Journal of Occupational Health

ObjectivesTo identify the association between heated tobacco product (HTP) smoking and occupational falls, particularly combined with other lifestyle variables, including sleeping duration and comorbidities. MethodsThis web-based nationwide cross-sectional study (September-November 2023) involved 18,440 current workers (mean age, 43 years; women, 43.9%) in Japan. The primary outcome was occupational fall incidence in the past year. The secondary outcome was fall-related fractures. Smoking status was categorized as never, former, or current smokers; current smokers further classified into exclusive cigarette, exclusive HTP, and dual smokers (both cigarettes and HTPs). Other behavioral factors and covariates included alcohol consumption, sleep duration, physical activity, comorbidities, body mass index, hypnotics/anxiolytics use, and sociodemographic variables. Incidence ratios (IRs) and 95% confidence intervals (CIs) for occupational falls were estimated using multilevel Poisson regression with robust variance. ResultsOccupational falls and fall-related fractures were reported by 7.3% and 2.8% participants, respectively, in the past year. Younger workers were more likely to experience occupational falls. Compared with never smokers, current smokers had higher occupational fall incidence (IR = 1.36, 95% CI: 1.20-1.54), with exclusive HTP (IR = 1.78) and dual smokers (IR = 1.64) showing particularly elevated incidences. Similar patterns were observed for fall-related fractures. Elevated IRs were also observed for other lifestyle variables, including short sleep duration and diabetes, with the strongest associations found among younger workers. ConclusionsCurrent smoking, particularly HTP use, and lifestyle behaviors were significantly associated with occupational falls in Japan. These findings highlight the importance of lifestyle modifications to prevent occupational falls. KEY MESSAGESO_ST_ABSWhat is already known on this topicC_ST_ABSIndividual lifestyle behaviors, including physical activity, sedentary behaviors, and sleep quality, are associated with the risk of falls. However, the association between the risk of falls and smoking habits, including heated tobacco product (HTP) use, which has emerged as a public health concern in Japan, remains poorly understood. What this study addsCurrent smoking, particularly HTP use, is associated with occupational falls. How this study might affect research, practice or policySmoking cessation can be considered a modifiable behavior for occupational fall prevention. Further studies are needed to investigate the relationship between smoking and the incidence of falls.

ObjectiveWe examined whether teleworking preference and frequency were associated with work functioning impairment. MethodsThis online cross-sectional study was conducted using a self-administered questionnaire among 27,036 full-time Japanese workers. The Work Functioning Impairment Scale was used to measure work functioning impairment, and we performed multilevel logistic regression analysis. ResultsHigher odds ratios for work functioning impairment were observed among employees who preferred to telework compared with those who preferred working in the workplace. A similar trend was observed among employees who teleworked 4 or more days a week compared with those who almost never teleworked. When teleworking preference and frequency were adjusted, only teleworking preference was associated with work functioning impairment. ConclusionsA preference for teleworking was associated with work functioning impairment and one factor that increased the teleworking frequency.

BackgroundLittle is known about the distribution of specific sites where occupational falls frequently occur within the workplace. This study aimed to examine the distribution of occupational falls by sites of occurrence in Japan. MethodsNational data of occupational falls resulting in absences of four or more days in 2023 were extracted from a website managed by the Ministry of Health, Labour and Welfare, Japan. Fall sites were classified as either outdoor or indoor. Indoor sites were further categorized as walkways, work platforms/walking planks, indoor stairs, or other sites. Walkways and work platforms/walking planks were defined as indoor level surfaces. The distribution of occupational fall by sites was described. ResultsAmong all occupational falls, 63.2% occurred at indoor sites (22,780/36,058). The most frequently reported site was indoor level surfaces, accounting for 49.0%, while indoor stairs accounted for 5.9%. When stratified by sex, 65.9% occurred at indoor sites among female workers while 59.0% occurred among male workers. The difference was largely attributable to a higher proportion of falls on indoor level surfaces among females (52.7% in females and 43.5% in males). ConclusionsIn Japan, a substantial proportion of occupational falls occurred at indoor sites, particularly on indoor level surfaces.

