Does it matter in the long run? Longitudinal effects and interactions in the differentiated job demands–resources model

Conditional reciprocal stressor-strain effects in university students: a cross-lagged panel study in Germany

University students worldwide are facing increasing mental health challenges. Traditional stress models, like the Job/Study Demand-Resources Model, link stressors directly to strain. Yet, recent studies suggest the influence of strain on stressors may be even stronger. Our research explored these reciprocal dynamics among university students, considering social support and mindfulness as potential moderators. We conducted a two-wave panel study with 264 university students. We ran separate cross-lagged panel structural equation analyses for three key health outcomes-emotional exhaustion, depression, and well-being-each paired with perceived study stressors, specifically workload and work complexity. Findings revealed significant stressor and strain effects, with social support notably moderating the impact of emotional exhaustion on workload. These insights challenge traditional stress theories and underscore the importance of mental health support and effective stress management strategies for students, emphasizing the need for proactive mental health initiatives in academic environments.

Burnout and its determinants among anaesthesia care providers in Switzerland: a multicentre cross-sectional study

The escalating epidemic of burnout in healthcare professionals affects provider well-being, patient care and sustainability of healthcare systems. The objective of this study was to determine the prevalence of burnout among anaesthesia care providers (consultants, trainees or nurse anaesthetists) in Switzerland and identify risk factors to develop strategies for prevention. This multicentre cross-sectional study was conducted at 22 anaesthesia departments in the German-speaking part of Switzerland, using an online questionnaire. Burnout assessment was performed using the Maslach Burnout Inventory. Additionally, the questionnaire included questions on workplace and personal risk factors. Of 1630 anaesthesia care providers contacted, 688 (42%) completed the survey. Among respondents who specified their work positions (n = 676), 52% (149/287) of nurses and 59% (229/389) of physicians were at high risk of burnout; and 9% (26/287) of nurses and 18% (70/389) of physicians met the criteria for burnout syndrome. Logistic regression analysis found significant associations between burnout and perceived lack of support at work among physicians (odds ratio (95%CI) 2.66 (1.40-5.24), p = 0.004); being a trainee in the 1st and 2nd year of training (2.91 (1.14-7.41), p = 0.024); being a trainee with > 5 years of experience (2.78 (1.08-6.98), p = 0.031); and male gender among nurses (4.13 (1.62-11.2), p = 0.004) and physicians (2.32 (1.22-4.47), p = 0.011). Work-related errors due to high workload or fatigue were reported by 65% (444/688) and consideration of leaving the profession due to working conditions was expressed by 46% (319/688) of respondents. Anaesthetic care providers in German-speaking Switzerland experience a considerable prevalence of burnout, influenced mainly by workplace factors.

Doctors' perceived working conditions, psychological health and patient care: a meta-analysis of longitudinal studies

OBJECTIVES

Studies have demonstrated an association between doctors' perceived working conditions, and their psychological well-being and patient care. However, few have examined inter-relationships among these three domains, and even fewer using longitudinal designs. Using meta-analytical structural equation modelling, we tested longitudinal relationships among doctors' perceived working conditions, their psychological well-being and patient care. We further tested if doctors' psychological well-being mediates the relationship between perceived working conditions and patient care.

METHODS

We carried out a systematic review using Academic Search Premier, Business Source Premier, PsycInfo, PsycArticles and Medline for the 20-year period between January 2000 and the start of the pandemic (January 2020). We included studies with practising doctors as participants, and that reported a quantifiable bivariate effect size between at least two of the three constructs of interest-perceived working conditions (ie, job demands, job resource), psychological well-being (ie, emotional exhaustion, work engagement) and patient care (ie, clinical care, patient safety). We pooled relationship effect sizes using random-effects meta-analysis, before testing for indirect effects using two-stage structural equation modelling.

