The occupational stress index : an approach derived from cognitive ergonomics and brain research for clinical practice

Contents Acknowledgements iv 1 Introduction 1 The Need for the Occupational Stress Index—An Approach Derived from 1 Cognitive Ergonomics and Brain Research for Clinical Practice 2 The Impact of Stressful Work on Health 4 How research in this area has proceeded: The crucial role of models 4 The Job Strain Model 4 The Effort Reward Imbalance Model 5 Evidence concerning exposure to psychosocial work stressors and adverse health outcomes 5 Cardiovascular Disease 5 Hypertension 10 Musculo-Skeletal Disorders 11 Mental Health Outcomes 11 Occupations with Evidence of Risk for Adverse Stress-Related Health Outcomes 12 Professional Drivers 12 Health Care Professionals 13 Teachers 14 Air Transport Professionals 14 Sea Pilots 15 Other Occupational Groups 15 ii 3 How Insights from Cognitive Ergonomics and Brain Research 16 Inform our Assessment of the Work Environment How we handle Information: A Neurophysiologic View 16 Levels of Information Transmission: High Demands versus Underload 22 Knowledge-Based versus Skill-Based Information Processing 27 Threat Avoidant Vigilance 30 The Conflict Dimension 34 Physically Aversive Exposures 36 4 Occupation-Specific versus Generic Self-Report Measures 38 To Assess Workplace Exposures The Occupational Stress Index as an Additive Burden Model to 38 Help Bridge The Gap The Occupational Stress Index (OSI) Model – Revised Version 40 The Organization of the OSI 41 Levels of Information Transmission 41 Stressor Aspects 41 The Two-Dimensional Matrix 42 The OSI Summations 42 The Generic versus Specific OSI’s 43 The Generic OSI 43 Occupation Specific OSI’s 44 OSI for Professional Drivers 44 OSI for Physicians 49 OSI for Clerical Workers 50 OSI for Teachers 50 Other Specific OSI’s in Development 51 5 The Occupational Stress Index In Clinical Practice 53 Preparing a Narrative Occupational History, which includes Psychosocial 53 Stressors as This Informs a Work-Related Diagnostic and Management Plan The Clinician’s Challenge 53 An Approach to taking a Work History which includes Psychosocial Stressors, 54 Based upon the OSI iii Part I—Pedagogical Occupational Histories based upon the OSI 58 A. Physician Specialist in Neuropsychiatry--using the OSI for MD’s 58 B. Long Route Truck Driver--using the OSI for professional drivers 79 C. Administrative Assistant--using the OSI for those who work daily with computers 92 D. Automobile Assembler—using the Generic OSI 120 Part II--Pedagogical Clinical Cases based upon the OSI-derived Occupational Histories 139 A. Physician with Paroxysmal Supraventricular Tachycardia 139 B. Truck Driver with silent myocardial ischemia & complex arrhythmias 142 C. Administrative Assistant with Angina Pectoris 146 D. Automobile Assembler – Status Post Acute Myocardial Infarction 150 Assessment And Approach To Management: 154 Answers To Questions From The Cases 6 The Revised OSI Questionnaires and Score Sheets 163 The Revised Version of the Generic OSI Questionnaire 165 Score Sheet 180 The Revised Version of the OSI for Professional Drivers Questionnaire 197 Score Sheet 206 The Revised Version of the OSI for Physicians Questionnaire 219 Score Sheet 233 The OSI for Teachers Questionnaire 248 Score Sheet 264 7 Conclusions and Future Perspectives 280 Bibliographic References 282