ObjectivesCompared to long-term expatriates, the health issues of short-term international business travellers are less clear. Particularly, there are no reports on the impact of the COVID-19 pandemic. We explored the changes in health challenges faced by Japanese international business travellers owing to the COVID-19 pandemic. DesignCross-sectional survey research using questionnaires SettingWe surveyed 3,845 listed public companies in Japan in September 2021. ParticipantsA total of 251 companies responded (response rate: 6.5%), of which 131 (52%) had foreign travel requirements for their business. Primary and secondary outcome measuresThe survey included questions regarding company size, business type, necessity for foreign travel, destination and number of trips, common health issues that arise, and the importance of business travel before and after the COVID-19 pandemic. ResultsAmong the companies, 44% replied that they could not predict the number of foreign business trips after the pandemic. However, 64% of companies responded that business travel would continue to be important in the future. Before the COVID-19 pandemic, the most important health concerns faced by business travellers were illness during travel (42%), followed by the prevention of infectious diseases and lifestyle disease management. Post-pandemic, 48% of the responses were for infectious diseases, including COVID-19, followed by 40% for travel-related diseases, and 25% for lifestyle-related diseases. ConclusionsOwing to global economic and social activities, business travel will continue to be necessary in the post-COVID-19 era. Comprehensive health management including prevention of infectious diseases is desirable for business travel. Strengths and limitations of this studyO_LIThis study provides valuable insights into the health problems of short-term expatriates, an area which has been left relatively unexplored compared to its long-term counterparts. C_LIO_LIThe potentially transformative effects of the COVID-19 pandemic on the health and well-being of expatriates are also considered. C_LIO_LIThis study will form a foundational document for reviewing the impact of the pandemic and establishing a healthcare system designed for business travellers in preparation for future pandemics. C_LIO_LIThe survey was exclusively conducted among Japanese firms, which restricts its scope and generalisability. C_LIO_LIBecause the survey was conducted from managers perspective, it did not provide an accurate assessment of the actual health status of business travellers. C_LI

ObjectivesThis prospective study aimed to examine the association of job demands, job control, and the lack of supervisor and coworker support with side effects after receiving COVID-19 vaccination in a sample of employees in Japan. MethodsThe data were retrieved from an online panel of full-time employees (E- COCO- J). The analysis included participants who were employed and were not vaccinated at baseline (June 2021) but received vaccination at a four-month follow-up (October 2021). An 11-item scale measured the side effects of COVID-19 vaccines. Four types of psychosocial working conditions (i.e., job demands, job control, and supervisor and coworker support) were measured using the Brief Job Stress Questionnaire (BJSQ). Multiple linear regression analyses were conducted to examine the relationship between the psychosocial working conditions and side effects of COVID-19 vaccines, adjusting for gender, age, educational attainment, marital status, occupation, chronic disease, dose of vaccination, anxiety from potential side effects of vaccines, fear and worry about COVID-19, and psychological distress at baseline. ResultsOverall, 747 employees were included in the analysis. The average number of side effects was 3.78 (SD=2.19): Arm pain (81.1%), fatigues (64.1%), muscle pains (63.3%), and fever (37.5 degrees Celsius +) (53.5%) were reported more frequently. Coworker support score was significantly and negatively associated with the numbers of side effects (standardized {beta}=-0.122, p=0.017). Women, young age, second time vaccination, and high psychological distress were significantly associated with several side effects. ConclusionsEmployees with low coworker support may be more likely to have side effects after COVID-19 vaccinations. The findings of this study could inform employees with low coworker support that increasing workplace support may reduce the side effects. Highlights The effect of poor psychosocial working conditions on side effects after COVID-19 vaccinations was unknown. Poor coworker support at baseline was significantly associated with increased side effects after COVID-19 vaccinations. Informing workers with low coworker support about the findings may help them prepare for the side effect and motivate them to improve coworker support to reduce side effects.

