Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort
Abstract
:1. Introduction
1.1. Sickness Absence in the Health and Social Care Industry
1.2. Job Demands and Decision Authority in the Health and Social Care Industry
1.3. Workplace Violence in the Health and Social Care Industry
1.4. Variation in Sickness Absence and Psychosocial Work Factors on Industry Level
2. Materials and Methods
2.1. Study Design
2.2. Study Sample
2.3. Variables
2.3.1. Outcome Variable
Sickness Absence
2.3.2. Predictor Variable
2.3.3. Mediating Variables
2.3.4. Covariates
2.4. Analytical Strategy
2.4.1. Descriptive Statistics
2.4.2. Autoregressive Cross-Lagged Mediation Models within a Multilevel Structural Equation Modelling (MSEM) Framework
3. Results
3.1. Descriptive Statistics
3.2. The Association between Employment in the Health and Social Care Industry and Sickness Absence (Model 1)
3.3. The Mediating Role of High Job Demands (Model 2)
3.4. The Mediating Role of Low Decision Authority (Model 3)
3.5. The Mediating Role of Exposure to Workplace Violence (Model 4)
4. Discussion
4.1. The Association between Employment in the Health and Social Care Industry and Sickness Absence
4.2. The Mediating Role of High Job Demands
4.3. The Mediating Role of Low Decision Authority
4.4. The Mediating Role of Exposure to Workplace Violence
5. Strengths and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Women | Men | Total | ||||
---|---|---|---|---|---|---|
n/means | %/st.dev | n/means | %/st.dev | n/means | %/st.dev | |
Predictor | ||||||
Employment in Health and Social Care | ||||||
Yes | 675 | 32.05 | 105 | 5.80 | 780 | 19.92 |
No | 1431 | 67.95 | 1705 | 94.20 | 3136 | 80.08 |
Putative mediators | ||||||
Job Demands | 2.59 | 0.56 | 2.58 | 0.53 | 2.59 | 0.55 |
Decision Authority | 1.72 | 0.48 | 1.68 | 0.49 | 1.70 | 0.49 |
Workplace Violence | ||||||
No | 1626 | 77.06 | 1601 | 88.36 | 3227 | 82.28 |
Yes | 484 | 22.94 | 211 | 11.64 | 695 | 17.75 |
Outcome variable | ||||||
Sickness Absence | ||||||
0 days | 1801 | 84.79 | 1669 | 91.45 | 3470 | 87.87 |
>0 days | 323 | 15.21 | 156 | 8.55 | 479 | 12.13 |
Demographic characteristics | ||||||
Gender | ||||||
Women | - | - | - | - | 2126 | 53.78 |
Men | - | - | - | - | 1826 | 46.22 |
Age | ||||||
1 < 34 years | 249 | 11.94 | 225 | 12.53 | 474 | 12.21 |
2 35–44 years | 522 | 25.04 | 470 | 26.17 | 992 | 25.56 |
3 45–54 years | 729 | 34.96 | 542 | 30.18 | 1271 | 32.75 |
4 55–64 years | 580 | 27.82 | 537 | 29.90 | 1117 | 28.78 |
5 > 64 years | 5 | 0.24 | 22 | 1.22 | 27 | 0.70 |
Education | ||||||
1 ≤ 9 years | 303 | 14.35 | 324 | 17.94 | 627 | 16 |
2 ≤ 12 years | 431 | 20.45 | 454 | 25.14 | 885 | 22.59 |
3 University < 3 years | 368 | 17.42 | 407 | 22.54 | 775 | 19.78 |
4 University ≥ 3years | 376 | 17.80 | 197 | 10.91 | 573 | 14.62 |
5 Research Education | 634 | 30.02 | 424 | 23.48 | 1058 | 27 |
Marital Status | ||||||
0 Not Married/cohabited | 932 | 43.86 | 812 | 44.47 | 1744 | 44.14 |
1 married/cohabited | 1193 | 53.14 | 1014 | 55.53 | 2207 | 55.86 |
Children living at home | ||||||
0 No | 1021 | 48.48 | 851 | 47.49 | 1872 | 48.02 |
1 Yes | 1085 | 51.52 | 941 | 52.51 | 2026 | 51.98 |
B (SE) | p | |
---|---|---|
1. Health and social care (HLTH)—Sickness Absence (SA) model | ||
Sickness Absence (SA) t | ||
Sickness Absence (SA) t-1 | 0.195 (0.013) | 0.000 |
Health and social care (HLTH) t-1 | 0.032 (0.010) | 0.002 |
Age | −0.033 (0.010) | 0.001 |
Children living at home | −0.017 (0.010) | 0.109 |
Married/co-habitant | −0.022 (0.009) | 0.015 |
Education | −0.050 (0.009) | 0.000 |
Gender | 0.069 (0.008) | 0.000 |
Health and social care (HLTH) t | ||
Health and social care (HLTH) t-1 | 0.918 (0.006) | 0.000 |
Sickness Absence (SA) t-1 | 0.005 (0.004) | 0.225 |
Age | 0.003 (0.004) | 0.514 |
Children living at home | −0.003 (0.003) | 0.362 |
Married/co-habitant | −0.002 (0.003) | 0.407 |
Education | 0.000 (0.003) | 0.935 |
Gender | 0.025 (0.003) | 0.000 |
2. Health and social care (HLTH)—High demands (DEM)—Sickness Absence (SA) model | ||
