management Spirituality & Religion. - 1476-6086 .- 1942-258X. ; 10:3, s. 271-281
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To determine whether employees’ spiritual values and practicesin the workplace attenuate occupational stress and work-related exhaustion,and promote mental well-being.Methods:Participants (N = 649) completedvalidated measures of mental well-being, occupational stress, and workrelatedexhaustion, as well as two newly developed measures of individualspiritual values and practices in the workplace.Results:Factor analysis confirmedthat spirituality items belonged to two separate constructs. In logisticregression models, the Spiritual Values in the Workplace scale was positivelyassociated with mental well-being and low occupational stress. Thespiritual practices at work scale was positively associated with low workrelatedexhaustion.Conclusions: Employee spiritual values and practices, aswell as workplace acceptance of such practices, appear to promote mentalwell-being and attenuate stress.
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| 5. |
- Arnetz, Judith E., et al.
(författare)
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Development and evaluation of a questionnaire for measuring patient views of involvement in myocardial infarction care
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:3, s. 229-238
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Patients' involvement in their healthcare has been associated with improved treatment outcomes in chronic illness. Less is known about the affects of patient involvement on the outcomes of acute illness, such as myocardial infarction. A better understanding of patients' views and behaviour during hospitalization might improve clinical practice and enhance patient involvement. AIM The aim of this study was to develop and evaluate a questionnaire for measuring patients' perceptions of their involvement during hospitalization for myocardial infarction care. METHODS Focus groups with myocardial infarction patients provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among myocardial infarction patients at eleven Swedish hospitals. RESULTS The questionnaire demonstrated good validity and reliability, with six factors measuring patient views and behaviour regarding involvement. CONCLUSION The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of patients regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of patient-staff interaction that need improvement. Pinpointing such areas may lead to improved patient involvement, satisfaction with care, and treatment outcomes.
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| 6. |
- Arnetz, Judith E., et al.
(författare)
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Gender differences in patient perceptions of involvement in myocardial infarction care
- 2009
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 8:3, s. 174-181
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gender differences in the clinical presentation, treatment and outcomes of myocardial infarction (MI) have been demonstrated. However, few studies have examined gender differences in patients' perceptions of involvement in MI care, and whether differing levels of involvement might be associated with gender differences in treatment and outcome. AIM: To examine possible gender differences in MI patients' perceptions of their involvement during hospitalization. METHODS: Questionnaire study conducted in 2005-2006 among MI patients under the age of 75 at eleven hospitals. Patient ratings of their involvement during hospitalization were analyzed for age-stratified gender differences. RESULTS: Younger (<70 years of age) female MI patients placed significantly more value on shared decision-making than younger (<70) men. More than one third of patients would have liked to be more involved in their care during hospitalization and discharge planning, with women significantly more dissatisfied than men. Significantly fewer younger female patients discussed secondary preventive lifestyle changes with cardiology staff prior to hospital discharge. CONCLUSION: Significant age-specific gender differences exist in MI patient ratings of, and satisfaction with, involvement during hospitalization. Further study is needed regarding the possible role of involvement in the recognized gender differences in the treatment and outcomes of MI.
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| 7. |
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| 8. |
- Arnetz, Judith E., et al.
(författare)
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Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome? : an exploratory study
- 2010
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 13:3, s. 298-311
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether patient involvement during hospitalization for acute myocardial infarction (MI) was associated with health and behavioural outcomes 6–10 weeks after hospital discharge. Background Patient involvement has been associated with improved health outcomes in chronic disease, but less research has focused on the effects of patient involvement in acute conditions, such as MI. Design Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients. Setting and participants Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals. Main outcome measures Patient ratings of three questionnaire scales related to involvement; cardiovascular symptoms, medication compliance, participation in cardiac rehabilitation, and achievement of secondary preventive goals. Results More positive patient ratings of involvement were significantly associated with fewer cardiovascular symptoms 6–10 weeks after hospital discharge. In contrast, patients who attended cardiac rehabilitation and achieved the goals for smoking cessation and systolic blood pressure were significantly less satisfied with their involvement. No association was found between involvement ratings and medication compliance. Conclusion This study represents a first attempt to examine associations between patient involvement in the acute phase of illness and short-term health outcomes. Some significant associations between involvement and health and behavioural outcomes after acute MI were found. However, higher involvement ratings were not consistently associated with more desirable outcomes, and involvement during hospitalization was not associated with MI patient health and behaviour 6–10 weeks after hospital discharge to the extent hypothesized.
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| 9. |
- Arnetz, Judith E., et al.
(författare)
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Organizational Climate Determinants of Resident Safety Culture in Nursing Homes
- 2011
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Ingår i: The Gerontologist. - : Oxford University Press (OUP). - 0016-9013 .- 1758-5341. ; 51:6, s. 739-749
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes. Design and Methods: Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures. Results: The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05). Implications: Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.
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| 10. |
- Arnetz, Judith E., et al.
(författare)
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Patient Involvement : A New Source of Stress in Health Care Work?
