Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment (original) (raw)
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International Archives of Occupational and Environmental Health, 2024
Objective: To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. Methods: Following PRISMA guidelines, we searched six scientifc databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. Results: We identifed 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type “Job and task modifcations” and a moderate level of evidence for the types “Flexible work and scheduling” and “Changes in the physical work environment”. For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. Conclusion: Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.
Implementing practices focused on workplace health and psychological wellbeing: A systematic review
Social Science & Medicine, 2021
Workplace health and wellbeing practices (WHWPs) often fail to improve psychological health or wellbeing because of implementation failure. In this systematic review, we identified critical success factors for WHWP implementation and gaps in the evidence. We reviewed 74 separate studies that assessed the implementation of WHWPs and their effects on psychological health or psychological wellbeing. Most studies were from advanced industrial Western democracies (71). Intervention types included primary (i.e., work redesign {37 studies}, health behavior change {8 studies}), secondary (e.g. mindfulness training, 11 studies), tertiary (i.e., focused on rehabilitation, 9 studies) and multifocal (e.g. including components of primary and secondary, 9 studies). Tangible changes preceded improvements in health and wellbeing, indicating intervention success cannot be attributed to non-specific factors. Some interventions had beneficial effects through mechanisms not planned as part of the intervention. Three factors were associated with successful WHWP implementation: continuation, learning, and effective governance. The review indicates future research could focus on how organizations manage conflict between WHWP implementation and existing organizational processes, and the dynamic nature of organizational contexts that affect and are affected by WHWP implementation. This systematic review is registered [PROSPERO: the International Prospective Register of Systematic Reviews ID: CRD42019119656;].
2012
The aim of this systematic review is to establish the research evidence of the relationship between the psychosocial work environment and employee health and its impact on organisational production. Searches in several databases were performed in September 2009. Previously known studies were also included. A total of 17 studies were identified using these methods. Study quality was evaluated using the EPHPP quality assessment tool. We found limited evidence that psychosocial work factors and employee health are predictors of production loss. The evidence was clearest with regard to job strain and musculoskeletal pain. Although there was some evidence for the impact of psychosocial work factors and the health of employees on self-rated performance, there was no evidence for any specific factors or health problems. The research into how psychosocial work factors and employee health affect organisational production still suffers from the fact that there are only few and low-quality stu...
Background Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and “burnout” at work than staff in other sectors. There is a growing call for the ‘triple aim’ of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom’s (UK) Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff. Objectives This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of) these recommendations and determine whether they improve staff health and wellbeing. Methods A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward) in collective activities to improve physical or mental health or promote healthy behaviours. Results Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1) pre-determined (one-size-fits-all) and no choice of activities (two studies); or 2) pre-determined and some choice of activities (one study); 3) A wide choice of a range of activities and some adaptation to local needs (five studies); or, 3) a participatory approach to creating programmes responsive and adaptive to local staff needs that have extensive choice of activities to participate in (three studies). Only five of the interventions included substantial involvement and engagement of leadership and efforts aimed at up-skilling the leadership of staff to support staff health and wellbeing. Incorporation of more of the recommendations did not appear to be related to effectiveness. The heterogeneity of study designs, populations and outcomes excluded a meta-analysis. All studies were deemed by their authors to be at least partly effective. Two studies reported statistically significant improvement in objectively measured physical health (BMI) and eight in subjective mental health. Six studies reported statistically significant positive changes in subjectively assessed health behaviours. Conclusions This systematic review identified 11 studies which incorporate at least one of the Boorman recommendations and provides evidence that whole-system healthy workplace interventions can improve health and wellbeing and promote healthier behaviours in healthcare staff.
Health and Wellbeing at Work in the United Kingdom
PsycEXTRA Dataset, 2000
The literature review is intended to provide evidence on whether health workplace interventions could be useful to mitigate health risk factors, and to reduce the costs associated with poor health and wellbeing in British workplaces and the NHS. In order to achieve this, the study:
Changing organisations and work-related health
Arbetslivsrapport, …, 2006
This report is presenting the methodological designs of different studies aiming at the investigation of the relationship between organisational characteristics and individual working conditions and health. The theoretical background to this line of research is summarized in Härenstam and collaborators (2006). The report displays methods, samples and designs of three studies. Three different methods were used in the studies and different focal units were chosen.
What really improves employee health and wellbeing
International Journal of Workplace Health Management, 2014
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The Australian National Workplace Health Project: Design and Baseline Findings
Preventive Medicine, 2000
Background. This paper describes the study design, uation of the efficacy of sociobehavioral and environrecruitment, measurement, and initial recruitment mental intervention approaches to workplace health outcomes of Australia's largest workplace intervention promotion. Although participants were randomized by trial, the National Workplace Health Project.