Assessing the effect of a Cognitive Behaviour Therapy (CBT)-based workshop on work-related rumination, fatigue, and sleep

When experiencing nice interactions at work: Good sleep quality via well-being

Based on the Work-Home Resources Model and Conservation of Resources Theory, we develop dual mechanisms by which nice interactions (patients' compliments and coworkers' informational support) predict sleep quality. Specifically, we expect these nice interactions to help individuals conserve their personal energy in the form of less cognitive depletion (a cognitive process) and diminished physical fatigue (a physical process). Further, we propose employees utilise their energy resources to experience better sleep quality. To test the proposed model, we utilised an experience-sampling method by recruiting 223 female nurses working in a regional university hospital in South Korea. Specifically, we measured nice interactions and personal resources at 3 PM on Day t and sleep quality at 5-6 AM on Day t + 1, and we administered the questionnaire for 10 consecutive days. Overall, after removing 79 invalid observations (not completing questionnaire in a timely manner), we had a final total of two-wave 1997 daily observations from 223 nurses. Receiving more compliments from patients and more information from coworkers positively affects nurses' cognitive energy (less cognitive depletion) and physical energy (less physical fatigue), which predicts better sleep quality. Finally, results supported indirect effects of these nice interactions on sleep quality via cognitive and physical processes.

Does a program-based cognitive behavioral therapy affect insomnia and depression in menopausal women? A randomized controlled trial

BACKGROUND

Menopausal women often complain of a range of physical and psychological symptoms known as menopausal syndrome. These symptoms are associated with fluctuating hormone levels, sleep disturbances, and mood swings.

AIM

This study aimed to examine the efficacy of a program-based cognitive behavioral group therapy (CBT) for insomnia and depression among women experiencing menopause.

METHODS

A randomized controlled trial of 88 women experiencing menopause was conducted in Egypt from June to September 2022 in outpatient clinics at Mansoura University Hospitals in Egypt. Participants were randomly assigned to a control group (45 women) and an intervention group (43 women). The intervention group received 7 weeks of CBT sessions. Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory 2nd Edition (BDI-II) were administered before and after the intervention.

RESULTS

In the intervention group, there was a significant difference in scores of the subdomains of PSQI, including sleep efficiency, daytime dysfunction, subjective sleep quality, and sleep disturbance (t = 8.911, 11.77, 7.638, and 11.054, respectively), while no significant difference in domains of using sleep medication, sleep duration, and sleep latency. Significant improvements were observed between pre-and-post-intervention in the intervention group for the total scores of PSQI, ISI, and BDII-II (t = 12.711, 16.272, and 12.384, respectively), indicating a large effect size for the three studied variables (r = .81, .87, .8, respectively).

LINKING EVIDENCE TO ACTION

This study demonstrated the efficacy of group CBT for lowering insomnia and depression in women experiencing menopause. Thus, results indicated the need of considering prompt and appropriate interventions such as CBT as a safe treatment option to prevent the aggravation of sleep and emotional problems for menopausal women.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT05920460.

Nurses' perceived health and occupational burnout: A focus on sleep quality, workplace violence, and organizational culture

AIM

This study investigates the mediation of sleep quality between perceived health and occupational burnout in hospital nurses, considering the moderation of workplace violence and organizational culture.

BACKGROUND

Occupational factors lead to physical and mental distress, burnout, and sleep issues in nurses. Approximately two-thirds of nurses experience burnout, impacting patient care quality and safety. Cultivating a positive organizational culture is essential for nursing workforce stability.

METHODS

This cross-sectional study employed convenience sampling to recruit 346 nurses from a teaching hospital in southern Taiwan in July-August 2020 (response rate: 87.3%). Self-administered questionnaires containing validated instruments were employed, including an adapted occupational burnout scale, the Chinese version of an organizational culture scale, a Perceived Health Questionnaire, a Workplace Violence Experience Scale, and the CPSQI; all instruments were reliable and valid. The analysis involved descriptive statistics, linear regression, and the Johnson-Neyman technique.

RESULTS

Nurses with better perceived health exhibited significantly lower occupational burnout (p < 0.001). Perceived health indirectly impacted burnout through sleep quality (p < 0.01) with organizational culture as a partial moderator. Bureaucratic organizational culture exacerbated this relationship. Additionally, decreased workplace violence moderated the connections among perceived health, sleep quality, and occupational burnout among nurses.

