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Kunz C, Millhoff C. A longitudinal perspective on the interplay of job demands and destructive leadership on employees' work ability in Germany. Int Arch Occup Environ Health 2023; 96:735-745. [PMID: 36964791 PMCID: PMC10219880 DOI: 10.1007/s00420-023-01962-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/14/2023] [Indexed: 03/26/2023]
Abstract
PURPOSE Work ability as a predictor of early retirement or lengthy/frequent sick leaves becomes more and more relevant due to the demographic change. Therefore, factors, which affect employees' work ability, need to be further examined with a theoretical base. According to Karasek's job demands-control (JDC) model, high job demands and low control are related to poor employee health. The subsequent job demands-control support (JDCS) model proposed that a lack of support, also from leaders, has a negative impact on health indicators. This article looked at whether destructive leadership reinforces the negative influence of high job demands on employees' work ability. METHODS We used the BAuA Working Time Survey waves 2015, 2017, and 2019 (BAuA-WTS), which are representative of employees in Germany. Our data set covers 2448 respondents, who took part in all three waves. Central to the analyses were the variables job demands, control, destructive leadership, and work ability. RESULTS Results from pooled ordinary least squares (OLS) and fixed effect (FE) models revealed that job demands influenced work ability negatively, whereas neither control by the employee nor the interaction of job demands and control was significant regarding effecting work ability in the FE models. Destructive leadership exerted a negative effect on work ability and moderated job demands significantly in the FE models meaning a further decrease in work ability. CONCLUSION Leadership behavior should be further examined as an important factor for work ability.
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Affiliation(s)
- Carolin Kunz
- TU Dortmund University / Technische Universität Dortmund, Dortmund, Germany.
| | - Catrin Millhoff
- TU Dortmund University / Technische Universität Dortmund, Dortmund, Germany
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Kuchenbaur M, Peter R. Quality of leadership and self-rated health: the moderating role of 'Effort-Reward Imbalance': a longitudinal perspective. Int Arch Occup Environ Health 2023; 96:473-482. [PMID: 36478030 PMCID: PMC9968269 DOI: 10.1007/s00420-022-01941-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Longitudinal studies on the influence of leadership behavior on employees' self-rated health are scarce. As a result, potential mechanisms describing the impact of leadership behavior on health have not been adequately investigated so far. The present study accounts for the influence of leadership behavior on self-rated health within the framework of the Effort-Reward Imbalance model. METHODS The study was conducted on the basis of a cohort which comprised a random sample of healthcare workers from ten different hospitals and one elderly nursing home in Germany. A 2-level repeated measurement model with random intercept and slopes was modeled, since it was aimed to account for individual as well as intra-individual variation of subjective health across three time points over 36 months. Beside 'Effort-Reward Imbalance' and 'Quality of Leadership' from the Copenhagen Psychosocial Questionnaire, physical and mental health was assessed by German version of the SF12 multipurpose short-form measure of health status. RESULTS 'Effort-Reward Imbalance' and a lack in 'Quality of Leadership' negatively affect self-rated physical health. No effect was found for self-rated mental health. Effort-Reward Imbalance significantly moderates the effect of 'Quality of Leadership' on self-rated physical health. CONCLUSION The findings, and the interaction effects in particular, suggest that leadership behavior moderated by factors such as appreciation and support, influences self-rated physical health. The study therefore provides an interpretation for leadership behavior and its influence on employees' self-rated health within the 'Effort-Reward Imbalance' model.
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Affiliation(s)
- Marco Kuchenbaur
- Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany.
| | - Richard Peter
- Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
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The influence of socio-cognitive mindfulness and resilience on middle managers' stress and thriving during COVID-19: results from two studies. JOURNAL OF MANAGEMENT DEVELOPMENT 2022. [DOI: 10.1108/jmd-05-2022-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PurposeThe purpose of this study was to examine the influence of socio-cognitive mindfulness on resilience, stress and thriving among middle managers in higher education at two separate periods during the COVID-19 pandemic. In Study 1, the authors examined how socio-cognitive mindfulness predicted perceived stress and whether the relationship between mindfulness and perceived stress was mediated by resilience. In Study 2, the authors replicated the first study and further hypothesized that the link between mindfulness and thriving was also mediated by resilience.Design/methodology/approachThe authors conducted cross-sectional correlational studies to test the hypotheses using data from 163 middle managers in higher education early in the pandemic in Study 1 and 204 middle managers a year later in Study 2.FindingsStudy 1 findings showed socio-cognitive mindfulness predicted perceived stress, and that resilience fully mediated this relationship. In Study 2, socio-cognitive mindfulness did not predict perceived stress, but it did predict thriving, and that relationship was fully mediated by resilience.Originality/valueThis research is the first to address how socio-cognitive mindfulness directly impacts perceived stress and thriving and its impact through building resilience. To date, few studies have focused on stress in higher education middle managers or addressed the importance of building socio-cognitive mindfulness and resilience to thrive amid ongoing challenges. Implications of the pandemic's influence on the results are also addressed.
