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BACKGROUND: Many psychosocial models of wellbeing at work emphasise the role of intrinsic motivational factors such as job autonomy, job complexity, and innovativeness. However, little is known about whether the employees of multinational enterprises differ from country to country with regard to intrinsic motivational factors, and whether these factors are associated with wellbeing similarly in the different countries. The purpose of this study was to examine the level of intrinsic motivational factors and their impact on functional incapacity in different countries in a multinational corporation. METHODS: In 2000, data were collected from a globally operating corporation with a questionnaire survey. The participants were 13 795 employees (response rate 59%; 56% under age 45; 80% men; 61% blue collar employees), who worked in similar industrial occupations in five countries (Canada, China, Finland, France, and Sweden). RESULTS: The Chinese employees reported higher autonomy and lower complexity at work than the employees from the other countries. After adjustment for age, sex, socioeconomic status, and physical work environment, job autonomy, and job complexity at work were associated with functional incapacity in most countries, whereas in China the impact was significantly stronger. In Finland and in China employees with low innovativeness at work were more prone to functional incapacity than corresponding employees in other countries. CONCLUSIONS: The level of intrinsic motivational factors varied between the Chinese employees and those in other countries. In line with theoretical notions, the relation between intrinsic motivational factors of work and functional incapacity followed a similar pattern in the different countries. However, these country specific results show that a culture specific approach to employee wellbeing should also be applied.

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BACKGROUND: The aim of this study was to test the hypothesis that people with a strong sense of coherence (SOC) have decreased all-cause mortality. METHODS: The effect of occupation and the SOC on all-cause mortality was studied among 4405 Finnish middle-aged employed men in a prospective 8-year follow-up study. RESULTS: Using Cox proportional hazards models the crude relative risk for all-cause mortality for the low SOC tertile when compared to the high SOC tertile was 1.23 (95% CI: 0.90-1.68). Adjusting for age, smoking, alcohol and occupation increased the risk slightly to 1.35. Occupation was an effect modifier, since among white-collar workers the corresponding relative risk of the low SOC tertile was 2.27 (95% CI: 1.12-4.59, p = 0.02) and among blue-collar workers the relative risk for all-cause mortality was stable (1.33-1.52) in each SOC tertile. The classic risk factors, smoking and alcohol, showed higher relative risks than the SOC. CONCLUSIONS: The effect of the health-promoting qualities of the SOC upon all-cause mortality was significant among white-collar workers, but not among blue-collar workers.

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BACKGROUND: Physicians' health problems have been discussed mainly in relation to substance abuse and psychiatric disorders. In this study, the prevalence of common chronic diseases and their treatment were determined. OBJECTIVE: To find differences in self-reported health status, amount of sick leave, and the use of health services among physicians according to sex and specialty. Data were also compared with those of the total employed population. DESIGN AND SETTING: Cross-sectional postal questionnaire survey in Finland. PARTICIPANTS AND METHODS: A random sample of licensed physicians younger than 66 years (n = 4477) was randomly selected from the register of the Finnish Medical Association. A total of 3313 physicians (74%) responded. MAIN OUTCOME MEASURES: Perceived health, prevalence of diseases, self-treatment of diseases, amount of sick leave, and medical consultations. RESULTS: Female physicians assessed their health as being better than other female employees and had used health services and had been on sick leave more often than their male colleagues. Male physicians assessed their health as being equal to that of other men. Both female and male physicians had fewer sick leave than other employees. However, physicians-especially men-reported many common chronic illnesses as often or more often than other employees. Physicians had consulted other medical professionals less often than other employees, and they primarily self-treated their illnesses. Of the specialties, psychiatrists had used health services and had been on sick leave more often than other physicians. CONCLUSION: This study indicates that the usual form of care of physicians' diseases is self-treatment and "working through" illnesses. Arch Fam Med. 2000;9:1079-1085

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The risk of coronary heart disease (CHD) was studied in 4405 Finnish middle-aged working men in different occupations according to their sense of coherence (SOC). The study design was prospective and the follow-up time was eight years. Clinical findings such as total cholesterol, systolic blood pressure and body-mass index showed differences when comparing blue and white collar workers. Lifestyle factors such as smoking also differed, but leisure time physical activity depended on SOC. In the white collar work environment the low SOC tertile had a high CHD incidence of 20.1 per 1000 person-years; the incidences in the medium and high SOC tertiles were 10.9 and 12.3, respectively. A similar effect was not observed in the blue collar work environment. There, contrary to theoretical expectations, the low SOC tertile had the lowest incidence of CHD. The difference in the CHD incidence pattern depended on the blue and white collar dichotomy and not on the branch (state agencies vs. industry). The SOC had a salutogenic effect among white collar workers, but failed to have any consequent effect on the health of blue collar workers. Further study is needed to look at the psychosocial factors among blue collar workers.