CONCLUSIONS

Given the inverse correlation between nurses' perceived health and occupational burnout and considering factors such as workplace violence, organizational culture, and sleep quality, healthcare institutions can proactively take steps to enhance nurses' overall well-being and mitigate burnout.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

By implementing wellness programs, mental health support, security training, robust reporting, and a zero-tolerance approach to violence, healthcare stakeholders can foster a safe and supportive work environment for nurses, thus improving well-being, patient outcomes, and healthcare quality.

Positive Well-Being, Work-Related Rumination and Work Engagement among Chinese University Logistics Staff

Logistics personnel in Chinese universities are facing unbalanced costs and benefit from overloaded work with minimum wages, which impede school development and their well-being. However, the logistics staff population has been neglected in past investigations pertaining to psychological health conditions. The present study aimed to examine the positive well-being, work-related rumination, and work engagement of logistics staff, their correlations, and the factors affecting well-being in 282 Chinese university logistics staff via the Smith Well-being Questionnaire, the Work-Related Rumination Questionnaire, and the Utrecht Work Engagement Scale. The results indicated low levels of well-being and high levels of work-related rumination and work engagement among Chinese university logistics staff. The presence of positive attitudes towards life and work and high levels of work engagement predicts enhanced well-being, while the presence of negative characteristics and work-related rumination predicts decreased well-being. In situations where the working hours and work duties are challenging to change, universities can regularly schedule psychological counselling sessions for logistics staff to improve their well-being.

A thematic analysis of how men and women post 56 years unwind from work during their free time

BACKGROUND

Recent research indicates that as men age, their tendency to ruminate about work decreases, while ruminating remains high in women, which poses an increased risk for impaired health among older women.

OBJECTIVE

This study explored gender differences/similarities in the process of unwinding from work in men and women aged between 56-65 years.

METHODS

Semi-structured qualitative interviews were conducted online with eight men and eight women, recruited from a UK leading organization that provides health care solutions between May and June 2022. Participants were asked about their job role and responsibilities, their leisure time activities, how they unwind post work, and their experiences of thinking about work related thoughts outside of work. Transcripts were analyzed using an inductive analysis.

RESULTS

Three superordinate themes were identified that underpinned their ability to unwind: 'Work style', 'Creating work-life balance' and 'Switching off from one's responsibilities'. Women reported a more perfectionist approach, they set high standards for themselves, were worried about making mistakes, and demonstrated, if in a supervisory role, a more nurturing and holistic approach to their colleagues/subordinates, while men, were more focused on task completion. Most women, but not men, also described difficulties in psychologically switching off from work, and stated they could only truly relax outside the home, when they are away from household activities.

CONCLUSION

The study provides nuanced insights into the experiences of unwinding from work, and the findings suggest the need for person-centric approaches in developing interventions to help workers over 56 years to psychologically disengage from work.

Reducing Work Withdrawal Behaviors When Faced with Work Obstacles: A Three-Way Interaction Model

Work withdrawal behavior is a type of negative reaction when employees face obstacles at work. Its negative impact on individuals and organizations has caught the attention of academic circles and managers. In this study, data from 596 full-time employees were collected using two timepoint measurements one month apart. The internal mechanism of the link between obstructive stress and job withdrawal behavior was analyzed, and the combined effects of work control and cognitive flexibility on the negative effects of obstructive stress were analyzed in terms of the work demand-control-personal model. The results showed that negative work rumination played a complete mediating role between obstructive stress and work withdrawal behavior, and cognitive flexibility, obstructive stress, and work control had a significant three-way interaction. The results suggest that more attention should be paid to the role of employee cognition to avoid employees' withdrawal behavior in the face of work obstacles. In addition, when providing work resources to employees, the organization should also consider ensuring that work resources can be fully utilized to play a positive role in buffering work obstacles.