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Erschens R, Seifried-Dübon T, Stuber F, Rieger MA, Zipfel S, Nikendei C, Genrich M, Angerer P, Maatouk I, Gündel H, Rothermund E, Peters M, Junne F. The association of perceived leadership style and subjective well-being of employees in a tertiary hospital in Germany. PLoS One 2022; 17:e0278597. [PMID: 36512621 PMCID: PMC9746986 DOI: 10.1371/journal.pone.0278597] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Professionals in the healthcare sector are a particularly vulnerable group for occupational strain due to high work-related psychological stress. For the implementation of targeted stress-prevention interventions as an important part of a workplace health management programme for all occupational groups and hierarchy levels, information about the current state of their mental health is mandatory. Hence, this study investigated the association of general well-being and different leadership styles among employees in a German tertiary hospital. METHODS Via an online survey, 10,101 employees were contacted. The final sample consisted of 1137 employees. Of these, 27.7% described themselves as leaders and 72.3% as followers. Most participants were female (74.8%), more than half were under 41 years old. Besides control variables, general well-being (WHO-5) and leadership style (transactional and transformational, laissez-faire and destructive leadership) were assessed. RESULTS Leaders reported higher well-being scores than followers. Physicians without leadership responsibilities had the lowest scores for well-being. Practitioners of both transformational and transactional leadership were associated with higher well-being scores, while those practicing laissez-faire and destructive leadership had lower scores for almost every professional group. CONCLUSION Results highlight the necessity for future multimodal health-preventive leadership interventions feature behavioural and organizational intervention modules specifically tailored to hospital professionals at different hierarchical and functional levels to foster the mental health of employees.
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Affiliation(s)
- Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
- * E-mail:
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tuebingen, Baden-Wuerttemberg, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
| | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Essen, Nordrhein-Westfalen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Nordrhein-Westfalen, Germany
| | - Imad Maatouk
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany
- Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Würzburg, Würzburg, Bayern, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Baden-Wuerttemberg, Germany
| | - Eva Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Baden-Wuerttemberg, Germany
| | - Martin Peters
- Department of Psychiatry II, Ulm University, Günzburg, Bayern, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, Tuebingen, Baden-Wuerttemberg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, University Hospital Magdeburg, Magdeburg, Sachsen-Anhalt, Germany
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Niedhammer I, Derouet-Gérault L, Bertrais S. Prospective associations between psychosocial work factors and self-reported health: study of effect modification by gender, age, and occupation using the national French working conditions survey data. BMC Public Health 2022; 22:1389. [PMID: 35854252 PMCID: PMC9295500 DOI: 10.1186/s12889-022-13773-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Prospective studies exploring the effects of psychosocial work factors on self-reported health (SRH) are lacking, especially those studying effect modifications. The objectives were to examine the prospective associations of these factors, and multiple exposures to these factors, with SRH in a national representative sample, and effect modifications by gender, age, and occupation. Methods The prospective study relied on the three data collection waves (2013, 2016, and 2019) of the national French Working Conditions survey and was based on a sample of 15,971 employees, in good SRH at the beginning of the follow-up period. The occupational exposures were time-varying variables measured in 2013 and 2016, and included: 20 psychosocial work factors grouped into 5 broad domains, 4 exposures related to working time/hours and 4 physical-biomechanical-chemical exposures. The incidence of poor SRH three years later was the outcome. Discrete time Poisson regression models were performed using weighted data and with adjustment for gender, age, marital status, life events, and occupation. Results Almost all the studied psychosocial work factors were predictive of poor SRH. Some physical-biomechanical-chemical exposures were found to predict poor SRH. Only rare effect modifications were observed according to gender, age, and occupation. Dose-response associations between multiple exposures and the incidence of poor SRH were observed for 4 among 5 domains of psychosocial work factors. Conclusions Our study underlined the effects of psychosocial work factors, as well as multiple exposure effects, on the incidence of poor SRH. However, most of these effects were the same across population groups related to gender, age, and occupation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13773-x.