ObjectiveAt present, there are relatively few studies on the burnout of young doctors in China. This study can enrich the relationship between work pressure, cognitive evaluation(benign and stress)and burnout among young doctors, and help to understand the current situation of burnout among young doctors. MethodsA questionnaire survey was conducted among 116 young doctors from different departments to collect data on career motivation, work stress, cognitive evaluation and burnout. Result(1)The work pressure of young doctors has a predictive effect on burnout.(2)The primary evaluation of young doctors has an independent effect on burnout.(3)The 116 young doctors surveyed in this article are all at a high level of burnout. Conclusion(1)The work pressure of young doctors has a predictive effect on job burnout. Effective intervention on pay-reward can further reduce the sense of burnout of young doctors and reduce occupational stress.(2)The primary evaluation of young doctors has an independent impact on burnout, and positive cognitive evaluation is beneficial to reduce the level of burnout.

The COVID-19 pandemic infected many people worldwide with SARS-CoV2. Psychological distress is one of the sequelae reported to occur in many of those infected (Choutka et al., 2022). We investigated the association between personal experience of COVID-19 infection and psychological distress in Japan. A total of 18,560 persons participated in the original survey, conducted in December 2020. After excluding unreliable responses, data from 14,901 persons who participated in a follow-up survey in December 2022-were included in the analysis. Odds ratios (ORs) were estimated by univariate and multiple logistic regression analysis with history of COVID-19 infection as the independent variable and presence of psychological distress as the dependent variable. This results showed that the experience of COVID-19 infection is associated with psychological distress. Moreover, most cases of mental distress among those who experienced COVID-19 infection can be at least partly explained by a perception of unfair treatment.

BackgroundCOVID-19 pandemic impacted the physical and mental health of Brazilian workers, especially those who started acting in home-office. Changes in the workplace, increased physical inactivity and fear of contracting the disease, known as coronophobia, may be related to increased musculoskeletal pain. ObjectiveTo analyze the prevalence of musculoskeletal pain and coronophobia in home-office workers during the COVID-19 pandemic, as well as evaluating the relationship between these variables. MethodA cross-sectional, observational and descriptive study with 736 participants was conducted through online questionnaire. Sociodemographic data, working conditions, pain, besides the evaluation of coronophobia using COVID-19 Phobia scale (C19P-S) and pain with the Nordic questionnaire of osteomuscular symptoms (NMQ) were collected. ResultsMost participants were female (78%), with an average age of 32.8 {+/-} 10.7 years. During the pandemic, 71% reported some osteomuscular symptoms, and of these, 64% began to have new paintings of pain in the pandemic, with higher incidence in the lower back and neck. Participants who began to perform their functions in home-office presented a higher incidence of pain and, among them, 53% reported that the furniture was not suitable for homework. Most had little fear of Covid-19, but moderate levels of coronophobia increased the chance of musculoskeletal pain (RP=1,74; IC 95%). There was a significant association between coronophobia and musculoskeletal pain. ConclusionsThe pandemic raised the prevalence of musculoskeletal pain, especially in cervical and lumba regions, and the fear of Covid-19 influenced this relationship.

We aim to conduct a prospective cohort study to benchmark occupational health and safety in Japan. Here, we describe the detailed protocol for the baseline survey based on the Checklist for Reporting Results of Internet E-Surveys. We conducted the baseline survey for the prospective cohort study in 2022. Our target population was workers in Japan aged 20 years or older, who we sampled to be representative of the Japanese workforce, stratified by sex, age, and region. Among 59,272 registered monitors who answered the initial screening questions, 29,997 completed the survey. After excluding 2,304 invalid responses, we used 27,693 valid participants in our final analysis. The number and mean age of men were 15,201 (55%) and 46 years; those of women were 12,492 (45%) and 45 years. With respect to sex, age, and regional composition, our sampling was representative of Japans working population. Our sampling for employment status and industry yielded almost the same proportions as a government-led representative sampling of workers in Japan.