The role of perceived autonomy support and fear of failure: A weekly diary study on work-related rumination

Grounded in self-determination theory, the present study examined the weekly fluctuations in different forms of work-related rumination depending on perceived autonomy support and fear of failure at the workplace. Work-related rumination has three dimensions, affective rumination (negative emotions or affect), problem-solving pondering (thinking over the actions to handle the problems), and psychological detachment (mentally distancing oneself from work during nonwork time). In total, 111 employees (Mage = 34.88, SD = 10.43) from various occupations were followed over the course of three weeks via weekly measurements, resulting in 333 matched observations. Multilevel random coefficient modeling showed that on the weeks when employees reported higher levels of perceived autonomy support from the leader, they engaged in affective rumination and problem-solving pondering less. However, weekly fluctuations in psychological detachment from work was not associated with perceived autonomy support. Moreover, on the weeks when employees experienced high fear of failure, they reported less psychological detachment from work during nonwork time. Lastly, within-and and between-person fear of failure moderated the negative link between perceived autonomy support and affective rumination. Findings showed that perceived autonomy support is a protective factor for employees high in both state and trait fear of failure in decreasing affective rumination. Directions for future research and implication for practice were discussed.

"I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer

OBJECTIVE

This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer.

DATA SOURCES

The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method.

CONCLUSION

The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts.

IMPLICATIONS FOR NURSING PRACTICE

Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.

The effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality in pregnant women: a randomized controlled trial

Sleep disorder is very common during pregnancy. Non-pharmacological treatments are a priority to improve the sleep pattern. This study aimed to determine the effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality (primary outcome) and anxiety and quality of life (secondary outcomes). This randomized controlled trial was performed on 75 pregnant women in Tabriz, Iran. Participants were randomly assigned to the intervention and control groups. The first intervention group received 8 sessions of cognitive-behavioral counseling and aromatherapy with Citrus aurantium essential oil 15-20 min before bedtime. The second intervention group received cognitive-behavioral counseling and aromatherapy with placebo and the control group received only routine prenatal care. Pittsburgh Sleep Quality Index, Pregnancy-Specific Quality of life Questionnaire, and Pregnancy-Specific Anxiety Scale were completed before and after intervention. After the intervention based on ANCOVA test and by adjusting the baseline score, the mean score of anxiety in the intervention group 1 (AMD: - 4.54; 95% CI - 6.79 to - 2.28) and intervention group 2 (AMD: - 3.30; 95% CI - 5.60 to - 0.97) was significantly lower than the control group. Also, the mean score of quality of life in intervention group 1 (AMD: 2.55; 95% CI 0.45-4.65) and intervention group 2 (AMD: 2.72; 95% CI 0.60-4.83) was significantly higher than the control group, but there was no statistically significant difference between the study groups in terms of sleep quality (P > 0.05). Also, there was no statistically significant difference between the two intervention groups after the intervention in terms of anxiety (P = 0.379) and quality of life (P = 0.996). Cognitive-behavioral counseling reduced anxiety and improved quality of life. However, further trials are required to reach a definitive conclusion. Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N63. Date of registration: 4/10/2020. URL: https://en.irct.ir/user/trial/54986/view; Date of first registration: 18/10/2020.

Relationship between sleep disturbance and burnout among Chinese urban teachers: Moderating roles of resilience

BACKGROUND

Sleep disturbance and burnout are prevalent among primary and secondary school teachers. Nevertheless, little is known about the relationship between sleep disturbance and burnout, and the mechanisms connecting this link. Our study aimed to explore the relationship between sleep disturbance and burnout among urban teachers, as well as to investigate this influencing mechanism further with resilience as a moderator.

METHODS

14,218 primary and secondary school teachers provided valid data. We assessed demographic information, sleep disturbance, burnout, and resilience. Multivariable logistic regression, Spearman correlation, and moderation analyses were used to evaluate the relationship between sleep disturbance and burnout and the moderating role of resilience.

RESULTS

Of the participants, the prevalence of sleep disturbance and sleep deprivation among teachers was 20.0% and 31.7%, respectively. Additionally, 58.4% of teachers reported moderate or severe burnout, and 15.3% had both sleep disturbance and burnout. Sleep disturbance was significant and positively related to burnout. Resilience was found to moderate the association between sleep disturbance and burnout.

CONCLUSIONS

These findings suggested strong associations between sleep disturbance and burnout. Interventions in improving resilience may protect teachers with sleep disturbance from burnout.

Too stressed to de-stress? The experience of work stress and recovery among attorneys during the COVID-19 pandemic

It is well-established that legal professionals experience high stress and often high rates of associated health problems. Much less is known about attitudes and behaviours around stress prevention in this occupation. Our study examined views of stress and recovery among 131 U.S. attorneys. In open-ended data, attorneys commonly expressed that their job is very demanding, and it impacts their health. Many respondents felt it was important to manage their stress but had difficulty doing so. Quantitative analyses showed that attitudes about stress (stress-related comparisons, viewing stress as achievement, stress-related impression management, and stigma around stress concerns) demonstrated several significant relationships with perceived stress, recovery experiences, remorse for relaxation, and work-family conflict. Our findings suggest that practical interventions to support the health and well-being of legal professionals may need to target the workload norms, as well as attitudes and beliefs about the normalness of high stress and insufficient recovery.

