AIMS: The purpose of this nationwide study was to assess the prevalence of probable alcohol abuse (PAA) among women working in geriatric care, and to study its demographics, medical and work-related correlates. METHODS: The employees of geriatric nursing homes and geriatric hospital wards in Iceland with 10 patients or more were invited to participate in this cross-sectional study. The response rate was 80% (n=1515), with 96% being women (n=1432). Men were consequently omitted from the study. Questions were included on demographics, psychosocial factors, workplace environment, health behavior, and medical history. PAA was defined as (a) having been given such a diagnosis by a physician, (b) having missed work because of drinking, or (c) if alcohol use was considered a problem by the employee herself, her family, friends, or the employer. RESULTS: A total of 4.8% of the employees fulfilled the criteria for PAA. These women were younger (41 vs. 45 years of age), more often single (25% vs. 15%) or divorced (13% vs. 9%), and less satisfied with work than the other women. Odds ratios for asthma, fibromyalgia, chronic fatigue, pain syndromes, mental disorders, and work-related accidents were elevated. Despite this, no differences were found concerning amount of sick leave. Their psychosocial work environment was worse but the physical work environment was the same. CONCLUSION: Women with probable alcohol abuse working in nursing homes have significant medical problems and psychosocial morbidity that is not reflected in more sick leave.
The study considered psychological distress among surviving bank employees differently entangled in downsizing and restructuring following the financial crisis of 2008.
A cross-sectional, nationwide study was conducted among surviving employees (N = 1880, response rate 68%). Multivariate analysis was conducted to assess factors associated with psychological distress.
In the banks, where all employees experienced rapid and unpredictable organizational changes, psychological distress was higher among employees most entangled in the downsizing and restructuring process. Being subjected to downsizing within own department, salary cut, and transfer to another department, was directly related to increased psychological distress, controlling for background factors. The associations between downsizing, restructuring, and distress were reduced somewhat by adding job demands, job control, and empowering leadership to the model, however, adding social support had little effect on these associations.
Employees most entangled in organizational changes are the most vulnerable and should be prioritized in workplace interventions during organizational changes.
AIMS: To explore longitudinal changes in the importance of mental and behavioural disorders and their subgroups among people receiving disability pension in Iceland in the period 1990 to 2007. METHOD: Estimation of the incidence of disability pension was based on national demographic data and information from the national disability register which includes the main diagnoses causing disability. RESULTS: The share of mental and behavioural disorders among new recipients of disability pension increased from 14 to 30% for women and 20 to 35% men. There was a marked increase in the incidence of disability due to disorders related to the use of alcohol and other psychoactive substances, mood disorders, disorders of psychological development and behavioural and emotional disorders with onset usually occurring in childhood and adolescence. The proportion of mental and behavioural disorders as the primary diagnosis among new recipients of disability pension increased. CONCLUSION: The most likely explanation for the changes we observe is alteration in social conditions leading to a lower threshold for seeking disability pension for mental disorders.
To analyze gender differences in levels of psychological distress, financial strain, lay off experiences and job search activity among unemployed and re-employed individuals who were laid-off due to the collapse of the financial sector in Iceland in 2008.
The study is based on questionnaires distributed to 759 former financial sector employees; 426 responses were received giving a 62.6% response rate.
The groups of unemployed and re-employed woman and men are compared using separate multivariate binary models to control for mediating factors.
The analysis reveals gender differences in demographic factors and jobs held prior to lay-off. More women than men were psychologically or finically distressed and claimed being shocked by the lay-off. A higher proportion of men than women were re-employed at the time of this study. The main difference between those re-employed and unemployed was lower financial strain among those re-employed for both men and women in this sample.
The study does not support the traditional view of men having more difficulties in the lay-off process than women. This calls for a rethinking regarding gender in lay-off and unemployment. A gender-based analysis is needed when considering the ramifications of losing a job and job search activity in the lay-off process.
To assess long-term effects of early traumatic brain injury (TBI) on mental health, cognition, behaviour and adjustment and to identify prognostic factors.
A 1-year nationwide cohort of all 0-19 year old Icelandic children and adolescents diagnosed with TBI in 1992-1993 (n = 550) received a questionnaire with clinical outcome scales and questions on TBI and socio-economic status (SES) by mail ~16 years post-injury. A control group (n = 1232), newly selected from the National Registry, received the same questionnaire. Non-respondents answered a shorter version by telephone. Overall participation was 67%.
Medically confirmed and self-reported TBI was reflected in worse outcome. Force of impact, number and severity of TBIs predicted poorer results. Parental SES and demographic factors had limited effects. Not reporting early, medically confirmed TBI did not exclude cognitive sequelae. In self-reported disability, absence of evaluation for compensation was not linked to outcome.
Clinical outcome was consistent with late complaints attributed to early TBI. TBI-related variables had greater prognostic value than other factors. Self-reporting of TBI sustained very early in life needs supplementary information from parents and medical records. More consistency in compensation evaluations following paediatric TBI is indicated.