RESULTS

Twenty-three samples from 11 countries representing 7275 doctors were meta-analysed. The results indicated that job resources predicted work engagement (ρ=0.18; 95% CI 0.11 to 0.24) and emotional exhaustion (ρ=-0.21; 95% CI -0.31 to -0.11), while job demands predicted emotional exhaustion (ρ=0.27; 95% CI 0.17 to 0.36). Better clinical care was also associated with higher levels of job resources (ρ=0.16; 95% CI 0.04 to 0.29), and lower levels of emotional exhaustion (ρ=-0.21; 95% CI -0.37 to -0.12) and job demands (ρ=-0.27; 95% CI -0.43 to -0.10). Both factors of the work environment were associated with clinical care through doctors' emotional exhaustion, but there were insufficient studies to test the indirect effects for work engagement or patient safety.

CONCLUSION

Our results demonstrate the need for a systems perspective to address working conditions to support both doctors' psychological well-being and patient care. Interventions should target doctors' job resources as they are more strongly associated with psychological well-being. However, given that job demands were strongly associated with emotional exhaustion, and in turn, clinical care, there is a need to better manage doctors' workload, conflict and pressure to support the current psychological well-being crises among this occupational group.

PROSPERO REGISTRATION NUMBER

CRD42020189070.

Structural equation modelling analysis on relationships of job demands and resources with work engagement, burnout and work ability: an observational study among physicians in Dutch hospitals

OBJECTIVE

To investigate to what extent work engagement mediates the relationships of job resources with work ability, and to what extent burnout mediates the relationships of job demands and resources with work ability.

DESIGN

Multicentre observational study.

SETTING

Academic and non-academic hospitals in the Netherlands.

PARTICIPANTS

Physicians (n=385) participated in this study.

PRIMARY AND SECONDARY OUTCOME MEASURES

We measured work ability with selected items from the validated Questionnaire of Experience and Evaluation of Work 2.0 (QEEW V.2.0), work engagement with the Utrecht Work Engagement Scale and burnout with the exhaustion subscale of the Oldenburg Burnout Inventory. The job demand 'workload' and job resources 'development opportunities', 'participation in decision-making', 'inspirational leadership' and 'relationships with colleagues' were measured using the QEEW V.2.0. The job demand 'bureaucratic burden' was measured with the Three Item Red Tape scale. A structural equation model was built to answer our research question.

RESULTS

Work engagement mediated relationships of job resources with physicians' work ability, and burnout mediated relationships of job resources and demands with work ability. Development opportunities (β=0.39, SE=0.12, p<0.001), participation in decision-making (β=0.18, SE=0.08, p=0.028) and relationships with colleagues (β=0.19, SE=0.19, p=0.002) were positively related to work engagement. Development opportunities (β=-0.20, SE=0.08, p=0.004) were negatively related and workload (β=0.51, SE=0.19, p<0.001) was positively related to burnout. Work engagement (β=0.22, SE=0.04, p<0.001) was positively related and burnout (β=-0.56, SE=0.06, p<0.001) was negatively related to work ability.

CONCLUSIONS

Physicians' work engagement and burnout mediated the relationships of various job demands and resources with their work ability. More work-engaged and less burned-out physicians reported better work ability. Hospitals may attenuate excessive workloads and facilitate development opportunities, participation in decision-making and good collegial relationships to enhance physicians' occupational well-being and performance.

Job demands-resources theory in times of crises: New propositions

This theoretical paper presents an extended Job Demands–Resources (JD–R) theory aimed at understanding how organizations and their employees can best deal with COVID-19 and other crises in the workplace. The crisis showed that job characteristics alone are insufficient to explain employee health and motivation, i.e., the two focal outcomes of the JD-R theory. Rather, demands and resources of the individual, the family, the job and the organization interact with each other to predict outcomes. Moreover, next to individual regulatory strategies also the regulatory strategies of the family, the leader and organization/team are suggested to modify the impact of demands and resources on outcomes. This was possible by integrating the crisis management literature in JD-R theory. Viewing the crisis from a job design perspective helped us to introduce several new and testable propositions that specify how employee well-being and functioning are impacted by crises and turbulent times.

