The “Working conditions and control questionnaire” (WOCCQ): Towards a structural model of subjective stress

An Integrated Approach to Workplace Mental Health: A Scoping Review of Instruments That Can Assist Organizations with Implementation

This study aimed to identify instruments that may assist organizations with implementing an integrated approach to workplace mental health using three activities from the knowledge to action (KTA) framework. A scoping review of published and grey literature, supported by stakeholder (business end-user and researcher) consultation, identified work-specific instruments that were relevant to at least one of the three domains of an integrated approach to workplace mental health: 'prevent harm', 'promote the positive', and 'respond to problems'. A total of 207 instruments were located, and 109 instruments met eligibility criteria. 10 instruments were located that were relevant to multiple domains, however most instruments (n = 72) were relevant to the 'prevent harm' domain. Instruments relevant to the 'promote the positive' (n = 14) and 'respond to problems' (n = 13) domains were limited. Most instruments found were suitable for the 'monitor, review and improve' KTA activity. Further development of instruments that can assist with 'promote the positive' and 'respond to problems' strategies are required, specifically those instruments that can assist organizations with the 'identify gaps and opportunities' and 'identify priorities and design new/enhanced interventions' KTA activities.

How things changed during the COVID-19 pandemic's first year: A longitudinal, mixed-methods study of organisational resilience processes among healthcare workers

COVID-19 had a huge impact on healthcare systems globally. Institutions, care teams and individuals made considerable efforts to adapt their practices. The present longitudinal, mixed-methods study examined a large sample of healthcare institution employees in Switzerland. Organisational resilience processes were assessed by identifying problematic real-world situations and evaluating how they were managed during three phases of the pandemic's first year. Results highlighted differences between resilience processes across the different types of problematic situations encountered by healthcare workers. Four configurations of organisational resilience were identified depending on teams' performance and ability to adapt over time: "learning from mistakes", "effective development", "new standards" and "hindered resilience". Resilience trajectories differed depending on professional categories, hierarchical status and the problematic situation's perceived severity. Factors promoting or impairing organisational resilience are discussed. Findings highlighted the importance of individuals', teams' and institutions' meso- and micro-level adaptations and macro-level actors' structural actions.

Development and validation of an occupational health triage tool

BACKGROUND

As work and health are closely interlinked, it is important to carefully monitor employees. However, limited resources restrict in-depth follow-up.

AIMS

This study was aimed to develop a low-cost screening instrument for employees' overall health status, that can be used across industries and that allows triaging workers to in-depth health surveillance in case of indications of health or functioning problems.

METHODS

We developed a new questionnaire-based algorithm built on multiple predictors to assess the need for further follow-up. We used a systematic review, Delphi panel (n = 9) and focus group (n = 5) to determine the predictors, tested for language pitfalls in a pilot study and evaluated the questionnaire's validity in two separate studies. Study 1 (n = 60) analysed the discriminatory power of the instrument by comparing it to the assessment of an occupational physician in a sample of employees from diverse occupational settings. Study 2 (n = 869) appraised the factor structure and internal consistency of the screening tool in a sample of employees from the hospital sector.

RESULTS

Risk factors, current physical and mental health, functioning, absenteeism, job satisfaction and lifestyle were identified as the most relevant predictors. Study 1 showed the survey had good criterion validity (area under the curve = 0.72). Study 2 (N = 869, 28% response) demonstrated the internal consistency (Cronbach's α = 0.94), and a factor analysis confirmed a second-order factor structure with adequate model fit (comparative fit index = 0.96, root mean square error of approximation = 0.04 and standardized root mean square residual = 0.07).

CONCLUSIONS

This questionnaire can be used to triage workers for occupational health follow-up and can, additionally, be useful to describe the epidemiology of work-related illness.

Adapting to the unexpected: Problematic work situations and resilience strategies in healthcare institutions during the COVID-19 pandemic's first wave

The COVID-19 pandemic's first wave required considerable adaptation efforts on the part of healthcare workers. The literature on resilient healthcare describes how the collective regulation strategies implemented by frontline employees make essential contributions to institutions' abilities to cope with major crises. The present mixed-methodology study was thus conducted among a large sample of employees in a variety of Swiss healthcare institutions and focused on problematic real-world situations experienced by them and their managers during the pandemic's first wave. It highlighted the anticipatory and adaptive strategies implemented by institutions, teams and individuals. The most frequently cited problematic situations involved organisational changes, interpersonal conflicts and workloads. In addition to the numerous top-down measures implemented by institutions, respondents also identified personal or team regulation strategies such as increasing staff flexibility, prioritising tasks, interprofessional collaboration, peer support or creating new communication channels to families. The present findings underlined the importance of taking greater account of healthcare support staff and strengthening managerial capacity to support interprofessional teams including those support staff.

