Using Bayesian networks to analyze occupational stress caused by work demands: preventing stress through social support

A Bayesian approach to reveal the role of psychological factors on turnover intention among nurses during the COVID-19 pandemic

BACKGROUND

Turnover intention is considered a significant challenge for healthcare and treatment organizations. The challenging conditions of treating COVID-19 patients and the physical and mental stress imposed on nurses during the pandemic may lead them to leave their jobs. The present study aimed to determine the role of psychological factors (general health, mental workload, work-family conflicts, and resilience) on turnover intention using a Bayesian approach during the COVID-19 pandemic.

METHODS

The present cross-sectional study was carried out during the winter of 2021 at three hospitals in Khuzestan Province, Iran. To collect data for this investigation, 300 nurses were chosen based on Cochran's formula and random sampling technique. Seven questionnaires, including General Health, Mental Workload, Work-Family Conflict, Resilience, Job Stress, Fear of COVID-19, and Turnover Intention Questionnaires. Bayesian Networks (BNs) were used to draw probabilistic and graphical models. A sensitivity analysis also was performed to study the effects of the variables. The GeNIe academic software, version 2.3, facilitated the examination of the Bayesian network.

RESULTS

The statistically significant associations occurred between the variables of fear of COVID-19 and job stress (0.313), job stress and turnover intention (0.302), and resilience and job stress (0.298), respectively. Job stress had the highest association with the fear of COVID-19 (0.313), and resilience had the greatest association with the work-family conflict (0.296). Also, the association between turnover intention and job stress (0.302) was higher than the association between this variable and resilience (0.219). At the low resilience and high job stress with the probability of 100%, the turnover intention variable increased by 20%, while at high resilience and low job stress with the probability of 100%, turnover intention was found to decrease by 32%.

CONCLUSION

In general, the results showed that four psychological factors affect job turnover intention. However, the greatest impact was related to job stress and resilience. These results can be used to manage job turnover intention in medical environments, especially in critical situations such as COVID-19.

The relationship between organizational dehumanization and work engagement: the mediating effect of nurses' work stress

BACKGROUND

Organizational dehumanization has detrimental consequences for nurses' wellbeing and leads to a stressful work environment. Moreover, it is very destructive to work engagement.

AIM

To examine the mediating role of nurses' work stress between organizational dehumanization and work engagement.

METHOD

A cross-sectional research design was conducted with 245 staff nurses over a one-month period. The researchers used structured equation modeling.

RESULTS

Work engagement and organizational dehumanization levels were both moderate. In addition, the degree of job stress among the nurses was moderate, too. The results of the structural equation modeling showed that the association between organizational dehumanization and job engagement is partially mediated by work stress.

CONCLUSIONS

For staff nurses to exhibit high levels of caring behaviors, this study emphasized the need to establish a work environment that employs tactics to improve workplace engagement and happiness. In addition to changing the organizational culture of nurses to eradicate organizational dehumanization and pressures related to the job.

Health Care Worker Burnout During the COVID-19 Pandemic in HIV Clinics in Guangxi, China: A Cross-sectional Analysis of Risk and Protective Factors

ABSTRACT

Dual epidemics of coronavirus disease 2019 (COVID-19) and HIV cause burnout among HIV health care workers. Guided by a socioecological framework, we investigated risk and protective factors of their burnout in Guangxi, China based on an online survey (N = 1,029) from April to May 2020. Descriptive and bivariate analyses and hierarchical regression were conducted. COVID-19-related stressors (B = 0.648 [0.482-0.816], p < .001), challenges while delivering HIV services (B = 0.236 [0.174-0.298], p < .001), and working in province/city-level institutes (B = 2.302, [0.828-3.776], p =.002) were risk factors. Protective factors were resilience (B = -0.596 [-0.687 to -0.504], p < .001), workplace social support (B = -0.410 [-0.717 to -0.044], p =.03), and institutional responsiveness to COVID-19 (B = -0.138 [-0.205 to -0.071], p < .001), respectively. Burnout-related interventions may benefit from promoting resilience, creating a supportive work environment, and strengthening institutional response to public health emergencies.

Job Stress and Cardiometabolic Lifestyle Modification Behaviors Among Workers in High-risk and Low-risk Workplaces

OBJECTIVE

There is scarce evidence revealing an association between job stress and cardiometabolic lifestyle modification behaviors among workers.