- 2016
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Ingår i: Health Communication. - : Informa UK Limited. - 1041-0236 .- 1532-7027. ; 31:12, s. 1566-1572
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Tidskriftsartikel (refereegranskat)abstract
- Patients have become increasingly well informed with higher expectations to be involved in decision-making processes regarding their care and treatment. However, few studies have examined the impact of patient involvement on health care providers' partnership-building communication. The aim of this study was to measure and explore the self-reported effects of patient involvement on the work of physicians and nurses. A questionnaire survey was distributed among cardiology staff in 12 Swedish hospitals (N=488, response rate 67%). The sample was comprised of registered nurses (RNs, n=303), licensed practical nurses (LPNs, n=132), and physicians (MDs, n=53). Confirmatory factor analysis was used to examine seven questionnaire statements concerning implications of patient involvement for one's clinical work. Regression analyses were used to examine factors associated with staff's partnership-building communication. Analysis confirmed two distinct factors accounting for 57% of the total variance, representing both negativeHasslesand positiveUpliftsaspects of patient involvement. Regression analyses revealed that only positive aspects (i.e., uplifts) of patient involvement predicted staff behavior aimed at involving patients. Working with actively involved patients may be a source of stress, both negative and positive, for health care professionals. By developing work routines for involving patients in their care, health care workplaces may help health care professionals to buffer the negative effects, and enhance the positive effects, of that stress.
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| 11. |
- Arnetz, Judith E., et al.
(författare)
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Physicians' and nurses' perceptions of patient involvement in myocardial infarction care
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151 .- 1873-1953. ; 7:2, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients' involvement in their healthcare has been associated with better health outcomes. However, few studies have examined whether patient involvement affects the work of healthcare professionals. A better understanding of professionals' views and behaviour is necessary for improving clinical practice and optimizing patient involvement. Aim: To measure perceptions and behaviour regarding patient involvement among physicians and nursing staff caring for patients with acute myocardial infarction. Methods: A questionnaire study conducted in 2005 among cardiology staff at twelve Swedish hospitals. The questionnaire included six scales measuring staff views and behaviour. Results: Physicians, registered nurses, and practical nurses did not differ significantly in their views of patient involvement, but did differ significantly in behaviour (p<.001). All three groups felt that an actively involved patient enriched their work, at the same time increasing their work load and taking time from other tasks. Physicians discussed daily activities and lifestyle changes with myocardial infarction patients before hospital discharge to a greater extent than nursing staff (p<.001). Conclusion: Physicians and registered nurses viewed time constraints as a hinder for patient involvement, while practical nurses felt unsure in communicating with patients. Considering these organizational and professional issues may improve patient involvement and health outcomes in myocardial infarction care. (C) 2007 European Society of Cardiology. Published by Elsevier B.V All rights reserved.
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| 12. |
- Arnetz, Judith E., et al.
(författare)
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Staff views and behaviour regarding patient involvement in myocardial infarction care : development and evaluation of a questionnaire
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Elsevier. - 1474-5151 .- 1873-1953. ; 7:1, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Healthcare legislation in several nations now dictates the responsibility of health care professionals to involve patients in decisions concerning care and treatment. However, few studies have examined the impact of patient involvement on the work of health care professionals. A better understanding of staff views and behaviour might enhance patient involvement. AIM The aim of this study was to develop and validate a questionnaire for measuring views and behaviour regarding patient involvement among physicians and nursing staff caring for patients with myocardial infarction. METHODS Focus groups among cardiology staff provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among cardiology staff at twelve Swedish hospitals. RESULTS The questionnaire demonstrated good validity and reliability, with two factors measuring staff views and four measuring behaviour. CONCLUSION The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of physicians and nursing staff regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of staff-patient interaction that need improvement, as well as implications of patient involvement for the work of each professional group on cardiology wards.
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| 13. |
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| 14. |
- Jamil, Hikmet, et al.
(författare)
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Do Household Smoking Behaviors Constitute a Risk Factor for Hookah Use?
- 2011
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Ingår i: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 13:5, s. 384-388
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Much research has focused on the role played by families in cigarette smoking behavior. However, there is a lack of such research for hookah (waterpipe) smoking. This study focuses on the role of family members' hookah smoking behaviors as a possible risk factor for hookah smoking. Methods: Eight hundred and one adults in southeast Michigan responded to an anonymous self-administered survey regarding personal and family members' hookah smoking behavior and perceptions of health risks related to hookah smoking. Multinomial logistic regression modeling was used to examine risk factors for hookah use. Results The prevalence of current hookah smoking in the study population was 26%. The odds ratio for an individual to smoke hookah were 9.5 (95% CI = 2.37-38.47, p < .01), 8.6 (95% CI = 3.92-19.02, p < .001), and 1.2 (95% CI = 1.14-1.41, p < .05) if the father, mother, or sibling, respectively, smoked hookah at home. Male gender and younger age were also significantly associated with hookah smoking. Household hookah smoking behaviors were also significant risk factors among former hookah smokers compared with nonsmokers, but there were no significant risk factors when comparing former hookah smokers with current hookah smokers. Conclusions: Having a father, mother, or sibling smoking hookah at home, male gender and younger age are significant risk factors for current hookah smoking.
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| 15. |
- Jamil, Hikmet, et al.
(författare)
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Risk Factors for Hookah Smoking Among Arabs and Chaldeans
- 2014
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 16:3, s. 501-507
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Tidskriftsartikel (refereegranskat)abstract
- Hookah smoking is more prevalent among individuals of Middle Eastern descent. This study examined general and ethnic-specific risk factors for hookah smoking among Arabs and Chaldeans. A self-administered anonymous questionnaire was conducted among 801 adults residing in Southeast Michigan. Binary logistic regression modeling was used to predict risk factors for hookah smoking. Hookah smoking was significantly more prevalent among Arabs (32 %) than Chaldeans (26 %, p < 0.01) and being Arab was a risk factor for lifetime hookah use. Younger age (<25 years), being male, higher annual income, and having health insurance were significant risk factors for hookah use. Chaldeans believed to a greater extent than Arabs that smoking hookah is less harmful than cigarette smoking (75 vs. 52 %, p < 0.001). Hookah smoking is prevalent in both ethnic groups, but significantly higher among Arabs. Results indicate that prevention efforts should target younger males with higher incomes.
