Ce travail doctoral s’interroge sur les déterminants des comportements d’épargne salariale. Le chapitre 1 présente un état des lieux de l’épargne salariale. Nous détaillons ensuite les principales règles de fonctionnement de l’épargne salariale. Nous présentons enfin les principaux déterminants des comportements d’épargne salariale identifiés par la littérature. Le chapitre 2 examine les déterminants socio-économiques de l’efficience des portefeuilles d’épargne salariale. Il propose également une analyse des déterminants des erreurs d’investissement des salariés mesurées par un indice. Nous dissocions les investissements faits dans le cadre des augmentations de capital réservées aux salariés et ceux faits au titre des autres plans d’épargne entreprise. Nous nous intéressons d’une part à la décision binaire d’investir ou pas, et à l’efficience du portefeuille d’autre part. Notre échantillon porte sur 30 000 salariés d’un groupe bancaire français et contient des informations sur les caractéristiques individuelles des salariés et le détail des montants investis dans les plans et leurs caractéristiques de rentabilité et de risque. Les caractéristiques des salariés affectent significativement l’efficience des portefeuilles. Nous mettons en évidence une forte concentration en actions de l’entreprise. Nous montrons également que l’investissement des salariés est sous optimal compte tenu de l’écart existant entre le ratio de Sharpe optimal que nous avons calculés et le ratio de Sharpe des salariés. Nous régressons enfin cette différence sur les caractéristiques des salariés. Le chapitre 3 analyse empiriquement les déterminants de l’investissement en actions de l’entreprise. L’actionnariat salarié diminuerait les comportements de retrait des salariés tels que l’absentéisme et la rotation du personnel. Or, la causalité inverse que nous postulerons n’avait jamais été analysée : l’effet de l’absentéisme et de la rotation du personnel sur l’investissement en actions de l’entreprise par ses salariés. Nous montrons que l’absentéisme et la rotation du personnel affectent significativement la participation. Nous validons nos hypothèses de recherche à l’aide de diverses méthodes de régression. Nous analysons un panel d’environ 15 000 salariés de près de 900 filiales d’un groupe français coté appartenant au secteur de la construction, des travaux publics et des concessions sur une période de 5 ans. La participation au plan d’actionnariat salarié dépend du niveau d’absentéisme et de rotation du personnel au sein de l’entreprise. L’absentéisme et la rotation du personnel influencent l’investissement en actions de l’entreprise différemment selon la catégorie socioprofessionnelle du salarié et les motifs d’absences et de sorties Le chapitre 4 administre un questionnaire à des épargnants individuels afin d’évaluer leur connaissance financière. Nous nous sommes inspirés des enquêtes de Lusardi et de la Banque Centrale Européenne afin de réaliser un questionnaire adapté au cas français. Nous constatons l’influence de l’éducation financière sur les décisions d’investir. Le questionnaire a été diffusé auprès des salariés d’un établissement bancaire d’une part et de leurs clients d’autre part. Bien que nos résultats confirment dans l’ensemble la littérature sur la connaissance financière, nous identifions plusieurs nouveaux résultats. / This dissertation questions the determinants of employee savings behavior. Chapter 1 presents an overview of employee savings schemes. We then detail the main rules of employee savings schemes. Finally, we present the main determinants of the behavior of employee savings schemes identified by the literature. Chapter 2 examines the socio-economic determinants of employee savings’ portfolio efficiency. It also proposes an analysis of the determinants of investment errors of employees measured by an index. We dissociate investments made in the context of Employee stock purchase plan and those made through other employee savings plans. We are interested in the binary decision to invest or not on the one hand and in the portfolio efficiency on the other hand. Our sample covers 30,000 employees of a French bank, contains information on the individual characteristics of employees and details of the amounts invested in the plans, their risk and risk characteristics. The characteristics of the employees significantly affect the efficiency of the portfolios. We highlight a strong concentration of company stocks. We also show that the investment of employees is not optimal given the gap between the optimal Sharpe ratio and the actual Sharpe ratio. We finally regress this difference on the characteristics of the employees. Chapter 3 empirically analyzes the determinants of investment in company shares. Employee stock ownership would reduce the withdrawal behavior of employees, such as absenteeism and turnover. However, the reverse causality we assume had never been analyzed: the effect of absenteeism and the staff turnover on the investment in employer’s stocks. We show that absenteeism and staff turnover significantly affect participation. We validate our hypotheses using a variety of regression methods. We analyze a panel of approximately 15,000 employees of nearly 900 subsidiaries over a period of 5 years of a French listed company belonging to the construction, public works and concessions sector. Participation in employee stock ownership plan depends on the level of absenteeism and turnover of employees within the company. Absenteeism and staff turnover influence the investment in company shares differently depending on the employee's occupations category and the reasons for absences and departures. Chapter 4 analyze the results of a survey we sent to individual savers to assess their financial literacy. We translated the surveys of Lusardi and the European Central Bank to produce a questionnaire adapted to the French case. We see the influence of financial education on investment decisions. The questionnaire was distributed to the employees of a bank on the one hand and their customers on the other. Although our results generally confirm the literature on financial literacy, we identify several new findings.