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Affiliation(s)
- Isabelle Niedhammer
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, 28 rue Roger Amsler, CS 74521, 49045, ANGERS Cedex 01, France.
| | - Laura Derouet-Gérault
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, 28 rue Roger Amsler, CS 74521, 49045, ANGERS Cedex 01, France
| | - Sandrine Bertrais
- INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, ESTER Team, 28 rue Roger Amsler, CS 74521, 49045, ANGERS Cedex 01, France
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Selander K, Nikunlaakso R, Laitinen J. Association between work ability and work stressors: cross-sectional survey of elderly services and health and social care service employees. Arch Public Health 2022; 80:83. [PMID: 35292109 PMCID: PMC8922061 DOI: 10.1186/s13690-022-00841-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
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.
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Babnik K, Staresinic C, Lep Ž. Some of the workforce face post COVID after the acute phase of the illness: The employer’s supportive role. HUMAN SYSTEMS MANAGEMENT 2022. [DOI: 10.3233/hsm-220003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: A considerable proportion of workers that recover from an acute phase of COVID-19 are confronted with post COVID-19 symptoms of varying severity and duration. Employers have an important role in addressing this new condition. OBJECTIVE: The aim of this study was to review organisational practises that could help employees suffering from long COVID-19 return to work and to link these suggestions to theoretical frameworks from the field of work and organisational psychology. METHODS: Since scientific publications on post COVID-19 are published daily, but sound empirical studies are still scarce, the synthesis of the scientific and professional literature was performed in the form of a narrative review. RESULTS: The results were organised according to the healthy workplace model and explained through the lens of the job demands-resources theory. The role of the employer has three aspects: collaboration, instructional pillars, and key actors. The main guidelines for implementation of the policies are an individualised approach, flexibility, and support. Supportive policies, practises, and relationships might have a direct impact on workers’ psychological resources. CONCLUSIONS: The model could help employers understand the conditions and necessary adaptations for workers with post COVID-19, as well as advance research in work and organisational psychology.
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Affiliation(s)
- Katarina Babnik
- Department of Psychology, University of Ljubljana, Faculty of Arts, Ljubljana, Slovenia
| | - Claire Staresinic
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Žan Lep
- Department of Psychology, University of Ljubljana, Faculty of Arts, Ljubljana, Slovenia
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Stengård J, Peristera P, Johansson G, Nyberg A. The role of managerial leadership in sickness absence in health and social care: antecedent or moderator in the association between psychosocial working conditions and register-based sickness absence? A longitudinal study based on a swedish cohort. BMC Public Health 2021; 21:2215. [PMID: 34863139 PMCID: PMC8642919 DOI: 10.1186/s12889-021-12236-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of sickness absence is particularly high among employees in health and social care, where psychosocial work stressors are pertinent. Managerial leadership is known to affect sickness absence rates, but the role leadership plays in relation to sickness absence is not fully understood; that is, whether poor leadership (i) is associated with sickness absence directly, (ii) is associated with sickness absence indirectly through the establishment of poor psychosocial working conditions, or (iii) whether good leadership rather has a buffering role in the association between work stressors and sickness absence. METHODS Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, 2010-2016, N=2333) were used. Autoregressive cross-lagged analyses within a multilevel structural equation modelling (MSEM) framework were conducted to test hypotheses i)-iii), targeting managerial leadership, register-based sickness absence and psychosocial work stressors (high psychological demands, poor decision authority and exposure to workplace violence). RESULTS A direct association was found between poor leadership and sickness absence two years later, but no associations were found between leadership and the psychosocial work stressors. Finally, only in cases of poor leadership was there a statistically significant association between workplace violence and sickness absence. CONCLUSIONS Poor managerial leadership may increase the risk of sickness absence among health and social care workers in two ways: first, directly and, second, by increasing the link between workplace violence and sickness absence.