Work Stress, Work-Related Rumination, and Depressive Symptoms in University Teachers: Buffering Effect of Self-Compassion

Purpose

The association between work stress and depressive symptoms has been well documented. More research is still needed to further investigate the underlying explanatory process mechanism and the potential protective function of personal resource in attenuating the negative effect of work stress on mental health. To address this gap and informed by the stress process model and emotion regulation theory,the present study examined the indirect role of work-related rumination and the buffering effect of self-compassion in university teachers, a population with increased vulnerabilities for both work stress and mental health issues.

Methods

This study collected data from 727 university teachers (M _age = 37.65 ± 7.77 years, 61.5% women) through an online survey. Indirect effect analysis and moderation effect analysis were implemented using structural equation modeling via Mplus.

Results

Work stress was directly and indirectly associated with depressive symptoms through work-related rumination, and self-compassion moderated the associations between (a) work stress and depressive symptoms and (b) work-related rumination and depressive symptoms. The direct and indirect effects of work stress on depressive symptoms were weaker in university teachers with high levels of self-compassion than in those with low levels of self-compassion.

Conclusion

Work stress was associated with depressive symptoms through a cognitive pathway. The findings deepen our understanding of the link between work stress and mental health outcomes by revealing the indirect role of cognitive processes, the protective function of emotion regulation strategies, and their interplay. Reducing work-related rumination and strengthening self-compassion may constitute effective interventions to alleviate the negative effects of work stress on mental health.

The Effect of Mental Health App Customization on Depressive Symptoms in College Students: Randomized Controlled Trial

BACKGROUND

Mental health apps have shown promise in improving mental health symptoms, including depressive symptoms. However, limited research has been aimed at understanding how specific app features and designs can optimize the therapeutic benefits and adherence to such mental health apps.

OBJECTIVE

The primary purpose of this study is to investigate the effect of avatar customization on depressive symptoms and adherence to use a novel cognitive behavioral therapy (CBT)-based mental health app. The secondary aim is to examine whether specific app features, including journaling, mood tracking, and reminders, affect the usability of the mental health app.

METHODS

College students were recruited from a university study recruitment pool website and via flyer advertisements throughout campus. A total of 94 participants completed a randomized controlled trial in which they were randomized to either customization or no customization version of the app. Customization involved personalizing a virtual avatar and a travel vehicle to one's own preferences and use of one's name throughout the app. Participants completed a 14-day trial using a novel CBT-based mental health app called AirHeart. Self-report scores for depressive symptoms, anxiety, and stress were measured at baseline and after the intervention. Postintervention survey measures also included usability and avatar identification questionnaires.

RESULTS

Of the 94 enrolled participants, 83 (88%) completed the intervention and postintervention assessments. AirHeart app use significantly reduced symptoms of depression (P=.006) from baseline to the end of the 2-week intervention period for all participants, regardless of the customization condition. However, no differences in depressive symptoms (P=.17) or adherence (P=.80) were observed between the customization (39/83, 47%) and no customization (44/83, 53%) conditions. The frequency of journaling, usefulness of mood tracking, and helpfulness of reminders were not associated with changes in depressive symptoms or adherence (P>.05). Exploratory analyses showed that there were 3 moderate positive correlations between avatar identification and depressive symptoms (identification: r=-0.312, P=.02; connection: r=-0.305, P=.02; and lack of relatability: r=0.338, P=.01).

CONCLUSIONS

These results indicate that CBT mental health apps, such as AirHeart, have the potential to reduce depressive symptoms over a short intervention period. The randomized controlled trial results demonstrated that customization of app features, such as avatars, does not further reduce depressive symptoms over and above the CBT modules and standard app features, including journal, reminders, and mood tracking. However, further research elucidating the relationship between virtual avatar identification and mental health systems is needed as society becomes increasingly more digitized. These findings have potential implications for improving the optimization of mental health app designs.

TRIAL REGISTRATION

Open Science Framework t28gm; https://osf.io/t28gm.