BackgroundSubstance use and mental disorders are highly prevalent in Thai homeless people living with no mental health recovery. The lack of psychosocial occupational therapists may be one huge problem for none of the measurement outcomes for clinical utility. We aimed to determine the known-group validity of the Assessment of Work Performance (AWP) with good content and internal consistency reliability. MethodsParticipants (N = 60) were recruited by screening with no cognitive impairment, no psychiatric symptoms, independent self-care, and on-the-job assignment at Nonthaburis destitute home. Mann-Whitney U tests firstly found a significant difference in process skills between males and females (p < .05). Data analysis of the ceiling effect was then conducted to design using cleaned samples (N = 22), and the Mann-Whitney U tests secondly found a significant difference in communication skills between males and females (p < .05). ResultsThere were no associations between the frequency of genders and substance abusers were computed using cross-tabulation (N = 60 versus N = 22). Besides a corrected sample, natural contexts of too easy job selection, no preparatory of supported employment, and non-purposeful living activities may be confounding factors of avolition, poor habit, and inactive life roles without wellness at the end of life. ConclusionThese preliminary results suggest a useful AWP with good known-group validity for measuring outcomes among vulnerable people and describing how to improve motor, process, and interactive communication skills based on the Model of Human Occupation (MOHO) in occupational therapists and Mental Health Recovery (MHR) workers.

ObjectivesThe pandemic of the new coronavirus disease (COVID-19) has created a challenging environment for workers. This study aimed to investigate the risk factors for workplace bullying and mental health outcomes during the pandemic among workers. MethodsWe conducted a nationwide online cross-sectional survey from August to September 2020 in Japan (N = 16,384). Workplace bullying was measured by one item from the Brief Job Stress Questionnaire; severe psychological distress (SPD) by K6 ([&ge;]13); and suicidal ideation by one item. Prevalence ratios were calculated by Poisson regression analyses adjusting for potential confounders such as gender, age, occupational characteristics, and a prior history of depression. ResultsOverall, 15% of workers experienced workplace bullying, 9% had SPD, and 12% had suicidal ideation during the second and third wave of the COVID-19 pandemic in Japan. The results of this study showed men, executives, managers, and permanent employees had a higher risk of bullying compared to women or part-time workers. Increased physical and psychological demands were common risk factors for bullying, SPD, and suicidal ideation. Newly starting working from home was a significant predictor for adverse mental health outcomes, however, it was found to be a preventive factor against workplace bullying. ConclusionsThe results of this study found different high-risk groups for bullying or mental health during the pandemic. When intervening to decrease workplace bullying or mental health problems, we should focus on not only previously reported vulnerable workers but also workers who experienced a change of their working styles or job demands. Key messagesO_ST_ABSWhat is already known about this subject?C_ST_ABSO_LIWorkplace bullying is one of the severe job stressors in the workplace that cause mental health problems. C_LIO_LIHealth care workers, less-educated workers, and non-regular female workers have been reported to have greater psychological distress during the COVID-19 pandemic. C_LI What are the new findings?O_LIAbout 15% of workers experienced workplace bullying, 9% had SPD, and 12% had suicidal ideation during the pandemic in Japan. C_LIO_LIMen, executives, managers, and permanent workers had a higher risk of bullying compared to women or part-time workers. C_LIO_LIIncreased physical or psychological demands were common risk factors for bullying, SPD, and suicidal ideation. C_LIO_LIWhile newly starting working from home was a preventive factor against workplace bullying, it was found to be a significant risk factor for adverse mental health outcomes. C_LI How might this impact on policy or clinical practice in the foreseeable future?O_LIThe results of this study indicate a different pattern of high-risk groups for bullying or mental health during the pandemic. C_LIO_LIWhen intervening to decrease workplace bullying or mental health problems, we should focus on not only previously reported vulnerable workers but also workers who experienced a change of their working styles or job demands. C_LI

INTRODUCTIONDisruptive clinician behavior (DCB) refers to unethical and unprofessional behavior that seriously affects patient safety by disrupting relationships among healthcare professionals and causing dysfunctional communication and teamwork. DCB often persists as an organizational culture in Japanese healthcare settings because of problems in the conventional leadership system along with professional and positional hierarchies. Therefore, this study verified a causal model of DCB in Japanese healthcare, including triggers, response, and impact. METHODSStaff at two general hospitals (751 and 661 beds) were surveyed using a web-based questionnaire. In total, 256 staff who had experienced victimization and agreed to complete the questionnaire were included in this study. The questionnaire comprised demographic information, a DCB scale, and items covering causal indicators of DCB: triggers, response, and impact (psychological/social and medical/management). RESULTSMediation and moderated mediation analyses showed that: (1) DCB had a negative impact on the medical/managerial state, which was partially mediated by psychological/social impact; and (2) the responses of victims and others acted as a bulwark in reducing the psychological/social impact to some extent. DISCUSSIONA prompt response to DCB as a bulwark reduces victims psychological and social adaptation deterioration. Therefore, occurrences of DCB should not be overlooked, and the victim and those around them should respond positively. However, response as a bulwark cannot protect the organizations medical care and management. Therefore, it is important to prevent DCB.

