This meta-analytic review responds to promises in the research literature and public domain about the benefits of workplace mindfulness training. It synthesizes randomized controlled trial evidence ...from workplace-delivered training for changes in mindfulness, stress, mental health, well-being, and work performance outcomes. Going beyond extant reviews, this article explores the influence of variability in workforce and intervention characteristics for reducing perceived stress. Meta-effect estimates (Hedge's g) were computed using data from 23 studies. Results indicate beneficial effects following training for mindfulness (g = 0.45, p < .001) and stress (g = 0.56, p < .001), anxiety (g = 0.62, p < .001) and psychological distress (g = 0.69, p < .001), and for well-being (g = 0.46, p = .002) and sleep (g = 0.26, p = .003). No conclusions could be drawn from pooled data for burnout due to ambivalence in results, for depression due to publication bias, or for work performance due to insufficient data. The potential for integrating the construct of mindfulness within job demands-resources, coping, and prevention theories of work stress is considered in relation to the results. Limitations to study designs and reporting are addressed, and recommendations to advance research in this field are made.
Abstract The aim of this systematic review was to determine the quality and comprehensiveness of guidelines developed for employers to detect, prevent, and manage mental health problems in the ...workplace. An integrated approach that combined expertise from medicine, psychology, public health, management, and occupational health and safety was identified as a best practice framework to assess guideline comprehensiveness. An iterative search strategy of the grey literature was used plus consultation with experts in psychology, public health, and mental health promotion. Inclusion criteria were documents published in English and developed specifically for employers to detect, prevent, and manage mental health problems in the workplace. A total of 20 guidelines met these criteria and were reviewed. Development documents were included to inform quality assessment. This was performed using the AGREE II rating system. Our results indicated that low scores were often due to a lack of focus on prevention and rather a focus on the detection and treatment of mental health problems in the workplace. When prevention recommendations were included they were often individually focused and did not include practical tools or advice to implement. An inconsistency in language, lack of consultation with relevant population groups in the development process and a failure to outline and differentiate between the legal/minimum requirements of a region were also observed. The findings from this systematic review will inform translation of scientific evidence into practical recommendations to prevent mental health problems within the workplace. It will also direct employers, clinicians, and policy-makers towards examples of best-practice guidelines.
Objectives
The economic burden of multimorbidity is considerable. This review analyzed the methods of cost-of-illness (COI) studies and summarized the economic outcomes of multimorbidity.
Methods
A ...systematic review (2000–2016) was performed, which was registered with Prospero, reported according to PRISMA, and used a quality checklist adapted for COI studies. The inclusion criteria were peer-reviewed COI studies on multimorbidity, whereas the exclusion criterion was studies focusing on an index disease. Extracted data included the definition, measure, and prevalence of multimorbidity; the number of included health conditions; the age of study population; the variables used in the COI methodology; the percentage of multimorbidity vs. total costs; and the average costs per capita.
Results
Among the 26 included articles, 14 defined multimorbidity as a simple count of 2 or more conditions. Methodologies used to derive the costs were markedly different. Given different healthcare systems, OOP payments of multimorbidity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 conditions, respectively, the ratios of multimorbidity to non-multimorbidity costs ranged from 2–16 to 2–10. Among the ten studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest percentage of multimorbidity costs to social care and inpatient care/medicine, respectively.
Conclusion
Multimorbidity was associated with considerable economic burden. Synthesising the cost of multimorbidity was challenging due to multiple definitions of multimorbidity and heterogeneity in COI methods. Count method was most popular to define multimorbidity. There is consistent evidence that multimorbidity was associated with higher costs.
Objective:
To review the recent descriptive and social epidemiology of common mental disorders in the workplace, including prevalence, participation, work disability, and impact of quality of work, ...as well as to discuss the implications for identifying targets for clinical and preventive interventions.
Method:
We conducted a structured review of epidemiologic studies in community settings (that is, in the general population or in workplaces). Evidence was restricted to the peer-reviewed, published, English-language literature up to the end of June 2005. We further restricted evidence to studies that used recent classification systems; then, if evidence was insufficient, we reviewed studies that used standardized psychiatric screening scales. To distinguish this article from recent reviews of health and work quality, we focused on new areas of investigation and new evidence for established areas of investigation: underemployment, organizational justice, job control and demand, effort–reward imbalance, and atypical (nonpermanent) employment.