Review of the Internal Structure, Psychometric Properties, and Measurement Invariance of the Work-Related Rumination Scale - Spanish Version

Background: The aim of the current study was to examine the internal structure and assess the psychometric properties of the Work-Related Rumination Scale (WRRS) – Spanish version in a Puerto Rican sample of workers. This instrument is a 15-item questionnaire, which has three factors, affective rumination, problem-solving pondering, and detachment. This measure is used in the occupational health psychology context; however, there is little evidence of its psychometric properties.

Materials and Methods: A total sample of 4,100 from five different study samples was used in this cross-sectional study design in which the WRRS was used. We conducted confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) to examine the internal structure of the Work-Related Rumination Scale. Measurement invariance across sex and age was examined.

Results: The three-factor model was supported; however, four items were eliminated due to their cross-loadings and factorial complexity. This 11-item Spanish version of the WRRS was invariant across sex and age. Reliability of the three-factors of WRRS were within the range of 0.74 to 0.87 using Cronbach’s alpha and McDonald’s omega. Correlations between the three factors were as expected as well as with other established measures.

Conclusion: The results suggest that the WRRS-Spanish version appears to be a reliable and valid instrument to measure work-related rumination using its three factors. Comparison across sex and age appear to be useful in occupational health psychology research setting since results suggest that the WRRS is invariant regarding those variables.

A randomized controlled trial to improve psychological detachment from work and well-being among employees: a study protocol comparing online CBT-based and mindfulness interventions

BACKGROUND

The changing landscape of the work environment, which often encompasses expectations of employees being continuously available, makes it difficult to disengage from work and recover. This can have a negative impact on employees' well-being, resulting in burnout, depression and anxiety, among other difficulties. The current study will test the effectiveness of two different online interventions (i.e., cognitive behavioral therapy; CBT and mindfulness-based stress reduction; MBSR) on employees' psychological detachment, burnout and other variables related to general (e.g., life satisfaction) and work-specific (e.g., work engagement) well-being.

METHODS/DESIGN

The study is designed as a randomized control trial with two intervention groups (i.e., CBT, MBSR) and a waitlist control group. Participants will be full-time employees from a wide range of organizations from Slovenia, who report moderate difficulties with psychological detachment from work and burnout and are not receiving any other form of treatment. The online interventions will encompass 12 sessions over 6 weeks (2 sessions per week); each session will include 1) an active audio-guided session and 2) home assignments, accompanied by handouts and worksheets. The study outcomes (i.e., psychological detachment, burnout, general and work-specific well-being), potential mechanisms (i.e., work-related maladaptive thinking patterns, mindfulness) and moderators (e.g., supervisor support for recovery) will be assessed immediately before and after the interventions (pre and post measurement) and 3 months after intervention completion (follow-up). Additionally, participants will fill out questionnaires for the assessment of the central mechanisms and study outcomes each week.

DISCUSSION

We expect that the CBT-based intervention will lead to greater improvements in psychological detachment from work and burnout compared to the MBSR and the waitlist control group. Additionally, we expect that the CBT-based intervention will also lead to greater enhancement of both general and work-related well-being.

TRIAL REGISTRATION

https://doi.org/10.1186/ISRCTN98347361 [May 19, 2020].

Positive and negative work reflection, engagement and exhaustion in dual-earner couples: Exploring living with children and work-linkage as moderators

Many employees think about their work during off-job time. Scholars have suggested that whether work-related thoughts during off-job time have detrimental or beneficial effects on employees’ well-being and performance depends on the nature of these thoughts. In this study with dual-earner couples we examined whether employees’ positive and negative work reflection during off-job time are associated with their own and with their partners’ work engagement and exhaustion. Furthermore, we investigated whether (a) living with children and (b) being work-linked (i.e. working in the same organisation and/or working in the same profession) moderated these relations. Both partners of 130 German heterosexual dual-earner couples responded to online questionnaires. We estimated multilevel analyses using the actor–partner interdependence model to analyse our dyadic data. We found positive associations between employees’ positive work reflection and both their own and their partners’ work engagement. Employees’ positive work reflection was also associated with their decreased exhaustion. Employees’ negative work reflection was negatively associated with their own work engagement and positively associated with their own exhaustion but unrelated to their partners’ outcomes. Moderator analyses revealed that living with children weakened the link between employees’ positive work reflection and their own work engagement and strengthened the link between their negative work reflection and exhaustion. The presence of couples’ work-linkage did not moderate any of these relations. This study builds on previous research by showing that employees’ positive work-related thinking is not only beneficial to themselves but also to their partners. Furthermore, the results suggest that living with children constitutes an additional demand that reduces the motivational effects of positive work reflection and amplifies the detrimental effects of employees’ negative work reflection.

