Job strain and supervisor support in primary care health centres and glycaemic control among patients with type 2 diabetes: a cross-sectional study

OBJECTIVES This study investigates associations between healthcare personnel's perceived job strain, supervisor support and the outcome of care in terms of glycaemic control among patients with type 2 diabetes. DESIGN A cross-sectional study from 2006. SETTING 18 primary care health centres (HCs) from five municipalities in Finland. PARTICIPANTS Aggregated survey data on perceived job strain and supervisor support from healthcare personnel (doctors, n=122, mean age 45.5 years, nurses, n=300, mean age 47.1 years) were combined with registered data (Electronic Medical Records) from 8975 patients (51% men, mean age 67 years) with type 2 diabetes. OUTCOME MEASURE Poor glycaemic control (glycated haemoglobin (HbA1c) ≥7%). RESULTS The mean HbA1c level among patients with type 2 diabetes was 7.1 (SD 1.2, range 4.5-19.1), and 43% had poor glycaemic control (HbA1c ≥7%). Multilevel logistic regression analyses, adjusted for patient's age and sex, and HC and HC service area-level characteristics, showed that patients' HbA1c-levels were less optimal in high-strain HCs than in low-strain HCs (OR 1.44, 95% CI 1.12 to 1.86). Supervisor support in HCs was not associated with the outcome of care. CONCLUSIONS The level of job strain among healthcare personnel may play a role in achieving good glycaemic control among patients with type 2 diabetes.