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Affiliation(s)
- Johanna Stengård
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Paraskevi Peristera
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91, Stockholm, Sweden
| | - Gun Johansson
- Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Nyberg
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Tsarouha E, Stuber F, Seifried-Dübon T, Radionova N, Schnalzer S, Nikendei C, Genrich M, Worringer B, Stiawa M, Mulfinger N, Gündel H, Junne F, Rieger MA. Reflection on leadership behavior: potentials and limits in the implementation of stress-preventive leadership of middle management in hospitals - a qualitative evaluation of a participatory developed intervention. J Occup Med Toxicol 2021; 16:51. [PMID: 34844608 PMCID: PMC8628435 DOI: 10.1186/s12995-021-00339-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Mental health and stress prevention aspects related to workplace in hospitals are gaining increasingly more attention in research. The workplace hospital is characterized by high work intensity, high emotional demands, and high levels of stress. These conditions can be a risk for the development of mental disorders. Leadership styles can hinder or foster work-related stress and influence the well-being of employees. Through leadership interventions, leaders may be encouraged to develop a stress-preventive leadership style that addresses both, the well-being of the leaders and of the subordinates. A comprehensive qualitative description of leaders’ experiences with interventions on the topic of stress-preventive leadership is yet missing in the literature. Therefore, we address leaders of middle management regarding the development of stress-preventive leadership styles through supporting interventions. The research questions are: How do leaders of middle management perceive their leadership role in terms of effectiveness in stress prevention? Which potentials and limits in the implementation of stress-preventive leadership are experienced? Methods The study follows a qualitative research design and content analysis. We conducted individual interviews with leaders of middle management (n = 30) of a tertiary hospital in Germany for the participatory development of an intervention. This intervention, consisting of five consecutive modules, addressed leaders of middle management in all work areas within one hospital. After participation in the intervention, the leaders were asked to reflect on and evaluate the implementation of the contents learned within focus group discussions. Overall 10 focus group discussions with leaders (n = 60) were conducted. Results The results demonstrate that leaders of middle management perceived potentials for a stress-preventive leadership style (e.g., reflection on leadership role and leadership behavior, awareness/mindfulness, and conveying appreciation). However, limits were also mentioned. These can be differentiated into self-referential, subordinate-related, and above all organizational barriers for the implementation of stress-preventive leadership. Conclusions Some of the organizational barriers can be addressed by mid-level leadership interventions (e.g., lack of peer-exchange) or possibly by adapted leadership interventions for top management (e.g., lack of stress-preventive leadership styles in top level management). Other organizational limits are working conditions (e.g., staff shortage) that can only be influenced by health policy decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-021-00339-7.
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Affiliation(s)
- Elena Tsarouha
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Natalia Radionova
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | | | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Essen, Germany
| | - Britta Worringer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Guenzburg, Germany
| | - Nadine Mulfinger
- Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Harald Gündel
- Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
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Richter A, Roczniewska M, Loeb C, Stempel CR, Rigotti T. The Cross-Level Moderation Effect of Resource-Providing Leadership on the Demands-Work Ability Relationship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179084. [PMID: 34501678 PMCID: PMC8431616 DOI: 10.3390/ijerph18179084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/17/2021] [Accepted: 08/22/2021] [Indexed: 01/01/2023]
Abstract
Employees in female-dominated sectors are exposed to high workloads, emotional job demands, and role ambiguity, and often have insufficient resources to deal with these demands. This imbalance causes strain, threatening employees’ work ability. The aim of this study was to examine whether resource-providing leadership at the workplace level buffers against the negative repercussions of these job demands on work ability. Employees (N = 2383) from 290 work groups across three countries (Germany, Finland, and Sweden) in female-dominated sectors were asked to complete questionnaires in this study. Employees rated their immediate supervisor’s resource-providing leadership and also self-reported their work ability, role ambiguity, workload, and emotional demands. Multilevel modeling was performed to predict individual work ability with job demands as employee-level predictors, and leadership as a group-level predictor. Work ability was poor when employees reported high workloads, high role ambiguity, and high emotional demands. Resource-providing leadership at the group level had a positive impact on employees’ work ability. We observed a cross-level interaction between emotional demands and resource-providing leadership. We conclude that resource-providing leadership buffers against the repercussions of emotional demands for the work ability of employees in female-dominated sectors; however, it is not influential in dealing with workload or role ambiguity.
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Affiliation(s)
- Anne Richter
- Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden;
- Correspondence:
| | - Marta Roczniewska
- Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden;
- Center of Research on Cognition and Behaviour, Institute of Psychology, Faculty in Sopot, SWPS University of Social Sciences and Humanities, 81 745 Sopot, Poland
| | - Carina Loeb
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23 Vasteras, Sweden;
| | - Christiane R. Stempel
- Department of Work & Organizational Psychology, FernUniversität Hagen, 58097 Hagen, Germany;
| | - Thomas Rigotti
- Department of Work and Organizational Psychology, Johannes Gutenberg University Mainz, 55128 Mainz, Germany;
- Leibniz Institute for Resilience Research, 55122 Mainz, Germany
