title: A multilevel study on the association of observer-assessed working conditions with depressive symptoms among female eldercare workers from 56 work units in 10 care homes in Denmark.
abstract: OBJECTIVE
  Eldercare workers in Denmark have a higher prevalence of poor psychological health than other occupational groups. We examined the association between working conditions assessed by trained observers and depressive symptoms assessed by self-report in a study of female Danish eldercare workers.
  
  
  METHODS
  Working conditions were observed based on action regulation theory and defined as (1) regulation requirements, a workplace resource providing opportunity for decision-making and skill development and (2) barriers for task completion. We examined the associations of individual and work unit averaged working conditions with depressive symptoms in a sample of 95 individually observed eldercare workers. Further, we examined the association of work unit averaged working conditions with depressive symptoms in a sample of 205 care workers, including both observed and non-observed individuals. We used regression models that allowed for correlations within work units and care homes and adjusted these models for demographics, job characteristics and stressful life events.
  
  
  RESULTS
  Higher levels of regulation requirements were associated with lower depressive symptoms at the individual level (p=0.04), but not at the workplace level. Barriers were not associated with depressive symptoms at the individual level. At the workplace level, a higher number of qualitatively different barriers (p=0.04) and a higher number of barriers for equipment use (p=0.03) were associated with lower levels of depressive symptoms in the age and cohabitation adjusted model, however statistical significance was lost in the fully adjusted model.
  
  
  CONCLUSIONS
  Low level of regulation requirements was associated with a high level of depressive symptoms. The study highlights the importance of examining both individual and workplace levels of working conditions.
authors.affiliation: National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Louise M
authors.initials: LM
authors.lastname: Jakobsen
authors.affiliation: National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Anette F B
authors.initials: AF
authors.lastname: Jorgensen
authors.affiliation: National Research Centre for the Working Environment, Copenhagen, Denmark.
authors.forename: Birthe L
authors.initials: BL
authors.lastname: Thomsen
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
authors.forename: Birgit A
authors.initials: BA
authors.lastname: Greiner
authors.affiliation: National Research Centre for the Working Environment, Copenhagen, Denmark Department of Public Health, University of Copenhagen, Copenhagen, Denmark Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Reiner
authors.initials: R
authors.lastname: Rugulies
mesh_terms: D000328:Adult; D003718:Denmark; D003866:Depressive Disorder / Q000209:etiology*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006707:Homes for the Aged; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D017132:Workplace / Q000523:psychology / Q000592:standards*
keywords: MENTAL HEALTH; OCCUPATIONAL & INDUSTRIAL MEDICINE