Annals of Occupational and Environmental Medicine

Research Article

The association between serum dehydroepiandrosterone sulfate (DHEAS) levels and job-related stress among female nurses: Seunghyeon Cho, Won-Ju Park, Wonyang Kang, Hyeong-Min Lim, Ji-Sung Ahn, Dae-Young Lim, Jai-Dong Moon; Ann Occup Environ Med 2019;31:e18. Published online August 14, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e18

Background

Dehydroepiandrosterone sulfate (DHEAS) is an endogenous steroid hormone produced by the adrenal gland. DHEAS has been suggested to play a protective role against psychosocial stress. The aim of this study was to investigate the association between job-related stress and blood concentrations of DHEAS according to occupational stress factors among female nurses.

Methods

A cross-sectional study was conducted among 118 premenopausal nurses from 4 departments (operating room, emergency room [ER], intensive care unit, and ward) of a university hospital. Participants were all rotating night shift workers who have worked for over a year and mean age of 33.5 ± 4.8 years. Data from structured questionnaires including the Korean Occupational Stress Score, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) were used.

Results

In the high job-related stressor group, scores of BDI, BAI, and PSQI were significantly higher than low-stressor group. ER nurses had relatively more work-burden related stressors, but they had significantly lower levels of anxiety and depression than other groups. And, ER nurses showed higher levels of DHEAS than the other department nurses. The differences were significant (p = 0.003). Additionally, there was a statistically significant difference even after adjusting for factors that could affect level of DHEAS, such as age, body mass index, drinking, and physical activity (p = 0.039).

Conclusions

This result suggests the possibility that DHEAS may play a role as a marker of proper stress management. The capacity to secrete DHEAS is not simply due to workload or job stressor but could be determined depending on how individuals and groups deal with and resolve stress. Proper resolution of stress may affect positive hormone secretion.

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Research Article

Effects of shift work on abdominal obesity among 20–39-year-old female nurses: a 5-year retrospective longitudinal study: Gyeong-Jin Lee, Kunhyung Kim, Se-yeong Kim, Jeong-Ho Kim, Chunhui Suh, Byung-Chul Son, Chae-Kwan Lee, Junghye Choi; Ann Occup Environ Med 2016;28:69. Published online December 5, 2016; DOI: https://doi.org/10.1186/s40557-016-0148-6

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Background

This study aimed to investigate the effects of shift work on abdominal obesity among young and middle-aged female nurses during a 5-year retrospective study.

Methods

This retrospective study included female nurses (20–39 years old) who worked at a university hospital in Korea and had available health screening results from 2010–2015. Among 2,611 employees, 934 healthy 20–39-year-old female nurses were identified, and data regarding their demographic information (age and date of employment), waist circumferences (WC), and lifestyle factors (alcohol and exercise) were obtained. Abdominal obesity was defined as a WC of ≥80 cm, based on the World Health Organization’s Asia-West Pacific standard in 2000. The mean WC change from baseline was analyzed using the paired t test, and the association between shift work and abdominal obesity was analyzed using the generalized estimating equation.

Results

Compared to all day workers (both age groups), the 20–29-year-old nurses did not exhibit significant changes in WC at each follow-up. However, among the 30–39-year-old nurses, shift workers exhibited a significant change in WC (vs. baseline) during years 4 and 5, compared to day workers. After adjusting for effective confounders and stratifying the participants according to age, the 20–29-year-old nurses exhibited an odds ratio of 3.21 (95 % confidence interval: 1.29–7.98) for shift work-associated obesity, although the odds ratio for the 30–39-year-old nurses was not statistically significant.

Conclusion

In the study population, shift work was associated with a significant change in mean WC among 30–39-year-old nurses, and the shift work-associated risk of abdominal obesity was significant among 20–29-year-old nurses. These results indicate that shift work may influence abdominal obesity differently in 20–29-year-old and 30–39-year-old female nurses.

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Research Article

Risk factors of musculoskeletal symptoms in university hospital nurses: Eunkwang Ryu, Byeongjin Ye, Youngil Yi, Jungwon Kim; Ann Occup Environ Med 2014;26:47. Published online November 4, 2014; DOI: https://doi.org/10.1186/s40557-014-0047-7

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Objectives

The purpose of this study was to investigate musculoskeletal symptom prevalence in university hospital nurses and explore the relation between musculoskeletal symptom prevalence and work related factors.