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Lehmann JAM, Schwarz E, Rahmani Azad Z, Gritzka S, Seifried-Dübon T, Diebig M, Gast M, Kilian R, Nater U, Jarczok M, Kessemeier F, Braun S, Balint E, Rothermund E, Junne F, Angerer P, Gündel H. Effectiveness and cost effectiveness of a stress management training for leaders of small and medium sized enterprises - study protocol for a randomized controlled-trial. BMC Public Health 2021; 21:468. [PMID: 33685418 PMCID: PMC7938293 DOI: 10.1186/s12889-021-10398-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leaders in small and medium-sized enterprises (SMEs) are exposed to increased stress as a result of a range of challenges. Moreover, they rarely have the opportunity to participate in stress management trainings. Therefore, KMU-GO (ger: Kleine und mittlere Unternehmen - Gesundheitsoffensive; en: small and medium-sized enterprises - health campaign) aims at conducting and evaluating such a stress management training. The focus of evaluation does not only lie on the effects on leaders participating but also on their employees. METHODS The study is planned as a 2 × 3 mixed design with two groups (intervention and waiting control group) as a between factor and point in time (at baseline, 6 and 12 months later) as a within factor. We aim at collecting data from N = 200 leaders. Based on the results of a preceding assessment, an already successfully implemented stress management training was adapted to SME needs and now serves as the framework of this intervention. The stress management training comprises one and a half days and is followed by two booster sessions (each 180 min) about 3 and 6 months after the training. The main focus of this intervention lies on specifying leaders stress reactivity while at the same time investigating its effects on employees' mental health. Further dependent variables are leaders´ depression and anxiety scores, effort-reward imbalance, sick days and psychophysiological measures of heart rate variability, hair cortisol, and salivary alpha-amylase. Cost-effectiveness analyses will be conducted from a societal and employers' point of view. DISCUSSION Stress management is a highly relevant issue for leaders in SMEs. By providing an adequate occupational stress management training, we expect to improve leaders´ and also employees` mental health, thereby preventing economic losses for SMEs and the national economy. However, collecting data from employees about the success of a stress management training of their leader is a highly sensitive topic. It requires a carefully planned proceeding ensuring for example a high degree of transparency, anonymity, and providing team incentives. TRIAL REGISTRATION The KMU-GO trial is registered at the German Clinical Trial Register (DRKS): DRKS00023457 (05.11.2020).
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Affiliation(s)
- J. A. M. Lehmann
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - E. Schwarz
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Z. Rahmani Azad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen Osianderstraße 5, 72076 Tübingen, Germany
| | - S. Gritzka
- Institute of Occupational and Social Medicine, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - T. Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen Osianderstraße 5, 72076 Tübingen, Germany
| | - M. Diebig
- Institute of Occupational and Social Medicine, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - M. Gast
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - R. Kilian
- Department of Psychiatry II, Ulm University and Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Str. 2, 89312 Günzburg, Germany
| | - U. Nater
- Department for Clinical and Health Psychology, Wien University, Liebiggasse 5, 1010 Wien, Austria
| | - M. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - F. Kessemeier
- Section of Health Care Research and Rehabilitation Research, Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110 Freiburg, Germany
| | - S. Braun
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - E. Balint
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - E. Rothermund
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - F. Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen Osianderstraße 5, 72076 Tübingen, Germany
| | - P. Angerer
- Institute of Occupational and Social Medicine, Heinrich-Heine-University Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - H. Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081 Ulm, Germany
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12
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Stuber F, Seifried-Dübon T, Rieger MA, Gündel H, Ruhle S, Zipfel S, Junne F. The effectiveness of health-oriented leadership interventions for the improvement of mental health of employees in the health care sector: a systematic review. Int Arch Occup Environ Health 2021; 94:203-220. [PMID: 33011902 PMCID: PMC7532985 DOI: 10.1007/s00420-020-01583-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 09/10/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE An increasing prevalence of work-related stress and employees' mental health impairments in the health care sector calls for preventive actions. A significant factor in the workplace that is thought to influence employees' mental health is leadership behavior. Hence, effective leadership interventions to foster employees' (leaders' and staff members') mental health might be an important measure to address this pressing issue. METHODS We conducted a systematic review according to the PRISMA statement (Liberati et al. 2009) and systematically searched the following databases: PubMed (PMC), Web of Science, PsycINFO (EBSCOhost), EconLit (EBSCOhost), and Business Source Premier (EBSCOhost). In addition, we performed a hand search of the reference lists of relevant articles. We included studies investigating leadership interventions in the health care sector that aimed to maintain/foster employees' mental health. RESULTS The systematic search produced 11,221 initial search hits in relevant databases. After the screening process and additional literature search, seven studies were deemed eligible according to the inclusion criteria. All studies showed at least a moderate global validity and four of the included studies showed statistically significant improvements of mental health as a result of the leadership interventions. CONCLUSIONS Based on the findings, leadership interventions with reflective and interactive parts in group settings at several seminar days seem to be the most promising strategy to address mental health in health care employees. As the available evidence is limited, efforts to design and scientifically evaluate such interventions should be extended.
