Psychosocial predictors of actual turnover among Belgian health care workers

Background: Turnover of nursing staff is a major challenge for healthcare settings and for healthcare in general, urging the need to improve retention. Aim: The aim was to explore the prospective relations between personal and psychosocial work-related factors and actual turnover among Belgian healthcare workers. Methods: Predictors of actual turnover were assessed using the longitudinal Belgian data from the Nurses Early Exit Study (NEXT). Two self-administered questionnaires with a time lag of one year were distributed, covering physical and psychosocial work-related factors, private life, turnover intentions and future perspectives. During follow-up, 90 employees who left the organization voluntary (leavers) and who had a complete data set were identified. These subjects were each matched with two stayers based on gender, age and organization type. Multiple logistic analyses were performed. Results: The first model adjusting for education level showed that quantitative job demands, job satisfaction, burnout, work-home interference, commitment to the institution, pay satisfaction, effort-reward imbalance and intent to leave the organization were significantly associated with actual turnover. When additionally adjusting for intent to leave the organization, job satisfaction (OR 0.29; 95% CI 0.13-0.62) and work-home interference (OR 1.35; 95% CI 1.00-1.81) were found to be the most important independent predictors of turnover. Conclusion: To tackle turnover, special attention should be given to turnover intention, work-home interference and job satisfaction because these risk factors were found to be the strongest predictors of actual turnover among nurses and nursing aids

Assessing physiological response mechanisms and the role of psychosocial job resources in the physical activity health paradox : study protocol for the Flemish Employees' Physical Activity (FEPA) study

Background: In the current labour system many workers are still exposed to heavy physical demands during their job. In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) is associated with an increased risk of cardiovascular diseases and all-cause mortality, termed the physical activity (PA) health paradox. In order to gain more insight into the PA health paradox, an exploration of structural preventive measures at the workplace is needed and therefore objective field measurements are highly recommended. The objective of this paper is to provide an overview of the protocol of the Flemish Employees' Physical Activity (FEPA) study, including objective measurements of PA, heart rate (HR) and cardiorespiratory fitness (CRF) to gain more insight into the PA health paradox. Methods: A total of 401 workers participated in the FEPA study across seven companies in the service and production sector in Belgium. The participants comprised 167 men and 234 women, aged 20 to 65years. OPA and LTPA were assessed by two Axivity AX3 accelerometers on the thigh and upper back. Ambulatory HR was measured by the Faros eMotion 90 degrees monitor. Both devices were worn during two to four consecutive working days. In addition, CRF was estimated by using the Harvard Step Test. Statistical analyses will be performed using Pearson correlation, and multiple regression adjusted for possible confounders. Discussion: This study aims to provide a better insight in the PA health paradox and the possible buffering factors by using valid and objective measurements of PA and HR (both during LTPA and OPA) over multiple working days. The results of the study can contribute to the prevention of cardiovascular disease by providing tailored recommendations for participants with high levels of OPA and by disseminating the results and recommendations to workplaces, policy makers and occupational health practitioners

Does Aerobic Exercise Increase 24-Hour Ambulatory Blood Pressure Among Workers With High Occupational Physical Activity?-A RCT.

ObjectiveHigh occupational physical activity (OPA) increases cardiovascular risk and aerobic exercise has been recommended for reducing this risk. This paper investigates the effects of an aerobic exercise intervention on 24-hour ambulatory blood pressure (ABP) among cleaners with high OPA.MethodsHundred and sixteen cleaners between 18 and 65 years were randomized. During the 4-month intervention period, the aerobic exercise group (AE) (n = 57) performed worksite aerobic exercise (2 × 30 minutes/week), while the reference group (REF) (n = 59) attended lectures. Between-group differences in 4-month ABP changes were evaluated by intention-to-treat analysis using a repeated-measure 2 × 2 multiadjusted mixed-models design.ResultsRelative to REF, 24-hour ABP significantly increased in AE: systolic 3.6 mm Hg (95% confidence interval (CI) 1.6-5.7) and diastolic 2.3 mm Hg (95% CI 0.9-3.8). Cleaners with high aerobic workload exhibited particularly high 24-hour ABP increases: systolic 6.0 mm Hg (95% CI 2.4-9.6), and diastolic 3.8 mm Hg (95% CI 1.3-6.4).ConclusionAerobic exercise increased 24-hour ABP among cleaners. This adverse effect raises questions about the safety and intended benefits of aerobic exercise, especially among workers with high OPA and a demanding aerobic workload. http://www.controlled-trials.com/ISRCTN86682076. Unique identifier ISRCTN86682076.Clinical trial registrationTrial Number ISRCTN86682076

Comparing the effectiveness of two cardiovascular prevention programmes for highly educated professionals in general practice : a randomised clinical trial

Background: Cardiovascular disease is a major cause of mortality and morbidity and its prevalence is set to increase. While the benefits of medical and lifestyle interventions are established, the effectiveness of interventions which seek to improve the way preventive care is delivered in general practice is less so. The aim was to study and to compare the effectiveness of 2 intervention programmes for reducing cardiovascular risk factors within general practice. Methods: A randomised controlled trial was conducted in Belgium between 2007-2010 with 314 highly educated and mainly healthy professionals allocated to a medical (MP) or a medical + lifestyle (MLP) programme. The MP consisted of medical assessments (screening and follow-up) and the MLP added a tailored lifestyle change programme (web-based and individual coaching) to the MP. Primary outcomes were total cholesterol, blood pressure, and body mass index (BMI). The secondary outcomes were smoking status, fitness-score, and total cardiovascular risk. Results: The mean age was 41 years, 95 (32%) participants were female, 7 had a personal cardiovascular event in their medical history and 3 had diabetes. There were no significant differences found between MP and MLP in primary or secondary outcomes. In both study conditions decreases of cholesterol, systolic blood pressure, and diastolic blood pressure were found. Unfavourable increases were found for BMI (p < .05). A significant decrease of the overall cardiovascular risk was reported (p < .001). Conclusions: Both interventions are effective in reducing cardiovascular risk. In our population the combined medical and lifestyle programme was not superior to the medical programme

The relation of ambulatory heart rate with all-cause mortality among middle-aged men : a prospective cohort study

The aim of this study was to investigate the association between average 24-hour ambulatory heart rate and all-cause mortality, while adjusting for resting clinical heart rate, cardiorespiratory fitness, occupational and leisure time physical activity as well as classical risk factors. A group of 439 middle-aged male workers free of baseline coronary heart disease from the Belgian Physical Fitness Study was included in the analysis. Data were collected by questionnaires and clinical examinations from 1976 to 1978. All-cause mortality was collected from the national mortality registration with a mean follow-up period of 16.5 years, with a total of 48 events. After adjustment for all before mentioned confounders in a Cox proportional hazards regression analysis, a significant increased risk for all-cause mortality was found among the tertile of workers with highest average ambulatory heart rate compared to the tertile with lowest ambulatory heart rate (Hazard ratio = 3.21, 95% confidence interval: 1.22-8.44). No significant independent association was found between resting clinic heart rate and all-cause mortality. The study indicates that average 24-hour ambulatory heart rate is a strong predictor of all-cause mortality independent from resting clinic heart rate, cardiorespiratory fitness, occupational and leisure time physical activity and other classical risk factors among healthy middle-aged workers.SCOPUS: ar.jinfo:eu-repo/semantics/publishe