Methods

A structured questionnaire was conducted with 620 nurses in a university hospital to look into the characters of responsibility and musculoskeletal symptom prevalence. The questionnaire respondents numbered 534, so the response rate was 86.1%. Among the respondents, three who gave insincere answers were excluded. The final study population was 531 respondents. ANSI Z-365 checklist was applied to look into ergonomic characteristics, and Korean Occupational Stress Scale Short Form was employed to measure job stress.

Results

In the case of the whole body, symptom prevalence amounted to 70.8%. Regarding each body region, shoulder symptom prevalence accounted for the highest, or 44.8%, waist 40.7%, and neck 33.3% in order. According to multiple logistic regression analysis, in the case of the whole body, the group with a high ANSI checklist grade had odds ratio of 3.59 (95% CI 1.48 ~ 8.76), and the group with high job stress had 3.19 (95% CI 2.01 ~ 5.07).

Conclusion

Regarding the occupational factors related to musculoskeletal symptoms of university hospital nurses, it was found that ANSI Z-365 checklist high risk group, total job tenure, department, shiftworks, and job stress had high relation with musculoskeletal symptoms. It is necessary to find an ergonomic solution and a stress reduction plan to prevent musculoskeletal disease.

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Research Article

Relationship between Psychosocial Risk Factors and Work-Related Musculoskeletal Disorders among Public Hospital Nurses in Malaysia: Nur Azma Amin, Rusli Nordin, Quek Kia Fatt, Rahim M Noah, Jennifer Oxley; Ann Occup Environ Med 2014;26:23-23. Published online August 9, 2014; DOI: https://doi.org/10.1186/s40557-014-0023-2

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Objective

This study examined the relationships between psychosocial work factors and risk of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

Methods

We conducted a cross-sectional study among 660 public hospital nurses. A self-administered questionnaire was used to collect data on the occurrence of WRMSDs according to body regions, socio-demographic profiles, occupational information and psychosocial risk factors. 468 questionnaires were returned (response rate of 71%), and 376 questionnaires qualified for subsequent analysis. Univariate analyses were applied to test for mean and categorical differences across the WRMSDs; multiple logistic regression was applied to predict WRMSDs based on the Job Strain Model’s psychosocial risk factors.

Results

Over two thirds of the sample of nurses experienced discomfort or pain in at least one site of the musculoskeletal system within the last year. The neck was the most prevalent site (48.94%), followed by the feet (47.20%), the upper back (40.69%) and the lower back (35.28%). More than 50% of the nurses complained of having discomfort in region one (neck, shoulders and upperback) and region four (hips, knees, ankles, and feet). The results also revealed that psychological job demands, job strain and iso-strain ratio demonstrated statistically significant mean differences (p < 0.05) between nurses with and without WRMSDs. According to univariate logistic regression, all psychosocial risk factors illustrated significant association with the occurrence of WRMSDs in various regions of the body (OR: 1.52–2.14). Multiple logistic regression showed all psychosocial risk factors were significantly associated with WRMSDs across body regions (OR: 1.03–1.19) except for region 1 (neck, shoulders and upper back) and region 4 (hips, knees, ankles, and feet). All demographic variables except for years of employment were statistically and significantly associated with WRMSDs (p < 0.05).

Conclusions

The findings indicated the high prevalence of WRMSDs in many body regions, and the risks of developing WRMSDs according to the various body regions were associated with important psychosocial risk factors based on the job strain model. These findings have implications for the management of WRMSDs among public hospital nurses in the Klang Valley, Malaysia.