The Moderating Role of Work-Related Rumination in Nurses’ Sleep Quality Trajectory During Morning Shift Work

Abstract. This diary study investigated nurses’ recovery after transitioning to morning shift work (i.e., their short-term adaptation to shift work) by examining the change trajectory of sleep quality over the course of five consecutive morning shifts. Results of latent growth analyses ( N = 132) showed that nurses’ sleep quality started at low levels and increased rapidly in the beginning until it stabilized toward the end of the shift work period. Moreover, work-related rumination moderated the sleep quality trajectory. When rumination was low, nurses’ sleep quality showed a quadratic trajectory, whereas when rumination was high, sleep quality showed a flatter and linear trajectory, suggesting that rumination impedes recovery after the transition and adaptation to morning shift work.

The Association Between Work-Related Rumination and Executive Function Using the Behavior Rating Inventory of Executive Function

Work-related rumination has been associated with a number of health complaints, however, little is known about the underlying factors associated with rumination. Previous work using proxy measures of executive function showed work-related rumination to be negatively associated with executive function. In this paper, we report two studies that examined the association between work-related rumination and executive function utilizing an ecological valid measure of executive function: the Behavior Rating Inventory of Executive Function (BRIEF-A, Roth et al., 2005). In study 1 (N = 63), high, relative to low work-related ruminators, were found to demonstrate lower executive function skills, in eight of the nine subscales of the BRIEF. The aim of study 2 (N = 237) was to identify, the key executive function subscale/s associated with work-related rumination. Controlling for known factors associated with work-related rumination (fatigue and sleep), regression analysis identified the behavioral regulation subscale “shift” as the key predictor within the model. Shift relates to our ability to switch attention, to think about different solutions, and dealing with and accepting change. It was concluded that these findings lend support for future research to develop interventions for enhancing shift ability, as an aid to reduce work-related ruminative thinking.

Effects of a 6-Week Internet-Based Stress Management Program on Perceived Stress, Subjective Coping Skills, and Sleep Quality

Occupational stress management intervention programs are known to be effective in preventing stress-related health burden. Two essential mechanisms underlie this effect: (i) a reduction in perceived stress (e.g., via relaxation-oriented techniques), and (ii) an improvement in coping skills (e.g., via cognitive-behavioral interventions). While relaxation-oriented interventions are more frequently employed in occupational settings, cognitive-behavioral stress management interventions reveal stronger effects on stress-related outcomes. As an effective and economic strategy, the dissemination of stress management programs via the internet is soaring, but most internet-based programs focus on relaxation or reducing perceived stress. In the present study, we examined the effects of a self-guided, cognitive-behavioral 6-week Internet-Based Stress Management (IBSM) program on perceived stress, coping skills, emotional exhaustion, depressive symptoms, and sleep quality. The IBSM consists of six modules focusing on the improvement of stress management skills such as dealing with acute stress, building up resources, or reappraising stress-facilitating cognitions. The participants have to work through the content on a weekly basis, requiring about 30 min per week followed by a transfer task lasting another 30 min. Healthy employees reporting elevated stress were recruited over the Internet and then randomly assigned to the IBSM group or a waiting list control group. A total of 134 participants completed all assessments before and after the training or waiting period. The IBSM group reported lower subjective stress levels after the program than the control group. In addition, the IBSM group exhibited improved coping skills and better sleep quality. Emotional exhaustion was reduced in both groups, while depressive symptoms did not change. These results suggest that a brief, 6-week, cognitive-behavioral internet-based stress management program improves coping skills, sleep quality, and well-being, and reduces the perceived stress of employees. Our results might encourage large-scale studies on the long-term stability and clinical efficacy of internet-based programs. The trial is registered in the German Clinical Trials Register (DRKS00014837) URL. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014837.

