Opinions of ageing workers on relative importance of health promotion

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Opinions of ageing workers on relative importance of health promotion

ISSN: 1322-7114

Accession: 00063413-200612000-00007

Full Text (PDF) 62 K

Author(s):	Naumanen, Paula PhD
Issue:	Volume 12(6), December 2006, p 352–358
Publication Type:	[Research Paper]
Publisher:	Copyright © 2006 Blackwell Publishing Ltd.
Institution(s):	Specialized Researcher, Finnish Institute of Occupational Health, Kuopio, Finland Correspondence: Paula Naumanen, Finnish Institute of Occupational Health, PO Box 93, FI-70701 Kuopio, Finland. Email: paula.naumanen@ttl.fi Accepted for publication January 2006

Keywords: ageing, health promotion, occupational health, worker

Abstract

This study describes individual, workplace and occupational health-promoting factors, and their impacts for worker's health from the perspective of ageing Finnish workers. The pretested questionnaire was sent to 150 ageing workers, of whom 93 returned the form. Statistical analyses were performed using frequencies, means, Mann–Whitney U-test and Krushkal–Wallis test. Over 90% of respondents stated that health habits, individual arrangements in the workplace, good workplace atmosphere, access to health checks, counselling and nursing care all represented important factors for health promotion. Better health, work satisfaction and motivation of employees were the main factors impacting on health promotion. Ageing workers stated that health and safety organization and rehabilitation institutes were the most important copartners. Management must take a positive attitude towards ageing workers and make the necessary arrangements to support their well-being and this should be done in collaboration with occupational health professionals.

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INTRODUCTION

Many Finnish and international studies have dealt with how workers' physical, psychological and social characteristics change as they age, how this impacts on their work ability and health. There have also been attempts to match these changes with the demands, productivity and pace of change of work in different occupations. Individuals > 45 years of age are called ageing workers in Finland.1,2 In this study, ‘ageing’ is therefore used to refer to workers over the age of 45 years. The physical capability to work decreases between the ages of 50 and 60 years, but this decline can be prevented by regular exercise.3–5 Enhanced psychological and social work ability can compensate for the declining physical work capabilities.6 Older workers in high-stress jobs might be at increased risk of suffering stress-related health problems.7 Older individuals might experience both positive and negative attitudes towards ageing. For example, ageing can be viewed as personal development, but it might be experienced as a negative trait because of reduced physical work ability, low self-esteem and feelings of being unneeded.8 Good health, a high level of education, optimism and functioning social relationships all can positively affect the experience of ageing in a positive manner. It has been claimed that the productivity of an aged worker does not necessarily decrease,2 even though morbidity might be more prevalent.9–11 There are many ways to maintain the work capabilities of older workers, for example, by improving the work environment, changing the work to be done and professional skills to be used. It is important also that supervisors and fellow workers adopt a positive attitude towards these older colleagues.4,5,12

In occupational health studies, health promotion has two focuses—the worker and the workplace. The worker's health means individual and holistic well-being and balance of the physical, mental and social ingredients, work ability and health habits associated with good physical condition, energy and vitality.13 The health of the work community is defined as well-being as a broad definition of health. Health in an institution is more than the combined total of each individual employee's health. Well-being is tied to the culture of the organization and supported by management. It is evidenced by mutual trust, genuineness, caring and respect.14 Health promotion means preventing, minimizing and eliminating health hazards in the workplace, maintaining and promoting the employee's work ability, and changing work practices, techniques and making the work environment a safer place.15

The main activities of Finnish occupational health-care professionals are workplace visits including evaluating and measuring environmental hazards at work, informing and counselling about health and work environment risks, and devising ways to minimize these poor practices. They also monitor the health and work ability of the personnel, including disabled workers, and plan and organize activities for maintaining their health and performance, collaborate with different copartners, maintain the first aid skills of the workers, and monitor the effectiveness and quality of their own actions. Health examinations, workplace visits, counselling, advising, informing and education constitute preventive occupational health-care. Occupational health professionals can also purchase extramural health-care services, such as nursing and rehabilitation for the benefit of employees.16,17