Results:
Depression and simple phobia were found to be the most prevalent disorders in the working population. The limited data on rates of participation suggested higher participation among people with depression, simple phobia, social phobia, and generalized anxiety disorder. Depression and anxiety were more consistently associated with “presenteeism” (that is, lost productivity while at work) than with absenteeism, whether this was measured by cutback days or by direct questionnaires. Seven longitudinal studies, with an average sample size of 6264, showed a strong association between aspects of low job quality and incident depression and anxiety. There was some evidence that atypical work was associated with poorer mental health, although the findings for fixed-term work were mixed.
Conclusions:
Mental health risk reduction in the workplace is an important complement to clinical interventions for reducing the current and future burden of depression and anxiety in the workplace.
IntroductionThe COVID-19 pandemic is exacerbating a wide range of symptoms of poor mental health among emergency medical service (EMS) ambulance populations. Evidence suggests that using ...organisational support can improve employee outcomes and in turn, patient outcomes. Understanding why EMS staff do and do not use support services is therefore critical to improving uptake, ensuring equitable access, and potentially influencing workforce well-being, organisational sustainability and patient care delivery. This systematic review aims to identify what support is available and any perceived barriers and facilitators to accessing and utilising organisational support.Methods and analysisSearches performed between 18 February 2022 and 23 February 2022 will be used to identify studies that report barriers and facilitators to EMS employee support among all government/state commissioned EMS ambulance systems. Electronic databases, AMED, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, EMBASE, EMCARE, HMIC, Medline and PsycINFO will be searched. All relevant English-language studies of adult employees of government/state commissioned EMS ambulance organisations published since December 2004 will be screened and relevant data extracted by two independent reviewers. A third reviewer will resolve any disagreements.The primary outcome is the identification of perceived barriers or facilitators to EMS staff using organisational support for mental health. The secondary outcome is the identification of supportive interventions offered through or by ambulance trusts. Study selection will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological quality of included studies will be appraised by administering rating checklists. A narrative synthesis will be conducted to report qualitative and quantitative data and will include population characteristics, methodological approach and information about barriers and facilitators.Ethics and disseminationEthical approval is not required because only available published data will be analysed. Findings will be disseminated through peer-reviewed publication and conference presentation.PROSPERO registration numberCRD42022299650.
Physical Activity and Depression in Young Adults McKercher, Charlotte M., BA; Schmidt, Michael D., PhD; Sanderson, Kristy A., PhD ...
American journal of preventive medicine,
02/2009, Letnik:
36, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Background Epidemiologic research suggests that physical activity is associated with decreased prevalence of depression. However, the relationship between physical activity accumulated in various ...domains and depression remains unclear. Further, previous population-based studies have predominantly utilized self-reported measures of physical activity and depression symptom subscales. Associations between physical activity in various domains (leisure, work, active commuting, yard/household) and depression were examined using both subjective and objective measures of physical activity and a diagnostic measure of depression. Methods Analyses (conducted in 2007) included data from 1995 young adults participating in a national study (2004–2006). Physical activity was measured by self-report (International Physical Activity Questionnaire) and objectively as pedometer steps/day. Depression (DSM-IV 12-month diagnosis of major depression or dysthymic disorder) was assessed using the Composite International Diagnostic Interview. Results For women, moderate levels of ambulatory activity (≥7500 steps/day) were associated with ∼50% lower prevalence of depression compared with being sedentary (<5000 steps/day) ( p trend=0.005). Relatively low durations of leisure physical activity (≥1.25 hours/week) were associated with ∼45% lower prevalence compared with the sedentary group (0 hours/week) ( p trend=0.003). In contrast, high durations of work physical activity (≥10 hours/week) were associated with an approximate twofold higher prevalence of depression compared with being sedentary (0 hours/week) ( p trend=0.005). No significant associations were observed for steps/day in men or for other types of self-reported activity including total physical activity in both men and women. Conclusions These findings indicate that the context in which physical activity is assessed and the measurement methods utilized are important considerations when investigating associations between physical activity and depression.
Objective.
To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs.
Data Source.
Data were obtained through a ...systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus.
Study Inclusion and Exclusion Criteria.
Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Return-to-work and workplace injury prevention studies were excluded.
Data Extraction.
Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI.
Data Synthesis.
ROI was calculated as ROI = (benefits − costs of program)/costs of program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences of quality score and important study characteristics on ROI were explored.
Results.