É reconhecida a importância da atividade física e do estilo de vida na prevenção das doenças cardiovasculares. Programas corporativos de condicionamento físico têm sido utilizados por empresas na tentativa de melhorar a saúde de seus funcionários. O objetivo deste trabalho foi verificar se existe relação entre atividade física e morbidade cardiovascular referidas por gerentes e diretores de uma indústria automobilística. Como objetivos secundários avaliar a associação entre atividade física e outras variáveis relacionadas com o estilo de vida, com a utilização de serviços de saúde, absenteísmo e presenteísmo. Por último, avaliar se a participação em um programa de condicionamento físico supervisionado influenciou a atividade física habitual dessa população. Para tanto, foram estudados 376 indivíduos ativos ou inativos, participantes ou não do programa de condicionamento físico. A atividade física habitual, que foi avaliada por meio do Escore de Baecke, e outras variáveis relacionadas com o estilo de vida, como consumo alimentar de gorduras, frutas e vegetais, hábito de fumar e consumo de bebidas alcoólicas foram levantadas por meio de questionário. O escore de atividade física apresentou associação negativa tanto com relação ao absenteísmo como quanto em relação ao indivíduo que executa trabalho quando doente. Não houve associação estatisticamente significativa com morbidade cardiovascular referida, procura por atendimento médico e presenteísmo. Os indivíduos que relataram morbidade cardiovascular apresentam média de idade mais alta e índice de massa corpórea mais elevada. O presenteísmo se associou positivamente com o maior consumo de frutas e vegetais . E o inverso foi observado nos indivíduos com maior absenteísmo, que consumiram menor quantidade de frutas e vegetais. Verificou-se que os participantes regulares do programa de condicionamento físico supervisionado, por um lado, apresentaram escore mais elevado de atividade física, e por outro referiram maior proporção de morbidade cardiovascular. Esta última característica também foi observada entre os que procuraram e participaram do programa mas não foram aderentes. / There is no doubt that the fitness activity together with a sound life style has a strong impact on preventing cardiovascular diseases. Corporate fitness programs have been utilized by most companies in an attempt to improve the overall health of their employees. The primary objective of this study was to verify if there is any relation between physical activity and cardiovascular morbidity as referred by a group of managers and directors of automotive industry. As a secondary objective we intended to evaluate the relationship between physical activity and other variants directly related to some issues, such as life style, utilization of health services, absenteeism and presenteeism. At last, evaluate if the attendance to a under supervision physical activity program has influenced the habitual physical activity of this mentioned population. In order to accomplish that, we have studied 376 individuals, actives or not, attending or not to a physical activity program. The habitual physical activity, which has been evaluated by the \"Escore de Baecke\" and some other variants related to life style, such as intake of fat, fruits and vegetables, smoking habits as well as alcohol intake. These data have collected by the application of a questionnaire. The physical activity score has shown a negative association either with regards to absenteeism or with regards to the individual who performs his or her job when sick. There has not been any significant statistic association among the referred cardiovascular morbidity, search for medical assistance and presenteeism. The individuals who reported cardiovascular morbidity showed a higher age average and also higher body mass. The presenteeism was positively associated with the higher intake of fruits and vegetables. And the opposite was also observed in individuals with higher absenteeism with a less intake of fruits and vegetables. It was also observed that the regular attendees of under supervision physical activity program, at one side, show higher physical activity score and by the other side showed a higher proportion of cardiovascular morbidity. This last characteristic was also observed among those individuals who looked for and participated in a physical activity program but did not have the opportunity to attend it.