METHODS

A cross-sectional, correlation study was conducted among workers in high-risk and low-risk workplaces by work characteristics.

RESULTS

Workers in high-risk workplaces had significantly higher job stress levels than low-risk workplaces. Higher job stress was significantly associated with lower cardiometabolic lifestyle modification behaviors (β = -0.14, P = .001). This significant association was evident only for high-risk workplaces in total job stress (β = -0.16, P = .001), including job demand (β = -0.16, P = .005) and job insecurity (β = -0.11, P = .026).

CONCLUSIONS

Strategies for alleviating job stress should be prioritized to high-risk workplaces, and these efforts may concomitantly contribute to cardiometabolic risk reduction.

Freelancing on digital work platforms – roles of virtual community trust and work engagement on person–job fit

Purpose

The purpose of this paper is to investigate the impact of virtual community trust on work engagement and person–job fit in the context of digital work platforms. The emergence of the platform economy is changing the work environment fundamentally. It has enabled the appearance of alternative work arrangements, such as temporary organizing and the increase of independent contracting, also among highly specialized knowledge workers.

Design/methodology/approach

Data were collected with an online survey and used to test the relationships between virtual community trust, work engagement and person–job fit. Confirmatory factor analysis and structural equation modeling were used to test the goodness of a theoretical model.

Findings

Based on the data of 127 experts contracting on digital work platforms, virtual community trust positively affects both work engagement and person–job fit. In addition, the relationship between work engagement and person–job fit in the context of digital work platforms is significant and positive.

Practical implications

This study shows that trust among independent contractors working on digital platforms is important for work engagement and that platform providers can improve work performance through person–job fit by assisting in the creation of trust among members of their platforms.

Originality/value

The research literature on knowledge work in the changing context of work is scarce, and the role of trust in the context of digital work platforms needs clarification. This paper tests a theoretical model on the effects of trust among highly skilled experts working in the digital platform context as independent contractors and provides evidence for the importance of building trust among members of a virtual work community.

Directors' stress in day care centers: related factors and coping strategies

Purpose

This study aims to explore what causes stress to day care center directors and what their coping strategies are. In addition, the study examined the extent to which directors experience work-related stress and burnout, and the factors associated with their work-related stress, engagement and recovery from work.

Design/methodology/approach

A mixed method approach was used.

Findings

The results showed that the main sources of directors' stress were connected to leading oneself, leading others, managing change and lack of social support. Moreover, the main coping strategies with stress were leading oneself, social support and leading others. In addition, both pre- and in-service leadership training played a significant role in the experience of stress. The nature of factors causing stress and coping strategies with stress may imply that directors need further support in self-management and developing their internal competences.

Research limitations/implications

The present study has limitations that need to be considered when making generalizations. First, a small sample size limits the generalization of the findings. Second, the study relied solely on one source of information, i.e. directors' self-reports. Third, data were collected only at one time point at the end of the year when stress levels might have accumulated. Finally, the study has been done in the Finnish educational context where day care center directors' job description varies depending on municipality.

Practical implications

The findings provide important information about the causes of directors' work-related stress as well as their coping strategies and about factors that might be related to those.

Social implications

Because directors' stress impact on children’s development and well-being through teachers' well-being, it is crucial to pay attention on directors' well-being and provide more support for them.

Originality/value

The current study is among the few ones focusing on the stress of directors at early childhood education (ECE) settings.

Assessing the Relative Impact of Diverse Stressors among Public Safety Personnel

Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps < 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health; however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health.

Psychosocial and Ergonomic Conditions at Work: Influence on the Probability of a Workplace Accident

Today, the economic and social importance of occupational accidents is undeniable worldwide. Hence, research aimed at reducing this type of accident is considered a discipline of great interest for society in general. In this environment, working conditions play a fundamental role in the occurrence of accidents, and from their study, results can be obtained that provide information for decision-making that guarantee optimum conditions for the development of the employees' tasks. Organizing the conditions of work execution is also a task that constitutes an essential aspect for a firm's productivity, therefore, affecting their viability and results. In this work, a model is proposed for the study of different groups of working conditions and their influence on the probability of occupational accidents, in accordance with the data provided by the 7^th National Survey of Working Conditions (VII NSWC). The survey sampled 8892 workers active in all sectors of national production and is the last nation-wide survey administered in Spain. Bayesian networks (BNs) are used to generate a network that analyzes working conditions in all areas (27 variables have been included in addition to those corresponding to the sector and accident), and then, more specifically, the relationship that is established between ergonomic factors in the workplace, psychosocial factors of the worker, and the probability of an accident. The results are achieved through the network obtained by highlighting some of the proposed variables. The dependencies generated by the chosen variables are analyzed, and subsequently, the probability of accident for each of the productive sectors is determined. It is concluded that the ergonomic risks associated with physical strains in the workplace, together with the lack of job satisfaction on the employer's behalf, both pose a very significant increase in the probability of being involved in an occupational accident, above the other variables of study.

