The psychosocial and health effects of workplace reorganisation. 1. A systematic review of organisational-level interventions that aim to increase employee control

Egan, Matt; Bambra, Clare; Thomas, Siân; Petticrew, Mark; Whitehead, Margaret; Thomson, Hilary

doi:10.1136/jech.2006.054965

Cited by 246 publications

(251 citation statements)

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“…Seven reviews addressing the health effects of changes to the psychosocial work environment were located: three examined increased employee control (Aust & Ducki, 2004;Bambra et al, 2007;Egan et al, 2007a), and four evaluated the effects of changes to the organisation of work (shift work, privatisation, health and safety legislation) (Bambra et al, 2008a;Bambra et al, 2008b;Egan et al, 2007b;Rivara & Thompson, 2000). Five of the reviews specifically examined effects on health inequalities (Bambra et al, 2007;Bambra et al, 2008a;Bambra et al, 2008b;Egan et al, 2007a;Egan et al, 2007b).…”

Section: Resultsmentioning

confidence: 99%

“…Five of the reviews specifically examined effects on health inequalities (Bambra et al, 2007;Bambra et al, 2008a;Bambra et al, 2008b;Egan et al, 2007a;Egan et al, 2007b). Five of the reviews met all seven of the critical appraisal criteria (Bambra et al, 2007;Bambra et al, 2008a;Bambra et al, 2008b;Egan et al, 2007a;Egan et al, 2007b).…”

Section: Resultsmentioning

confidence: 99%

“…Two focused largely on increasing employee participation in workplace decision making (Aust & Ducki, 2004;Egan et al, 2007a), whilst the other examined the effects of increased control over work tasks (Bambra et al, 2007).…”

Section: Employee Controlmentioning

confidence: 99%

“…The review of participatory employee committees (involvement of employees or employee representatives in modifying the workplace, in budgetary decisions, or in personnel matters) synthesised eighteen studies (Egan et al, 2007a). The review found that participatory committee interventions which increased employee control had a consistent and positive impact on self-reported health.…”

Section: Employee Controlmentioning

confidence: 99%

“…Further, the five reviews which examined differences by socio-economic or demographic group (Bambra et al, 2007;Bambra et al, 2008a;Bambra et al, 2008b;Egan et al, 2007a;Egan et al, 2007b), when taken together, tentatively suggest that organisational workplace interventions may also have the potential to have an impact on health inequalities amongst employees.…”

Section: Effects Of the Interventionsmentioning

confidence: 99%

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Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment

Bambra

Gibson

Sowden

et al. 2009

Preventive Medicine

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(2009) 'Working for health ? evidence from systematic reviews on the e ects on health and health inequalities of organisational changes to the psychosocial work environment.', Preventive medicine., 48 (5). pp. 454-461. Further information on publisher's website:http://dx.doi.org/10. 1016/j.ypmed.2008.12.018 Publisher's copyright statement:Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-pro t purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Results: Seven systematic reviews were identified. Changes to the psychosocial work environment were found to have important and generally beneficial effects on health.Importantly, five reviews suggested that organisational level psychosocial workplace interventions may have the potential to reduce health inequalities amongst employees.Conclusion: Policy makers should consider organisational level changes to the psychosocial work environment when seeking to improve the health of the working age population. Abstract: 165 words Keywords

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Employee Controlmentioning

confidence: 99%

Section: Employee Controlmentioning

confidence: 99%

Section: Effects Of the Interventionsmentioning

confidence: 99%

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Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment

Bambra

Gibson

Sowden

et al. 2009

Preventive Medicine

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Controlled Interventions to Reduce Burnout in Physicians