Work and sleep quality in railway employees: an actigraphy study

This actigraphy study tests whether daily work stressors (time pressure, social stressors), work resources (control, social support) and mental detachment from work predict sleep quality, when controlling for demands and control after work. Fifty-two railway employees participated during five consecutive workdays by completing diary questionnaires and wearing an actigraphy device. The results confirmed that social stressors from supervisors predicted more frequent sleep fragmentation and lower sleep efficiency the following night. Higher levels of daily time control at work predicted shorter sleep-onset latency and better self-reported sleep quality. Leisure time control as a covariate turned out to be a private resource, followed by fewer awakenings the following night. Detachment after work related negatively to social stressors and time pressure at work but was unrelated to indicators of sleep quality; detachment after work neither mediated nor moderated the relationship between social stressors from supervisors and sleep quality. Work redesign to increase time control and reduce social stressors is recommended to preserve daily recovery in railway employees. Practitioner summary: Sleep is important to renew health- and safety-related resources in railway employees. This diary and actigraphy study shows that higher daily work stressors were antecedents of lower sleep quality the following night, while more time control was followed by better sleep quality. Work redesign could promote health and safety by improving sleep quality.

Little things matter: a daily diary study of the within-person relationship between workplace incivility and work-related rumination

Workplace incivility is a low-intensity, counterproductive work behavior associated with negative health outcomes and organizational consequences (e.g., turnover intention). In the present study, I used a daily diary design to investigate the short-term within-person effects of workplace incivility on work-related rumination. Time pressure was included in the present study to underline the importance of workplace incivility for off-work ruminative thoughts beyond the known effects of a stressful workday. Additionally, I propose mood at the end of the workday as a mediator for the proposed relationships. The results of my study corroborate the existence of the daily within-person and the more stable weekly between-person effect of workplace incivility on off-work ruminative thoughts. These results suggest that the experience of short-term and fluctuating workplace incivility has an impact on off-work ruminative thinking even when controlling for the known effects of time pressure. With regard to my proposed mediational effect, my hypothesis was not confirmed. In an additional analysis, however, mediation was confirmed when time pressure was excluded from the model. Further, the within-person relationship between time pressure and work-related rumination was mediated by mood.

Quality of leadership and presenteeism in health professions education and research: a test of a recovery-based process model with cognitive irritation and impaired sleep as mediators

Presenteeism (PRES) includes working while feeling ill and constrained in performance. Compared with absence from work, PRES generates significantly higher cost estimates. Health problems and PRES are related to leadership quality. Hence, research on corporate health management needs to explore why leadership problems (LP) correspond to more frequent PRES.This study tests recovery after work as an underlying process with cognitive irritation (COGIRR) and sleep problems (SP) as simultaneous mediators and explores three mediation pathways (path one: LP→COGIRR→PRES; path two: LP→SP→PRES; and path three: LP→COGIRR→SP→PRES). Out of 293 employees of a university's school of health professions in German-speaking Switzerland, 211 completed a questionnaire. LP and PRES were found to be positively related (r(211) = .22, p < .01). The tests of mediation yielded no significant results for path one and two, but the third mediation path LP→COGIRR→SP→PRES was positive and differed significantly from zero (B = 0.83, CI95 = 0.33 to 1.69). According to our results, a recovery-based mediation model fits the empirical self-report data best. These results suggest that occupational health interventions should improve leadership quality to promote recovery after work in order to increase health and productivity by reduced PRES.

Impaired sleep predicts onset of low back pain and burnout symptoms: evidence from a three-wave study

In a three-wave questionnaire study of 405 working participants, who were initially free of low back pain (LBP) and emotional exhaustion, sleep problems were evaluated as a potential risk factor for the development of LBP and burnout up to three years later. Prospective risk paths were compared between the sexes and between two age-groups (18 to 45 years and older than 45 years). A longitudinal structural equation model showed a good fit with empirical data (RMSEA = .04, SRMR = .06, CFI = .97). Prospective risk paths between the latent constructs showed sleep problems to significantly predict self-reported LBP (β = .15, p = .011) and burnout (β = .24, p < .001) two years later. Sleep problems also predicted the occurrence of burnout three years later (β = .18, p = .002). Sleep-related risk of burnout after two years was greater in older than younger participants (β_older = .42 vs. β_younger = .13, p < .001). Sleep problems seem to precede LBP and burnout in working individuals. Health promotion initiatives should use sleep quality as an important early risk indicator, and interventions should focus on promoting better quality sleep, in an attempt to reduce the incidence of LBP and burnout.