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Affiliation(s)
- Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Monika A Rieger
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tuebingen, Tuebingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Sascha Ruhle
- Department of Business Administration, in particular, Work Human Resource Management and Organization Studies, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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13
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Vonderlin R, Schmidt B, Müller G, Biermann M, Kleindienst N, Bohus M, Lyssenko L. Health-Oriented Leadership and Mental Health From Supervisor and Employee Perspectives: A Multilevel and Multisource Approach. Front Psychol 2021; 11:614803. [PMID: 33536980 PMCID: PMC7848224 DOI: 10.3389/fpsyg.2020.614803] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/24/2020] [Indexed: 11/13/2022] Open
Abstract
The link between leadership and mental health at the workplace is well established by prior research. However, most of the studies have addressed this relationship from a single-source perspective. The aim of this study was to examine how supervisor and employee ratings of health-oriented leadership correspond to each other and which sources are predictive for employee mental health. We assessed data within 99 teams (headed by 99 supervisors) containing 713 employees in 11 different companies in Southern Germany. Supervisors and their staff completed questionnaires on the supervisors' health-oriented staff-care dimensions awareness, value of health and health behavior (Health-Oriented Leadership Scale, HoL) and current mental distress (Hospital Anxiety and Depression Scale, HADS). Hierarchical linear models revealed that supervisors' self-ratings were significantly related to their employees' ratings (at the team level) only on the health behavior dimension, but not on the health awareness and value of health dimensions. Also, supervisors rated themselves significantly higher on HoL compared to their employees. Employee ratings of HoL significantly predicted their own level of mental distress (direct within-level effect), whereas supervisor ratings of HoL did not predict employees' mental distress at the team level (direct cross-level effect). Supervisors' self-ratings of HoL did not influence the relationship between employee ratings of HoL and their mental distress on an individual level (cross-level interaction). These results highlight the complex relationship between multisource assessments of HoL and employee mental health, emphasizing the importance of subjective perception for mental health. Future studies should investigate under which conditions supervisor and employee ratings correspond to each other and are predictive for mental health at the workplace.
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Affiliation(s)
- Ruben Vonderlin
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Burkhard Schmidt
- University of Applied Sciences Fresenius Heidelberg, Heidelberg, Germany
| | - Gerhard Müller
- Department of Health Promotion/Occupational Health Management, AOK Baden-Wuerttemberg, Stuttgart, Germany
| | - Miriam Biermann
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Nikolaus Kleindienst
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Martin Bohus
- Institute for Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.,McLean Hospital, Harvard Medical School, Boston, MA, United States
| | - Lisa Lyssenko
- Department of Public Health and Health Education, University of Education, Freiburg, Germany
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14
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Worringer B, Genrich M, Müller A, Junne F, Angerer P. How Do Hospital Medical and Nursing Managers Perceive Work-Related Strain on Their Employees? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4660. [PMID: 32605266 PMCID: PMC7369983 DOI: 10.3390/ijerph17134660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/15/2020] [Accepted: 06/19/2020] [Indexed: 11/30/2022]
Abstract
Health-oriented supportive leadership behavior is a key factor in reducing work stress and promoting health. Employees in the health sector are subject to a heavy workload, and it has been shown that 40% of them show permanent health problems. A supportive leadership behavior requires the manager's awareness of the employees' well-being. However, little is yet known about how medical and nursing managers perceive the well-being of their staff. To explore this issue, we conducted a total of 37 semi-standardized interviews with 37 chief physicians (CPs), senior physicians (SPs), and senior nurses (SNs) in one German hospital. The interviews were content-analyzed based on the definitions of strain of the 'Federal Institute for Occupational Safety and Health'. Results show that hospital managers are aware of fatigue and further consequences such as deterioration of the team atmosphere, work ethics, treatment quality, and an increased feeling of injustice among employees. Most managers reported sick leaves as a result of psychosomatic complaints due to the permanent overstrain situation at work in the hospital. Results of this qualitative study are discussed in the light of health-oriented management relating to relevant stress models and to findings concerning staff shortages.
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Affiliation(s)
- Britta Worringer
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Düsseldorf University, 40225 Düsseldorf, Germany;
| | - Melanie Genrich
- Institute of Psychology, Work & Organizational Psychology, University of Duisburg-Essen, 45141 Essen, Germany; (M.G.); (A.M.)
| | - Andreas Müller
- Institute of Psychology, Work & Organizational Psychology, University of Duisburg-Essen, 45141 Essen, Germany; (M.G.); (A.M.)