Made available in DSpace on 2016-01-26T12:51:24Z (GMT). No. of bitstreams: 1 deniseberetta_dissert.pdf: 1517104 bytes, checksum: babf62d67de911fbbe1915e031c6d8fa (MD5) Previous issue date: 2001-12-21 / The nursing working conditions in hospitals have been considered insalubrious since these workers are liable to many risks including physical, chemical, biological, ergonomic, mechanical and psychosocial. As a result of this exposure, they may become ill; consequently staying off work. This is an epidemiological study with a census to describe the working absences due to sick leave of nurses from a general teaching hospital. These absences were registered at the Centro de Atendimento ao Trabalhador (CEAT) in the period from 1995 to 1999. A total of 1,002 registrations of absences from working of members of nursing team was analyzed: 9.1% nurses, 1.7% nursing technicians, 69.7% nursing assistances and 19.5% of nursing orderlies. These people were related to 1,986 episodes of sick leave during the studied period: 1,826 (91.4%) by health licenses; 123 (6.2%) by working accidents; and 37 (1.2%) by maternity leave. According to the analysis of characteristics related to these absentees, the majority was women and workers aged between 31 to 40 years old, married, with full-time work of 1 to 6 years; in general, the period of time spent away from work was 1 to 4 days, and mostly employees were working in complex units. The characteristics of the episodes of absenteeism by health licence were frequently due to genito-urinary problems, badly defined diseases and respiratory system diseases. The nursing assistants and the nursing orderlies had registration of all classifications of the International Statistical Classification of Disease and Related Health Problems (1994). This study showed some ethic-legal infractions mainly in relation to the nursing orderlies as well as showing several factors which may be related to the episodes of working absences. Therefore, it may give ways to better analysis of this situation in the hospital improving the current working conditions; moreover, a further deeper investigation of absenteeism which causing more serious and longer problems. / As condições de trabalho da enfermagem em hospitais tem sido consideradas insalubres pela exposição a riscos de natureza física, química, biológicas, ergonômicas, mecânicas e psicossocial, provocando adoecimento e consequentemente afastamentos do trabalho. Nesta abordagem realiza-se este estudo epidemiológico, censitário que teve como objetivo descrever os afastamentos do trabalho por motivo de licença médica de exercentes de enfermagem de um hospital geral de ensino, registrados no centro do atendimento do trabalhador (ceat), no período de 1995 à 1999. Foram analisados os registros de afastamentos do trabalho de 1002 pessoas da equipe de enfermagem, sendo 9,1% de enfermeiros, 1,7% de técnicos de enfermagem, 69,7% de auxiliares de enfermagem e 19,5% de atendentes de enfermagem, que envolvem-se em 1986 episódios de afastamentos no período em estudo, sendo 1826 (91,4%) por licença saúde; 123 (6,2%) por acidentes de trabalho e 37 (1,2%) por licença gestante. Nota de Resumo Na análise das características dos episódios de afastamentos constatou-se que acometeu principalmente mulheres, funcionários com idade entre 31 e 40 anos, na categoria de casados, com tempo de serviço de 1 a 6 anos, tempo de afastamento de 1 a 4 dias e entre aqueles que atuavam em unidades complexas. Nota de Resumo Quanto às características dos episódios de afastamento por licença saúde, ficam ressaltados que os problemas de saúde mais freqüentes foram do sistema geniturinário, doenças mal definidas e doenças do sistema respiratório e que os auxiliares de enfermagem e atendentes de enfermagem tiveram registros em todas as classificações de doenças do classificação internacional de doenças (cid) - 10. Assim, com este trabalho identificou-se infrações ético legais, principalmente em relação ao atendente de enfermagem e que vários fatores podem ser relacionados com os episódios de afastamento do trabalho, dando subsídios para uma melhor análise desta situação neste hospital, para melhoria das condições de trabalho vigente, além de sugerir um investigação mais profunda sobre os afastamentos que estão provocando problemas mais sérios e com maior duração.

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No. of bitstreams: 1 DISSERT José Antonio dos Santos Martins.pdf: 2220571 bytes, checksum: d2a8c0ae3c3c50da3e560e214a0093ab (MD5) Previous issue date: 2016-09-08 / Nos dias atuais, a presença do cirurgião-dentista especialista em Odontologia do Trabalho se faz necessária e de fundamental importância no ambiente laboral das diversas classes de trabalhadores, com o intuito de atuar favoravelmente sobre a saúde destes, através da identificação de potenciais riscos a ela e, também, pela necessidade de se educar o trabalhador para que ele mesmo seja o melhor promotor da saúde na empresa. Neste sentido a Odontologia do Trabalho visa à busca permanente da compatibilidade entre a atividade laboral e a preservação da saúde bucal do trabalhador e, sob a ótica da gestão, a Odontologia do Trabalho difere das atividades comumente praticadas no consultório, exatamente por não mais caracterizar uma relação simples entre Dentista-cliente. Dentro deste contexto o objetivo desta pesquisa é analisar a contribuição dos exames periódicos odontológicos na manutenção da saúde bucal dos servidores do Instituto de Engenharia Nuclear (IEN), através da avaliação do prontuário de saúde bucal do Conselho Federal de Odontologia (CFO). Como metodologia, foi realizada uma revisão da literatura que fundamentou a pesquisa de campo que visa mapear a percepção de 30 (trinta) especialistas em odontologia do trabalho sobre o protocolo utilizado durante os exames periódicos odontológicos do IEN, através da aplicação de um questionário. Nos resultados da pesquisa, observa-se que todos os respondentes possuem mais de 10 (dez) anos de experiência profissional, e os itens que julgaram mais importantes nas investigações clínicas foram as doenças cardiovasculares, hematológicas, transmissíveis e as hepáticas. Além disso, foi atribuída também uma importância alta na realização dos exames clínico e radiológico. Sendo