AIMS: The aim was to describe the mortality pattern among unskilled female industrial workers with the hypothesis that they were disadvantaged compared to other women and that smoking-related causes of death were in excess among them. METHODS: The study group comprised 13349 women who had contributed at any time to a pension fund for unskilled industrial workers in Reykjavik during the time period 1970-1995. The follow-up was from 1975 to 1995. The death rate of the study group was compared to that of women in the general population during the time period 1981-1995. The study group was studied with regard to selected causes of death, by age at first entrance into the pension fund, different lag-time, and by employment-time. RESULTS: Results showed an excess of external causes but a deficit of most other causes of death, among those smoking related diseases. The high mortality by external causes was consistent in all the analyses. Standardised mortality ratio (SMR) for external causes in the total group was 1.79 (95% CI 1.45-2.19), for lung cancer 1.04 (95% CI 0.80-1.34) and for ischemic heart disease 0.77 (95% CI 0.65-0.91). Mortality was highest among those who started to pay in the pension fund at younger ages. CONCLUSIONS: The notable excess of external causes in the group needs further exploration. The results did not confirm the hypothesis that smoking-related causes of death were in excess in the group. Methodological problems related to studies on women workers are discussed.
BACKGROUND: Nursing is a stressful, physically demanding occupation and a rush setting for musculoskeletal problems. The aim of this study is to explore the extent of the association between psychosocial work characteristics and musculoskeletal symptoms among women working in geriatric care. METHODS: The participants were female employees of all geriatric nursing homes and geriatric hospital wards in Iceland having a staff of 10 or more. A total of 1,886 questionnaires were distributed. The response rate was 80%. RESULTS: Finding the job mentally difficult, mental exhaustion after one's shift, dissatisfaction with supervisors or the flow of information, insufficient influence at work, dissatisfaction with the hierarchy, intense time pressure, lack of solidarity, dissatisfaction with the job, harassment, violence or threats at work; all of the aforementioned gave crude odds ratios (OR) two or above for one or more musculoskeletal symptoms. Mental exhaustion and harassment, violence, and threats were the factors connected with symptoms from all the body regions studied. CONCLUSIONS: The extent of the association of work-related psychosocial factors and musculoskeletal symptoms among the geriatric female nursing staff is substantial and needs to be taken into account by occupational health services and others involved in preventive work. Am. J. Ind. Med. 44:679-684, 2003.
Mental health of parents and their quality of life is likely to be affected when a child in the family has a psychiatric disorder. The purpose of this study is to assess quality of life and mental health of parents of referred children waiting for service at the only child psychiatric service in Iceland, with reassessment at least 3 months after first attendance to the service. In order to do so, 208 parents of 123 children waiting for psychiatric care were sent the Icelandic Quality of Life (IQL), the General Health Questionnaire (GHQ-30) and the CAGE screen for alcoholism. For reassessment, responders in the first phase were assessed again with the IQL and GHQ-30, at least 3 months after initiation of child psychiatric interventions. A total of 120 of the 208 parents (58%) responded in the first phase of the study, 49 fathers and 71 mothers. The mean (+/- s, standard deviation) standardized IQL T-score was for the fathers 51+/- 7.5 but significantly lower for the mothers or 45 +/-11.5 (P = 0.001) compared to normal sample of same-age women (T-scores of 50 are normal). Nearly 55% of women compared with 26% of men were psychiatric cases, scoring 5 or higher on the GHQ. According to a CAGE score of 2 and above 16% of fathers and 14% of mother abused alcohol. No significant change occurred in parents GHQ-30 or IQL before and after initiation of treatment. We conclude that mothers of children with mental disorders have poor quality of life, and high prevalence of mental disorders; hence child psychiatry clinics need to ensure that mothers receive appropriate care along with the child.
To examine the scope of paediatric traumatic brain injury (TBI) as a health concern and to identify prognostic factors for TBI-related sequelae.
The study was prospective and nationwide. A questionnaire was sent to a study group (SG) of all 0-19 years old in Iceland, diagnosed ~16 years earlier with TBI during a 1-year period, 1992-1993 (n?=?550) and to a control group (CG) (n?=?1232), selected from the National Register.
In the CG 49.5% reported having sustained TBI and 7.0% reported long-term disability. In the group with TBI, force of impact to the head, more than one incident of TBI and the injury severity by gender interaction predicted late symptoms. TBI severity had substantially less effect than force of impact and was close to non-existent for females.
Based on two independent nationwide samples, the scope of TBI as a health concern in adolescence and young adulthood is greater than previously documented. The findings suggest that TBI event-related factors, especially force of impact, have greater predictive value than clinical symptoms of severity at the acute stage, females being more sensitive to the effects of mild TBI than males.
Educational qualifications are reliable predictors of women's self-assessed health. AIMS: To study possible inequalities in health among women with different educational backgrounds working in geriatric care and to find groups that might need special public health measures. METHODS: In this cross-sectional questionnaire reaching throughout Iceland, the participants were employees in 62 geriatric nursing homes and geriatric hospital wards with 10 or more employees. A total of 1886 questionnaires were distributed. The 84-item questionnaire included questions on demographic and work-related factors, health and life style. Age-adjusted odds ratios (OR) were calculated for work-related psychosocial, physical and health factors, and confidence intervals were set at 95% (95% CI). Registered nurses were taken as a reference category. RESULTS: The response rate was 80%. Registered nurses accounted for 16%, practical nurses 21%, unskilled attendants 44%, cleaning personnel 8% and others 12%. The practical nurses, unskilled attendants and cleaning personnel assessed work as more physically difficult, and more monotonous both physically and mentally, than did the registered nurses, who enjoyed more physical and mental well-being than the others. However, the registered nurses visited doctors as often as the other groups did. CONCLUSIONS: Personnel groups in geriatric care have different physical and psychosocial workloads. The results provide opportunities to guide public health measures for people employed in geriatric care and possibly in other settings, such as hospitals and health care institutions.