Application of tabu search-based Bayesian networks in exploring related factors of liver cirrhosis complicated with hepatic encephalopathy and disease identification

This study aimed to explore the related factors and strengths of hepatic cirrhosis complicated with hepatic encephalopathy (HE) by multivariate logistic regression analysis and tabu search-based Bayesian networks (BNs), and to deduce the probability of HE in patients with cirrhosis under different conditions through BN reasoning. Multivariate logistic regression analysis indicated that electrolyte disorders, infections, poor spirits, hepatorenal syndrome, hepatic diabetes, prothrombin time, and total bilirubin are associated with HE. Inferences by BNs found that infection, electrolyte disorder and hepatorenal syndrome are closely related to HE. Those three variables are also related to each other, indicating that the occurrence of any of those three complications may induce the other two complications. When those three complications occur simultaneously, the probability of HE may reach 0.90 or more. The BN constructed by the tabu search algorithm can analyze not only how the correlative factors affect HE but also their interrelationships. Reasoning using BNs can describe how HE is induced on the basis of the order in which doctors acquire patient information, which is consistent with the sequential process of clinical diagnosis and treatment.

Multiple exposures to the risk of work absenteeism among Brazilian schoolteachers

The study aimed to identify multiple exposures to the risk of work absenteeism among Brazilian schoolteachers, independently of the reasons reported by teachers (n = 6,510). The data came from a telephone survey on health, working conditions, and absenteeism among schoolteachers in Brazil (Educatel Study, 2015/2016). Exposures were identified and studied by principal components analysis and Poisson regression, with a focus on working conditions and quality of school administration. Three components of risk factors for work absenteeism were identified. Component 1 featured lack of opportunities for new learning experiences, insufficient time for performing tasks, constraints on teachers' autonomy, and little or no social support in the school environment; component 2 was characterized by the perception of heavy demand from tasks and an agitated classroom environment due to students' lack of discipline and intense noise; and component 3 by the experience of verbal or physical violence from students. All three components were specially associaed with stress-related work absenteeism in relation to reported stress at school (aPR = 3.87; 95%CI: 2.93-5.10; p < 0.05/aPR = 3.18; 95%CI: 2.47-4.09; p < 0.05/aPR = 3.31; 95%CI: 2.58-4.25; p < 0.05; respectively) and emotional problems (aPR = 2.28; 95%CI: 1.93-2.70; p < 0.05/aPR = 2.43; 95%CI: 2.05-2.87; p < 0.05/aPR = 2.09; 95%CI: 1.78-2.45; p < 0.05; respectively). The identification of these risk components highlighted the need for systemic changes in Brazilian Basic Education schools.

Correction Workers' Burnout and Outcomes: A Bayesian Network Approach

The present study seeks to demonstrate how Bayesian Network analysis can be used to support Total Worker Health^® research on correction workers by (1) revealing the most probable scenario of how psychosocial and behavioral outcome variables in corrections work are interrelated and (2) identifying the key contributing factors of this interdependency relationship within the unique occupational context of corrections work. The data from 353 correction workers from a state department of corrections in the United States were utilized. A Bayesian Network analysis approach was used to probabilistically sort out potential interrelations among various psychosocial and behavioral variables. The identified model revealed that work-related exhaustion may serve as a primary driver of occupational stress and impaired workability, and also that exhaustion limits the ability of correction workers to get regular physical exercise, while their interrelations with depressed mood, a lack of work engagement, and poor work-family balance were also noted. The results suggest the importance of joint consideration of psychosocial and behavioral factors when investigating variables that may impact health and wellbeing of correction workers. Also, they supported the value of adopting the Total Worker Health^® framework, a holistic strategy to integrate prevention of work-related injury and illness and the facilitation of worker well-being, when considering integrated health protection and promotion interventions for workers in high-risk occupations.