et al. 2017

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IMPORTANCE: Burnout is prevalent in physicians and can have a negative influence on performance, career continuation and patient care. Existing evidence does not allow clear recommendations for the management of burnout in physicians. OBJECTIVE: To evaluate the effectiveness of interventions to reduce burnout in physicians. We also examined whether different types of interventions (physician-directed or organization-directed interventions), physician characteristics (length of experience) and healthcare setting characteristics (primary or secondary care) were associated with improved effects. DATA SOURCES: Medline, Embase, PsycINFO, Cinahl, and Central, were searched from inception to May 2016. The reference lists of eligible studies and other relevant systematic reviews were hand-searched. STUDY SELECTION: Randomized controlled trials and controlled before-after studies of interventions targeting burnout in physicians. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed the risk of bias. The main meta-analysis was followed by a number of pre-specified subgroup and sensitivity analyses. All analyses were performed using random-effects models and heterogeneity was quantified using I 2. MAIN OUTCOME AND MEASURES: The core outcome was burnout scores focused on emotional exhaustion, reported as standardized mean differences and their 95% confidence intervals. RESULTS: Twenty independent comparisons from 19 studies were included in the metaanalysis (n=1,550 physicians). Interventions were associated with small significant reductions in burnout (SMD=-0.29, 95% CI=-0.42 to-0.16; equal to a drop of 3-points on the emotional exhaustion domain of the Maslach Burnout Inventory above change in the controls). Subgroup analyses suggested significantly improved effects for organization-5 directed interventions (SMD=-0.45, 95% CI=-0.62 to-0.28) compared to physician-directed interventions (SMD=-0.18, 95% CI=-0.32 to-0.03). Interventions delivered in experienced physicians and in primary care were associated with higher effects compared to interventions delivered in inexperienced physicians and in secondary care, but these differences were not significant. The results were not influenced by the risk of bias ratings. CONCLUSION: Evidence from this meta-analysis suggests that current intervention programs for burnout in physicians are associated with small benefits which may be boosted by adoption of organization-directed approaches. This finding provides support for the view that burnout is a problem of the whole healthcare organization, rather than individuals.

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Association of Psychosocial Stress With Risk of Acute Stroke

et al. 2022

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ImportancePsychosocial stress is considered a modifiable risk factor for stroke. Given the prevalence of chronic and acute exposure to stress, it represents a potentially attractive target for population-health interventions.ObjectivesTo determine the association of psychosocial stress with the risk of acute stroke and explore factors that might modify the association of stress with risk of acute stroke in a large international population.Design, Setting, and ParticipantsINTERSTROKE is an international retrospective case-control study of risk factors for first acute stroke in 32 countries in Asia, North and South America, Europe, Australia, the Middle East, and Africa. A total of 13 462 patients with stroke and 13 488 matched controls were recruited between January 11, 2007, and August 8, 2015. The present analyses were performed from June 1 to 30, 2021, and included 13 350 cases and 13 462 controls with available data on psychosocial stress.ExposuresPsychosocial stress and occurrence of stressful life events within the preceding year were measured using a standardized questionnaire of self-reported stress at home and work.Main Outcomes and MeasuresThe association of stress with acute stroke and its subtypes was examined using multivariable conditional logistic regression and factors that might modify the association, particularly self-reported locus of control.ResultsAmong 26 812 participants included in the analysis, the mean (SD) age of cases was 62.2 (13.6) years; that of controls, 61.3 (13.3) years; 7960 cases (59.6%) and 8017 controls (59.6%) were men. Several periods of stress and permanent stress were reported for 2745 cases (20.5%) and 1933 controls (14.4%), with marked regional variation in prevalence, with the lowest in China (201 of 3981 [5.0%] among controls and 364 of 3980 [9.1%] among cases) and highest in South East Asia (233 of 855 [26.1%] among controls and 241 of 782 [30.8%] among cases). Increased stress at home (odds ratio [OR], 1.95 [95% CI, 1.77-2.15]) and at work (OR, 2.70 [95% CI, 2.25-3.23]) and recent stressful life events (OR, 1.31 [95% CI, 1.19-1.43]) were associated with an increased risk of acute stroke on multivariable analyses (vs no self-reported stress). Higher locus of control at home was associated with a reduced odds of all stroke (OR, 0.73 [95% CI, 0.68-0.79]), and higher locus of control both at work and at home were associated with a lower odds of acute stroke and significantly diminished the association with stress at work (OR, 2.20 [95% CI, 1.88-2.58]; P = .008 for interaction) and home (OR, 1.69 [95% CI, 1.44-1.98]; P &lt; .001 for interaction) for acute stroke.Conclusions and RelevancePsychosocial stress is a common risk factor for acute stroke. The findings of this case-control study suggest that higher locus of control is associated with lower risk of stroke and may be an important effect modifier of the risk associated with psychosocial stress.

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The psychosocial and health effects of workplace reorganisation. 1. A systematic review of organisational-level interventions that aim to increase employee control

Cited by 246 publications

References 49 publications

Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment

Working for health? Evidence from systematic reviews on the effects on health and health inequalities of organisational changes to the psychosocial work environment

Controlled Interventions to Reduce Burnout in Physicians

Association of Psychosocial Stress With Risk of Acute Stroke

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