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| 16. |
- Jamil, Hikmet, et al.
(författare)
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Sociodemographic risk indicators of hookah smoking among White Americans : A pilot study
- 2010
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Ingår i: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 12:5, s. 525-529
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the sustained public health efforts to decrease cigarette smoking, there is an increasing trend in the use of alternative tobacco products that are perceived by some as less harmful. One example is hookah smoking. This study aimed to assess hookah trends among White Americans. Methods: Two hundred and forty-five White American adults residing in southeast Michigan answered a self-administered standardized questionnaire that included basic demographics, socioeconomic status, and questions related to hookah smoking behavior. Logistic regression was used to determine risk indicators for hookah smoking. Results: The combined prevalence of hookah smoking in the White American study population was 19%, with 10% of the sample smoking hookah only and 9% smoking both hookah and cigarettes. Approximately 19% of respondents believed that smoking hookah was less harmful than smoking cigarettes. Significant risk indicators for smoking hookah were being younger than 22 years and living with a family member who used tobacco. Discussion: In addition to reporting the prevalence of use in this important group of potential users, we outline important sociodemographic risk factors for hookah use in a non-Arab American population. More research is needed with a larger population to better understand this new tobacco trend in order to curb a new potential health threat.
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| 17. |
- Lumley, Mark A., et al.
(författare)
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The Relationship of Chronic and Momentary Work Stress to Cardiac Reactivity in Female Managers : Feasibility of a Smart Phone-Assisted Assessment System
- 2014
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Ingår i: Psychosomatic Medicine. - : Lippincott Williams & Wilkins. - 0033-3174 .- 1534-7796. ; 76:7, s. 512-518
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate a wireless smart phone-assisted (SPA) system that assesses ongoing heart rate (HR) and HR-triggered participant reports of momentary stress when HR is elevated during daily life. This SPA system was used to determine the independent and interactive roles of chronic and momentary work stress on HR reactivity among female managers. Methods: A sample of 40 female managers reported their chronic work stress and wore the SPA system during a regular workday. They provided multiple reports of their momentary stress, both when triggered by increased HR and at random times. Relationships among chronic stress, momentary stress, and HR were analyzed with hierarchical linear modeling. Results: Both chronic work stress (b = 0.08, standard error [SE] = 0.03, p = .003) and momentary work stress (b = 1.25, SE = 0.62, p = .052) independently predicted greater HR reactivity, adjusting for baseline HR, age, smoking, caffeine, alcohol use, and momentary physical activity levels. More importantly, chronic and momentary stress significantly interacted (b = 1.00, SE = 0.04, p = .036); high momentary stress predicted elevated HR only in the context of high chronic stress. Conclusions: Female managers who experience chronic work stress displayed elevated cardiac reactivity during momentary stress at work. The joint assessment of chronic stress and momentary stress and their relationship to physiological functioning during work clarifies the potential health risks associated with work stress. Moreover, this wireless SPA system captures the immediate subjective context of individuals when physiological arousal occurs, which may lead to tailored stress management programs in the workplace.
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| 18. |
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| 19. |
- Wright, A. Michelle, et al.
(författare)
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Determinants of resource needs and utilization among refugees over time
- 2016
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 51:4, s. 539-549
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Tidskriftsartikel (refereegranskat)abstract
- This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.
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| 20. |
- Wright, A. Michelle, et al.
(författare)
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Kidnapping and Mental Health in Iraqi Refugees : The Role of Resilience
- 2017
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Ingår i: Journal of Immigrant and Minority Health. - : SPRINGER. - 1557-1912 .- 1557-1920. ; 19:1, s. 98-107
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Tidskriftsartikel (refereegranskat)abstract
- Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms.
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| 21. |
- Wright, A. Michelle, et al.
(författare)
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Unemployment in Iraqi refugees : The interaction of pre and post-displacement trauma
- 2016
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 57:6, s. 564-570
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Tidskriftsartikel (refereegranskat)abstract
- Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N=286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin.
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| 22. |
- Arfken, Cynthia L, et al.
(författare)
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Alcohol use among Arab Americans : what is the prevalence?
- 2011
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 13:4, s. 713-718
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Tidskriftsartikel (refereegranskat)abstract
- Information is limited on alcohol use among Arab Americans. The purpose of this study was to describe and analyze the alcohol use pattern among Arab Americans by reviewing existing surveys using an acculturation model. Secondary data analysis. Nationally, English-speaking immigrant Arab Americans reported lower rates of lifetime alcohol use (50.8%), past month use (26.4%) and binge drinking (10%) than the White majority group. In a state survey, self-identified English-speaking Arab Americans were less likely to report past month use (45.6%) than the White majority group but reported similar rate of binge drinking (17.0%). Locally, lifetime drinking was reported by 46.2% of the immigrants but only 13.4% of refugees fleeing war. Few databases are available to estimate alcohol use pattern among Arab Americans; the limited data suggest a drinking pattern consistent with acculturation. However, the potential influence of other factors is unknown and needs to be investigated.
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| 23. |
- Arnetz, Bengt B, et al.