assim, conclui-se com as respostas obtidas, que a aplicabilidade e eficiência dos exames periódicos odontológicos são de grande valor para a saúde dos servidores do IEN. Desse modo, tem-se a expectativa de que este trabalho auxilie na conscientização sobre saúde bucal com os trabalhadores, buscando-se relacionar os riscos ocupacionais com as doenças manifestadas na cavidade bucal e contribuindo essencialmente para a manutenção da saúde bucal dos servidores do IEN. / Nowadays, the work of Surgeon Dentist specialized on Occupational Odontology, it is more essential than ever, being extremely necessary in the labor of many work classes, acting in favor over the health of the employees, by the identification of potential risks associated to their labors and also by the need to educate the employee in order to make himself the best promoter of health in their companies. With this main goal, the occupational odontology aims the constant searching of the compatibility between the labor activity and the preservation of the worker´s oral health and under the management point of view, what makes the activities from this professional different from the usual activities practiced in a dentist office, not being an ordinary relation between client and dentist. Inside this context, the goal of this research it is analyze the contribution of dental periodical examinations in the oral health maintenance of the workers from Nuclear Engineering Institute (IEN), through an evaluation of the oral dental health record from Federal Council of Dentistry (CFO). As methodology, a literature review was made to substantiate the field research that aims to map the perception of 30 (thirty) dentistry experts on the protocol used for the periodic dental checks from IEN, applying a survey. The results of the research, it is observed that all respondents have more than 10 (ten) years of professional experience and the items that they judged more relevant in clinical investigations were: cardiovascular, hematologic, assignable and liver diseases. In addition, it was also given a high importance of performing the clinical and radiological examinations. Thus, its concluded with the answers that the applicability and efficiency of dental periodic examinations have a great value for the health of IEN employees. In this way, it is hoped this research helps the awareness of the employers regarding oral health, seeking to relate occupational hazards with the diseases that emerged from the oral cavity and essentially contributing for the maintenance of oral health from IEN´s workers.

<p>The present thesis follows an intensive care unit during four year of hard work and demanding organisational changes (1998-2001). The changes were mainly initiated by diminishing resources and a legislative claim to pay regard to the quality aspect of health care service. The process of implementing a quality system was the main focus for the thesis. Triangulation was used aiming at explore the process from different views. Two interviews studies were conducted one with the staff and another with the leadership. Both interviews were analysed thematically combined with a phenomenographic technique (e.g. using the how, and what aspect). A longitudinal quasi experimental time-series study was also accomplished. The correlation between staff variables and workload were measured once a year. The result show a 20 % increase in workload per staff and year. The staff judged the organisational climate for innovativeness stable over the period. Sick leave increased, and more so, than the general trend in the society. In spite of this increase the prevalence of stress related symptoms was the same. Two different systems emerged, a complex adaptive system and a mechanical system. The two systems exist and functions intertwined. Because of the construction of the patient register it is possible to see that the situation around a patients being admitted ≥ 5 days functions according to the complex systems character while the situation around the acute patients functions according to a mechanical system. Sick leave correlated with number of patient admitted ≥ 5 days (P=,000). It seemed the problem found had its root in the unawareness of the existing of a complex system. The result has implications for a need of increased awareness about how to manage the situation when the ICU is functioning according to the complex adaptive system.</p>

The present thesis follows an intensive care unit during four year of hard work and demanding organisational changes (1998-2001). The changes were mainly initiated by diminishing resources and a legislative claim to pay regard to the quality aspect of health care service. The process of implementing a quality system was the main focus for the thesis. Triangulation was used aiming at explore the process from different views. Two interviews studies were conducted one with the staff and another with the leadership. Both interviews were analysed thematically combined with a phenomenographic technique (e.g. using the how, and what aspect). A longitudinal quasi experimental time-series study was also accomplished. The correlation between staff variables and workload were measured once a year. The result show a 20 % increase in workload per staff and year. The staff judged the organisational climate for innovativeness stable over the period. Sick leave increased, and more so, than the general trend in the society. In spite of this increase the prevalence of stress related symptoms was the same. Two different systems emerged, a complex adaptive system and a mechanical system. The two systems exist and functions intertwined. Because of the construction of the patient register it is possible to see that the situation around a patients being admitted ≥ 5 days functions according to the complex systems character while the situation around the acute patients functions according to a mechanical system. Sick leave correlated with number of patient admitted ≥ 5 days (P=,000). It seemed the problem found had its root in the unawareness of the existing of a complex system. The result has implications for a need of increased awareness about how to manage the situation when the ICU is functioning according to the complex adaptive system.

