انگیختگی ادراکی ایجاد حافظه های جدید اپیزودیک را بهبود می بخشد

Purpose We aimed to analyse the impact of psychosocial work environment on non-work-related sickness absence (NWRSA) among a prospective cohort study, stratified using a random sampling technique. Methods Psychosocial variables were assessed among 15,643 healthy workers using a brief version of the Spanish adaptation of Copenhagen Psychosocial Questionnaire. A one year follow-up assessed the total count of NWRSA days. Zero-inflated negative binomial regression was used for multivariate analyses. Results After adjusting for covariates, low levels of job control and possibilities for development (Odds Ratio [OR]: 1.17; 95% CI: 1.01-1.36 [men]; OR: 1.39 95% CI: 1.09-1.77 [women]), poor social support and quality of leadership (OR: 1.29; 95% CI: 1.11-1.50 [men]; OR: 1.28; 95% CI: 1.01-1.63 [women]), and poor rewards (OR: 1.34; 95% CI: 1.14-1.57 [men]; OR: 1.30; 95% CI: 1.01-1.66 [women]) predicted a total count of sickness absence greater than zero, in both men and women. Double presence was also significantly associated with NWRSA different than 0, but only among women (OR: 1.40; 95% CI: 1.08-1.81). Analyses found no association between psychosocial risk factors at work and the total count (i.e., number of days) of sickness absences. Conclusions The results suggest that work-related psychosocial factors may increase the likelihood of initiating a NWRSA episode, but were not associated with the length of the sickness absence episode. Among our large cohort we observed that some associations were gender-dependent, suggesting that future research should consider gender when designing psychosocial interventions aimed at decreasing sickness absences. Keywords Working Conditions; Psychological Stress; Occupational Health; Occupational Risks; Occupational Exposure; Sick leave; Absenteeism; Cost of Illness

Sickness-related absences are a major concern in occupational health and has increasing become a focus of interest among researchers. Nevertheless, sick leave is an essential resource for the working population. The development of sick pay, which allows workers to receive compensation when they are temporarily unable to work due to illness, has signified important progress for social security systems. That being said, sickness-related benefits are a major source of costs for both insurance companies (i.e., productivity losses and replacement costs) and employees (i.e., potential for variable income reduction) depending on the type of insurance and country-specific social security characteristics (Coggon et al., 2013; Markussen et al., 2012; Torá-Rocamora et al., 2013). In Spain, sickness absence is covered for both work-related and non-work-related injuries and diseases, but with different regulations (Gimeno et al., 2014). Classification as an occupational disease is constrained by a specific list of conditions, for defined occupations, and developed under the influence of definite exposures (Spanish General Law on Social Security, 1994). Occupational injuries, on the other hand, refer to those caused in the context of an accident at work or while commuting (European Commission, 2013). The remainder of injuries and diseases are considered non-work-related. In the case of non-work-related sickness absence (NWRSA), sick pay extends from the fourth day of sickness absence to 12 months, with the possibility of an additional six month period following an evaluation by the Social Security Institute. Sick leave must be certified by the patient’s general practitioner on a weekly basis from the initial onset of the episode until completion (Gimeno et al., 2014). Occupational diseases and injuries generally involve additional benefits (e.g., sick pay from the first day). In order to minimise the detrimental effects of work absences, it is essential to enhance our knowledge regarding the complex multifactorial processes that result in workers requesting sick leave. Previous research has analysed the impact of the psychosocial work environment on sickness absence (Coggon et al., 2013; Houdmont et al., 2012; Markussen et al., 2012), with significant but variable associations between specific work-related psychosocial factors and sickness absence, including: job strain or its components (Alavinia et al., 2009; Casini et al., 2010; Casini et al., 2013; Laaksonen et al., 2010; Niedhammer et al., 2013), effort–reward imbalance (Head et al., 2007; Ndjaboué et al., 2014), job insecurity (Blekesaune, 2012), or work–family conflict (Casini et al., 2010; Casini et al., 2013; Clays et al., 2009; Hämmig and Bauer, 2014). However, there is a fundamental need to reproduce these analyses in different countries, where social security systems can vary greatly. Indeed, specific regulations that effect sick pay entitlement within each country, as well as macroeconomic variables (e.g., unemployment rate) can modulate associations between work-related psychosocial factors and sickness absence. To date, several studies have been conducted using cross-sectional designs (Casini et al., 2010; Coggon et al., 2013; Hämmig and Bauer, 2014; Niedhammer, et al., 2013; Roelen et al., 2008) or self-reported sickness absence as a surrogate measure of sick leave (Blekesaune, 2012; Coggon et al., 2013; Hämmig and Bauer, 2014; Houdmont et al., 2014; Niedhammer, et al., 2013). Therefore, from an occupational viewpoint, many findings in the literature have been biased through the analysis of selected populations (Alavinia et al., 2009; Head et al., 2007; Houdmont et al., 2012; Laaksonen et al., 2010; Rugulies et al., 2010; Virtanen et al., 2008) or low response rates (Casini et al., 2010; Casini et al., 2013; Clays et al., 2009). Moreover, investigations have seldom incorporated tools specifically developed for the assessment of the psychosocial work environment. As such, the generalisability of these results to real professional practice is limited, and evidence regarding the predictive validity of available questionnaires and scales is lacking (Rugulies et al., 2010). Furthermore, no study conducted to date has explicitly focused on the role of psychosocial factors at work on NWRSA. Here, we aimed to analyse the impact of the psychosocial work environment on sickness absence due to non-work-related diseases and injuries.