(författare)
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Longitudinal determinants of energy levels in knowledge workers
- 2014
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 56:1, s. 79-85
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Increasingly, workers in the service, welfare, and health care sectors suffer adverse effects (ie, depression, burnout, etc) of "low-energy syndromes." Less is known about energy-based outcomes among knowledge workers. This study aimed to identify determinants of self-rated energy in knowledge workers and examine how these determinants change over time.METHODS: In collaboration with a large union and employer federation, 317 knowledge workers in Sweden responded to the health and productivity survey three times.RESULTS: At each assessment, worry, satisfaction with eating habits, and work-effectiveness were predictive of energy levels; however, only work-effectiveness covaried with energy over time.CONCLUSIONS: This study suggests that perceived work-effectiveness is an important factor in preventing knowledge workers from experiencing "low-energy syndromes." Lifestyle factors also play a role. Therefore, multifaceted interventions for increasing energy are needed.
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| 24. |
- Arnetz, Bengt B, et al.
(författare)
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Obstructive sleep apnea, posttraumatic stress disorder, and health in immigrants
- 2012
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Ingår i: Psychosomatic Medicine. - 0033-3174 .- 1534-7796. ; 74:8, s. 824-831
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States.METHODS: A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health.RESULTS: The prevalence of obstructive sleep apnea among post-Gulf Warimmigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p < .001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH.CONCLUSIONS: Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies.
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| 25. |
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| 26. |
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| 27. |
- Arnetz, Bengt B., et al.
(författare)
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The Effects of 884 MHz GSM Wireless Communication Signals on Self-reported Symptoms and Sleep : An Experimental Provocation Study
- 2007
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Ingår i: PIERS online. - 1931-7360. ; 3:7, s. 1148-1150
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Tidskriftsartikel (refereegranskat)abstract
- In the current study we assessed possible effects of prolonged (3 hours) exposure to 884 MHz GSM wireless communication signals on self-reported symptoms, cognitive function, and electroencephalographically (EEG) recorded sleep. The study group consisted of 36 women and 35 men. Twenty-two women and sixteen men reported symptoms they specifically related to mobile phone use (SG). The rest of the participants reported no mobile phone-related symptoms (NG). Potential participants volunteering for the study were evaluated by physicians, including some biochemical assessments, to rule out medical conditions that could interfere with study variables of interest. Once selected, participants spent three different sessions in the laboratory. The habituation session was followed by two subsequent sessions. In these subsequent sessions, subjects were either exposed to sham exposure (sham) or 884 MHz GSM wireless communication signals for 3 hours (an average of 1.4 W/kg including periods of DTX and Non-DTX. Exposure directed to the left hemisphere). Data was collected before, during and following the exposure/sham sessions. Data collected included self-reported symptoms, including headache, cognitive function, mood, and electroencephalographic recordings. During actual exposure, as compared to sham exposure, sleep initiated one hour after exposure was affected. There was a prolonged latency to reach the first cycle of deep sleep (stage 3). The amount of stage 4 sleep was also decreased in exposed subjects. NG subjects reported more headaches during exposures vs. sham exposure. Neither group (SG and NG) was able to detect the true exposure status more frequently than by chance alone. The study indicates that during laboratory exposure to 884 MHz wireless signals, components of sleep, believed to be important for recovery from daily wear and tear, are adversely affected. Moreover, participants that otherwise have no self-reported symptoms related to mobile phone use, appear to have more headaches during actual radiofrequency exposure as compared to sham exposure. However, subjects were not able to detect the true exposure status more often than would have been expected by statistical chance alone. Additional self-reported findings, biochemical, performance and electrophysiological data are currently being analyzed. Possible health implications from the findings will also be further explored.
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| 28. |
- Arnetz, Bengt B, et al.
(författare)
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Trauma resiliency training for police : psychophysiological and performance effects
- 2009
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Ingår i: Journal of Police and Criminal Psychology. - : Springer Science and Business Media LLC. - 0882-0783 .- 1936-6469. ; 24:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study is to test the effects of police trauma resilience training on stress and performance during a critical incident police work simulation. Rookie police officers (N = 18) participated in a randomized trial of a 10-week imagery and skills training program versus training as usual. Twelve months later, psychophysiological stress and police work performance were assessed during a live critical incident simulation. Training resulted in significantly less negative mood, less heart rate reactivity, a larger increase in antithrombin, and better police performance compared to controls. Trends for cortisol and self-reported stress also suggested benefits of training. This novel training program is a promising paradigm for improving police well-being, stress resiliency, and optimizing job performance.
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| 29. |
- Arnetz, Bengt B., et al.