The purpose of this thesis has been to analyse seven major factors that tend to influence the rate of early retirement in Sweden. The scope of data was gathered for every municipality in Sweden. Economic theories of labour supply, Moral Hazard, Adverse Selection and the Insurance Model were used to analyse the empirical results. In the analysis, earlier studies of the rate of sickness absence were important and used as a framework in choosing the explanatory variables for the econometric model. The analysed variables were; average income, average sickness days, educational level, foreign born, public sector employment, unemployment and the share of women in the population. As a consequence of the rift that occurred in 2003, when the average sickness days decreased and disbursed early retirements simultaneously increased, the relationship between these two variables was given special attention. The empirical findings confirmed our conjectures and were consistent with earlier research. Average income and the level of education were negatively related to the rate of early retirement. Moreover foreign born, average sickness days and unemployment showed a positive relation to early retirement. The relationship between average sickness days and early retirement had statistically changed and decreased between the years. A possibility is that other factors, such as changed social norms and increased stress in society (which are difficult to measure in a statistical and economical sense) might have become more relevant in explaining the rate of early retirement. / Syftet med denna uppsats har varit att analysera sju viktiga faktorer som tenderar att påverka graden av förtidspensionering i Sverige. Data omfånget insamlades för alla kommuner i Sverige. Ekonomiska teorier om arbetsutbud, Moral Hazard, Adverse Selection och Insurance Model användes för att analysera de empiriska resultaten. I analysen var tidigare studier utav graden av sjukfrånvaro viktig och användes som ramverk i valet av de förklarande variablerna till den ekonometriska modellen. De analyserade variablerna var; medelinkomst, genom-snittliga sjukdagar, utbildningsnivå, utlandsfödda, offentligt anställda, arbetslöshet och andelen kvinnor i befolkningen. Som en konsekvens utav den klyfta som uppstod 2003, när de genomsnittliga sjukdagarna minskade och utbetalda förtidspensioner samtidigt ökade, gavs sambandet mellan dessa två variabler speciell uppmärksamhet. De empiriska iakttagelserna bekräftade våra förväntningar och stämde överens med tidigare forskning. Medelinkomst och utbildningsnivå var negativt relaterade till graden av förtidspensionering. Dessutom var utlandsfödd, genomsnittliga sjukdagar och arbetslöshet positivt relaterade till förtidspensionering. Relationen mellan de genomsnittliga sjukdagarna och graden av förtidspensionering hade statistiskt sätt ändrats genom att ha minskat mellan åren. En tänkbar förklaring till detta skulle kunna vara att andra faktorer, såsom skiftande sociala normer och en ökande stress i samhället (vilka är svåra att mäta statistiskt och ekonomiskt) kan ha blivit mer relevanta i att förklara graden av förtidspensionering.

<p>The purpose of this thesis has been to analyse seven major factors that tend to influence the rate of early retirement in Sweden. The scope of data was gathered for every municipality in Sweden. Economic theories of labour supply, Moral Hazard, Adverse Selection and the Insurance Model were used to analyse the empirical results. In the analysis, earlier studies of the rate of sickness absence were important and used as a framework in choosing the explanatory variables for the econometric model. The analysed variables were; average income, average sickness days, educational level, foreign born, public sector employment, unemployment and the share of women in the population. As a consequence of the rift that occurred in 2003, when the average sickness days decreased and disbursed early retirements simultaneously increased, the relationship between these two variables was given special attention. The empirical findings confirmed our conjectures and were consistent with earlier research. Average income and the level of education were negatively related to the rate of early retirement. Moreover foreign born, average sickness days and unemployment showed a positive relation to early retirement. The relationship between average sickness days and early retirement had statistically changed and decreased between the years. A possibility is that other factors, such as changed social norms and increased stress in society (which are difficult to measure in a statistical and economical sense) might have become more relevant in explaining the rate of early retirement.