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72016 Tübingen, Germany;
| | | | - Peter Angerer
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Düsseldorf University, 40225 Düsseldorf, Germany;
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15
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First-Line Managers' Experiences of Working with a Structured Support Model for Systematic Work Environment Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113884. [PMID: 32486310 PMCID: PMC7312806 DOI: 10.3390/ijerph17113884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 11/23/2022]
Abstract
Background: This paper describes the experiences of first-line managers when working with a structured support model for systematic work environment management in their work groups. First-line managers play a key part in influencing the work environment. Methods: In this study, a sample of managers implementing a structured support model, the Stamina model, in Swedish municipalities were interviewed. A total of 31 (n = 31) interviews were conducted at two time points during a one-year period. The collected data were analysed using a qualitative thematic approach. Results: The results showed that managers experienced discomfort when giving the responsibility of working with work environmental issues to employees. However, managers also experienced and were impressed by how well it worked in allowing employees to take on work environmental issues. Managers found that they balanced between being quiescent and, at the same time, actively monitoring progress in the work groups. Conclusions: The results from this study implicate that managers need to be sensitive to the needs and capacity of their work groups. The oracle in Delphi stated know yourself. We conclude: Know your group!
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Fløvik L, Knardahl S, Christensen JO. The Effect of Organizational Changes on the Psychosocial Work Environment: Changes in Psychological and Social Working Conditions Following Organizational Changes. Front Psychol 2019; 10:2845. [PMID: 31920874 PMCID: PMC6932979 DOI: 10.3389/fpsyg.2019.02845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 12/02/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose: The present study aimed to clarify the prospective effects of various types and frequencies of organizational changes on aspects in the psychosocial work environment. Methods: The study had a prospective, full-panel, repeated measures design. Data were collected by self-administered, online questionnaires, with a 2-year interval between measurement occasions. Five types of organizational change were assessed - company restructuring, downsizing, layoffs, partial closure, and partial outsourcing. The effects of change on eleven, specific work factors were measured utilizing QPS Nordic. At baseline, 12652 employees participated, while 8965 responded at follow-up. Generalized estimating equations were utilized to estimate the effects of change taking place within the last 12 months or more than 24 months prior. Results: Cross-sectional analyses, i.e., changes occurring within the last 12 months, showed all 11 work factors to be statistically significantly associated with the organizational changes restructuring, downsizing, and partial closure (coefficients ranging -0.28 to 0.04). In the prospective analyses, i.e., the effects of change taking place more than 24 months prior, associations were no longer significant for a number of work factors, although all types of organizational change remained significantly associated with at least three work factors (coefficients ranging -0.14 to 0.05). Following repeated organizational changes, statistically significant associations were shown for all 11 work factors (coefficients ranging from 0.39 to -0.04). Conclusion: Following both separate and repeated organizational change, various psychological and social work factors were altered, with the most pronounced effects following repeated change. These results suggest the implementing organizational change, especially repeated change, may have an adverse effect on various parts of the psychosocial work environment. The negative effects of a company's psychosocial working conditions may contribute to the adverse health effects often observed following such changes and help explain why many change initiatives fail to reach its intended results.
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Affiliation(s)
- Lise Fløvik
- Department of Work Psychology and Physiology, National Institute of Occupational Health (STAMI), Oslo, Norway
| | | | - Jan Olav Christensen
- Department of Work Psychology and Physiology, National Institute of Occupational Health (STAMI), Oslo, Norway
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17
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Scharf J, Vu-Eickmann P, Li J, Müller A, Angerer P, Loerbroks A. Work-Related Intervention Needs and Potential Occupational Outcomes among Medical Assistants: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132260. [PMID: 31248036 PMCID: PMC6651363 DOI: 10.3390/ijerph16132260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 11/16/2022]
Abstract
Medical assistants' (MAs) working conditions have been characterized as precarious, and workplace-related intervention needs have been identified. However, strategies to change the MAs adverse working conditions are mostly seen on an individual level, including leaving the employer or even the profession. Since such intentions are antecedents of actual turnover, we aimed to quantify the potential link of reported unmet intervention needs with unfavorable occupational outcomes. Data were collected by means of a nationwide survey among medical assistants (n = 994) in Germany (September 2016-April 2017). The three subscales working conditions, reward from the supervisor, and task-related independence were derived from a 12-item instrument regarding work-related interventions needs (the independent variables). We used subscale-specific z-scores and a total needs z-score. The four outcome variables (i.e., intention to leave the employer, intention to leave the MA profession, choosing MA profession again, and recommending MA profession to young people) were dichotomized, and logistic regression analyses were performed and limited to MAs in employment (n = 887). We found that increasing needs according to the categorized total needs score were associated with increasing odds of all occupational outcomes. Needs pertaining to working conditions and reward from the supervisor were the strongest determinants of MAs' consideration of leaving their employer or profession (Odds ratios: 1.55-2.61). In summary, our study identified unmet work-related intervention needs that are associated with unfavorable occupational outcomes. In light of staffing shortage in health care, the identified needs should be addressed to ensure that sufficient recruitment of junior staff in the profession of medical assistants remains feasible and that experienced staff is retained.