As electret technology can drastically improve the filtration efficiency of disposable procedure masks and portable air purifiers, it is widely used to prevent the airborne transmission of SARS-CoV-2. Furthermore, alcohol disinfectants are now widely used in offices, hospitals, and homes to prevent contact infection; hence, there is a concern that alcohol exposure may inactivate electret. In this study, 5 types of high-efficiency particulate air filter (HEPA) air purifiers--of which, one was made of fiberglass HEPA filter--14 types of cubical masks, and 11 types of pleated masks available to Japanese citizens were subjected to discharge according to the alcohol exposure protocol based on ISO (International Organization for Standardization) 16890, and changes in filtration efficiency and pressure drop were measured before and after the discharge. The results revealed that 17 (68%) of the 25 masks exhibited a significant decrease in filtration efficiency; this decrease due to discharge depended on the filter material. However, masks of polypropylene, polyethylene, and poly-vinylidene-difluoride composite fiber materials exhibited no significant decrease in filtration efficiency. In addition, 4 (80%) of the 5 HEPA filters showed a 40-64% decrease in filtration efficiency, while no decrease in filtration efficiency was observed for the fiberglass HEPA filter. Our survey (n = 500 Japanese adults, including 30 healthcare professionals) revealed that approximately 90% of the general public was unaware that the performance of masks and air purifiers could be degraded by direct spraying of alcohol--for disinfection purposes--or vapor exposure. Furthermore, 36% of the surveyed healthcare professionals indicated that they had sprayed alcohol directly on their masks. Therefore, based on the results of this experiment, we examined effective consumer warnings that could be utilized on the product labels and in the instructions. The results showed that it would be more effective to detail the extent and duration of the adverse effects of disregarding the precautions.

The spread of new coronavirus (COVID-19) infections show no signs of stopping. Therefore, if the era of With-Colona will continue for a while, we must consider how to deal with this disaster well. The practice of social distance is one of the powerful tools for that purpose. In previous research, analysis of the factors that influence social distance has also been carried out using information from the US occupation information site O*NET. However, they targeted all industries, not specific industries. Therefore, in this paper, we analyzed the factors that influence Physical Proximity in the manufacturing industry, which has a large impact on the economy given the scale of employment. As the method, first, exploratory factor analysis is performed using O*NET information, and the extracted 7 variables, Sitting Work, Adverse Conditions, Information Processing, Bridging Work, Teamwork, Response to Aggression, and Intelligent Work, are used in the regression analysis. As a result, it was shown that Teamwork is the biggest factor that influences Physical Proximity. Also, Adverse Conditions and Response to Aggression showed a positive correlation and Sitting Work showed a negative correlation. By job type, Maintenance, Installation & Repair tended to have higher Physical Proximity than Manufacturing Production Process Development, Production & Quality Assurance. Keywords: New Coronavirus (COVID-19), social distance, physical proximity, teamwork, explanatory factor analysis, O*NET