</p> / <p>Syftet med denna uppsats har varit att analysera sju viktiga faktorer som tenderar att påverka graden av förtidspensionering i Sverige. Data omfånget insamlades för alla kommuner i Sverige. Ekonomiska teorier om arbetsutbud, Moral Hazard, Adverse Selection och Insurance Model användes för att analysera de empiriska resultaten. I analysen var tidigare studier utav graden av sjukfrånvaro viktig och användes som ramverk i valet av de förklarande variablerna till den ekonometriska modellen. De analyserade variablerna var; medelinkomst, genom-snittliga sjukdagar, utbildningsnivå, utlandsfödda, offentligt anställda, arbetslöshet och andelen kvinnor i befolkningen. Som en konsekvens utav den klyfta som uppstod 2003, när de genomsnittliga sjukdagarna minskade och utbetalda förtidspensioner samtidigt ökade, gavs sambandet mellan dessa två variabler speciell uppmärksamhet. De empiriska iakttagelserna bekräftade våra förväntningar och stämde överens med tidigare forskning. Medelinkomst och utbildningsnivå var negativt relaterade till graden av förtidspensionering. Dessutom var utlandsfödd, genomsnittliga sjukdagar och arbetslöshet positivt relaterade till förtidspensionering. Relationen mellan de genomsnittliga sjukdagarna och graden av förtidspensionering hade statistiskt sätt ändrats genom att ha minskat mellan åren. En tänkbar förklaring till detta skulle kunna vara att andra faktorer, såsom skiftande sociala normer och en ökande stress i samhället (vilka är svåra att mäta statistiskt och ekonomiskt) kan ha blivit mer relevanta i att förklara graden av förtidspensionering.</p>

Σκοπός της διατριβής ήταν η διερεύνηση του φαινομένου της απουσίας (για λόγους υγείας) από την εργασία στον ιδιωτικό τομέα και ιδίως στη βαριά βιομηχανία, και τη πιθανή επίδραση στην ικανότητα εργασίας. Η παρούσα διδακτορική διατριβή στηρίχτηκε κυρίως στη μελέτη του αρχείου αναρρωτικών αδειών (μιας κοόρτης) εργαζομένων σε ένα από τα μεγαλύτερα ναυπηγεία της χώρας, καθώς και στις ετήσιες στατιστικές αναφορές του Ιδρύματος Κοινωνικών Ασφαλίσεων (ΙΚΑ) της τελευταίας 20ετίας. Τα χαμηλά επίπεδα απουσιασμού ασθενείας στον ιδιωτικό τομέα στην Ελλάδα επιβεβαιώθηκαν από τη μελέτη που έγινε στα πλαίσια αυτής της διατριβής, αν και τα αποτελέσματα υποδεικνύουν ότι ο απουσιασμός ασθενείας στην Ελλάδα είναι ελαφρώς μεγαλύτερος από ότι υποδείκνυαν οι πρόσφατες διεθνείς συγκριτικές μελέτες. Το ποσοστό απουσιασμού (Absenteeism rate) βρέθηκε περίπου 2.5%, από τα χαμηλότερα στην Ευρώπη. Παρόλα αυτά, επειδή περιλαμβάνει τον εργάσιμο χρόνο που διαφέρει από χώρα σε χώρα, δεν χρησιμοποιείται συχνά στις μελέτες αν και ίσως είναι ο πιο έγκυρος δείκτης απουσιασμού. Η μέση διάρκεια απουσίας για κάθε εργαζόμενο ανά έτος ήταν 5.8 ημέρες( μέγιστη τιμή 8 ημέρες προς το τέλος της περιόδου μελέτης) με ένα αντίστοιχο μέσο όρο που ξεπερνούσε κατά πολύ τις 10 ημέρες στην υπόλοιπη Ευρώπη. Ενδιαφέρον εύρημα αποτελεί το γεγονός ότι οι μικρής διάρκειας απουσίες (<4 ημέρες) αντιστοιχούσαν στο 25% της συνολικής διάρκειας των απουσιών, κάτι που μέχρι τώρα δεν μπορούσε να υπολογιστεί από τα εθνικά στατιστικά δεδομένα του ΙΚΑ. Κατά τη μελέτη των δεδομένων του ΙΚΑ τις δυο τελευταίες δεκαετίες, βρέθηκε μια κυματοειδής πορεία του απουσιασμού, επιδεικνύοντας πτωτική πορεία μέχρι τα τέλη τις δεκαετίας του 1990, σε συμφωνία με τις προηγούμενες μελέτες και εν συνεχεία μια ανοδική πορεία, αν και μέχρι το τέλος της περιόδου μελέτης τα επίπεδα παρέμειναν χαμηλότερα από τα αρχικά. Σίγουρα οι παρατηρήσεις αυτής της μελέτης χρήζουν περαιτέρω διερεύνησης, καθώς ο χαμηλός απουσιασμός μόνο μερικώς μπορεί να αποδοθεί στα χαμηλά επίπεδα αποζημίωσης μισθού σε περίπτωση αναρρωτικής άδειας ή τα υψηλά ποσοστά ανεργίας. Βασικός σκοπός πρέπει πάντα να είναι η διατήρηση και προώθηση της καλής υγείας των εργαζομένων, μέσω όσο το δυνατόν καλύτερων εργασιακών συνθηκών. Καθώς τόσο οι εργασιακές συνθήκες όσο και η υγεία των εργαζομένων είναι σε μια δυναμική κατάσταση, χρειάζονται εργαλεία παρακολούθησης. Η μέτρηση του απουσιασμού ασθενείας είναι ένας παράγοντας που πάντα θα πρέπει να εκτιμάται από τον ιατρό εργασίας και τον εργοδότη, χρησιμοποιώντας τους διάφορους δείκτες που έχουν καθιερωθεί. Σαν συμπληρωματικό εργαλείο