Demands (DEM) t-1 | ||
Health and social care (HLTH) t-1 | 0.025 (0.018) | 0.164 |
Age | −0.060 (0.018) | 0.001 |
Children living at home | 0.015 (0.016) | 0.360 |
Married/co-habitant | 0.002 (0.016) | 1.351 |
Education | 0.137 (0.018) | 0.000 |
Gender | 0.068 (0.017) | 0.000 |
Demands (DEM) t | ||
Sickness Absence (SA) t-1 | −0.003 (0.009) | 0.776 |
Demands (DA) t-1 | 0.657 (0.024) | 0.000 |
Age | −0.060 (0.018) | 0.001 |
Children living at home | 0.015 (0.016) | 0.360 |
Married/co-habitant | 0.022 (0.016) | 0.177 |
Education | 0.137 (0.018) | 7.728 |
Gender | 0.068 (0.017) | 3.899 |
Sickness absence (SA) t | ||
Sickness absence (SA) t-1 | 0.194 (0.013) | 0.000 |
Health and social care (HLTH) t-1 | 0.030 (0.010) | 0.002 |
Demands (DEM) t-1 | 0.031 (0.010) | 0.003 |
Age | −0.032 (0.010) | 0.001 |
Children living at home | −0.017 (0.010) | 0.099 |
Married/co-habitant | −0.023 (0.009) | 0.012 |
Education | −0.054 (0.009) | 0.000 |
Gender | 0.067 (0.008) | 0.000 |
3. Health and social care (HLTH)—Low decision authority (DA)—Sickness absence (SA) model | ||
Decision Authority (DA) t-1 | ||
Health and social care (HLTH) t-1 | 0.086 (0.014) | 0.000 |
Age | −0.122 (0.014) | 0.000 |
Children living at home | −0.021 (0.014) | 0.135 |
Married/co-habitant | −0.041 (0.014) | 0.002 |
Educ | −0.173 (0.013) | 0.000 |
Sex | 0.084 (0.015) | 0.000 |
Decision Authority (DA) t | ||
Decision Authority (DA) t-1 | 0.615 (0.009) | 0.000 |
Sickness absence (SA) t-1 | 0.018 (0.007) | 0.014 |
Age | −0.030 (0.008) | 0.000 |
Children living at home | −0.001 (0.007) | 0.924 |
Married/co-habitant | −0.008 (0.007) | 0.231 |
Education | −0.066 (0.007) | 0.000 |
Gender | 0.048 (0.007) | 0.000 |
Sickness absence (SA) t | ||
Sickness absence (SA) t-1 | 0.195 (0.013) | 0.000 |
Health and social care (HLTH) t-1 | 0.028 (0.010) | 0.005 |
Decision Authority (DA) t-1 | 0.029 (0.009) | 0.002 |
Age | −0.030 (0.010) | 0.005 |
Children living at home | −0.016 (0.010) | 0.121 |
Married/co-habitant | −0.021 (0.009) | 0.022 |
Education | −0.045 (0.009) | 0.000 |
Gender | 0.067 (0.008) | 0.000 |
4. Health and social care (HLTH)—Workplace violence (VIOL)—Sickness absence (SA) model | ||
Workplace violence (VIOL) t-1 | ||
Health and social care (HLTH) t-1 | 0.256 (0.016) | 0.000 |
Age | −0.112 (0.014) | 0.000 |
Children living at home | −0.001 (0.014) | 0.937 |
Married/co-habitant | −0.022 (0.012) | 0.081 |
Education | −0.011 (0.012) | 0.386 |
Gender | 0.039 (0.012) | 0.001 |
Workplace violence (VIOL) t | ||
Workplace violence (VIOL) t-1 | 0.500 (0.015) | 0.000 |
Sickness absence (SA) t-1 | 0.021 (0.009) | 0.023 |
Age | −0.030 (0.010) | 0.002 |
Children living at home | −0.017 (0.010) | 0.107 |
Married/co-habitant | −0.021 (0.009) | 0.018 |
Education | −0.050 (0.009) | 0.000 |
Gender | 0.068 (0.008) | 0.000 |
Sickness absence (SA) t | ||
Sickness absence (SA) t-1 | 0.195 (0.013) | 0.000 |
Health and social care (HLTH) t-1 | 0.022 (0.010) | 0.036 |
Workplace violence (VIOL) t-1 | 0.031 (0.010) | 0.002 |
Age | −0.030(0.010) | 0.036 |
Children living at home | −0.017(0.010) | 0.107 |
Married/co-habitant | −0.021(0.009) | 0.018 |
Education | −0.050(0.009) | 0.000 |
Gender | 0.068(0.008) | 0.000 |
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Nyberg, A.; Peristera, P.; Toivanen, S.; Johansson, G. Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort. Int. J. Environ. Res. Public Health 2022, 19, 53. https://doi.org/10.3390/ijerph19010053
Nyberg A, Peristera P, Toivanen S, Johansson G. Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort. International Journal of Environmental Research and Public Health. 2022; 19(1):53. https://doi.org/10.3390/ijerph19010053
Chicago/Turabian StyleNyberg, Anna, Paraskevi Peristera, Susanna Toivanen, and Gun Johansson. 2022. "Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort" International Journal of Environmental Research and Public Health 19, no. 1: 53. https://doi.org/10.3390/ijerph19010053