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The working world is progressing from the industrial era to the era of knowledge. The critical factor of success in work is shifting from machines to the human mind. All work that essentially uses and produces knowledge during and as a result of the work process can be defined as knowledge work. Knowledge jobs involve many health-promoting features, but stress and burnout may be caused by the rapid increase in the knowledge-intensity of work, new job demands, and emerging new professional subcultures emphasizing excessive commitment to work. Very little empirical evidence is available on these developments. Much more research is needed to understand the essential features of knowledge work, the change in organizational cultures, and the values guiding this process from the point of view of human resources. Research is also needed to develop organizational strategies for the prevention of stress and burnout in knowledge jobs.

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750 male industrial managers participated in a survey specifying the role of sense of coherence in occupational stress. A strong sense of coherence buffered from strain almost independently of respondents' age, exposure to stressors, or perceived stressors; however, a strong sense of coherence was slightly related to the selection of individuals into jobs characterized by relatively low exposure to such stressors as lack of control and role ambiguity. Sense of coherence did not moderate the relationship among exposure to stressors, perceived stressors, and strain experienced.

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OBJECTIVES: The risk of coronary heart disease (CHD) in shift work and the possible pathways for CHD in industrial workers were studied along with the importance of shift work as an occupational class gradient of CHD risk. METHODS: Data from a psychosocial questionnaire and on life-style factors, blood pressure, and serum lipid levels were used for a follow-up study of a cohort of 1806 workers. CHD was determined from official Finnish registers. Cox's proportional hazards models were used with different covariates to evaluate the relative risks associated with shift work. RESULTS: All the blue-collar workers smoked more and a had higher systolic blood pressure than the white-collar workers. Three-shift workers scored low for job-decision latitude on the Karasek job stress scales. There were no differences in the total cholesterol or high-density lipoprotein cholesterol levels. When all the shift workers were compared with all the day workers, the relative risk of CHD was 1.5 [95% confidence interval (95% CI) 1.1-2.1] when only age was adjusted for and 1.4 (95% CI 1.0-1.9) when life-style factors, blood pressure, and serum lipids were also adjusted for. The blue-collar day workers and 2-shift and 3-shift workers had relative risks of 1.3 (95% CI 0.8-2.0), 1.9 (95% CI 1.1-3.4), and 1.7 (95% CI 1.1-2.7), respectively, when compared with the white-collar day workers. CONCLUSIONS: Shift work is an important part of the occupational gradient in CHD risk among industrial workers; some evidence was found for the hypothesis that a direct stress-related mechanism explains part of the increased CHD risk.

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Blue-collar workers (4,523 men and 927 women) participated in a survey comparing two alternative models, one assuming the level of self-esteem (SE) to result to a significant extent from the strain induced by occupational stressors and the other stating the level of SE as a determinant of stressor perception and experienced strain. The results of multiple regression analyses did not support the latter model, whereas the first model was partially supported: Monotony was associated with increased strain and decreased SE among younger (< or = 35 years) male participants and older (> 35 years) female participants, and lack of control related to increased strain and decreased SE among older male participants. These observations were made in the context of psychological strain symptoms but not in the context of physiological strain symptoms.

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The authors analyzed empirically the roles of impatience-irritability and ambition-energy components of the Type A behavior pattern (TABP) in the occupational stressor-strain relationship. They tested three models, using a sample of 659 industrial managers to determine whether the TABP components affected strain independently from perceived stressors (the direct effects model); or indirectly, by moderating effects of perceived stressors (the moderated effects model); or whether perceived stressors provoked TABP components, which influenced the number of strain symptoms (the mediated effects model). Multiple regression procedures showed, as expected, that the two TABP components acted quite differently in the stress process. With the direct effects model, the impatience-irritability component consistently increased numbers of psychological and physiological symptoms, regardless of perceived occupational stressors. The ambition-energy component, on the other hand, was activated by an abundance of development possibilities experienced at work. This, in turn, partly explained the decrease in perceived levels of psychological and physiological symptoms. The results relating to the ambition-energy component supported the mediated effects model and demonstrated a positive effect on subjective health perceptions.

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The purpose of this study was to identify management-related factors contributing to personnel satisfaction in hospital wards. The sample population consisted of the employees of 15 hospital wards in four medical departments. The wards were classified into two categories on the basis of the satisfaction of the personnel with the management: 'satisfied wards' (seven wards with a highly satisfied personnel, n = 124) and 'other wards' (eight wards, n = 186). The employees of 'satisfied wards' reported more innovative activities and continuous quality improvements, more possibilities to participate in decision-making, more efficient communication within the ward and between other units, and more managerial activities for promoting the well-being of the staff compared with the personnel of 'other wards'. According to the ratings of the nursing directors, the quality of patient care in the 'satisfied wards' was higher, but there were no differences in cost-effectiveness between the study groups.