(författare)
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War-related mental health disorders among Iraqis 10 years after the 1991 Gulf War : A comparative study of soldiers and civilians living under sustained socio-environmental stress
- 2009
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Ingår i: The New Iraqi Journal of Medicine. - 1817-5562. ; 5:1, s. 9-21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prior studies of mental health consequences of the Gulf War (GW) have been confined to Allied forces, limiting the ability to control for important geographically and culturally-related factors. We conducted an epidemiological mental health study among Iraqi soldiers and civilians who are still residing in Iraq. This group has been exposed to sustained socio-environmental stress. Methods: A cross-sectional sample of 742 Iraqi GW veterans and 413 civilians responded to a validated mental health survey. The response rate was 96.3%. Mental health disorders, including post traumatic stress disorder (PTSD), were classified using both self-reports and validated scales. War-related exposure was calculated using the sum score of items assessing trauma exposure. Results: Iraqi soldiers reported significantly more depression (Odds Ratio [OR] 4.9; 95% confidence interval [CI] 2.2-11.1) and anxiety (OR 3.9; 95% CI, 1.2-13.3) compared to civilians, adjusting for age, education, and smoking. Soldiers closest to Kuwait during the GW reported significantly more depression compared to soldiers deployed further away from the war epicenter (OR 104.6; 95% CI, 28.0-390.8) and anxiety (OR 4.1; 95% CI, 1.5-11.1). The highest self-reported trauma exposure occurred in the southwest of Iraq. Conclusion: Iraqi soldiers that took part in the GW are at increased risk suffering from many of the same mental health disorders plaguing Allied soldiers. Soldiers closest to Kuwait were more at risk, suggesting a direct link to war-specific environmental exposures, although self-reported trauma exposure was higher in the southwest of Iraq. The study offers additional insights into the mental health consequences of living under sustained socio-environmental stress, originating from the Iraqi war. The study points out socio-environmental factors worthy of further explorations.
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| 30. |
- Dunn, Patrick M., et al.
(författare)
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Meeting the imperative to improve physician well-being : assessment of an innovative program
- 2007
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Ingår i: Journal of general internal medicine. - : Springer Science and Business Media LLC. - 0884-8734 .- 1525-1497. ; 22:11, s. 1544-1552
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative. OBJECTIVE To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being. DESIGN AND PARTICIPANTS From 2000 to 2005, 22–32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning. MEASUREMENTS Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey. RESULTS Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study. CONCLUSIONS A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk.
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| 31. |
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| 32. |
- Hallman, David, 1979-, et al.
(författare)
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Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck-shoulder pain
- 2011
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 111:8, s. 1725-1735
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate reactions in trapezius muscle blood flow (MBF), muscle activity, heart rate variability (HRV) and systemic blood pressure (BP) to autonomic tests in subjects with chronic neck-shoulder pain and healthy controls. Changes in muscle activity and blood flow due to stress and unfavourable muscle loads are known underlying factors of work-related muscle pain. Aberration of the autonomic nervous system (ANS) is considered a possible mechanism. In the present study, participants (n = 23 Pain, n = 22 Control) performed autonomic tests which included a resting condition, static hand grip test (HGT) at 30% of maximal voluntary contraction, a cold pressor test (CPT) and a deep breathing test (DBT). HRV was analysed in time and frequency domains. MBF and muscle activity were recorded from the upper trapezius muscles using photoplethysmography and electromyography (EMG). The pain group showed reduced low frequency-HRV (LF) and SDNN during rest, as well as a blunted BP response and increased LF-HRV during HGT (a dagger systolic 22 mm Hg; a dagger LF(nu) 27%) compared with controls (a dagger systolic 27; a dagger LF(nu) 6%). Locally, the pain group had attenuated trapezius MBF in response to HGT (Pain 122% Control 140%) with elevated trapezius EMG following HGT and during CPT. In conclusion, only HGT showed differences between groups in systemic BP and HRV and alterations in local trapezius MBF and EMG in the pain group. Findings support the hypothesis of ANS involvement at systemic and local levels in chronic neck-shoulder pain.
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| 33. |
- Hansson, Ann-Sophie, et al.
(författare)
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Effects of organizational changes on health and sickness absence among health care employees. : A longitudninal study measuring biologic stress hormones, individual and work-site facotrs.
- 2007
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Ingår i: World Conference of Stress.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A series of organizational changes during the last decades in health care organizations have resulted in an uncertain and turbulent working life with negative effects on health and job satisfaction. The aim of this longitudinal study was to assess affects on health and sickness absence among health care employees after organizational changes. The population consisted of 278 employees divided in a study group, structurally concerned of the changes and a control group. The response rate was 81% and 74% respectively at baseline and follow up measurements. Group differences were analyzed both for an open (n= 226) and closed cohort (n= 156) using one-way ANOVA as well as a two-way ANOVA for repeated measurement in a closed cohort. To explain predictors for changed health a stepwise linear regression analysis was used. The results in the open cohort showed that the study group experienced significantly worse self-rated health and worse work satisfaction after the reorganization compared with the control group. The study group had also increased their level of work related exhaustion. The results from the closed cohort showed that the recovery hormone DHEA-S had significantly decreased and sickness absence increased among employees in the study group compared to those in the control group. Factors that best predicted changed health after the reorganization were work related exhaustion, age and coping ability. Sickness absence had increased significant for the study group at the 1-year follow up (7% and 2% respectively).
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| 34. |
- Hansson, Ann-Sophie, et al.
(författare)
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Organizational Change, Health and Sick Leave among Health Care Employees : A Longitudinal Study Measuring Stress Markers, Individual and Work Site Factors
- 2008
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Ingår i: Work & Stress. - : Informa UK Limited. - 0267-8373 .- 1464-5335. ; 22:1, s. 69-80
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Tidskriftsartikel (refereegranskat)abstract
- This controlled longitudinal study was conducted to investigate the effects of organizational change on employees' self-reported health, work satisfaction, work-related exhaustion, stress, and sick leave. The population consisted of 226 employees at T1 and 198 at T2, divided into a study group affected by organizational changes, and a reference group not affected by them. Group differences for the outcome measures self-rated health (SRH), work satisfaction, work-related exhaustion, and hormones associated with stress were analysed using a two-factor ANOVA design for repeated measurements. Our findings showed no significant differences, either across time or between groups for SRH, work satisfaction, and work-related exhaustion. However, we did find significant change across time and between groups for the recovery hormone DHEA-S. Days of sick leave increased by 7% for employees in the study group and by 2% in the reference group. Serum cortisol showed significantly decreased levels across time but not between groups. The decreased recovery potential in the study group might have long-term health implications. The study points to the importance of looking at the impact of organizational change on employee well-being from a number of perspectives, such as self-reported health parameters, registered sick-leave data, and biological stress markers.
