Job demands, emotional dissonance and elderly abuse: The moderating role of organizational resources

Psychometric properties of the Perth emotional labour scale: Preliminary support for a new measure with theoretical implications

Emotional labour is the process by which people regulate emotions congruently with occupational requirements. Research consistently links emotional labour to greater levels of burnout. However, we argue this literature is potentially confounded by measurement error. We sought to validate an English adaptation of a recent emotional labour measure that addresses measurement error concerns in an under-researched sample at risk of burnout-psychologists providing psychotherapy. We termed this measure the Perth Emotional Labour Scale (PELS) which is based upon Andela and colleagues' (2015) original measure. Additionally, we explored what factors of emotional labour contributed most to burnout in this group. We recruited 418 psychologists (81.58% female, 17.46% male, 0.96% non-binary) across Australia (N = 362, 86.60%) and New Zealand (N = 56, 13.40%). Factor analyses and correlational analyses examined the PELS' reliability and validity. Hierarchical multiple regression analysis explored whether each component of emotional labour contributed unique variance to emotional exhaustion (EE). Preliminary support for the PELS' psychometric properties was found and emotional dissonance was found to be the only emotional labour factor that uniquely contributed to EE. We demonstrate preliminary psychometric support for the PELS but recommend further development and argue our findings have unique implications for research and practice.

"Just pee in the diaper" - a constructivist grounded theory study of moral distress enabling neglect in nursing homes

BACKGROUND

A growing body of evidence shows that many nursing home residents' basic care needs are neglected, and residents do not receive qualitatively good care. This neglect challenges nursing staff´s professional and personal ideals and standards for care and may contribute to moral distress. The aim of this study was to investigate how nursing staff manage being a part of a neglectful work culture, based on the research question: "How do nursing home staff manage their moral distress related to neglectful care practices?"

METHODS

A qualitative design was chosen, guided by Charmaz´s constructivist grounded theory. The study was based on 10 individual interviews and five focus group discussions (30 participants in total) with nursing home staff working in 17 different nursing homes in Norway.

RESULTS

Nursing staff strive to manage their moral distress related to neglectful care practices in different ways: by favouring efficiency and tolerating neglect they adapt to and accept these care practices. By disengaging emotionally and retreating physically from care they avoid confronting morally distressing situations. These approaches may temporarily mitigate the moral distress of nursing staff, whilst also creating a staff-centred and self-protecting work culture enabling neglect in nursing homes.

CONCLUSIONS

Our findings represent a shift from a resident-centred to a staff-centred work culture, whereby the nursing staff use self-protecting strategies to make their workday manageable and liveable. This strongly indicates a compromise in the quality of care that enables the continuation of neglectful care practices in Norwegian nursing homes. Finding ways of breaking a downward spiralling quality of care are thus a major concern following our findings.

Staff-to-resident abuse in nursing homes: a scoping review

BACKGROUND

Elder abuse in long-term care is an important public health concern with social, health-related, and economic implications. Staff-to-resident abuse is of particular interest since institutions should protect residents' rights and prevent harm. To provide an up-to date comprehensive overview of staff-to-resident abuse in nursing homes, we performed a scoping review considering types of abuse, their prevalence and associated factors, descriptions, experiences, and preventive interventions.

METHODS

We performed a scoping review following the framework provided by Arksey and O'Malley. We searched MEDLINE (via PubMed), CINAHL, PsycINFO via Ovid, and Cochrane Library. Additionally, we performed free web searching using Google Scholar and checked relevant reviews. Two reviewers independently selected studies. We narratively synthesised the results.

RESULTS

Out of 3876 references retrieved by our search, we included 46 studies in 47 reports. The prevalence rates of abuse varied widely, ranging from 0 to 93% depending on the type of abuse. Associated factors of abuse at the staff, resident, and nursing home level were evaluated inconsistently. Abuse was perceived ambiguous: even though it was considered unacceptable, it was underreported. We found only four studies addressing preventive interventions. Of these, four made recommendations for intervention development. Only one study with an experimental design examined a multi-component intervention including education and mutual support.

CONCLUSIONS

The review yielded heterogenous evidence not allowing a concrete conclusion on prevalence and associated factors. However, the results show the significance of the problem and indicate that there are associate factors of abuse that can be influenced by appropriate interventions. These are amongst other staff education, organisational culture, and conditions. Further research should investigate the composition and content of preventive interventions and their potential to reduce abusive behaviours.

Wishes and Needs of Nursing Home Residents: A Scoping Review

Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where person-centered care is implemented, residents report greater satisfaction and quality of life. This approach is based on the wishes and needs of the residents. Therefore, the purpose of this scoping review is to explore the wishes and needs of nursing home residents. A scoping review of the literature was conducted in which 12 databases were systematically searched for relevant articles according to PRISMA-ScR guidelines. Both quantitative and qualitative study designs were considered. A total of 51 articles met the inclusion criteria. Included articles were subjected to thematic analysis and synthesis to categorize findings into themes. The analysis identified 12 themes to which the wishes and needs were assigned: (1) Activities, leisure, and daily routine; (2) Autonomy, independence, choice, and control; (3) Death, dying, and end-of-life; (4) Economics; (5) Environment, structural conditions, meals, and food; (6) Health condition; (7) Medication, care, treatment, and hygiene; (8) Peer relationship, company, and social contact; (9) Privacy; (10) Psychological and emotional aspects, security, and safety; (11) Religion, spirituality; and (12) Sexuality. Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting.

