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- W867796847 abstract "Re: Madsen et al. Unnecessary work and mental health: a prospective analysis of Danish human service by Durand-Moreau Q, Lodde B, Dewitte J-FAffiliation: Occupational and Environmental Diseases Center, University Hospital of Brest, 5 Avenue Foch, 29609 Brest, France. quentin.durand-moreau@chu-brest.frRefers to the following text of the Journal: 2014;40(6):631-638The following article refers to this text: 2015;41(2):218Key terms: letter to the editor; mental health; unnecessary work taskRe: Madsen et al. Unnecessary work and mental health: a prospective analysis of Danish human service workersMadsen et al (1) recently published a secondary analysis on data provided by the Project on Burnout, Motivation and Job Satisfaction (PUMA). The aim of their study, published in the Scandinavian Journal of Work, Environment & Health was to examine the associations between unnecessary work and a decreased level of mental health. Though the topic was quite novel, reading this work proved disturbing and raised issues.Based on the results of this study, the authors stated that there is an association between unnecessary work (assessed by a single question) and a decreased level of mental health, idem [assessed by the Mental Health Inventory (MHI-5)], in the specific population included in this PUMA survey.The authors point out a limitation of the study, namely that unnecessary work were evaluated using one single question: Do you sometimes have to do things in your job which appear to be unnecessary?. Semmer defines unnecessary work task as tasks that should not be carried out at all because they do not make sense or because they could have been avoided, or could be carried out with less effort if things were organized more efficiently (2). De facto, qualifying what an unnecessary task is requires stating or explaining whether the task makes sense. Making sense or not is not an objective notion. It is very difficult for either a manager or an employee to say if a task is necessary or not. Most important is that it makes sense from the worker's point of view. Making sense and being necessary are not synonyms. Some do not make sense but are economically necessary (eg, when, as physicians, we are reporting our activity using ICD-10 on computers instead of being at patients' bedsides or reading this journal). Thus, there is a wide gap between Semmer's definition and the question used by the authors to evaluate his concept. A secondary analysis based on a single question is not adequate to evaluate unnecessary tasks.Nowadays, the general trend is to reduce the size of questionnaires because they are too long and cannot be used in a routine practice. But an analysis performed on a single question is quite risky: in psychometrics, redundancy is used to confirm a measurement. We lose precision on what exactly we are testing by asking a single question.Madsen et al's results show that among workers saying they are always or often performing unnecessary tasks, the MHI mean score was 74.00 versus 78.20 for people who never or almost never perform unnecessary (P=0.0038). Even though it is a statistically significant result, its clinical relevance is never questioned. What is the impact of losing 4.20 points at MHI test instead of losing 20 points for instance? Statistical difference does not mean clinical relevance.These results show a statistical association, not a causality relationship. The authors did not show that performing unnecessary lowers the level of mental health. It may be the exact opposite. Maybe having poorer mental health (eg, depression, with anhedonia) may make the workers think that what they're doing is useless.In their conclusion, Madsen et al suggest that the elimination of unnecessary work may be beneficial for employees' mental health. To our mind, on the contrary, it may increase psychic suffering. …" @default.
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- W867796847 date "2015-03-01" @default.
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- W867796847 title "Re: Madsen et Al. Unnecessary Work Tasks and Mental Health: A Prospective Analysis of Danish Human Service workers/Author Response to Letter. Ref: Madsen et Al. Unnecessary Work Tasks and Mental Health: A Prospective Analysis of Danish Human Service Workers" @default.
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