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| 35. |
- Hansson, Ann-Sophie, et al.
(författare)
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Risk-factors for stress-related absence among health care employees : a bio-psychosocial perspective. Associations between self-rated health, working conditions and biological stress hormones
- 2006
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Ingår i: Italian Journal of Public Health. - 1723-7807. ; 3:3-4, s. 53-61
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Tidskriftsartikel (refereegranskat)abstract
- Background Stress is a major cause of sickness absence and the health care sector appears to be especially at risk. This cross sectional study aimed to identify the risk factors for absence due to self-reported stress among health care employees. Methods: 225 health care employees were categorized into two groups based on presence or not of self-rated sickness absence for stress. Questionnaire data and stress sensitive hormones measurements were used. Results Employees with stress related sick leave experienced worse health, poorer work satisfaction as well as worse social and home situations than those employees without stress-related sick leave. No-significant differences were identified regarding stress-sensitive hormones. The risk for employees, not satisfied at work, of becoming absent due to stress was approximately three fold compared to those who reported being satisfied (OR 2.8, 95% confidence interval; (CI) 1.3 - 5.9). For those not satisfied with their social situation, the risk for sickness absence appeared to be somewhat higher (OR 3.2; CI 1.2 - 8.6). Individual factors such as recovery potential and meaning of life as well as work related factors such as skill development and work tempo predicted employee’ s work satisfaction. Conclusions Based on cross sectional data, work-site and individual factors as well as social situations appear to increase the risk for absence due to stress among health care employees. Lower recovery potential, higher work tempo and poor leadership appeared to be related to the high degree of work related exhaustion experienced by employees.
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| 36. |
- Hansson, Ann-Sophie, et al.
(författare)
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Risk-factors for Stress-related Absence Among Health Care Employees: A Bio-Psychosocial Perspective. Associations Between Self-rated Health, Working Conditions and Biological Stress Hormones.
- 2006
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Ingår i: Italian Journal of Public Health. - 1723-7807. ; 3:3-4, s. 53-61
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Stress is one of the major reasons for sickness absence and especially the health care sector appears to be at risk. This cross sectional study aimed to identify risk factors of absence due to self-reported stress among health care employees. Methods: 225 health care employees were categorized into two groups based on self-rated sickness absence for stress or not. Questionnaire data and stress sensitive hormones measurements were used. Results: Employees with stress related sick leave experienced their health, work satisfaction as well as their social- and home situation worse than employees without stress- related sick leave. No statistically significant differences were identified regarding stress-sensitive hormones. The risk for employees not satisfied at work to become absent due to stress compared to those with a sufficient work situation appears to be about three times higher (OR 2.8, 95% CI 1.3 - 5.9). For those not satisfied with their social situation, the risk for being sickness absent appear to be somewhat higher (OR 3.2; CI 1.2 - 8.6).Individual factors as recovery potential and meaning of life and work related factors as skill development and work tempo predicted employee’ s work satisfaction. Conclusion: Based on cross sectional data, work-site and individual factors as well as social situation appear to increase the risk for absence due to stress among health care employees. Lower recovery potential, higher work tempo and a worse leadership appeared to be related to the high degree of work related exhaustion among the employees.
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| 37. |
- Hansson, Ann-Sophie, et al.
(författare)
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Stress-related Absence Among Health Care Employees: A Bio-Psychosocial Perspective.
- 2007
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Ingår i: European Congress of Work and Organizational Psychology.
-
Konferensbidrag (refereegranskat)abstract
- Objective: Stress is one of the leading reasons for sickness absence and especially the health care sector appears to be at risk and this study aimed to identify risk-factors of absence due to stress among health care employees in a cross-sectional study. Methods: 225 health care employees was categorized into two groups based on self-rated sickness absence or not. Questionnaire data and stress sensitive hormones measurements were used. Results: Strong significance between the groups was emphasized for work-related factors, social – and home situation. Stress-related sick leave was explained by unsatisfactory work conditions, social situation and less ability to recover. No statistically significant differences were identified regarding stress-sensitive hormones. Conclusions: Factors on different levels (social, work-site and individual) were found to be predictive for stress-related absence. Unexpected result, despite of the study’s cross-sectional nature, was the non-existing significance between stress hormones and stress-related absence.
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| 38. |
- Hansson, Ann-Sophie, et al.
(författare)
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Stress-related Absence Among Health Care Employees: A Bio-Psychosocial Perspective.
- 2006
-
Ingår i: 14 th European Conference on Public Health.