Pressão laboral, saúde e condições de trabalho dos professores da Educação Básica no Brasil

Morbidades em geral e licenças médicas são prevalentes no grupo dos professores da Educação Básica, cuja missão é essencial para a formação dos cidadãos. O objetivo foi produzir informações sobre as características demográficas, características da escola e da rede de ensino, e situação de saúde do grupo que percebeu pressão laboral. A amostra probabilística foi calculada por seleção aleatória simples, de maneira a representar o universo de 2.229.269 professores da Educação Básica no Brasil. O questionário multitemático foi respondido ao telefone. A pergunta que deu origem à variável desfecho, “Você tem dificuldade para faltar ao trabalho mesmo quando está com dor ou outro problema de saúde?”, foi testada e validada. A resposta viabilizou operacionalizar empiricamente o conceito de pressão laboral. Utilizou-se o teste do qui-quadrado de Pearson e o método de árvore de decisão na análise multivariada. O ajuste do modelo final foi avaliado por meio da estimativa de risco de classificação incorreta. As subdivisões da árvore indicam o apoio social como o primeiro determinante da pressão laboral, 55% relataram que têm dificuldade para faltar ao trabalho, mesmo quando estão com dor ou qualquer outro problema de saúde, 70% do grupo que avaliou sua saúde como ruim e muito ruim se sentiram pressionados para comparecer ao trabalho quando doentes ou com dor. Os fatores associados foram: fraco apoio social, ambiente agitado em função da indisciplina dos alunos e problema de saúde considerado como doença ocupacional. Diante das metas de valorização dos professores da Educação Básica, diferenciais de gênero e estilos de gestão, além da infraestrutura nas escolas, devem ser considerados.

Attitudes toward evidence-based practices, occupational stress and work-related social support among health care providers in China: A SEM analysis

Individuals' attitudes toward evidence-based practices (EBP) are critical in adopting, implementing and maintaining the EBP in clinical settings. Multiple empirical studies have examined how work context may shape perceptions and attitudes towards EBP. The current study aims to further explore how both work and family contexts, as assessed by three psychosocial indicators (i.e., occupational stress, work-related social support from coworkers, and work-related social support from family), may affect attitudes toward EBP among health care providers in HIV clinics in China. We analyzed cross-sectional survey data from 357 health care providers recruited from 40 HIV clinics across 16 cities/counties in Guangxi China. Structural equation model (SEM) was constructed to test the hypothesized relationships among key study variables. Occupational stress was negatively associated with work-related social support from coworkers (β = -.19, 95%CI = [-.31,-.12]), which in turn was positively associated with attitudes toward EBP (β = .17, 95%CI = [.04, .30]). Similarly, occupational stress was negatively related to work-related social support from family (β = -.34, 95%CI = [-.42,-.25]), which in turn was positively related to attitudes toward EBP (β = .23, 95%CI = [.12, .35]). Occupational stress was negatively associated with attitudes toward EBP, but the magnitude of association did not reach statistical significance at α = .05. Work-related social support from family partially mediated the association between occupational stress and attitudes toward EBP (Sobel's z = 3.27, p < .05). Our findings suggest the importance of integrating work and family contexts, especially family support into the strategies of facilitating the adoption and implementation of EBP. The current study also underscores the needs to reduce occupational stress and enhance work-related social support among health care providers who are in frequent contact with HIV patients. In addition, lack of work-related family support may be a main barrier preventing health care providers from developing a positive attitude toward EBP. Therefore, the interventions aiming for promoting adoption and utilization of EBP need to involve specific strategies to resolve work-family conflicts and improve family members' understanding and support for health care providers in China, especially those who work in a stressful work context such as HIV care.

Prevalence of hyperlipidemia in Shanxi Province, China and application of Bayesian networks to analyse its related factors

This study aimed to obtain the prevalence of hyperlipidemia and its related factors in Shanxi Province, China using multivariate logistic regression analysis and tabu search-based Bayesian networks (BNs). A multi-stage stratified random sampling method was adopted to obtain samples among the general population aged 18 years or above. The prevalence of hyperlipidemia in Shanxi Province was 42.6%. Multivariate logistic regression analysis indicated that gender, age, region, occupation, vegetable intake level, physical activity, body mass index, central obesity, hypertension, and diabetes mellitus are associated with hyperlipidemia. BNs were used to find connections between those related factors and hyperlipidemia, which were established by a complex network structure. The results showed that BNs can not only be used to find out the correlative factors of hyperlipidemia but also to analyse how these factors affect hyperlipidemia and their interrelationships, which is consistent with practical theory, is superior to logistic regression and has better application prospects.

