| Study | Design and methods appraisal∗ | Setting and participants | Intervention and implementation† | Psychosocial outcomes (p<0.05)‡§ | Health outcomes (p<0.05)§ | ||
| Boumans and Landerweerd (1999)33 | Prospective cohort with comparison group8- and 14-month follow-upFinal sample n _ 59Methods appraisal: 1, 3, 5, 7, 10 | Hospital, the NetherlandsNurses | Primary nursingIntroduced as result of a change in hospital policy. Workers were trained for the new roles. Few reported details on effectiveness of implementation or commitment of employees | Satisfaction with head nurse (S)Satisfaction with contacts with colleagues (S) | ↔↔ | Health complaints(Dutch VOEG scale)Sickness absence | ↔↔ |
| Boumans and Berg (2000)34 | Prospective cohort with comparison group12-month follow-upFinal sample n _ 248Methods appraisal: 1, 2, 4, 7, 8, 10 | Hospital, the NetherlandsProfessional care-givers | Primary nursingInitiated by the hospital. An advisory group of care-givers, managers and researchers oversaw implementation. Workers were trained for the new roles. No other details on effectiveness of implementation or commitment of employees | Job complexity (D)Job clarity (C)Satisfaction with job clarity (C)Job autonomy (C)Satisfaction with management (S)Satisfaction with contacts with colleagues (S) | ↔↑↔↔↑↔↔ | Emotional exhaustion(Maslach Burnout Inventory) | ↔ |
| Melchor et al (1996)35 | Prospective cohort with comparison group12-month follow-upFinal sample n _ 161Methods appraisal: 1, 2, 4, 6, 7, 8, 10 | Hospitals, the NetherlandsNurses | Primary nursingIntroduced out of managerial concerns about staff burnout. A support group oversaw the work intervention and implementation was evaluated on a monthly basis. Workers were trained for the new roles. Few other details reported on the effectiveness of implementation or commitment of employees | Depersonalisation (S) | Emotional exhaustion(Maslach Burnout Inventory) | ↔ | |
| Berkhout et al (2004)36 | Prospective cohort with comparison group3- and 10-month follow-upFinal sample n _ 147Methods appraisal: 1, 2, 7, 8, 9, 10 | Nursing homes, the NetherlandsProfessional care-givers | Primary nursingFew reported details on effectiveness of implementation or commitment of employees. Authors did comment though that implementation of the intervention was partial in some cases. | Job demands (D)Job autonomy (C)Social support (S) | ↔↔↔ | Health complaints(Dirken Questionnaire for the study of experienced health)Sickness absence | ↔↔ |
| Wahlstedt et al (2000, 2001)32 37 | Prospective cohort with comparison group1-month follow-upFinal sample n _ 82Methods appraisal: 1, 3, 4, 5, 7, 10 | Postal sorting office, SwedenManual workers and shop floor supervisors | Increased task variety, more teamwork, more personnel, more time to plan work, bonus schemeIntervention(s) introduced by employers to improve the psychosocial work environment and to reduce sickness absence and staff turnover. Employees volunteered to be involved in the intervention | Psychological work demands (D)Authority over decisions (C)Skill discretion (C)Social support (S)Contact with superior (S)Contact with team-mates (S) | ↑↑↔↑↔↔ | Shoulder and thoracic symptoms (Nordic questionnaire on musculoskeletal complaints)Neck and low back symptoms (Nordic questionnaire on musculoskeletal complaints) | ↑ |
| Fredriksson et al (2001)40 | Prospective cohort. Some qualitative components9-month follow-upFinal sample n _ 102Methods appraisal: 1, 2, 4, 9, 10, | Factory floor, SwedenManual workers | Production line introduced, decreased task variety, teamworkingIntroduced to increase productivity, reduce the need for skilled labour and reduce sick leave. Few reported details on effectiveness of implementation or commitment of employees | High job demands (D)Possibilities to influence work (C)Poor social support at work (S) | ↔↓↔ | Musculoskeletal disordersVisits to health centreSickness absence | ↓↓↔ |
| Wall et al (1990)38 | Prospective cohort | Factory floor, UK | Increased operator control on production line | Job pressure (D) | ↓ | General strain | ↔ |
| 50-day follow-up | Manual workers | Introduced to increase staff performance. Training was provided. Representatives of employees of all grades and the researchers were involved in a working party overseeing the implementation of the intervention. Some employees were resistant to the intervention | (GHQ-12) | ||||
| Final sample n _ 19 | Job-related strain | ↔ | |||||
| Methods appraisal: 1, 2, 4, 5, 7, 9, 10 | (Warr Job Related Anxiety Scale) | ||||||
| Majchrzak and Cotton (1988)39 | Prospective cohort1-month follow-upFinal sample n _ 31Methods appraisal: 1, 2, 4, 7, 8, 9, 10 | Factory floor, USAManual workers | Computerisation of production lineIntervention introduced to increase productivity after the company split up. Employees volunteered to be involved in the intervention but the authors suggest that this was because they were worried about keeping their jobs. No training was providedFew reported details on effectiveness of implementation | Input and output unpredictability (C)Degree of coordination needed (C)Process unpredictability (C)Control over input and output quality (C)Control over process quality (C)Informal communication opportunities (S) | ↓↔↔↑↓↑ | Psychological problems(Brett Scale)Perceived quality of life(Brett Scale) | ↔↔ |
∗Methods appraisal (box 2): 1, prospective; 2, representative sample; 3, appropriate comparison group; 4, baseline response > 60%; , follow-up > 80% in cohort, > 60% in cross-section; 6, adjustment for non-response and drop-out; 7, conclusions substantiated by data; 8, adjustment for confounders; 9, all intervention group exposed, non-contaminated comparison group; 10, appropriate statistical tests.
†See box 1.
‡D, demand; C, control; S, support.
§↑, Improvement; ↓, worsening; ↔, little change.