παρακολούθησης προτείνεται η χρήση του Δείκτη Ικανότητας Εργασίας (Work Ability Index), που είναι ένα ερωτηματολόγιο, το οποίο σταθμίστηκε στα Ελληνικά και εκτιμά γενικά τη λειτουργική ικανότητα των εργαζομένων, όντας άμεσα συνδεδεμένο με τον απουσιασμό ασθενείας. Η ελληνική έκδοση του Δείκτη Ικανότητας Εργασίας έδειξε ικανοποιητικές ψυχομετρικές ιδιότητες και συνοχή, και μπορεί να αποτελέσει μια αξιόπιστη εναλλακτική επιλογή στα εργαλεία αξιολόγησης της ικανότητας εργασίας σε ατομικό και ομαδικό επίπεδο. Ο παράγοντας Bradford είναι ένας ακόμα δείκτης που η προγνωστική του δύναμη όσον άφορα το βραχυπρόθεσμο απουσιασμό φάνηκε σε αυτή τη μελέτη. Προτείνεται επίσης η χρήση και των δυο αυτών δεικτών με την μορφή ενός νέου δείκτη (Δείκτης Πρόβλεψης Πιθανής Απουσίας), για την ανίχνευση εργαζομένων και τομέων εργασίας με αυξημένη πιθανότητα απουσίας για λογούς υγείας τα αμέσως επόμενα χρόνια. Στα πλαίσια της στάθμισης έγινε επίσης φανερό το πρότυπο νοσηρότητας του πληθυσμού των ναυπηγείων, όπου κυριαρχούν οι μυοσκελετικές και αναπνευστικές παθήσεις μαζί με το τραύμα, ενώ τη μεγαλύτερη επίδραση στην ικανότητα εργασίας φαίνεται να έχουν οι καρδιαγγειακές και ψυχικές παθήσεις. Αναδείχτηκε επίσης η υποδιάγνωση των ψυχικών παθήσεων, που είναι ένα γενικότερο πρόβλημα στην Ελλάδα. Οι ραδιοτεχνίτες και οι φλογοχειριστές φαίνονται να εμφανίζουν τα μεγαλύτερα επίπεδα απουσιασμού. Οι παράγοντες που βρέθηκαν να συσχετίζονται θετικά με αυξημένα επίπεδα απουσιασμού είναι η μικρή ηλικία, οι χειρωνακτικές εργασίες, το χαμηλό επίπεδο εκπαίδευσης και η εργασιακή εμπειρία άνω των 3 ετών. Συμπερασματικά, χρειάζονται περαιτέρω μελέτες για να κατανοηθεί πλήρως ο απουσιασμός ασθενείας, σε όλους τους εργασιακούς τομείς και βεβαίως εκπαίδευση του ιατρικού προσωπικού στο θέμα της χορήγησης αναρρωτικών αδειών, όπου θα βοηθούσε η χρήση εργαλείων όπως αυτά που μελετήθηκαν σε αυτή τη διατριβή(πχ Disability Guidelines), και ήδη βρίσκουν εφαρμογή σε άλλες χώρες. / The aim of this study was to estimate the levels and analyse sickness absence in the private sector in Greece, using shipyard and national insurance data. Field data were collected in a cohort of shipyard employees in the period between 1999 and 2006. In addition, national sickness absenteeism data (compensated days) of employees insured at the Social Insurance Institute (IKA, the largest insurance scheme in Greece) were retrieved from the Institute’s annual statistical reports for the period 1987-2006. Low levels of sickness absence in the private sector in Greece have been confirmed by this study, although the findings show that sickness absence in Greece is slightly higher than what the recent international comparative studies indicate. The absenteeism rate was 2.5%, which is one of the lowest in Europe. Nevertheless, due to the fact that it involves working hours which differ from one country to another, it is not often used in the studies despite being the most valid indicator of absence. The average duration of absence for every employee per year was 5.8 days (maximum number was 8 days towards the end of the study). In Europe, the average number of days of sickness absence exceeded 10 days. An interesting finding is the fact that short period absences (<4 days) constituted 25% of the total duration of absences, which could not be calculated until now by the national statistical data of the Social Insurance Institute (IKA). While studying the data of IKA of the last two decades, a sinusoidal-like trend was recorded regarding absenteeism. Declining trend by the end of the 1990s was observed, in accordance with previous studies and then an increasing trend, although at the end of the study period the levels remained lower than those at the beginning. Further research is needed concerning the observations of this study since the low absenteeism levels can only be partially attributed to the low compensation rate in case of sick-leave or to the high levels of unemployment. The primary objective should always be health preservation and promotion of the employees by means of the best possible working conditions. As both working conditions and employees’ health are dynamic situations, monitoring tools are required. Sickness absence should always be monitored by the occupational health physician as well as the employer, using the various established tools. The use of Work Ability Index is recommended as an additional monitoring tool. It is a questionnaire, directly linked to