Which work-related characteristics are most strongly associated with common mental disorders? A cross-sectional study

OBJECTIVES

Studies exploring work-related risk factors of common mental disorders (CMDs), such as major depressive disorder (MDD), generalised anxiety disorder (GAD) or alcohol abuse, have generally focused on a limited set of work characteristics. For the first time in a primary care setting, we examine simultaneously multiple work-related risk factors in relation to CMDs.

METHOD

We use data from a study of working individuals recruited among 2027 patients of 121 general practitioners (GPs) representative of the Nord-Pas-de-Calais region in the North of France (April-August 2014). CMDs (MDD; GAD; alcohol abuse) were assessed using the Mini-International Neuropsychiatric Interview. Six worked-related factors were examined (work intensity, emotional demands, autonomy, social relations at work, conflict in values and job insecurity). Several covariates were considered (patient, GP and contextual characteristics). To study the association between workplace risk factors and CMDs, we used multilevel Poisson regression models adjusted for covariates.

RESULTS

Among study participants, 389 (19.1%) met criteria for MDD, 522 (25.8%) for GAD and 196 (9.7%) for alcohol abuse. In multivariable analyses adjusted for covariates, MDD/GAD was significantly associated with work intensity (RR 1.16, 95% CI 1.06 to 1.27) (absolute risk=52.8%), emotional demands (RR 1.24, 95% CI 1.13 to 1.35) (absolute risk=54.9%) and social relations at work (RR 0.78, 95% CI 0.70 to 0.87) (absolute risk=15.0%); alcohol abuse was associated with social relations at work (RR 1.25, 95% CI 1.01 to 1.53) (absolute risk=7.6%) and autonomy (OR 0.82, 95% CI 0.67 to 0.99) (absolute risk=8.9%).

CONCLUSIONS

Several workplace factors are associated with CMDs among working individuals seen by a GP. These findings confirm the role of organisational characteristics of work as a correlate of psychological difficulties above and beyond other sources of risk.

Work intensity in men and work-related emotional demands in women are associated with increased suicidality among persons attending primary care

BACKGROUND

A large proportion of persons died by suicide are employed at the time of death and work-related factors partly contribute to suicide risk. Our aim was to examine the association between multiple aspects of work organization and suicidal ideation in a study conducted in primary care.

METHODS

Data came from a study of 2027 working patients attending a GP representative of patients in the Nord Pas-de-Calais region in France (April-August 2014). Suicidality was assessed using the MINI (Mini International Neuropsychiatric Interview). Six emergent worked-related factors were explored (work intensity, emotional demands, autonomy, social relationships at work, conflict of values, insecurity of work). Several covariates were considered: patient's and GP's characteristics, and area-level data (material and social deprivation, psychiatrist and GPs' density, suicide attempts and suicide rates).

RESULTS

8.0% of participants reported suicidal ideation in the preceding month (7.5% of men and 8.6% of women, p = .03). In multivariate analyses adjusted for covariates, suicidality was significantly associated with work intensity (OR = 1.65; 95%CI [1.18-2.31]) in men and with work-related emotional demands (OR = 1.35; 95%CI [1.01-1.80]) in women. Area-level data were not associated.

LIMITATIONS

Our cross-sectional study cannot assess the direction of the relationships under study.

CONCLUSION

Our results emphasise a central role for GPs in suicide prevention among workers and highlight the importance of work-related factors with regard to suicidality in primary care.

Job Demands, Job Resources, Burnout, Work Engagement, and Their Relationships: An Analysis Across Sectors

OBJECTIVE

The aim of this study was to gain insight in the importance of job demands and resources and the validity of the Job Demands Resources Model across sectors.

METHODS

We used one-way analyses of variance to examine mean differences, and multi-group Structural Equation Modeling analyses to test the strength of the relationships among job demands, resources, burnout, and work engagement across the health care, industry, service, and public sector.

RESULTS

The four sectors differed in the experience of job demands, resources, burnout, and work engagement, but they did not vary in how (strongly) job demands and resources associated with burnout and work engagement.

CONCLUSION

More attention is needed to decrease burnout and increase work engagement, particularly in industry, service, and the public sector. The Job Demands-Resources model may be helpful in this regard, as it is valid across sectors.

Exposure to Workplace Bullying: The Role of Coping Strategies in Dealing with Work Stressors

Studies investigating both work- and individual-related antecedents of workplace bullying are scarce. In reply, this study investigated the interaction between workload, job insecurity, role conflict, and role ambiguity (i.e., work-related antecedents), and problem- and emotion-focused coping strategies (i.e., individual-related antecedents) in association with exposure to workplace bullying. Problem-focused coping strategies were hypothesised to decrease (i.e., buffer) the associations between workload, job insecurity, role conflict, and role ambiguity and exposure to bullying, while emotion-focused coping strategies were hypothesised to increase (i.e., amplify) these associations. Results for a heterogeneous sample (N = 3,105) did not provide evidence for problem-focused coping strategies as moderators. As expected, some emotion-focused coping strategies amplified the associations between work-related antecedents and bullying: employees using "focus on and venting of emotions" or "behavioural disengagement" in dealing with job insecurity, role conflict, or role ambiguity were more likely to be exposed to bullying. Similarly, "seeking social support for emotional reasons" and "mental disengagement" amplified the associations of role ambiguity and the associations of both role conflict and role ambiguity, respectively. To prevent bullying, organisations may train employees in tempering emotion-focused coping strategies, especially when experiencing job insecurity, role conflict, or role ambiguity.

