Using an Epidemiological Approach to Critically Analyze a Population Health Problem

Introduction
Psychosocial Factors. A feeling of workplace well- being serves as a key component of employee strategy. Of late, there has been considerable focus on this element, particularly in the healthcare sector and with healthcare workers. In western countries, the combination of an unappealing workplace atmosphere, work-linked stress, a shortage of practitioners, and an increasingly elderly population underscores the necessity of updated studies in this area. The concept of well- being is a summative one, encompassing physical, societal, and emotional facets within as well as external to the organization (i.e., workplace). Further, it is a key factor determining productivity – psychosocial, organizational climate, which encompasses work climate, social support, and works recognition is believed to have a significant influence on the workplace well- being. Psychosocial elements make up elements like job satisfaction, physical workload, and social support on the job (Goetz, Berger, Gavartina, Zaroti & Szecsenyi, 2015).
Psychosocial elements denote interactions between workplace conditions, atmosphere, and content, as well as employee capability, requirements, culture, and extra- work-related personal aspects that might, based on experience and perception, have an impact on personnel health, workplace performance, and satisfaction. Thus, evaluating these facets might prove vital to preventing occupational ailments and fostering employee health.
Psychosocial elements and health problems. "Psychosocial" elements like stress, job control, resentment, depression, and despair appear to be linked to physical wellbeing, especially heart ailment. Adverse risk profiles about psychosocial facets group with generic social disadvantage. Owing to the above, the "psychosocial hypothesis" puts forward the idea that psychosocial components constitute a major source of inequities in the domain of health. Such components include several psychological characteristics, states, or social-environmental components with negative connotations (Macleod & Smith, 2003).
One point worth taking into account is the way "psychosocial adversity" may end up contributing to a physical ailment. It probably has the potential to promote unhealthy behaviors like smoking, or potentially directly result in neuroendocrine perturbations which impact illness risk. Here, it would be prudent to introduce the difference between basic and contingent sources (which are termed, elsewhere, as sufficient and probabilistic grounds respectively). The relationship between a contingent source and a healthcare outcome is dependent on the association of the former with any fundamental source. Hence, psychosocial adversity may end up, resulting in greater illness risks in scenarios wherein psychosocial adversity proved to be linked positively to smoking. All these relationships aren't automatic (Macleod & Smith, 2003).
Karasek model. Karasek created a model influencing Demand-Control, which scrutinizes factors associated with psychosocial workplace attributes. Moreover, it regards occupational stress to be the product of differences between work conditions and reaction capability of employees carrying out workplace tasks, and control available for fulfilling their demands (Fernandes & Rocha, 2009).
Karasek's (1981) model stresses the following psychosocial work dimensions: control of work and mental demands of developed vocational tasks. Control relates to skill development and application, for instance, the need for learning new practices, innovativeness, level of repetition, special unique skill development, and diversified tasks. Psychological demands encompass conditions employees are bound by during their activities, including variables measuring volume, pace, task performance time, and the presence of contradictory demands.
A blend of lower- and higher-level experiences about the two dimensions leads to diverse work characteristics as represented by the several four groups. These groups include low demand (i.e., a great degree of control over work at low mental demand), high work demand (low control but high demand), active work (i.e., high control as well as demand), and passive work (i.e., low control as well as demand). Some such scenarios may be deemed to be risk factors likely contributing to the development of physical and psychological pathology in working-class members (Fernandes & Rocha, 2009).
Section 1
The Problem
My chosen work environment is educational institutions, with teachers/educators being the target population. Educators are increasingly present with major occupational health issues. They are routinely allocated, increasing tasks that surpass those allotted traditionally to their role. Such tasks largely decide student results (whether failure or success). Teachers encounter overcrowded classrooms, unhealthy work factors, and structural, institutional inadequacy. Add this to their tremendous workload, and they are left feeling dysfunctional and stressed out. A key contributor is inadequate or no rest breaks, which plays a part in high truancy and turnover rates. Psychosocial factors and the workplace climate have been perceived as being the main contributors to educator health issues (Fernandes & Rocha, 2009).
Occupational health issues among educators are recognized as existing, widespread issues (Jardim & Pereira, 2016; Leka & Jain, 2010), leading to high rates of absence from work, the repercussions of which are individual as well as institutional (Cladellas & Castelló, 2011). A large number of researchers have highlighted the importance of work- linked psychosocial risk (PR) factors here. But it is hard to integrate the outcomes, possibly because most researches on the subject either revolves around the Burnout Syndrome or school teachers. A small number of research works have concentrated on an integrative link between psychosocial determinants (Kinman, 2001).
This link results from educators' stressful work conditions, which include huge classes, low salaries, and lacking instructive assets to work with (Zamri, Moy & Hoe, 2017). Psychosocial occupational determinants are capable of gravely impacting personnel health and well- being, at the physical as well as psychological levels. Psychosocial influences may manifest as insomnia, anxiety, depression, and bad temper (Eatough, Way & Chang, 2012).