Teacher's sleep quality: linked to social job characteristics?

Besides dealing with high workload, being a teacher is challenging with respect to the social context. There is increasing evidence that adverse social job characteristics challenge sleep quality. The current study tests whether restraint sleep quality (defined as worse sleep quality before than during vacation) is related to time-related job stressors, job resources, and social job characteristics. Forty-eight elementary school teachers (42% women) participated both during the last week before and the first week after vacation. Before vacation, teachers were asked for demographics and working conditions with reference to the last 30 d, and sleep quality with reference to the last 7 d. After vacation sleep quality during vacation was assessed and used as reference for working time sleep quality. Results showed mean levels of sleep quality increased during vacation. In teachers with restrained working time sleep quality (38%), experiences of failure at work, social exclusion, and emotional dissonance were more frequent than in teachers with unrestrained working time sleep quality (Ps<0.05). Groups did not differ in time-related stressors, time control and social support from supervisors. Emotion work, social exclusion and individual experience of failure seem to challenge sleep quality in teachers.

Exploring the psychological health of emergency dispatch centre operatives: a systematic review and narrative synthesis

Background

The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives.

Methods

Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set. Studies were included if they were published in English, and explored the psychological health of any EDC operatives, across fire, police, and emergency medical services. Studies were excluded if they related solely to other emergency workers, such as police officers or paramedics. Methodological quality of included studies was assessed using checklists adapted from the Critical Appraisal Skills Programme. A narrative synthesis was conducted, using thematic analysis.

Results

A total of 16 articles were included in the review. Two overarching themes were identified during the narrative synthesis: ‘Organisational and Operational Factors’ and ‘Interactions with Others’. Stressors identified included being exposed to traumatic calls, lacking control over high workload, and working in under-resourced and pressured environments. Lack of support from management and providing an emotionally demanding service were additional sources of stress. Peer support and social support from friends and family were helpful in managing work-related stress.

Discussion

EDC operatives experience stress as a result of their work, which appears to be related to negative psychological health outcomes. Future research should explore the long-term effects of this stress, and the potential for workplace interventions to alleviate the negative impacts on psychological health.

PROSPERO Registration Number

CRD42014010806.

A Meta-Analysis on Antecedents and Outcomes of Detachment from Work

Detachment from work has been proposed as an important non-work experience helping employees to recover from work demands. This meta-analysis (86 publications, k = 91 independent study samples, N = 38,124 employees) examined core antecedents and outcomes of detachment in employee samples. With regard to outcomes, results indicated average positive correlations between detachment and self-reported mental (i.e., less exhaustion, higher life satisfaction, more well-being, better sleep) and physical (i.e., lower physical discomfort) health, state well-being (i.e., less fatigue, higher positive affect, more intensive state of recovery), and task performance (small to medium sized effects). However, average relationships between detachment and physiological stress indicators and work motivation were not significant while associations with contextual performance and creativity were significant, but negative. Concerning work characteristics, as expected, job demands were negatively related and job resources were positively related to detachment (small sized effects). Further, analyses revealed that person characteristics such as negative affectivity/neuroticism (small sized effect) and heavy work investment (medium sized effect) were negatively related to detachment whereas detachment and demographic variables (i.e., age and gender) were not related. Moreover, we found a medium sized average negative relationship between engagement in work-related activities during non-work time and detachment. For most of the examined relationships heterogeneity of effect sizes was moderate to high. We identified study design, samples' gender distribution, and affective valence of work-related thoughts as moderators for some of these aforementioned relationships. The results of this meta-analysis point to detachment as a non-work (recovery) experience that is influenced by work-related and personal characteristics which in turn is relevant for a range of employee outcomes.

Is Work-Related Rumination Associated with Deficits in Executive Functioning?

Work-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centerd around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behavior. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (0.33), cognitive flexibility (-0.24), and situational awareness at work (-0.28). Study II (n = 939), expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with ‘lapses of attention’ (OR = 4.8), ‘lack of focus of attention’ (OR = 3.4), and ‘absent mindedness’ (OR = 4.3). The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium, and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3) and finishing projects (OR = 2.4), fidgeting (OR = 1.9), memory (OR = 2.2), pursuing tasks in order (OR = 1.8), and feeling compelled to do things (OR = 2.0). It was argued that work-related rumination may not be related to work demands per se, but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of intervention programes aimed at helping people to switch off and unwind from work.