Work–Home Interface and Well-Being

Abstract. Much effort has been expended in the past decade to examine the causal relationship between work–family conflict (WFC) and negative indicators of well-being. Comparatively little is known about the effects of work–family enrichment (WFE) on well-being. Even more importantly, very few studies have examined the concomitant effects of both WFC and WFE in terms of well-being. This study aims to fill these gaps by investigating the directionality of the causal relationships between WFC, WFE, and two well-being variables (i.e., job strain and job engagement). We examined these relationships using a two-wave cross-lagged panel design. Our sample was composed of 978 workers from a Belgian Federal Public Service. Reciprocal relationships were found between WFC–job strain, WFC–job engagement, and WFE–job engagement.

Systematic comparative content analysis of 17 psychosocial work environment questionnaires using a new taxonomy

BACKGROUND

Many questionnaires have been developed to measure how psychosocial characteristics are perceived in a work environment. But the content validity of these questionnaires has rarely been questioned due to the absence of a reference taxonomy for characteristics of work environments.

OBJECTIVES

To propose an exhaustive taxonomy of work environment characteristics involved in psychosocial risks and to apply this taxonomy to questionnaires on workplace psychosocial factors.

METHODS

The taxonomy was developed by categorizing factors present in the main theoretical models of the field. Questionnaire items most frequently cited in scientific literature were retained for classification.

RESULTS

The taxonomy was structured into four hierarchical levels and comprises 53 categories. The 17 questionnaires analyzed included 927 items: 59 from the "physical environment" category, 116 from the "social environment" category, 236 from the "work activity" category, 255 from the "activity management" category, and 174 from the "organizational context" category.

CONCLUSIONS

There are major content differences among analyzed questionnaires. This study offers a means for selecting a scale on the basis of content.

[Working conditions, stress and burnout of Belgian professionals in radiotherapy: Comparative analysis and emotional labor exploration]

PUPOSE

This national survey aims, on the one hand, to perform a comparative analysis of working conditions, job strain and burnout of Belgian nurses, physicists and radiation oncologists working in radiotherapy and, on the other hand, to explore the role of emotional labor in the development of stress and burnout.

METHODS

We used the Working Conditions and Control Questionnaire, the Positive and Negative Occupational States Inventory, the Maslach Burnout Inventory, the negative work-home interaction subscale of the Survey Work-Home Interaction Nijmegen (NEGWHI), Perceived Organizational Support Scale and Emotional Labor Scale. One open question asked about problematic job situations.

RESULTS

Ninety-eight nurses and physicists participated (33 % response rate), in addition to 66 radiation oncologists from a previous study. Although global scores of working conditions, job strain and burnout corresponded to normal scores, comparative analysis identified physicists as focus group concerning job strain and burnout. Moreover, nurses and physicists surface acting was a good predictor of job strain (β=0.22, P=0.01), emotional exhaustion (β=0.32, P<0.001) and depersonalization (β=0.43, P<0.001). Nevertheless, perceived organizational support was a moderator in this relation.

CONCLUSION

Radiotherapy employees were in the norms. The importance of organizational support was demonstrated to avoid potential health problems, for workers experiencing high levels of emotional demands.

Working conditions, job strain and work engagement among Belgian radiation oncologists

PURPOSE

This national survey has measured the working conditions, work engagement, job strain, burn out, and the negative work-home interaction among Belgian radiation oncologists with validated questionnaires. In fact, previous studies had in general shown an interest to burn out and its association with working conditions among oncology workers, but not focused on radiation oncologists in particular. Moreover, few studies concerned work engagement and its association with working conditions although this could be important in preventing burn out.

METHODS

We used the WOrking Conditions and Control Questionnaire, the Positive and Negative Occupational States Inventory, the Maslach Burn out Inventory, and the negative work-home interaction subscale of the Survey Work-home Interaction Nijmegen. One open question asked about problematic job situations.

RESULTS

Sixty-six radiation oncologists participated (30% response rate). Median scores of most of working conditions corresponded to normal scores. Control over time management (45.8) was close to low score, while control over future (60.9) was high. Median score of job strain (48.9) was normal, whereas median score of work engagement (60) was high. Median score of burn out was low. The mean of negative work-home interactions (1.1) was higher than the mean of 0.84 in a reference sample (t=4.3; P<0.001). The most frequent problematic situations referred to work organization (e.g. time pressure) and specific resources (e.g. chief support).

CONCLUSIONS

Radiation oncologists showed a very high level of work engagement and experienced several job resources. However, some resources (as supervisor support) were missing and needed to be developed. These results were discussed in the context of motivational process described in the Job Demands-Resources Model.