This Model of Aging Workers in Occupational Health Care Project was carried out in 2002–2003 in northern Karelia, Finland. An earlier qualitative study described the health promotion of ageing employees from the point of view of occupational health professionals. The findings revealed that workers could improve their health through living habits, stable lifestyle, a positive attitude, personal relationships and development of professional skills. Individual work arrangements, a good work atmosphere, professional education, appreciative and supportive leadership and cooperation were crucial positive factors for maintaining occupational health. The occupational health professionals have organized health examinations, workplace visits, counselling, nursing and rehabilitative services and a variety of activities. The impacts of health promotion activities were better health, well-being and capabilities of workers, improved work productivity, motivation, collaboration, positive image of workplace and work satisfaction.18

Aims

The present study describes the clients' views of the importance of the health promotion activities. Their opinions about the earlier examined factors are presented as percentages. The exact study aims were to describe: (i) individual health promotion factors; (ii) workplace health promotion factors; (iii) occupational health promotion factors; and (iv) the impacts of health promotion factors for ageing workers.

METHODS

Data collection

Finnish occupational health nurses of five Northern Karelian units were sent a total of 150 structured and pretested questionnaires (30 to each unit) with introductory letters and return envelopes. They were asked to distribute these forms to > 45-year-old workers and ask the workers to fill in questionnaires while they waited in the reception area in the occupational health service unit. This took place between October and December 2003. These units returned a total of 93 (62%) questionnaires. The author developed the instrument used in this study, based on qualitative study results collected from 16 Finnish occupational health professionals, who participated in the Health Promotion Project of Aging Worker in Northern Karelia during the years 2002 and 2003.18 The instrument included 56 variables and six background factors (Tables 1–3). The respondents were asked for their views on a list of statements on a scale from 1 (strongly disagree) to 4 (strongly agree). These were grouped into two classes by connecting alternatives 1 and 2, and alternatives 3 and 4, and by naming them ‘disagree’ and ‘agree’. The author assessed the face validity, and two experts assessed the content validity of the instrument. The internal consistency of the instrument has been tested by split-half correlation ranging from 0.90 to 0.91. Cronbach's alpha ranged from 0.78 to 0.89 and the total scale alpha was 0.94. These alpha values were above Nunnally's criterion of r > 0.70 for a new scale.19

Table 1 The demographics of the ageing workers

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Table 2 The opinions of ageing workers towards individual, workplace and occupational health promotion factors and the comparisons with type of job (position in table) according to the Krushkal–Wallis test

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Table 3 The opinions of ageing workers towards the impacts of health promotion and the comparison whether this is affected by professional education according to the Krushkal–Wallis test

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Data

The final sample size was 93 (62%), of whom 72 were women and 21 men (Table 1). The average age of the participants was 52 years (range 44 –63 years). They had worked on average for 29 years (range 7–49 years). Altogether, 52% (n = 46) of the respondents had completed a secondary school education. The rest had completed vocational college, university, polytechnic or some other education. Some participants had only basic schooling (11%). Respondents held positions of regular employees (79%), management (16%) or temporary employees (5%). The majority of participants worked as full-time employees (87%), and the rest were part-time employees (13%).

Data analysis

The data were analysed statistically with the SPSS Windows 11.5 program (Microsoft, Chicago, USA). Frequencies, medians and means, together with standard deviations were computed for all items. The items were not normally distributed. The Mann–Whitney U-test was used to test differences between two independent groups, and the Kruskal–Wallis test to detect differences between three or more groups. Significance was set at P < linkindex="24" class="fulltext-RA" href="http://ovidsp.uk.ovid.com/spb/ovidweb.cgi#65">20,21 The tables illustrate the quantitative results.

Ethical considerations

The heads of all five occupational health service units gave their permission for this study. The occupational health nurses handed out the introductory letter to the volunteer participants with the questionnaire stating the purpose, aims and methods of the study, and assuring that participation in the study was voluntary: the anonymity of the participants would be ensured during and after the study, and the data security would be guaranteed. They had also the possibility to contact the researcher to obtain more information.