The purpose of this study was to investigate the association between various levels of physical activity, self-perception, cardiometabolic risk factors, and weekend catch-up sleep ratio (CSR). Using raw data from the Korea National Health and Nutrition Examination Survey 2018 - 2021, all participants were divided into three groups (< 1.0, 1.0 [&le;] CSR < 1.5, or [&ge;] 1.5) by CSR, which is the value calculated by dividing weekend sleep time by weekday sleep time. After matching age and gender, 2,484 Korean adults were selected as study participants. Descriptive statistics, chi-square test, ANOVA, and multinomial logistic regression analysis were performed to analyze the data. The results showed a significant association between weekend CSR and socioeconomic status, physical activity, self-perception levels, and cardiometabolic risk factors. Specifically, compared to the reference group (1 [&le;] CSR < 1.5), those with a CSR < 1 were 2.42 times more likely to live in a single-family house (OR = 2.42, 95% CI = 1.77 - 3.32) and 1.71 times more likely to engage in vigorous physical activity meeting WHO guidelines (OR = 1.71, 95% CI = 1.20 - 2.46). They were also 1.33 times more likely to perceive themselves as obese (OR = 1.33, 95% CI = 1.00 - 1.76). Conversely, those in the CSR [&ge;] 1.5 group were 3.93 times more likely to be pink-collar workers (OR = 3.93, 95% CI = 2.70 - 5.71), 1.72 times more likely to perceive their stress levels as quite (OR = 1.72, 95% CI = 1.20 - 2.47), and 1.87 times more likely to have diabetes (OR = 1.87, 95% CI = 0.97 - 3.60). Alterations in CSR could indicate changes in physical activity levels, sedentary behavior duration, and other health indicators, ultimately influencing overall well-being. Therefore, a comprehensive healthcare approach incorporating CSR considerations is increasingly essential.

IntroductionVirtual classes brought many changes to the lives of students, not only the fact of being more exposed to screens, but also because of the repercussions. AimTo determine the factors associated with suffering from neck pain, dry eye and Sjogrens syndrome in students in Latin America during the first wave of COVID-19. MethodologyAnalytical cross-sectional study, using the COM and DEQ-5 scales, neck pain and dry eye/Sjogrens syndrome, respectively, were measured; socio-educational variables were associated with them. DiscussionOf the 3939 students, those who lived in Panama, Chile and Bolivia were the ones who suffered the most from these pathologies. These pathologies were associated with the greater number of hours of computer use (all values p<0,001) and sex (all values p<0,002), medical students had more frequent dry eye and Sjogrens syndrome (both p<0,031), Graduate students had more neck pain (p<0.001), but college students had less dry eye (p=0.025) and those at private universities had more neck pain (p=0.024). DiscussionImportant results of these three pathologies were found, this serves so that students can be evaluated in depth in each university, for a specialized diagnosis and try to avoid medium and long-term consequences for the constant use of electronic devices. ConclusionNeck pain, dry eye and Sjogrens syndrome in students were associated with more hours of computer use and female sex, medical students had more frequent dry eye and Sjogrens syndrome, graduate students had more neck pain, university students had less dry eye and those from private universities had more neck pain.

BackgroundBurnout is a phenomenon characterized as a consistent state of being exhausted physically, mentally, and emotionally. Grit, tolerance for ambiguity, religiosity, and social support are protective factors that may mitigate burnout and improve life satisfaction. This study assessed the association between specific protective resources of students from a medical school in Visayas at all year levels with online-based education-related burnout during the COVID-19 pandemic. MethodsA total of 234 medical students from a medical school in Visayas during the academic year 2020-2021 were sampled using stratified random sampling technique. Demographics were obtained. Specific protective resources of grit, religiosity, social support and tolerance for ambiguity, and burnout symptoms were measured using validated online questionnaires. Protective associations of specific resources on burnout levels were assessed using multivariate logistic regression analysis. Predictive capabilities of resources with statistically significant protective effects were summarized using Receiving Operating Characteristic (ROC) curve. ResultsAll year levels experienced burnout based on Maslach Burnout Inventory-Student Survey (MBI-SS) subscales, with PBL 2 having the highest incidence comprising 33 respondents (49%). Majority of the students experienced moderate burnout on emotional exhaustion (44%) and low burnout on depersonalization (58%), while all of them had high burnout levels on the subscale of personal accomplishment (100%). Most students were moderately gritty (91%) and had high tolerance for ambiguity (98%), overall religiosity index (82%), and social support from significant others (68%); family (68%); and friends (76%). Grit, religiosity and social support had positive significant correlations and reductive effects to burnout. Tolerance for ambiguity did not show any significant relationship with burnout. Grit, religiosity and social support are good predictors of burnout. Grit had good diagnostic accuracy and discrimination. Religiosity and social support were moderately accurate predictors of burnout. ConclusionsGrit, religiosity and social support are significantly protective on burnout levels of medical students from online-based education during the COVID-19 pandemic.