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Affiliation(s)
- Jessica Scharf
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Patricia Vu-Eickmann
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
- Department of Environmental Health Sciences, Fielding School of Public Health; School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141 Essen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany.
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18
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Scharf J, Vu-Eickmann P, Li J, Müller A, Wilm S, Angerer P, Loerbroks A. Desired improvements of working conditions among medical assistants in Germany: a cross-sectional study. J Occup Med Toxicol 2019; 14:18. [PMID: 31168312 PMCID: PMC6545209 DOI: 10.1186/s12995-019-0237-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background In outpatient care in Germany, medical assistants (MAs) are the contact persons for patients' concerns and their working conditions are relevant to their own health and the provided quality of care. MAs working conditions have been described as precarious leading to high levels of work stress. Consequently, we aimed to examine MAs' needs for work-related improvements. Methods We surveyed 887 employed MAs between September 2016 and April 2017. A 20-item questionnaire measured desired improvements. To measure correlations between variables we computed a matrix of tetrachoric correlations for binary variables and performed an exploratory factor analysis. We ran ordinal logistic regression models employing 11 independent variables to examine determinants of needs. Results A total of 97.3% of the participants expressed any need and, on average, 10.27 needs were reported. Most frequently, needs were expressed related to a higher salary (87.0%), less documentation (76.0%) and more recognition from society (75.4%). Exploratory factor analysis suggested three dimensions of needs for work-related improvements (i.e. working conditions, reward from the supervisor and task-related independence). Ordinal logistic regression models only identified determinants for the outcome variable task-related independence, which was more frequent in those with longer work experience or in a leadership position. Conclusions The high prevalence of desired workplace-related improvements among MAs highlights the relevance of modifying their working conditions. The fact that we found only few determinants signals that there are no specific high-risk subgroups, but interventions to improve MAs' working conditions should target the entire MA population.
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Affiliation(s)
- Jessica Scharf
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Patricia Vu-Eickmann
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Jian Li
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany.,2Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, USA
| | - Andreas Müller
- 3Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45, ,141 Essen, Germany
| | - Stefan Wilm
- 4Institute of General Practice, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Werdener Str. 4, 40227 Düsseldorf, Germany
| | - Peter Angerer
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- 1Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
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19
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Stuber F, Seifried-Dübon T, Rieger MA, Zipfel S, Gündel H, Junne F. Investigating the Role of Stress-Preventive Leadership in the Workplace Hospital: The Cross-Sectional Determination of Relational Quality by Transformational Leadership. Front Psychiatry 2019; 10:622. [PMID: 31551829 PMCID: PMC6735266 DOI: 10.3389/fpsyt.2019.00622] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/05/2019] [Indexed: 01/17/2023] Open
Abstract
Introduction: A good relationship quality between leaders and staff members promotes mental health and prevents stress. To improve the relationship quality, it is important to identify variables which determine relationship quality at the workplace. Therefore, this study aims to identify specific leadership characteristics which support the development of a positive relationship between hospital leaders and staff members. Methods: A cross-sectional study design was applied. A total number of 1,137 leaders (n = 315) and staff members (n = 822) of different professions (physicians, nursing staff, therapeutic professionals, administration staff, IT staff, clinical services, office assistants, scientists, others) working at a tertiary hospital in Germany assessed transformational leadership style as a staff-oriented leadership style and leader-member relationship quality by self-report questionnaires [integrative leadership questionnaire (FIF), leader-member exchange (LMX-7) questionnaire]. The data were statistically analyzed by mean comparisons and a multiple linear regression analysis. Results: Leaders rated their own transformational leadership style (M = 3.98, SD = 0.43) systematically higher than staff members assessed their leader (M = 2.86, SD = 1.04). Evaluation of relationship quality showed similar results: leaders evaluated their relationship quality to one exemplary staff member higher (M = 4.06, SD = 0.41) than staff members rated their relationship quality to their direct leader (M = 3.15, SD = 0.97). From the staff members' perspective, four sub-dimensions of transformational leadership, that is, "individuality focus," "being a role model," "fostering innovations," and "providing a vision" showed large effect sizes in the regression analysis of relationship quality (R 2 = 0.79, F (14,690) = 189.26, p < 0.001, f = 1.94). Discussion: The results of our study are in line with previous investigations in other working contexts and point to a profession-independent association as the professional group of participants did not contribute to the variance explanation of the regression analysis. The exploration of potential determinants of relationship quality at work can, for example, support the development of leadership training programs with a focus on transformational leadership style. This might be an opportunity to foster high relationship quality between leaders and staff members and consequently might represent one strategy to prevent stress in the health care sector.
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Affiliation(s)
- Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Tübingen, Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Tübingen, Germany
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