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This prospective study focused on childhood and adult psychosocial determinants of blood pressure (BP) measured at working age, including work factors, individual characteristics and socioeconomic factors. Data had been collected over 20 years ago from a sample representative of Finnish children. For this follow-up, 150 subjects responded to a questionnaire and attended a personal examination at the mean age of 37 yr. Hierarchical regression analyses were made for women and men. A split half procedure was applied for the control of possible chance associations. Work conditions and perceived health were not associated with BP. Social conditions in youth were powerful predictors of high adult BP for men. Poor living conditions in youth explained 16% of their diastolic BP and 9% of their systolic BP. The result may be regarded as strong evidence for early determinants of hypertension.

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This study investigated risk perception, well-being, and organizational commitment among nuclear power plant personnel. The study group, 428 employees from a nuclear power plant, completed a questionnaire which included the same questions as those in previous surveys on risk perception of lay persons and industrial workers. Hazards at work were not seen as a sizable problem by nuclear power plant personnel. The study group estimated the safety of nuclear power plants better and the possibility of serious nuclear accident as more unlikely than the general public. Compared to employees in other industrial companies, the overall perceived risks at work among plant personnel did not exceed the respective perceptions of the reference groups. Risk-related attitudes did not explain well-being among plant personnel, but the relationship between the perceived probability of a serious nuclear accident at work and organizational commitment yielded to a significant correlation: Those plant workers who estimated the likelihood of an accident higher were less committed to the organization.

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The predictive value of psychosocial factors in the development of neck--shoulder and low-back symptoms was investigated in a life-long follow-up study of 154 subjects. Measurements taken in adolescence, such as intelligence, alexithymia (low verbal productivity in projective personality tests), social confidence, hobbies, and the socioeconomic status of the family, showed no consistent associations with neck--shoulder or low-back symptoms in adulthood. Of the variables recorded in adulthood, weak mental resources for promoting health (poor sense of coherence) were consistently associated with neck--shoulder pain, whereas low fundamental education predicted low-back symptoms. The results suggest that psychosocial factors in childhood have a minor role as direct predictors of later symptoms.

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This longitudinal study investigated which job factors and personal resources contribute to self-assessed competence and life satisfaction. The effects of preemployment social conditions and personality, as assessed in adolescence, on competence and life satisfaction in adulthood were studied in 345 women and 361 men who had participated in a 1961 to 1963 psychological examination. Persons with high life satisfaction and competence had favorable work conditions and more personal resources and social support. Their coping strategies were primarily problem focused, whereas those with less sense of well-being were emotion focused. Persons of low competence who were satisfied with their lives had social support from others, cooperation, and prestige at work, but their income was low. The quality of home care, sports participation, and self-esteem in youth predicted competence in adulthood. The quality of home care, intelligence, cultural activities, and self-esteem in adolescence predicted adult life satisfaction.

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Mental load and strain in the work of firemen and fire alarm center operators were studied in a group of 260 fireman and 6 female full-time operators from three fire brigades. The firemen proved to be satisfied with their work, and signs of chronic psychological problems were uncommon. Situational work load and related strain may, however, be extreme during active operations. A large proportion (42%) of the firemen suffered from strain after the 24-h long daily work period. Those who had recently worked as paramedics in the ambulance service or in the alarm center were under more strain than ordinary fire fighters. Biochemical stress indicators revealed a high activation of firemen at the alarm center. The difference found between firemen and full-time female operators may be due to a variation in the adaptive functions of the two sexes.

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The ventromedial hypothalamus of the unrestrained cat was stimulated electrically through permanent electrodes. The stimulation parameters, amplitude, duration and frequency of the square wave pulses were combined to produce a 20% increase of the resting heart rate value. The total electric charge for each parametric combination was calculated. The charge per stimulation (10 s) varied from about 1 to 100 micro-coulombs, depending on the parametric combination used. The response could therefore not be expressed as a function of the charge but depended on the individual parametric combinations. The relation among the stimulation parameters and the total amount of electric charge of the pulses was estimated by the correlation technique. The results suggested that about 60% of the variation in the electric charge resulting in the constant response was due to the variation of the pulse repetition frequency. The optimal parameters for eliciting cardio-acceleration in the cat by stimulation of the ventromedial hypothalamus seem to be pulse durations between 0.1 and 0.5 ms and pulse repetition frequencies below 100 P/s, with pulse amplitude as the dependent variable.

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