The Influence of Recognition and Social Support on European Health Professionals' Occupational Stress: A Demands-Control-Social Support-Recognition Bayesian Network Model

Healthcare professionals undergo high levels of occupational stress as a result of their working conditions. Thus, the aim of this study is to develop a model that focuses on healthcare professionals so as to analyze the influence that job demands, control, social support, and recognition have on the likelihood that a worker will experience stress. The data collected correspond to 2,211 healthcare workers from 35 countries, as reported in the sixth European Working Condition Survey (EWCS). The results obtained from this study allow us to infer stress under several working condition scenarios and to identify the more relevant variables in order to reduce this stress in healthcare professionals, which is of paramount importance to managing the stress of workers in this sector. The Bayesian network proposed indicates that emotional demands have a greater influence on raising the likelihood of stress due to workload than do family demands. The results show that the support of colleagues, in general, has less effect on reducing stress than social support from superiors. Furthermore, the sensitivity analysis shows that, in high-demand and low-control situations, recognition clearly impacts stress, drastically reducing it.

Constructing a Bayesian network model for improving safety behavior of employees at workplaces

INTRODUCTION

Unsafe behavior increases the risk of accident at workplaces and needs to be managed properly. The aim of the present study was to provide a model for managing and improving safety behavior of employees using the Bayesian networks approach.

METHODS

The study was conducted in several power plant construction projects in Iran. The data were collected using a questionnaire composed of nine factors, including management commitment, supporting environment, safety management system, employees' participation, safety knowledge, safety attitude, motivation, resource allocation, and work pressure. In order for measuring the score of each factor assigned by a responder, a measurement model was constructed for each of them. The Bayesian network was constructed using experts' opinions and Dempster-Shafer theory. Using belief updating, the best intervention strategies for improving safety behavior also were selected.

RESULTS

The result of the present study demonstrated that the majority of employees do not tend to consider safety rules, regulation, procedures and norms in their behavior at the workplace. Safety attitude, safety knowledge, and supporting environment were the best predictor of safety behavior. Moreover, it was determined that instantaneous improvement of supporting environment and employee participation is the best strategy to reach a high proportion of safety behavior at the workplace.

CONCLUSION

The lack of a comprehensive model that can be used for explaining safety behavior was one of the most problematic issues of the study. Furthermore, it can be concluded that belief updating is a unique feature of Bayesian networks that is very useful in comparing various intervention strategies and selecting the best one form them.

Effect of 5-HT2A Receptor Polymorphisms, Work Stressors, and Social Support on Job Strain among Petroleum Workers in Xinjiang, China

Previous studies have shown that work stressors and social support influence job strain. However, few studies have examined the impact of individual differences on job strain. In Xinjiang, there are a large number of petroleum workers in arid deserts. The present study investigated the effects of work stressors, social support, and 5-hydroxytryptamine receptor (5-HTR2A) genotype on the etiology of job strain among petroleum workers in Xinjiang. A cross-sectional study was carried out between January and August 2013. A total of 700 workers were selected by a three-stage stratified sampling method. 5-HTR2A genotypes were determined with the SNaPshot single nucleotide polymorphism assay. Work stressors and job strain were evaluated with the Occupational Stress Inventory-Revised questionnaire. Social support was assessed with the Chinese Social Support Rating Scale. Work overload and responsibility were significantly associated with job strain. Low social support was associated with severe vocational and interpersonal strain. High social support was a protective factor against job strain (odds ratio (OR) = 0.32, 95% confidence interval (CI): 0.14–0.76). The CC genotype of rs6313 and the AA genotype of rs2070040 were linked to severe vocational strain. Ordinal logistic regression analysis revealed that the CC genotype of rs6313 was linked to higher risk of job strain than the TT genotype (OR = 1.88, 95% CI: 1.10–3.23). These data provide evidence that work stressors, low social support, and 5-HTR2A gene polymorphism contributes to the risk of job strain.