-
Konferensbidrag (refereegranskat)abstract
- Stress is one of the major reasons for sickness absence and especially the health care sector appears to be at risk. This cross sectional study aimed to identify risk factors of absence due to self-reported stress among health care employees.225 health care employees were categorized into two groups based on self-rated sickness absence for stress or not. Questionnaire data and stress sensitive hormones measurements were used. Results: Employees with stress related sick leave experienced their health, work satisfaction as well as their social- and home situation worse than employees without stress- related sick leave. No statistically significant differences were identified regarding stress-sensitive hormones. The risk for employees not satisfied at work to become absent due to stress compared to those with a sufficient work situation appears to be nearly three times higher, 2.8 (95% CI 1.3 to 5.9). For those not satisfied with their social situation, the risk for being sickness absent appears to be somewhat higher, 3.2 (CI 1.2 to 8.6). Individual factors as recovery potential and meaning of life and work related factors as skill development and work tempo predicted employee’ s work satisfaction.Conclusion: Based on cross sectional data, work-site and individual factors as well as social situation appear to increase the risk for absence due to stress among health care employees. Lower recovery potential, higher work tempo and a worse leadership appeared to be related to the high degree of work related exhaustion among the employees.
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| 39. |
- Jamil, H., et al.
(författare)
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Post-Displacement Employment and Health in Professional Iraqi Refugees vs. Professional Iraqi Immigrants
- 2012
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Ingår i: Journal of Immigrant & Refugee Studies. - : Informa UK Limited. - 1556-2948 .- 1556-2956. ; 10:4, s. 395-406
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates employment and health outcomes in Iraqi refugees compared to Iraqi immigrants. We surveyed 148 Iraqi professional refugees and 111 Iraqi professional immigrants residing in the United States. We hypothesized that Iraqi refugees would report lower employment and worse self-rated health as compared to Iraqi immigrants. Logistic regression was used to test various models. Results showed that more immigrants were employed, as well as employed in their original profession as compared to refugees. Regardless of immigration status, participants' age and the way they rated their job played a larger role in health. The study is the first to demonstrate that, controlling for professional, ethnic, and cultural background, there are unknown mechanisms resulting in lower employment and skilled employment in refugees as compared to matched immigrant controls. Furthermore, satisfaction with the new work appears more important than employment, per se.
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| 40. |
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| 41. |
- Maghout Juratli, Sham, et al.
(författare)
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Demographic and lifestyle factors associated with perceived stress in the primary care setting : a MetroNet study
- 2011
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Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 28:2, s. 156-162
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Stress and stress-related disorders are common in primary care. The stress-related needs for patients are often unmet partially due to the time and resource constraints inherent to many primary care settings. We examined the relative significance of key demographic and lifestyle factors related to stress among primary care patients. This information is unknown and needed to strategize these increasingly limited resources.METHODS: We distributed surveys to 100 consecutive adult patients in each of four family medicine centres in metropolitan Detroit between 2006 and 2007. Hierarchical multivariable regression analyses were used to assess the relative significance of the demographic and lifestyle factors related to stress.RESULTS: Of the 400 distributed surveys, 315 (78.7%) answered a minimum of 70% of the questions and were included in the analysis. The lifestyle factors [exercise, body mass index (BMI), sleep, social support, recovery or self-care skills (such as the ability to rest, relax and recuperate)] explained 39% (P < 0.001) of the variance in stress compared to 10% (P < 0.001) by the demographic factors (age, gender, race, employment, education and marital status). Stress was inversely related to sleep (P < 0.001), recovery (P < 0.001) and social support (P = 0.02) and positively to education (P < 0.001).CONCLUSIONS: The modifiable lifestyle factors explained significantly more of perceived stress among primary care patients than the demographic factors. Sleep and recovery had the biggest inverse relationship with stress, which suggests that they should be the primary target for assessment and intervention in patients who report stress or stress-related disorders.
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| 42. |
- Maghout-Juratli, Sham, et al.
(författare)
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The causal role of fatigue in the stress-perceived health relationship : a MetroNet study.
- 2010
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Ingår i: Journal of the American Board of Family Medicine. - : American Board of Family Medicine (ABFM). - 1557-2625 .- 1558-7118. ; 23:2, s. 212-219
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We conducted a cross-sectional survey of 4 primary care MetroNet centers in metropolitan Detroit. Our objective was to describe the causal role of fatigue in the relationship among stress, stress resiliency, and perceived health in primary care. Fatigue is a public health problem that has been linked to stress and poor health. The causal role of fatigue between stress and perceived health is unknown. METHODS: Four hundred surveys were distributed to adult patients in 4 primary care centers in metropolitan Detroit between 2006 and 2007. Internal consistency reliabilities and principal factor analyses were calculated for the key psychological scales. Perceived health is the primary outcome. Path models were used to study the relationship among stress, fatigue, and perceived health. We also modeled the impact of select stress resiliency factors including sleep, recovery, and social support. RESULTS: Of the 400 distributed surveys, 315 (78.7%) had a response rate of 70% or more and were included in the analysis. Respondents were predominantly middle aged (median age, 43 years); female (58.7%); and African American (52.0%). The majority worked full time (56.5%); did not have a college degree (77.7%); and were not married (55.2%). Fatigue was reported by 59% of respondents, 42.7% of which was unexplained. The path model supported the causal role of fatigue between stress and perceived health. The positive effects of sleep, recovery, and social support on fatigue, stress, and perceived health were validated. CONCLUSION: Fatigue was common in this metropolitan primary care environment and completely mediated the relationship between stress and poor perceived health. Therefore, stress, when significant enough to cause fatigue, may lead to poor health.
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| 43. |
- Sha, K, et al.