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Original Article

The Relationship between Hospital Departments and Risk of Developing Tuberculosis among Nurses Working at a University Hospitalin Korea: Retrospective Cohort Study: Jin Ha Yoon, Sung Soo Oh, Ki Hyun Lee, Sung Kyung Kim, Je Ho Oh, Chung Se Won, Sei Jin Chang, Bong Suk Cha, Ae Yong Eom, Sang Baek Koh; Korean Journal of Occupational and Environmental Medicine 2011;23(1):64-70. Published online March 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.1.64

Abstract PDF: OBJECTIVES
To investigate the occurring characteristics of pulmonary tuberculosis (TB) among nurses working at a university hospital in Korea.
METHODS
A retrospective cohort study was conducted using medical records from a university hospital. A total of 351 nurses without any pulmonary disease were enrolled during 2000~2007, and were followed up until October 2010. To compare with the incidence of TB between occupational subgroups, workplaces were divided into high and low TB-exposure risk departments. For statistical analysis, the relative risks for TB incidences between departments were estimated using Cox proportional hazards models and mean incidences were estimated with person-time years.
RESULTS
Seven cases of TB were observed during 2001 person-years. Five and two cases were observed in the high and low TB-exposure risk departments, respectively. The relative risk of TB infection in the high TB-exposure risk departments were 6.52 (95% CI, 1.26~33.60) compared to that in the low TB-exposure risk department. The mean incidence of TB in the total nurses was 0.350% per person-year.
CONCLUSIONS
According to the concept of occupational and environmental medicine, high TB-exposure risk departments were more likely to be at increased risk of tuberculosis.

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Original Article

The Reliability and Validity of the Negative Acts Questionnaire-Revised (NAQ-R) for Nurses for the Assessment of Workplace Bullying: Woong Nam, Ji Won Kim, Yong Kyu Kim, Jung Wan Koo, Chung Yill Park; Korean Journal of Occupational and Environmental Medicine 2010;22(2):129-139. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.129

Abstract PDF

OBJECTIVE: This study was conducted to assess the reliability, the validity, the psychological characteristics, and the internal structure of the Negative Acts Questionnaire-Revised (NAQ-R) for nurses for the assessment of the workplace bullying.
METHODS
A total of 190 female nurses who worked in a university hospital and who had participated in an annual health surveillance program were recruited into the study. A structured questionnaire was used to evaluate each participant's workplace bullying, job stress, and psychosocial wellbeing. Workplace bullying was assessed using the negative acts questionnaire-revised (NAQ-R), job stress was assessed using the Korean Occupational Stress Scale-Short Form (KOSS-SF) and psychosocial wellbeing was assessed using the Psychosocial Wellbeing Index-Short Form (PWI-SF). Resulting answers from the questionnaires were analyzed by chi-square, ANOVA, correlation analysis, and factor analysis.
RESULTS
Victims of workplace bullying of nurses in a hospital is 37(19%) based on operational bullying criteria. The Cronbach's alpha for the negative acts questionnaire-revised (NAQ-R) is 0.9260. By exploratory factor analysis, we conclude that 3 factor are most relevant. Criterion validity was satisfied with that a negative acts questionnaire-Revised (NAQ-R) resulting in a statistically significant and positive relationship with PWI-SF , construct validity was satisfied with that NAQ-R has statistically significant and high positive correlation with the occupational climate of the KOSS results.
CONCLUSIONS
The negative acts questionnaire-revised (NAQ-R) is a reliable and valid tool for the assessment of workplace bullying in the hospital nurse. By using this tool, we can imply the prevalence of and the condition of workplace bullying among the nurse.

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Original Article

The Relationship between Job Stress and Psychosocial Stress among Nurses at a University Hospital: Hwan Cheol Kim, Keun Sang Kwon, Dai Ha Koh, Jong Han Leem, Sin Goo Park, Joo Youn Shin, Yeui Cheol Lee, Yong Kyu Kim; Korean Journal of Occupational and Environmental Medicine 2006;18(1):25-34. Published online March 31, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.1.25