Biomedical scientists (BMSs) are important professionals for healthcare services as they help in the detection, diagnosis, and treatment of numerous diseases. To the best of our knowledge, this is the first study to assess ergonomics knowledge, attitude, and practice among BMSs. A cross-sectional study was carried out among BMSs using a self-constructed questionnaire. The association between these parameters and various risk factors was measured using the Chi-square test. The study included 110 BMSs. Females represented 68.2% and 45.5% were in the age of 25-34. Good ergonomics knowledge showed in 54.5% and 82.7% showed high positive attitude. However, poor ergonomics showed in 83.5%. There was no significant interrelation between the three parameters. A significant association was found between the male gender (0.040), more than 20 working experience (0.016), and good ergonomics practice. Biomedical scientists have good knowledge, high attitude but the poor practice of ergonomics. Ergonomics training and practice should be firmly enhanced among these healthcare professionals.

Psychiatric nurses frequently encounter moral dilemmas and emotional exhaustion, both of which significantly influence job satisfaction and turnover intentions. Studies highlight that these factors are key drivers of nurse attrition. Given the high turnover rates in this field, understanding the mechanisms connecting these factors is essential.The aim of this study was to investigate the current status of moral dilemmas, emotional exhaustion, and turnover intentions among psychiatric nurses, and to explore the mediating effect of emotional exhaustion in the relationship between moral dilemmas and turnover intentions.A convenience sampling method was used to select psychiatric nurses from four secondary and tertiary hospitals in Guangdong Province as the study subjects in February 2025. Data were collected using a descriptive information form, the Moral Dilemmas Scale for Psychiatric Nurses, the Emotional Exhaustion Scale, and the Turnover Intention Scale. Path analysis was conducted using structural equation modeling with AMOS 24.0, and the mediating effect was tested.A total of 403 nurses participated in the study. The mean score for moral dilemmas was (30.10 {+/-} 32.20), for emotional exhaustion was (12.45 {+/-} 6.68), and for turnover intention was (2.37 {+/-} 0.94). The total score of moral dilemmas was positively correlated with the total score of emotional exhaustion (r = 0.400, p < 0.01), the total score of emotional exhaustion was positively correlated with the total score of turnover intention (r = 0.389, p< 0.01), and the total score of moral dilemmas was positively correlated with the total score of turnover intention (r = 0.514,p < 0.01). Emotional exhaustion partially mediated the relationship between moral dilemmas and turnover intention, with a mediating effect value of 0.172, accounting for 42.86% of the total effect. Emotional exhaustion can be considered as a key mediator in the relationship between moral dilemmas and turnover intentions in psychiatric nursing.Moral dilemmas and turnover intentions were at a moderate to low level, and emotional exhaustion was at a moderate level for this group of nurses. Emotional exhaustion has an effect on the relationship between moral dilemmas and turnover intentions among psychiatric nurses.

PurposeThis study aims to conduct test-retest reliability of the AWP - Thai version. Internal consistency has been tested after completing an approval process of forward-backward translation and achieving good content validity. Under the shortage of mental workforce, vocational rehabilitation (VR) has been trained to enhance supported employment in homeless people with mental illness (MI). The Assessment of Work Performance (AWP) is required for Thai translation to classify the quality of job skills in one pilot setting at Nonthaburis destitute home. MethodsTwo weeks were set for test-retest reliability of the AWP collecting a group of participants (n = 59). Intraclass Correlation Coefficient (ICC) was calculated at the 95% confidential level with an F-test of true value. ResultsModerate to good test-retest reliability of the AWP is addressed for all participants and separation of those participants into four groups of job selection: rug hooking, cleaning food table, sweeping the leaves, and community gardening. However, a cautious interpretation of ICC provides accurate implications of the AWP in both clinical utility and the VR program evaluation. ConclusionsThe AWP is a performance-based tool that can be an observable process in participatory work routines. Motor, process, and interactive communication skills are essential components connected to a practical solution to enhance the VR to the social welfare system.