(författare)
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SPA : a smart phone assisted chronic illness self-management system with participatory sensing
- 2008
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Konferensbidrag (refereegranskat)abstract
- The medical system has not been able to effectively adaptto the dramatic transformation in public health challenges,from acute to chronic and lifestyle-related illnesses. Althoughacute illnesses can be treated successfully in an officeor hospital, chronic illnesses comprise the bulk of healthcare needs and require a very different approach. Patient involvementis critical for sustainable and successful chronicdisease management. Regular feed-back of relevant healthdata to the individual patient facilitates patient involvement.Yet, there is a lack of effective and easily deployed tools forself-monitoring and self-care, and people often do these taskspoorly, especially people at socioeconomic risk for chronicillness, such as urban minorities. Based on the most currentcognitive and behavioral change research, we proposethat the prevention or treatment of chronic illnesses will begreatly aided by an innovative system that can monitor aperson’s body, behavior, and environment during his or herdaily life, and then alert the person to take corrective actionwhen health risks are identified. In this paper, we proposea smart phone assisted chronic illness self-management system,named SPA. Our system can provide continuous monitoringon the health condition of the system user and givevaluable in-situ context-aware suggestions/feedbacks to improvethe public health.
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| 44. |
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Stress in Health and Disease
- 2006
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- This first book to address the most urgent issues combines a solid research approach with applied individual and stress issues. It focuses on our latest knowledge of various causes of stress and its neuro-cognitive and biological implications. World-renowned authors cover all perspectives: societal, individual, organ and molecular level.
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| 45. |
- Svensen, Erling, et al.
(författare)
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Health complaints and satisfied with the job? : A cross-sectional study on work environment, job satisfaction, and subjective health complaints
- 2007
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 49:5, s. 568-573
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to examine the prevalence of subjective health complaints (SHCs) among satisfied and dissatisfied workers. The second aim was to evaluate whether any SHC differences were attributable directly to the work environment or mediated by the individual perception of the environment (satisfactory or not). METHOD: In a cross-sectional study of 458 employees (56% women) in 5 different organizations, work environment, job satisfaction, and SHC were measured. RESULTS: Satisfied workers reported an average of five to six subjective health complaints that correspond to the prevalence found in a Norwegian general population. Work environment explained 43% of the variance for job satisfaction and 9% of the variance in SHCs. CONCLUSION: SHCs are common among satisfied workers. Work environment has only a limited influence on this validated health indicator.
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| 46. |
- Wallin, Lars, et al.
(författare)
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Understanding work contextual factors : a short-cut to evidence-based practice?
- 2006
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 3:4, s. 153-164
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors. AIM: The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors. METHOD: The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden. FINDINGS: Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion. CONCLUSIONS AND IMPLICATIONS: These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.
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| 47. |
- Wiholm, Clairy, et al.
(författare)
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Mobile phone exposure and spatial memory.
- 2009
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Ingår i: Bioelectromagnetics. - : Wiley. - 1521-186X .- 0197-8462. ; 30:1, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Radiofrequency (RF) emission during mobile phone use has been suggested to impair cognitive functions, that is, working memory. This study investigated the effects of a 2 1/2 h RF exposure (884 MHz) on spatial memory and learning, using a double-blind repeated measures design. The exposure was designed to mimic that experienced during a real-life mobile phone conversation. The design maximized the exposure to the left hemisphere. The average exposure was peak spatial specific absorption rate (psSAR10g) of 1.4 W/kg. The primary outcome measure was a "virtual" spatial navigation task modeled after the commonly used and validated Morris Water Maze. The distance traveled on each trial and the amount of improvement across trials (i.e., learning) were used as dependent variables. The participants were daily mobile phone users, with and without symptoms attributed to regular mobile phone use. Results revealed a main effect of RF exposure and a significant RF exposure by group effect on distance traveled during the trials. The symptomatic group improved their performance during RF exposure while there was no such effect in the non-symptomatic group. Until this new finding is further investigated, we can only speculate about the cause.
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| 48. |
- Wiholm, Clairy, et al.
(författare)
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Stress management and musculoskeletal disdsorders in knowledge workers : The possible mediating effects of stress hormones
- 2006
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 8:1, s. 5-14
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Tidskriftsartikel (refereegranskat)abstract
- Psychosocial stressors have been reported to be a risk factor for musculoskeletal symptoms (MSS) in modern offices. The exact mechanisms are not known but there are two theories. One concerns mentally induced muscle tension, and the other concerns impact on muscle fibers from stress hormones. To date, there have been only descriptive studies and short-term studies of the possible role of stress in the etiology of MSS symptoms. Furthermore, none have involved hormonal end-points and the use of a prospective and controlled design. The aims of this study were to (i) assess the possible impact on MSS (in neck and back/lower arm, respectively) from structured stress management programs, and (ii) determine the possible mediating role of stress hormones in linking stress and MSS symptoms. The subjects were telecommunications systems design engineers. Participants responded to a standardized questionnaire on MSS. Each subject also responded to a comprehensive questionnaire on psychosocial and physical work environments. Blood samples were collected as well, in order to measure possible changes in the psychobiological markers. Half of the subjects participated in one of three stress management programs (n=66), while the other half functioned as a reference group (n=50). Stress management significantly reduced lower-arm symptoms during the active training period of the study. There was an interaction between higher testosterone levels and stress management on the one hand and lower-arm symptoms on the other. No remaining effects on lower-arm symptoms were seen at the 5-month follow-up after the formal training was terminated. Results suggest that stress management might be beneficial for certain types of MSS in the short term, with active coaching from a group leader. There is support for theories suggesting that stress-sensitive hormones have a role in linking stress to MSS.
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