Academic journal article Scandinavian Journal of Work, Environment & Health

Effectiveness of a Participatory Physical and Psychosocial Intervention to Balance the Demands and Resources of Industrial Workers: A Clusterrandomized Controlled Trial

Academic journal article Scandinavian Journal of Work, Environment & Health

Effectiveness of a Participatory Physical and Psychosocial Intervention to Balance the Demands and Resources of Industrial Workers: A Clusterrandomized Controlled Trial

Article excerpt

Semi- and unskilled (blue-collar) workers have a higher risk of premature drop-out from the labor market than skilled and white-collar workers (1). An important explanatory factor is the high physical work demands faced by semi- and unskilled workers (such as spending a large proportion of one's worktime standing, walking and forward bending) which impose an adverse effect on health and act as a barrier to sustainable employment (2). However, these employee groups also face various psychosocial work conditions which may deplete personal resources (3). If ample recovery opportunities are not available, the resulting continuous depletion of resources can lead to adverse effects on workers' well-being and health (4). Ultimately, in the absence of adequate recovery, negative long-term effects such as exhaustion, losses of function, and physical and mental impairment can occur (4, 5).

Long-term effects of poor recovery from work are often preceded by acute symptoms, measured by the need for recovery inventory (ie, a person's desire to be temporarily relieved from demands in order to restore his or her resources) (5, p330). If sufficient recovery is not achieved, the worker must exert additional effort to meet the demands of their job the next day, and this process may start a vicious cycle leading to prolonged fatigue and exhaustion (5). Poor recovery is shown to predict high employee turnover (6), poor well-being (7), high sickness absence (6), and poor sleep and emotional complaints among workers (8).

Work ability is another scientific concept reflecting whether employees can perform their job without strain (9, 10). Work ability is defined as "how good is the worker at present, in the near future, and how able is he/ she to do his/her work with respect to work demands, health, and mental resources" (11, p3). Building on a balance model, factors that contribute to strain are described as demands, while resources are described as factors that prevent or reduce strain (12). The work ability concept takes an inclusive view of demands and resources as factors that can be found both at the workplace (as in the job demands-resources model) as well as in the individual (11, 13). This makes the model compatible with a job demands-resources approach, while remaining cognizant of potential influence from other demands or resources than those described in the extant literature. A decreased work ability has been documented to be associated with high work demands (14, 15), low personal resources, stress and burnout (16, 17), as well as future sickness absence (14, 18), and early retirement (14, 19).

Blue-collar workers more often experience fatigue (20, 21) and impaired work ability compared to other occupational groups (22-24) reflecting an imbalance between work demands and resources, which can partly explain their increased prevalence of early labor market dropout (14). Intervention studies have aimed to improve the work ability and recovery in a variety of study populations, but with minor or no improvements (25-29). Beneficial intervention results have been observed for healthcare workers' recovery (30, 31). However, the generalizability of these interventions to other work sectors is uncertain given the large differences in work demands, resources and the organization of work. A reason for the lack of positive intervention effects on recovery and work ability of many interventions could be that most previous studies did not, as it has been recommended, target a sufficiently wide array of organizational, psychosocial, and physical factors using a multi-dimensional approach (25-27, 32). Predominantly, the individual worker level has been targeted in previous interventions on recovery and work ability (26, 27, 30, 33, 34). In contrast, organizational interventions (35, 36) have the potential to reduce or remove the causes of strain for entire workgroups (primary prevention) (37) and not only for workers in need. Thus, integration of the organizational and individual levels in workplace interventions are recommended for improving workers' health and well-being (38). …

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