Abstract PDF

OBJECTIVES
This cross-sectional study investigated the relationship between job stress and psychosocial stress among nurses at a university hospital in Incheon, Korea.
METHODS
A questionnaire survey was administered to 476 nurses, of which 320 (67.2%) questionnaires were returned and 299 (62.8%) were regarded as containing reliable data for analyses. A structured self-reported questionnaire was used to assess each respondent's sociodemographics, sleep quality, physical burden, job stress and psychosocial stress. Seven domains of occupational stress (e.g., Job demand, Insufficient job control, Interpersonal conflict, Job insecurity, Lack of reward, Organizational system and Occupational climates) according to the Korean Occupational Stress Scale (KOSS) were used and psychosocial stress was measured using Dr. Chang's PWI-SF (Psychosocial Well-being Index-Short Form). We estimated the relation of job stress to psychosocial stress using univariate and logistic regression analyses.
RESULTS
The logistic regression analyses indicated that the groups with high stress in 'Insufficient job control' (OR=2.67, 95% C.I.=1.37-5.23), 'Interpersonal conflict' (OR=2.32, 95% C.I.=1.19-4.51), 'Job insecurity' (OR=2.51, 95% C.I.=1.17-5.36), 'Organizational system' (OR=2.80, 95% C.I.=1.39-5.63), and 'Lack of reward' (OR=2.98, 95% C.I.=1.55-5.74) were more likely to experience high psychosocial stress.
CONCLUSIONS
Our results tend to suggest that job stress is associated with psychosocial stress. The importance of job stress should be acknowledged and stress management programs need to be instigated to minimize the psychosocial stress caused by job stress.

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Original Article

The Relationship between Job Stress and Needlestick Injury among Nurses at a University Hospital: Hwan Cheol Kim, Yong Kyu Kim, Yeui Cheol Lee, Joo Youn Shin, Jee Na Lee, Jong Han Leem, Shin Goo Park; Korean Journal of Occupational and Environmental Medicine 2005;17(3):216-224. Published online September 30, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.3.216

Abstract PDF

OBJECTIVES
This cross-sectional study investigated the relationship between job stress and needlestick injury the nurses at a University hospital in Incheon, Korea.
METHODS
A questionnaire survey was conducted targeting 476 nurses, of which 320 (67.2%) questionnaires were returned and 256 (53.8%) were regarded as being reliable data for analyses. We estimated the relation of job stress to needlestick injury using univariate and multiple logistic regression analyses.
RESULTS
One hundred sixty-five nurses (64.5%) had suffered at least one needlestick injury (included sharp injuries) during the previous year. After adjusting for potential confounders, we found that the high job control group was less likely than the other group to experience needlestick injury (OR=0.51, 95% CI=0.27-0.97). Job demand and social support, however, were unrelated to needlestick injury. The high job strain group was more likely to experience needlestick injury (OR=2.57, CI=1.13-5.83) than the low job strain group.
CONCLUSIONS
Our results tend to suggest that nurses who were in the low job control or high job strain status were more likely to suffer a high rate of needlestick injury.

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Jung-Yeon Hong, Jung-Wan Koo
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Original Article

Musculoskeletal Symptoms and Related Factors for Nurses and Radiological Technologists Wearing a Lead Apron for Radiation Protection: Jung Im Yoo, Jung Wan Koo; Korean Journal of Occupational and Environmental Medicine 2004;16(2):166-177. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.166

Abstract PDF

OBJECTIVES
To determine the complaint rates of musculoskeletal symptoms and understand the related factors of musculoskeletal symptoms in nurses and radiological technologists wearing a lead apron for radiation protection.
METHOD
The study subjects were 192 nurses and radiological technologists who work at the cardiac catheterization room or angioroom in the department of radiology. A self-recording questionnaire was used to investigate the general characteristics, occupational characteristics, characteristics related to wearing a lead apron, and subjective musculoskeletal symptoms designed by the National Institute for Occupational Safety and Health (NIOSH).
RESULTS
Complaint rates of musculoskeletal symptoms by NOISH were 51.0% in the upper /lower back, 49.0% in the shoulder, and 47.9% in the leg/knee/ankle. From multiple logistic regression analysis, musculoskeletal symptoms of the shoulder were influenced by two-piece type apron and long time wearing an apron, symptoms of upper/lower back by long time wearing an apron, sex, higher average working hours per a day and short resting time, symptoms of leg/knee/ankle by long time wearing an apron, working career at the present department (cardiac catheterization room or angioroom) and short resting time.
CONCLUSION
The complaint rates of the musculoskeletal symptoms were affected by the characteristics of wearing a lead apron for radiation protection such as wearing time and apron type. Therefore, it is suggested that the workers who are wearing an apron need the proper wearingtime and resting time, and suitable apron type and size for the body.

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