Does context count? The association between quality of care and job characteristics in residential aged care and hospital settings: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Within residential aged care settings, reduced quality of care (QOC), abuse, and neglect have been global phenomena which require urgent intervention. As the reported rate of these problems is much higher in aged care compared to hospital settings, we investigated whether differing job design characteristics between the two settings might explain the difference.

RESEARCH DESIGN AND METHODS

We used a meta-analysis to compare differences in the relationships between high job demands, low job resources, and job strain with QOC and counter-productive work behaviors (CWBs) across aged care and hospital settings.

RESULTS

Data was extracted from 42 studies (n=55 effects). QOC was negatively correlated with high job demands (ρ̅ =-.22, 95% CI: -.29:-.15, k=7), low job resources (ρ̅ = -.40, 95% CI:-.47:-.32, k=15), and job strain (ρ̅ =-.32, 95% CI: -.38:.-.25, k=22), CWBs had a positive relationship with job demands (ρ̅ =.35, 95%CI: .10:.59, k=3) and job strain (ρ̅ =.34, 95% CI: .13:.56, k=6). The association between poor QOC and low job resources was stronger in aged care (r=-.46, 95% CI:-.55:-36, k=8) than in hospital settings (r= -.30, 95% CI:-.41:-.18, k=7).

DISCUSSION AND IMPLICATIONS

Our findings suggest that relationships between low job resources and poor quality of care are exacerbated in residential aged care contexts. To improve care outcomes, stakeholders should improve job resources such as skill discretion, supervisory supports, and increased training and staffing levels in residential aged care.

Emotional Dissonance in the Spanish Services Sector: The Role of Support in the Workplace

The purpose of this study was twofold. The first aim was to analyze the detrimental effect that emotional dissonance may have on service workers by testing its relationship with job satisfaction, intention to leave the organization, and organizational deviance. The second was to test whether two types of social support (i.e., co-worker and organizational support) and their combination moderate these relationships from a multilevel perspective. The sample was composed of 556 employees from Spanish service sector. Using random coefficient models analyses, results showed, first, that emotional dissonance was related to lower levels of job satisfaction (PE = -.1, p < .05) and higher levels of intention to leave the organization (PE = .12, p < .05); second, that co-worker support moderate the relationship between emotional dissonance and job satisfaction (PE = .10, p < .05), organizational deviance (PE = -.08, p < .05), and intention to leave the organization (PE = -.13, p < .05); third, organizational support, conceptualized as a collective construct at organizational level, moderate the relationship between emotional dissonance and organizational deviance (PE = -.08, p < .05); and finally, the combination of both types of support do not explained additional variance of the emotional dissonance-outcomes relation. These results underline the need to take into consideration different source of social support and their levels of analysis to better understand emotional dissonance and its outcomes.

The effects of job demands on nurses' burnout and presenteeism through sleep quality and relaxation

AIMS AND OBJECTIVES

The main aim of this study was to investigate the indirect effects of emotional dissonance and workload on presenteeism and emotional exhaustion through sleep quality and relaxation.

BACKGROUND

Numerous investigations have found that job demands are related to employees' health and behaviours, but additional studies are needed among nurse samples. Specifically, little is known about the relationships between nurses' emotional dissonance and workload on one hand, and presenteeism and emotional exhaustion on the other hand. Moreover, research is needed to further explore the psychological mechanisms underlying these relationships.

DESIGN

We used a cross-sectional design. Our study was carried out between October 2015-February 2016. Precisely, we asked nurses from various French healthcare centres to fill out a questionnaire survey. We ensured to meticulously follow the STROBE guidelines for cross-sectional research in designing and reporting this study.

METHOD

An empirical study with a sample of 378 nurses was conducted.

RESULTS

In line with our hypotheses, our findings revealed that emotional dissonance and workload were negatively linked to sleep quality and relaxation, which were, in turn, related to lower levels of presenteeism and emotional exhaustion. Workload and emotional dissonance were also directly and positively related to emotional exhaustion, while emotional dissonance was associated with higher levels of presenteeism. Finally, the indirect effects of emotional dissonance and workload on emotional exhaustion through sleep quality as well as the indirect effects of emotional dissonance on emotional exhaustion through relaxation were significant and positive.

CONCLUSIONS

Overall, our results provide insight into the effects of emotional dissonance and workload on presenteeism and emotional exhaustion through recovery processes.

RELEVANCE TO CLINICAL PRACTICE

The present findings have some practical implications for reducing nurses' emotional exhaustion and presenteeism. Specifically, managers and organisations should try to design and craft jobs to decrease the presence of negative work characteristics (i.e., workload and emotional dissonance). Our results also suggest that recovery processes may be important factors to focus on.