RESULTS

Individual health promotion factors

An individual worker can promote his/her own health by adhering to good health habits, and by enjoying a balanced and stable life with time for both work and leisure activities. Close personal relationships, mental strength and positive attitude towards health, life and work, professional development and self-rehabilitation were assessed as being crucial factors for good health. More than 95% of respondents stated that they believed these factors were crucial for good health (Table 2). According to the Kruskal–Wallis test, regular and temporary employees appreciated more often positive attitude (P = 0.044) towards health than those working in management.

Workplace health promotion factors

Over 90% of ageing workers thought that individual arrangements in the workplace, balanced work demands and taking into account each worker's capabilities, a positive work atmosphere and cooperation were necessary for health (Table 2). Also the importance of personnel leadership, appreciation of employees, listening, encouraging, motivating and discussing with them, professional education and professional skills were highly appreciated, whereas communal activities (75%) were perceived as being less important for health promotion. According to the Kruskal–Wallis test, good atmosphere (P = 0.000), appreciation of personnel (P = 0.021) and their encouragement (P = 0.034) were the most important health promotive factors listed by the management and regular employees.

Occupational health promotion factors

Over 90% of participants thought that health checks, counselling and education, access to nursing, health condition tests, rehabilitation, mental support, listening, as well as discussing of client's problems were important services provided by occupational health professionals (Table 2). Communal activities (72%), treatment (72%), collaborative meetings (80%) and generation of health statistics (64%) were considered as being less important occupational health-promoting activities. According to the Kruskal–Wallis test, regular employees appreciated more often nursing services (P = 0.033) and rehabilitation services (P = 0.039) than those working in management or those in temporary position.

The impacts of health promotion for the ageing worker

Over 90% of respondents thought that the consequences of health promotion activities were better health, good working ability, well-being of the work community, work satisfaction, motivation of employees and ability to cooperate with others (Table 3). Less than 80% of ageing workers considered that productivity and good public relations image of the work site were important factors. The Mann–Whitney U-test indicated that full-time employees were more appreciative of health than part-time employees (P = 0.010). According to the Krushkal–Wallis test, well-educated employees placed greater emphasis on working ability (P = 0.032), work satisfaction (P = 0.007) and motivation (P = 0.000), considering these factors as being more important than their less educated counterparts.

DISCUSSION

This study has assessed the importance of different individual, workplace and occupational health promotion factors, and their impacts on worker's health from the point of view of ageing Finnish workers. This study revealed the importance of these factors presented as percentages and this has not been evaluated in earlier studies. Crucial health-promoting activities are individual health habits, positive attitudes, development of personal skills, occupational health services provided by occupational health professionals and workplace arrangements. These results are similar to earlier studies that have examined workers in general.4,5,12,15,18 This study revealed the importance of appreciative and supportive leadership. It also confirmed the positive impacts of health promotion activities. The majority of respondents understood and appreciated the importance of individual, workplace and occupational health-care activities. However, the high percentages of these factors are no guarantee that ageing workers and the heads of management in the workplace will actually adhere to these practices in their personal life and in their workplaces.

Some strengths and limitations were identified during the study. All of the participants did not complete the questionnaire and it was not possible to repeat the inquiry because the nurses did not register the names of the participants who received the questionnaire. Even though the number of participants was rather small, the data gathered were sufficient to perform an extensive analysis. The participants represented different occupational professions and positions. The results were similar to those of earlier studies, and they are applicable to all workers regardless of age. About one-third of participants gave some positive feedback in writing about the usefulness of this research topic. The remainder did not supply any feedback.

The findings show that there are many possibilities to promote health, well-being and work ability of ageing workers. These are achieved by cooperation between the workers, the workplace and occupational health-care professionals. It is important to support the working capabilities of older workers in an effective and systematic manner. Employers should appreciate the advantages associated with ageing workers, and need to assume a positive attitude towards those workers and their health promotion. Further research will focus on assessing the effectiveness of different health promotion activities.

ACKNOWLEDGEMENTS

The author is greatly indebted to Chief Welfare Officer Sirpa Salo and the occupational health professionals participating in this project. The Ministries of Labour and Health and Social Affairs funded this project.

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Key words: ageing; health promotion; occupational health; worker

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