Background: Work in the health and social care services (HSS) is very stressful and sickness absences are high. Nevertheless, little is known about their work stressors and work ability. The first aim of this study is to describe the prevalence of different work stressors and their accumulation among eldercare workers compared to general HSS workers. Second aim is to analyze associations between different work stressors and work ability and thus provide information on factors that are important in enhancing work ability. Methods: This cross-sectional survey examined HSS employees in Finland in 2020. The response rate was 67% (N = 22,502). Descriptive analyses were used to describe the control variables and the differences between the work stressors of general HSS and eldercare employees. After this, multinomial logistic regression analysis revealed the association between work stressors and work ability. Results: Eldercare employees experienced more often moral distress than HSS employees in general, and this further lowers their work ability. Single work stressors––Karasek’s strain, Siegrist’s ERI, organizational injustice and moral distress––increased the odds of low work ability (OR range 1.4–2.5) in comparison to no work stressors. However, the association with single stressors was roughly one third of that with the accumulation of all four work stressors (OR = 6.8). Thus, the accumulation of several stressors was most harmful for work ability. Conclusions: This study provides novel information on the accumulation of work stressors in relation to work ability. The results suggest that in order to enhance work ability, HSS organizations should pay more attention to preventing several stressors from accumulating. Eldercare organizations in particular need to develop effective measures for lowering moral distress.

Work in the health and social care sector is stressful, and work-related stress increases the risk of depression, anxiety, burnout, and sleep disorders. Although interventions to reduce stress and burnout at workplaces have been developed and studied, most studies have lacked the effectiveness to improve the situation. Thus, more knowledge on interventions and analysis of their mechanisms is needed to reduce the risk of more adverse mental health problems (MHP). We conducted a scoping review to identify the relevant literature on individual and organizational interventions to improve mental health in health and social care workplaces. Data were gathered on target groups, intervention types and their effectiveness, and the outcomes of the interventions. We summarized this data thematically. The final review consisted of 76 studies. Mental health interventions primarily focused on health care workers rather than social care professionals. The interventions were mostly directed at individual workers, ignoring organizational-level interventions. They used a great variety of outcomes and questionnaires, and the questionnaires that measured the outcomes were used ambiguously. In most cases, the reported effectiveness of the studied interventions was incoherent, and many of the interventions had both statistically significant and non-significant effects. Evidence that interventions reduce the risk of work-related MHP is scarce. High-quality randomized controlled trials of interventions to promote mental health with more coherently formed outcomes are needed, especially on the organizational level. More interventions to improve social care professionals' mental health are also needed.

The aging of the population in Western countries will increase the use of social and health services in the future. Employees in eldercare are at risk for experiencing moral distress, which is associated with poor work ability. The causes and consequences of moral distress among eldercare workers remain undiscovered. This scoping review investigates the existing studies of causes and consequences of moral distress among eldercare workers. Additionally, it seeks evidence of interventions designed to mitigate moral distress in eldercare workers. Fourteen studies were included in the final review. Most of the included studies were qualitative, aiming to increase understanding of morally challenging situations in eldercare. We also found quantitative studies with cross-sectional designs and small sample sizes. Thus, no reliable evidence of causal effects between moral distress and worker wellbeing in eldercare was found. We found no interventions undertaken to resolve moral distress among eldercare workers, either. More research is needed on the causes and consequences of moral distress and on interventions to mitigate moral distress among eldercare workers. This is of utmost importance to increase the attractiveness of eldercare as a workplace and to improve eldercare workers’ ability to work and sustain long working careers.

Discussions about social isolation have been extensive over the past few decades. A less sociable nature of social ties has been identified in Western societies. The phenomenon has been associated with demographic changes such as aging and living alone as well as changes in the use of new technologies. In this study we employ representative Finnish Time Use Surveys from three decades, 1987–1988 (n = 1887), 1999–2000 (n = 2673) and 2009–2010 (n = 1887) to examine the trends in social isolation, measured as time spent alone. Our results showed that between 1987 and 2010 the time spent alone increased by 124 min per day. The increase was linear and occurred in nearly all population groups. Structural factors, such as aging and an increase in the number of single households, are strongly associated with increased time spent alone. Time spent alone has increased, especially during leisure activities. Specifically, time spent watching television and using computers is associated with the decreasing tendency for face-to-face interaction.

Psychosocial job stressors increase the risk of mental health problems for the workers in health and social services (HSS). Although previous studies suggest that the accumulation of two or more stressors is detrimental to mental health, few studies have examined the synergistic interaction of accumulating job stressors. We examined survey responses from 9855 Finnish HSS workers in a cross-sectional study design from 2021. We conducted an interaction analysis of high job demands, low rewards and low workplace social capital on psychological distress, focusing on the relative excess risk due to interaction (RERI). Additionally, we analysed the interaction of job demands, low rewards and COVID-19 burden (extra workload and emotional load). Our analysis showed that the total RERI for the job stressors on psychological distress was considerable (6.27, 95% CI 3.14, 9.39). The total excess risk was caused by two-way interactions, especially between high demands and low rewards and by the three-way interaction of all stressors. The total RERI for job demands, low reward and COVID-19 burden (3.93, 95% CI 1.15, 6.72), however, was caused entirely by two-way interaction between high demands and low rewards. Mental health interventions tackling high demands, low rewards and low social capital are jointly needed.

Work in the health and social sector (HSS) is highly straining and therefore recovery from work needs to be promoted. Less is known on how job resources can be used to alleviate job strain and increase recovery from work. Thus, we analyzed the following: the association between job demands and work recovery; the connections of engaging leadership and psychological safety to recovery from work; and the moderating effects of engaging leadership and psychological safety on the relationship between strain and recovery from work. This cross-sectional study of 18,155 HSS and 4347 eldercare employees in 2020 using linear regression analysis showed that job strain (p < 0.001) and moral distress (p < 0.001) were associated with decreased recovery from work. Engaging leadership (p < 0.001) and psychologically safe work community (p < 0.001) enhanced recovery from work independently. Engaging leadership mitigated the harmful effect of job strain (p < 0.01) and moral distress (p < 0.05), and psychological safety mitigated the effect of job strain (p < 0.001), but not moral distress (p > 0.05). Thus, it is important to reduce job strain so that employees recover from work. Further job resources such as engaging leadership and psychological safety are important in themselves as they support recovery from work and employees’ well-being, but also as they alleviate job demands.