sickness absence, which generally evaluates the employees’ functional ability. The Greek version of Work Ability Index displayed satisfactory psychometric properties and consistency thus constituting an appropriate option for evaluating work ability in both individual and population-based settings. The Bradford factor is another index whose prognostic strength concerning short-term absenteeism was evident in this study. The use of both these tools in the form of one new index (Sickness Absence Probability Factor) is also recommended in order to identify employees and work areas with an increased tendency for sickness absence. During the validation process, the morbidity pattern of the shipyard population also became obvious. Musculoskeletal, respiratory diseases as well as trauma are most prevalent, whereas cardiovascular and mental diseases seem to have the biggest impact on work ability. The underdiagnosis of mental diseases was also revealed, which is a general problem in Greece. Radiomen and flame-cutters seem to have the highest levels of absence, while the factors which were found to be positively linked to high levels of absenteeism are young age, manual labor, low educational level and working experience over 3 years. In conclusion, further research is necessary to fully describe and understand the phenomenon of sickness absence in various work fields. Medical staff training in the area of issuing sick-leave is essential and has already been implemented in other countries. Tools, like the ones studied in this dissertation should be utilized.

Tyrimo tikslas – nustatyti pasitenkinimo darbo sąlygomis, saviveiksmingumo ir subjektyviai suvokiamo darbinės veiklos efektyvumo sąsajas bei įvertinti ar pasitenkinimas darbo sąlygomis ir saviveiksmingumas gali prognozuoti subjektyviai suvokiamą darbinės veiklos efektyvumą. Tyrime dalyvavo 204 Kauno ir Vilniaus miestų įmonių įvairių specialybių darbuotojai ( 98 vyrai ir 106 moterys). Tiriamųjų amžiaus vidurkis 29,75 metai. Tiriamieji buvo parinkti patogiosios atrankos būdu. Pasitenkinimui darbo sąlygomis įvertinti buvo sudarytas klausimynas remiantis literatūros apžvalga. Tai vienfaktorinis reiškinys, kuris sudarytas iš 17 klausimų. Saviveiksmingumui nustatyti buvo naudota bendra saviveiksmingumo skalė (The General Self – Efficacy Scale, Jerusalem M. ir Schwarzer R., 1993), kurią sudaro dešimt teiginių. Subjektyviai suvokiamo darbinės veiklos efektyvumas buvo matuojamas dviem aspektais: nedalyvavimo darbinėje veikloje skale (SPS6 scale, Koopman et al., 2002), antrasis aspektas yra neatvykimo į darbą dažnumo indeksas, sudarytas šiam tyrimui doc. Dr. L. Gustainienės ir Talalaitės A. (2012) Tyrimo rezultatai parodė, kad didėjantis pasitenkinimas darbo sąlygomis siejasi su mažėjančiu nedalyvavimu darbinėje veikloje ir nebuvimu darbe. Taip pat didėjant saviveiksmingumui, mažėja nedalyvavimas darbinėje veikloje. Rezultatai parodė, kad moterų imtyje nedalyvavimą darbinėje veikloje ir nebuvimą darbe prognozuoja pasitenkinimas darbo sąlygomis, o vyrų imtyje saviveiksmingumas. / The aim of the study was to assess relationship between the satisfaction with job conditions, self-efficacy and subjective evaluation of work effectiveness. There were 204 employers (106 – women, 98 – men) who participated in the research. The respondents were from Kaunas and Vilnius organizations. The average age of the participants 29,75 years. For the assessment of satisfaction with job condition was made a questionnaire with reference from literature review. The questionnaire consist of 17 propositions. For the assessment of self-efficacy was used The General Self – Efficacy Scale (Jerusalem, M., Schwarzer, R., 1993). Subjective evaluation of work effectiveness was evaluating by two aspects: The first one is a phenomen as being present at work but unable to be fully engaged with the work environment so for the assessment was used Presenteeism Scale (SPS6, Koopman et al., 2002). The second aspect is absenteeism (frequency index of not being at work) – it was made with reference from literature review. Results of a study showed that increasing satisfaction with job conditions correlates with decreasing presenteeism and absenteeism. Moreover, increasing self-efficacy decreases presenteeism. Furthermore, study showed that presenteeism and absenteeism is prognosticated by satisfaction with job conditions in cluster of women and presenteeism and absenteeism is prognosticated by self-efficacy.