General practitioner visits and physical activity with asthma—the role of job decision authority: a cross-sectional study
Psychosocial working conditions—in terms of job decision authority, among others—may influence asthma self-management at work and in leisure time, as recent qualitative research has shown. We sought to statistically investigate potential relationships between job decision authority and two types of self-management behaviours: physical activity (PA) and visits to the general practitioner (GP).
We combined data from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe (SHARE) for cross-sectional analyses. The sample was restricted to participants who were employed and reported asthma but no other chronic lung disease (n = 387). The three key variables were each measured by one item. We estimated the prevalence ratios of adequate PA (i.e., more than once a week) and regular GP visits (i.e., ≥ 4 per year) according to job decision authority (low vs. high) using Poisson regression with the robust variance.
We found no evidence of a relationship between job decision authority and PA. However, employees with low levels of job decision authority had a higher prevalence of reporting that they consulted their GP at least four times per year (prevalence ratio = 1.30; 95% confidence interval = 1.03–1.65).
This study was the first to quantitatively investigate the relationship between job decision authority and PA specifically among individuals with asthma. Our results contradict prior epidemiological studies among general working populations, which reported a positive relationship between job decision authority and PA. Our results concerning the association between low job decision authority and more GP visits are inconsistent with our qualitative findings but supported by epidemiological studies among general occupational samples.
KeywordsAsthma Health care utilization Job decision authority Physical activity Self-management Survey of Health, Ageing and Retirement in Europe
The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812), and FP7 (SHARE-PREP: No. 211909, SHARE-LEAP: No. 227822, SHARE M4: No. 261982). Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the U.S. National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, OGHA_04-064, HHSN271201300071C), and from various national funding sources is gratefully acknowledged (see www.share-project.org). Our work was supported by refonet—Rehabilitation Research Network of the German Pension Fund Rhineland, grant number 14006.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Waves 1 and 2 received ethical approval by the ethics committee of the University of Mannheim, Germany.
- Global Initiative for Asthma (2018) Pocket Guide for asthma management and prevention (updated 2018). https://ginasthma.org/download/836/. Accessed 23 Oct 2018
- Grover H, Higgins B (2016) GPs have key role in improving outcomes in acute asthma. Pract 260:15–19Google Scholar
- Holtermann A, Krause N, Van Der Beek AJ, Straker L (2018) The physical activity paradox: six reasons why occupational physical activity (OPA) does not confer the cardiovascular health benefits that leisure time physical activity does. BMJ Publ Group Ltd Br Assoc Sport Exer Med 1:1. https://doi.org/10.1136/bjsports-2017-097965 CrossRefGoogle Scholar
- Loerbroks A, Bosch JA, Sheikh A, Yamamoto S, Herr RM (2018) Reports of wheezing and of diagnosed asthma are associated with impaired social functioning: secondary analysis of the cross-sectional World Health Survey data. J Psychosom Res 105:52–57. https://doi.org/10.1016/j.jpsychores.2017.12.008 CrossRefGoogle Scholar
- Parslow RA, Jorm AF, Christensen H, Broom DH, Strazdins L, Souza R (2004) The impact of employee level and work stress on mental health and GP service use: an analysis of a sample of Australian government employees. BMC Public Health 4:41. https://doi.org/10.1186/1471-2458-4-41 CrossRefGoogle Scholar
- The global asthma report 2018 (2018) Auckland, New Zealand: Global Asthma Network. http://globalasthmareport.org/Global%20Asthma%20Report%202018.pdf. Accessed 23 Oct 2018