In the present research, the subject of hypertension associated with psychosocial elements among school teachers will be addressed.
Hypertension (HT) among teachers: HT refers to a temporary or chronic arterial blood pressure elevation with arbitrary systolic measures of above 160 mmHg, and diastolic measures over 90 mmHg. It is a universal issue, with over 25 percent of adults across the globe diagnosed with it in industrialized (333 million) as well as unindustrialized nations (639 million). It is a key preventable disability and premature death related risk factor. Furthermore, it, particularly, constitutes a key risk factor when it comes to the contraction of CVDs (cardiovascular diseases) like CAD (coronary artery disease), hypertensive heart ailment, chronic kidney ailment, stroke, cerebrovascular illness, aortic aneurysm, and peripheral artery illness (Mucci et al., 2016).
Workplace stress is a factor in HT development, with a consistent share of research works exploring diverse commonly- cited workplace elements such as job insecurity, control and strain (i.e., job quality), pay, satisfaction, perceived dissatisfaction, and work hours. Other studies on the subject have already revealed how stress might result in blood pressure fluctuations, cholesterol blood level elevation, triglyceride level increase, hematocrit growth, blood fluidity, and fibrinogen growth. Psychological stress might result in unusual SNS (sympathetic nervous system) activation, which triggers hormonal cascades interfering with blood pressure, greater platelet activity, and coagulation – factors working as cerebrovascular event "triggers" (Mucci et al., 2016).
Section 2
Research Methods
Assessment strategies. This research will assume the form of case-control research, which compares patients with an ailment or targeted result (cases) with those without illness or result (controls), retrospectively comparing the frequency of exposure to risk factors existing in individual groups for ascertaining the link between the illness and risk factor. Case-control researches are observational because no intervention or effort is expended for altering the illness course. The objective is a retrospective determination of exposure to targeted risk factors from each group, i.e., controls and cases. These research works aim at estimating odds. Hence, case-control researches are also called "case-referent" or "retrospective" researches.
Advantages of case-control study: Case-control researches proves helpful in the study of rare illnesses or conditions. They are less time- consuming as the illness or condition is something that has already transpired. Further, they allow researchers to study various risk factors all at the same time. They also prove valuable as initial researches for establishing a link and are capable of answering queries that remain unanswered if one resorts to any other research design (The Himmelfarb Health Science Library, 2019).
Disadvantages of case-control study: A retrospective research usually presents the challenge of data quality, as they are dependent on memory. Moreover, those suffering from a health condition will be driven better when it comes to recalling risk factors (i.e., recall bias). Such researches aren't ideal when it comes to the assessment of diagnostic exams as the cases suffer from the condition while the controls don't. It may be hard to identify and create an appropriate control group.
Formation of groups. Control, as well as case group members, will be systematically chosen. The latter encompasses educators suffering from hypertension. Educators teaching at diverse schools will be considered and approached for the study. The former group will encompass educators not suffering from hypertension. The informed consent of study subjects will be acquired. Additionally, subjects will receive assurance that they are free to quit the study whenever they desire during the study, and their information will remain highly confidential. Information gleaned from participants will only be utilized for study purposes.
Demographic information and work characteristics of participants: Data collection will be performed using a structured questionnaire, with revised WHO STEPS protocol applied (World Health Organization, 2019). A researcher-created socio-demographic questionnaire will be administered to gather demographic data (such as age, sex, marital status, etc.), informational problems, and work specificities (School Type, Scientific Area, Number of Years Worked, Contract Type, Work Schedule Type, Work Hour Percentage, Greater Overload Function, and Number of cumulative tasks carried out).
Measures/Tools: The measures described below will be utilized in the research.
Interview comprising of close-ended questions: Answers to some questions linked to familial and personal history, and eating, salt consumption, and smoking habits will be gathered via a short interview. Height, weight, blood pressure, waist circumference, and hip circumference will be accordingly measured in case of control as well as case groups.
Kessler psychological distress scale (K10): This ten-item scale (Kessler et al., 2002) represents a small though highly reliable tool for the evaluation of general psychological distress. Founded on psychological distress self- reporting over the past one month, symptoms are measured based on a five-step Likert scale ("no day," "few days," "some days," "most days," "every day"), with the overall score lying between 10 and 50.
Copenhagen psychosocial questionnaire (COPSOQ): This highly dependable (Kristensen et al., 2005) scale aims at appraising PRs at work. COPSOQ is a valuable instrument that collects global consensus on adequacy for the assessment of several salient psychosocial dimensions. It is different from other similar scales in that it undertakes a systematic analysis of the relationship between psychosocial workplace atmosphere and health, and is not restricted to or grounded in any particular theoretical model.
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