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首页> 美国政府科技报告 >Organization of Work and Self-Care Among Aging Workers with Coronary Heart Disease.
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Organization of Work and Self-Care Among Aging Workers with Coronary Heart Disease.

机译：老年冠心病患者的工作安排和自我护理。

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The American workforce is aging. Over 3.5 million workers have CHD with significant work limitations and disability. Yet, little is known about how aging workers with CHD practice self-care, (i.e., adherence to medication and treatment, symptom monitoring and symptom management) on a daily basis within the context of employment or the consequences of poor self-care behaviors on aging worker health and safety. Furthermore, the effect of organization of work (OW), defined as work process (e.g., the way jobs are designed and performed) and organizational practices (e.g., human resource policies) on the health behavior of self-care and worker productivity in this population has not been explored. As a K01 award, a portion of the grant was focused on career development activities of the PI with the goal of preparing the candidate to transition to a successful independent investigator with expertise in OW research and a focus on optimizing self-care among aging workers with chronic illness. In the research component, a prospective mixed methods study was conducted to investigate the self-care practices of 125 working adults over age 50 (69% Male, 85% White; mean age 59.2±5.4 years) with CHD and the relationship of OW, job-level factors, self-care, and health and productivity outcomes (health status, quality of life, absenteeism and presenteeism). There were three specific aims: 1) to describe the self-care practices of aging workers with CHD, 2) to identify self-care types of aging workers with CHD and identify the characteristics and work-related determinants of self-care types and 3) to explore the relationship of OW and job-level characteristics to self-care, health status, quality of life and work-related outcomes. A subsample (n=40) participated in in-depth interviews about self-care, workplace factors, work-life balance, and attitudes and self-efficacy about self-care on the job. Overall, self-care was marginal in this sample, with 32% reporting poor adherence to treatment regimens. Self-care differed across job category, which was explained in part by the qualitative data. Job control and workplace support facilitated self-care for some; but job demands and work-life imbalance were associated with poorer self-care as individuals tried to balance competing work-life-health priorities. Quantitative and qualitative data were integrated to derive a typology of self-care, which we labeled as: novice (45.5%), expert (36.4%), and inconsistent (18.2%). The model predicting self-care cluster membership was significant (17.622, p=.001); self-care confidence and length of time with CHD were the only significant individual factors. Qualitative data explained the influence of workplace and job-level factors across self-care types. Experts described positive attitudes, high self-efficacy and supportive work environments. Those labeled inconsistent reported job stress, negative work attitudes and struggled with balancing work-life-health. Importantly, the transition period from disability to return to work was identified as critical and may influence self-care in novices who lack confidence, and contribute to failed self-care within the context of work over time. These results suggest that targeted intervention should focus on the return to work transition period and help workers with CHD manage stress, negotiate job accommodations and navigate barriers to sustainable self-care in the workplace.

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