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1.  Psychological stress and strain on employees in dialysis facilities: a cross-sectional study with the Copenhagen Psychosocial Questionnaire 
Background
Work in dialysis facilities involves long term contact with chronically ill patients. International comparisons make it clear that dialysis work is being concentrated, staff is being reduced and more patients are being treated. It is more than 20 years since the last German publication on job strains and job satisfaction experienced by dialysis staff was published. The present study examines the stress and strain currently experienced by the staff of German dialysis facilities.
Methods
The staff of 20 dialysis facilities were surveyed with the Copenhagen Psychosocial Questionnaire (COPSOQ). The questionnaire was extended by adding dialysis-specific questions. The data from the dialysis facilities were assessed by comparison with other professions in medical care - nurses and geriatric nurses - using data recorded in the German COPSOQ database.
Results
A total of 367 employees took part in the study, corresponding to a response rate of 55%. For almost all psychosocial aspects, the dialysis staff regarded the stress and strain as being more critical than did the geriatric nurses. There were some positive differences in comparison to hospital nursing, including less conflict between work and private life. However, there were also negative differences, such as fewer possibilities of influencing the work.
Conclusions
The results of the study show that dialysis work exhibits both positive and negative aspects in comparison with other healthcare professions. The results in the different facilities were highly variable, indicating that the deficits found in the individual scales are not inevitable consequences of working in dialysis in general, but are influenced and might be favourably altered by the individual facilities.
doi:10.1186/1745-6673-9-4
PMCID: PMC3918173  PMID: 24499468
Belastung; Beanspruchung; Dialyse-Beschäftigte; Gesundheitsberufe; psychosoziale Arbeitsbedingungen; COPSOQ; Stress; Strain; Dialysis staff; Health occupations; Psychosocial factors; COPSOQ
2.  Frequency and consequences of violence and aggression towards employees in the German healthcare and welfare system: a cross-sectional study 
BMJ Open  2012;2(5):e001420.
Objectives
In this study, the frequency and consequences of aggressive assaults on employees in the German healthcare and welfare system were investigated.
Design
A retrospective cross-sectional study.
Setting
Employees in the German healthcare system and their experiences of violence and aggression were examined in this study.
Participants
The sample consisted of 1973 employees from 39 facilities (6 facilities for the disabled, 6 hospitals and 27 outpatient and inpatient geriatric care facilities) who have regular contact with patients or clients.
Main outcome measures
The frequency of physical and verbal violence towards employees and the consequences of aggressive assaults were analysed.
Results
56% of respondents had experienced physical violence and 78% verbal aggression. The highest frequency of physical violence was in inpatient geriatric care (63%) (p=0.000). Younger workers run a higher risk of being affected by physical violence than older colleagues (OR 1.8, 95% CI 1.3 to 2.4). There is also an increased risk of experiencing physical violence in inpatient geriatric care (OR 1.6, 95% CI 1.2 to 2.0). Around a third of workers feel seriously stressed by the violence experienced. The better the facility trained employees for dealing with aggressive and violent clients, the less risk employees ran of experiencing either verbal aggression (OR 0.5, 95% CI 0.4 to 0.7) or physical violence (OR 0.7, 95% CI 0.6 to 0.9). Training by the facility has a positive effect on experienced stress (OR 0.6, 95% CI 0.4 to 0.8).
Conclusions
Violence towards nursing and healthcare personnel occurs frequently. Every third respondent feels severely stressed by violence and aggression. Occupational support provisions to prevent and provide aftercare for cases of violence and aggression reduce the risk of incidents and of perceived stress. Research is needed on occupational support provisions that reduce the risk of staff experiencing verbal and physical violence and the stress that is associated with it.
doi:10.1136/bmjopen-2012-001420
PMCID: PMC3488706  PMID: 23087013
Epidemiology; Public Health
3.  Infectious diseases in healthcare workers – an analysis of the standardised data set of a German compensation board 
Introduction
Healthcare workers (HCW) are exposed to infectious agents. Disease surveillance is therefore needed in order to foster prevention.
Methods
The data of the compensation board that covers HCWs of non-governmental healthcare providers in Germany was analysed for a five-year period. For hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, the period analysed was extended to the last 15 years. The annual rate of occupational infectious diseases (OIDs) per 100,000 employees was calculated. For needlestick injuries (NSI) a rate per 1,000 employees was calculated.
Results
Within the five years from 2005 to 2009 a total of 384 HCV infections were recognised as OIDs (1.5/100,000 employees). Active TB was the second most frequent cause of an OID. While the numbers of HBV and HCV infections decreased, the numbers for active TB did not follow a clear pattern. Needlestick injuries (NSIs) were reported especially often at hospitals (29.9/1,000 versus 7.4/1,000 employees for all other HCWs).
Conclusion
Although they are declining, HCV infections remain frequent in HCWs, as do NSIs. Whether the reinforcement of the recommendations for the use of safety devices in Germany will prevent NSIs and therefore HCV infections should be closely observed.
doi:10.1186/1745-6673-7-8
PMCID: PMC3474162  PMID: 22553942
Healthcare workers; Infections; Tuberculosis; Needlestick injuries; Blood-borne virus infections

Results 1-3 (3)