The results of this study clearly demonstrate that the psychosocial working environment within the maritime industry is associated with mental health outcomes such as stress, anxiety, and depression. Furthermore, the analysis suggests that work environment measures taken to adapt to the COVID-19 pandemic were independently associated with these mental health outcomes.
Comparing the outcome measures of our sample with other populations shows that international seafarers are more stressed than general population samples from Sweden and the United States (PSS-10). [18, 25]. Similar patterns are seen for both anxiety (GAD-7) and depression (PHQ-9). The prevalence of anxiety disorders among seafarers is similar to or slightly higher than in general population samples (e.g. Sweden and Australia).in Germany and Belgium [16, 26,27,28]but slightly lower among U.S. healthcare seekers than in primary care settings. [23, 24]. Note that the concept of mental health varies across cultures, making it difficult to make definitive comparisons between specific settings and global populations. .
A number of studies have investigated the mental health of international seafarers, particularly during the COVID-19 pandemic. [30,31,32]. These studies found similar or slightly higher levels of stress, anxiety, and depression compared to our results. However, the same psychometric measurements were not applied and a larger sample of seafarers was not included.
Employers’ ability to communicate effectively, clearly and transparently with seafarers has been found to be associated with improved mental health. This shows that employers had the power to influence mental health on board by how they implemented mitigation strategies put in place during the pandemic. Similar findings have been found in several studies with other frontline workers, suggesting that this association is due to appropriate organizational support and communication buffering the negative effects of mitigation strategies. is suggested. But it also influenced the overall approach (optimistic or pessimistic) to new challenges. [32, 34].
Our finding that changes in safety perceptions during the pandemic are associated with mental health outcomes may also be associated with the above relationships. Furthermore, previous research has shown that there is a direct link between crew retention and safety at sea. . Therefore, this suggests that low safety awareness leads to a poor psychosocial environment. This is true in a business where safety awareness is rooted in culture. emphasizing safety can be interpreted as a way to worsen corporate culture and professional pride . Continuing this mindset and focusing on safety, as well as structured communication and support in general, will be effective as a buffer against negative psychosocial work environments. .
Research points to social environment as important determinant of mental health especially in professional settings . However, in our data, policy indicators were generally associated with all three mental health outcomes, but social interactions and climate were not. This may have something to do with the need to have a clear structure and routine to tie into your daily habits, especially if you’ve been on a boat for many months. This is thought to alleviate the negative effects of stress on mental health. .
Overall, there were clear differences between the results on board and on land, particularly regarding anxiety and depression. This is not at all surprising, as mental health outcomes change over time and are negatively correlated with active duty or vacation status. . The fact that the association with stress is still significant is very likely indicative of vacation-related stress. [42, 43]But additional financial stress is also to blame.
This study has several policy implications. First, the results show that shipping companies’ mitigation strategies, particularly clear and transparent communication with crew onboard ships, had a positive impact on mental health. Other elements of the mitigation strategy are promoting and promoting a positive working environment, focusing on accident recognition and prevention, providing appropriate medical and health services whenever needed on board or at home; and to keep seafarers’ families updated with the latest information. they are concerned. However, perhaps the most important policy issue to be resolved is to enable crew changes in times of crisis. . Our findings demonstrate that the delays that occurred during the pandemic not only affected those on board, but also had a significant impact on those on shore, impacting the lives of large numbers of people and, therefore, providing mental health relief. It clearly shows that there is a serious negative impact on human health. Especially in low- and middle-income country settings. In conclusion, based on the results of this study and in line with previous studies, developing a health-promoting workplace for seafarers with an emphasis on preventive measures, as these are known to have a significant impact on seafarer health. recommended to shipping companies. [31, 45, 46].
strengths and limitations
The most obvious strength of this study lies in its sheer number. No other study in the past has surveyed so many sailors at the same time using the same equipment. Furthermore, the study included seafarers of 154 different nationalities, and with some exceptions (mainly the participation rates of Indonesian and Chinese seafarers), the proportions of these nationalities are not representative of the entire workforce. It was something to do. This applies not only to age and gender, but also to the proportion and ranking of executives. However, the sampling had some limitations. First, although only 44 shipping companies voluntarily participated, including some of the world’s largest companies, many companies, especially small and medium-sized companies, did not participate. It was. Furthermore, some ship types had lower numbers of participants compared to other ship types (primarily cruise ships), which can be explained by the suspension of cruise ship operations during the pandemic.
Another strength of this study is that it applied a validated scale as a measure of the outcome variable. A common challenge in mental health epidemiology is the large number of different psychometric scales available to researchers. In this case, we decided to choose well-established and validated measures that can identify levels of stress, anxiety, and depression in general population samples. We never applied these scales to diagnose or triage respondents.
The main limitation of this study was the low response rate. Of the 160,000 seafarers invited, just over 10% completed the full survey. Analysis of those who did not participate in the study was not possible. However, there were no statistically significant differences in age, gender, or current location between those who did not complete the survey and those who did. On the other hand, those who actually responded to the survey were statistically significantly more likely to become executives and had been in their current job for a shorter period of time. More importantly, on scales measuring stress, anxiety, and depression, mean scores were statistically significantly higher for those who did not respond to the survey, and this finding may be related to psychosocial work environment and mental health outcomes. This indicates that we underestimate the relevance of
Another obvious limitation of this study was the cross-sectional design, which precluded drawing conclusions about inferences between psychosocial work environment and mental health outcomes.
Anticipating that the response rate would decline over the course of the study, we wanted to keep the questionnaire as short as possible, so we decided to exclude more comprehensive measures of psychosocial work environment. This has several implications, primarily that the operation of the psychosocial work environment is based on symptoms rather than perceptions. This suggests that we may have assessed the psychosocial working environment as better than it actually was, which could also lead to lower estimates and suboptimal regression modeling. .