Fifty-one studies (61 intervention arms) published between 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r = .84–.93). Methodological quality improved over time. Overall weighted ROI mean ± standard deviation (confidence interval) was 1.38 ± 1.97 (1.38–1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI was found. High-quality studies (n= 18) had a smaller mean ROI, 0.26 ± 1.74 (.23–.30), compared to moderate (n= 16) 0.90 ± 1.25 (.90–.91) and low-quality (n= 27) 2.32 ± 2.14 (2.30–2.33) studies. Randomized control trials (RCTs) (n= 12) exhibited negative ROI, −0.22 ± 2.41(–.27 to –.16). Financial returns become increasingly positive across quasi-experimental nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11–1.14), 1.61 ± 0.91 (1.56–1.65), and 2.05 ± 0.88 (2.04–2.06), respectively.
Conclusion.
Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants.
Depression often coexists with myocardial infarction (MI) and has been found to impede recovery through reduced functioning in key areas of life such as work. In an era of improved survival rates and ...extended working lives, we review whether depression remains a predictor of poorer work outcomes following MI by systematically reviewing literature from the past 15 years.
Articles were identified using medical, health, occupational and social science databases, including PubMed, OVID, Medline, Proquest, CINAHL plus, CCOHS, SCOPUS, Web of Knowledge, and the following pre-determined criteria were applied: (i) collection of depression measures (as distinct from 'psychological distress') and work status at baseline, (ii) examination and statistical analysis of predictors of work outcomes, (iii) inclusion of cohorts with patients exhibiting symptoms consistent with Acute Coronary Syndrome (ACS), (iv) follow-up of work-specific and depression specific outcomes at minimum 6 months, (v) published in English over the past 15 years. Results from included articles were then evaluated for quality and analysed by comparing effect size.
Of the 12 articles meeting criteria, depression significantly predicted reduced likelihood of return to work (RTW) in the majority of studies (n = 7). Further, there was a trend suggesting that increased depression severity was associated with poorer RTW outcomes 6 to 12 months after a cardiac event. Other common significant predictors of RTW were age and patient perceptions of their illness and work performance.
Depression is a predictor of work resumption post-MI. As work is a major component of Quality of Life (QOL), this finding has clinical, social, public health and economic implications in the modern era. Targeted depression interventions could facilitate RTW post-MI.
To investigate whether there are bi-directional associations between anxiety and mood disorders and body mass index (BMI) in a cohort of young adults.
We analysed data from the 2004-2006 (baseline) ...and 2009-2011 (follow-up) waves of the Childhood Determinants of Adult Health study. Lifetime DSM-IV anxiety and mood disorders were retrospectively diagnosed with the Composite International Diagnostic Interview. Potential mediators were individually added to the base models to assess their potential role as a mediator of the associations.
In males, presence of mood disorder history at baseline was positively associated with BMI gain (β = 0.77, 95% CI: 0.14-1.40), but baseline BMI was not associated with subsequent risk of mood disorder. Further adjustment for covariates, including dietary pattern, physical activity, and smoking reduced the coefficient (β) to 0.70 (95% CI: 0.01-1.39), suggesting that the increase in BMI was partly mediated by these factors. In females, presence of mood disorder history at baseline was not associated with subsequent weight gain, however, BMI at baseline was associated with higher risk of episode of mood disorder (RR per kg/m
: 1.04, 95% CI: 1.01-1.08), which was strengthened (RR per kg/m
= 1.07, 95% CI: 1.00-1.15) after additional adjustment in the full model. There was no significant association between anxiety and change in BMI and vice-versa.
The results do not suggest bidirectional associations between anxiety and mood disorders, and change in BMI. Interventions promoting healthy lifestyle could contribute to reducing increase in BMI associated with mood disorder in males, and excess risk of mood disorder associated with BMI in females.
The mental health of postgraduate research students (PGRs) is a growing area of interest to Higher Education Institutions (HEIs) and researchers and has important implications for PGR wellbeing, ...success, and attrition. This study aimed to explore PGR experiences of mental health during the pandemic, the supervisory relationship, and seeking support. Semi-structured interviews were conducted with 20 PGRs from across the UK. Questions invited PGRs to share their experience of supervision, the impact of supervision on their mental health, and any experience of discussing mental health with their supervisor(s). The experiences of supervision varied, as did the university responses to the pandemic and levels of supervisory support. A number of PGRs felt that their supervision experiences had negatively impacted their wellbeing and reported stigma and discriminatory practices. Themes identified included discourses, supervisory knowledge, university resources, and the research culture as key factors that impacted the mental health of PGRs. Supervisors often upheld perceptions of PhD life as being isolating, with negative impacts on wellbeing to be expected, setting expectations of overworking, anxiety, and stress. The move from pandemic to post-pandemic life posed both challenges and benefits. Issues of training on mental health awareness, university processes, and accessibility of services should be considered by HEIs.
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