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Wåhlin C1,2, Lindmark U3, Johnston V4, Wagman P5, Rolander B5,6
1County Council of Östergötland, Occupational and Environmental Medicine, Linköping University Hospital, Linköping, Sweden, 2Karolinska Institutet, Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Stockholm, Sweden, 3Jönköping University, Centre for Oral Health, Department of Natural Sciences and Biomedicine, School of Health and Welfare, Jönköping, Sweden, 4The University of Queensland, RECOVER Injury Research Centre, Herston, Australia, 5Jönköping University, Department of Rehabilitation, School of Health and Welfare, Jönköping, Sweden, 6County Council of Jönköping, Futurum, Academy for Health and Care, Jönköping, Sweden
Background: Dental organizations face new challenges associated with changing population needs for dental care and workplaces need to develop strategies to meet these challenges. Any redesign of organizational structures may influence employees' perception of their work conditions and subsequent health.
Purpose: This longitudinal study aimed to compare whether leadership, perceived work load, health and sickness presenteeism differed with varying mix of dental professionals staff roles and clinic size in dental organizations.
Methods: A prospective cohort study of dentists, dental hygienists and dental nurses working in the Public Dental Service in a Swedish County was conducted. In 2012 all 486 employees were invited to complete a web-based questionnaire (response rate = 66%) with a follow-up questionnaire in 2014 (response rate = 65%). The questionnaire contained items about workplace physical and psychosocial conditions, leadership, work ability, psychosomatic conditions, pain and symptoms in the musculoskeletal system and, sickness presenteeism. Comparisons were made between clinic size (Small clinics ≤10, Medium size clinics 11-20 and Large clinics >20 employees) and between 2012 and 2014. There were also comparisons between clinics with more or an equal proportion of dental hygienists (HDH clinics) and clinics with higher proportion dentists than dental hygienists (HD clinics).
Results: The change in leadership was greater for medium size HD clinics where 9% perceived poor leadership in 2012 and 27% in 2014, and large HD clinics where 17% perceived poor leadership in 2012 and 31% in 2014 and also a higher proportion reported sickness presenteeism subsequent to high physical load (29% to 43%). Sickness presenteeism due to physical reasons was reported by 31% of all dental employees during 2012 and increased to 43% during 2014 and, due to psychosocial stressors by 13% in 2012 and increased to 21% in 2014. Furthermore, 52% and 55% reported poor work ability in relation to the psychosocial demands at work in 2012 and 2014, respectively. Between 86-99% of all employees in 2012 and 2014 reported high precision demands and poor work posture. Small HDH clinics reported a higher proportion of sleep problems in 2014 (13%) compared with 2012 (3%). High psychosocial demands were perceived by 61-63% of all employees in both 2012 and 2014. There was a significant deterioration in experienced leadership quality from 17% in 2012 to 30% in 2014.
Conclusion(s): Perceived physical workload remains high for dental employees regardless of the clinic size or organizational structure. Over the two-year study, deterioration in perceived leadership was reported and more employees reported sickness presenteeism due to physical and psychosocial stressors. These features were particularly evident in large clinics with a greater proportion of dentists. The results indicate that preventive measures need to be taken to promote a sustainable and healthy work environment, especially in large dental clinics. The workplace is a promising arena for health promotion since employees spend about 30-40 hours per week at work.
Implications: As the treating physiotherapist it is important to include and evaluate questions about physical and psychosocial work load that may contribute to sickness presenteeism for patients with work-related disorders.
Keywords: Dental organizations, Physical workload, Psychosocial workload
Funding acknowledgements: This work was funded by Medical Research Council of Southeast Sweden (FORSS)
Purpose: This longitudinal study aimed to compare whether leadership, perceived work load, health and sickness presenteeism differed with varying mix of dental professionals staff roles and clinic size in dental organizations.
Methods: A prospective cohort study of dentists, dental hygienists and dental nurses working in the Public Dental Service in a Swedish County was conducted. In 2012 all 486 employees were invited to complete a web-based questionnaire (response rate = 66%) with a follow-up questionnaire in 2014 (response rate = 65%). The questionnaire contained items about workplace physical and psychosocial conditions, leadership, work ability, psychosomatic conditions, pain and symptoms in the musculoskeletal system and, sickness presenteeism. Comparisons were made between clinic size (Small clinics ≤10, Medium size clinics 11-20 and Large clinics >20 employees) and between 2012 and 2014. There were also comparisons between clinics with more or an equal proportion of dental hygienists (HDH clinics) and clinics with higher proportion dentists than dental hygienists (HD clinics).
Results: The change in leadership was greater for medium size HD clinics where 9% perceived poor leadership in 2012 and 27% in 2014, and large HD clinics where 17% perceived poor leadership in 2012 and 31% in 2014 and also a higher proportion reported sickness presenteeism subsequent to high physical load (29% to 43%). Sickness presenteeism due to physical reasons was reported by 31% of all dental employees during 2012 and increased to 43% during 2014 and, due to psychosocial stressors by 13% in 2012 and increased to 21% in 2014. Furthermore, 52% and 55% reported poor work ability in relation to the psychosocial demands at work in 2012 and 2014, respectively. Between 86-99% of all employees in 2012 and 2014 reported high precision demands and poor work posture. Small HDH clinics reported a higher proportion of sleep problems in 2014 (13%) compared with 2012 (3%). High psychosocial demands were perceived by 61-63% of all employees in both 2012 and 2014. There was a significant deterioration in experienced leadership quality from 17% in 2012 to 30% in 2014.
Conclusion(s): Perceived physical workload remains high for dental employees regardless of the clinic size or organizational structure. Over the two-year study, deterioration in perceived leadership was reported and more employees reported sickness presenteeism due to physical and psychosocial stressors. These features were particularly evident in large clinics with a greater proportion of dentists. The results indicate that preventive measures need to be taken to promote a sustainable and healthy work environment, especially in large dental clinics. The workplace is a promising arena for health promotion since employees spend about 30-40 hours per week at work.
Implications: As the treating physiotherapist it is important to include and evaluate questions about physical and psychosocial work load that may contribute to sickness presenteeism for patients with work-related disorders.
Keywords: Dental organizations, Physical workload, Psychosocial workload
Funding acknowledgements: This work was funded by Medical Research Council of Southeast Sweden (FORSS)
Topic: Occupational health & ergonomics; Musculoskeletal; Professional practice: other
Ethics approval required: Yes
Institution: Linköping University, Sweden
Ethics committee: Regional Ethical Review Board in Linköping, Sweden
Ethics number: ref. no: 2012/186-31
All authors, affiliations and abstracts have been published as submitted.
