Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting

Abstract

Objectives: To assess the effectiveness of a workplace intervention aimed at reducing adverse psychosocial work factors (psychological demands, decision latitude, social support, and effort-reward imbalance) and mental health problems among care providers. Methods: A quasi-experimental design with a control group was used. Pre-intervention (71% response rate), and one-year post-intervention measures (69% response rate) were collected by telephone interviews. Results: One year after the intervention, there was a reduction of several adverse psychosocial factors in the experimental group, whereas no such reduction was found in the control group. However, there was a significant deterioration of decision latitude and social support from supervisors in both experimental and control groups. There was also a significant reduction in sleeping problems and work related burnout in the experimental hospital, whereas only sleeping problems decreased in the control group while both client related and personal burnout increased in this hospital. The comparison between the experimental and control groups, after adjusting for pre-intervention measures, showed a significant difference in the means of all psychosocial factors except decision latitude. All other factors were better in the experimental group. Conclusion: Results suggest positive effects of the intervention, even though only 12 months have passed since the beginning of the intervention. Follow up at 36 months is necessary to evaluate whether observed effects are maintained over time. In light of these results, we believe that continuing the participative process in the experimental hospital will foster the achievement of a more important reduction of adverse psychosocial factors at work. It is expected that the intensity of the intervention will be directly related to its beneficial effects. Long term effects will however depend on the willingness of management and of staff to appropriate the process of identifying what contributes to adverse psychosocial factors at work and to adopt means to reduce them.

Intervention Study on Psychosocial Work Factors and Mental Health and Musculoskeletal Outcomes

“…These results showed an improvement in three of the four psychosocial work factors (high PD, low co-workers SS and low reward). These results are consistent with those of previous prospective intervention studies that observed an improvement in at least one psychosocial work factor (Anderzen and Arnetz 2005;Bourbonnais et al 2006;Kauffeld et al 2004;Logan and Ganster 2005;Mikkelsen and Gundersen 2003;Mikkelsen et al 2000;Sluiter et al 2005;Theorell et al 2001;Wahlstedt et al 2000). It is noteworthy that, in our study, only the respect and esteem dimension of reward improved.…”

“…2. A number of previous studies had small intervention groups, that is, 100 or fewer workers, which limited the statistical power and the possibility of detecting differences in outcomes between intervention groups (Bond and Bunce 2001;Bourbonnais et al 2006;Fredriksson et al 2001;Kauffeld et al 2004;Kawakami et al 2005;Mikkelsen and Gundersen 2003;Sluiter et al 2005;Wahlstedt et al 2000).…”

“…Only three studies assessed the psychosocial work factors defined in Siegrist's model (Aust et al 1997;Bourbonnais et al 2006;Lavoie-Tremblay et al 2004).…”

“…Follow-up time was not long enough to allow the effects of the intervention to occur. Indeed, most recent studies evaluated the effects on health outcomes one year or less after the implementation of the intervention (Anderzen and Arnetz 2005;Berkhout et al 2004;Bond and Bunce 2001;Bourbonnais et al 2006;Eklof and Hagberg 2006;Fredriksson et al 2001;Jackson and Mallarky 2000;Kawakami et al 2005;Michie et al 2004;Mikkelsen and Gundersen 2003;Mikkelsen et al 2000;Park et al 2004;Parker 2003;Ryan et al 2005;Sluiter et al 2005;Theorell et al 2001;Wahlstedt et al 2000). An appropriate follow-up requires that sufficient time elapse since the implementation of the intervention to produce a meaningful decrease in adverse work factors and consequent improvement in health outcomes.…”

Process evaluation for organizational stress and well-being interventions: Implications for theory, method, and practice.

“…Bourbonnais et colleagues (Bourbonnais, Brisson, Vinet, Vézina, et al, 2006;Bourbonnais, Brisson, Vinet, Vezina, & Lower, 2006) used the model by Goldenhar et al (2001) to conduct a participative intervention aimed at reducing adverse psychosocial constraints and prevent mental health problems in healthcare providers. The researchers conducted a quasi-experimental study with one experimental and one control group, with three measures over 36 months.…”