Plain Language Summary

Organizations have been struggling to find out how their employees are affected by the COVID-19 pandemic and what they can do to support their well-being and improve their functioning during the pandemic and beyond. The well-being and job performance of individual employees are difficult to predict which becomes even more complicated during times of crisis. The Job Demands–Resources theory is a helpful means because it suggests that employee health and motivation are outcomes of two different processes, i.e., the health impairment process and the motivational process. Job demands, such as work pressure and demanding customers, exhaust the energy of employees and consequently diminish their health, whereas job resources, such as autonomy and social support, help employees to deal with the demands and to develop themselves. The pandemic showed that the interplay between demands and resources of the individual, the job, the family and the organization predict outcomes. Moreover, next to individual regulatory strategies also the regulatory strategies of the family, the leader and organization/team are suggested to modify the impact of demands and resources on outcomes. Viewing the crisis from a job design perspective helped us to introduce in the Job Demands–Resources theory several testable propositions that specify how employee well-being and functioning are impacted by crises and turbulent times.

Electronic communication during nonwork time and withdrawal behavior: An analysis of employee cognition-emotion-behavior framework from Chinese cultural context

Although a large number of literatures have explored the relationship between electronic communication during nonwork time and individual perception and behavior under the Western culture background, we still have some limitations on this topic under the cultural background of collectivism, dedication and “Guanxi” in China. Different from Western organizations, Chinese employees tend to put work first and are more inclusive of handling work tasks during nonwork time. This type of communication during nonwork time can significantly affect employees’ cognition, emotion and behavior. From the perspective of Job Demands-Resources theory, this study constructs a double-edged (U-shaped) model between electronic communication during nonwork time and employee withdrawal behavior. Sample data were collected from 516 employees with clear working time boundaries in China. The results indicate that electronic communication during nonwork time has a U-shaped effect on employee withdrawal behavior and an inverted U-shaped effect on employee’s cognition, namely job engagement. Job engagement plays a mediating role between them. Moreover, regulatory emotional self-efficacy has a moderating effect on the relationship between electronic communication during nonwork time and job engagement. These findings not only provide theoretical and practical implications for managers and employees on how to reduce withdrawal behaviors, but also advance our understanding of electronic communication during nonwork time in Chinese cultural context.

Psychosocial working conditions and chronic low-grade inflammation in geriatric care professionals: A cross-sectional study

Background

Chronic low-grade inflammation has been suggested as a key factor in the association between stress exposure and long-term health. Care work is recognized as a profession with a high degree of job stress and health risks. However, for care professionals, the study base on inflammatory activity due to adverse working conditions is limited.

Objective

The aim of this study was to explore associations between self-reported psychosocial working conditions and care professionals’ biomarkers of systemic low-grade inflammation.

Methods

N = 140 geriatric care professionals (79.3% females, mean age = 44.1 years) of six care facilities were enrolled in a cross-sectional study consisting of standardized medical examinations and employee surveys. Standardized questionnaires were used for evaluation of psychosocial work characteristics (work overload, job autonomy, social support) based on Karasek’s job strain model. Blood samples were drawn for two biomarkers of inflammatory activity: C-reactive protein (CRP) and leukocyte count. Analyses comprised uni- and multivariate logistic and linear regression analyses.

Results

We determined a proportion of 5.4% of care professionals with increased low-grade inflammation. We further observed a relationship between job autonomy and CRP, such that reports of high job autonomy were associated with increased levels of CRP (adjusted OR = 4.10, 95% CI [1.10, 15.26], p = .035), which was robust in additional analyses on further potential confounders. No significant associations with participants’ leukocyte numbers were found.

Conclusions

This exploratory study contributes to the research base on links between workplace stress and ensuing illness in care professionals. Our findings may help to identify risk and protective factors of the work environment for chronic low-grade inflammation. The results require further scrutiny, and future prospective studies on associations of psychosocial working conditions, low-grade inflammation and long-term health outcomes in care professionals are needed.

Health-oriented leadership as a job resource: can staff care buffer the effects of job demands on employee health and job satisfaction?

Purpose

Drawing upon the job-demands resources and the job demands-control-support model, the authors examined the buffering effect of health-oriented leadership (HoL) in terms of staff care on the relationship between job demands and employee health and job satisfaction.

Design/methodology/approach

Cross-sectional data from two studies (N1 = 314 and N2 = 260) were analyzed using moderation analyses.

Findings

Study 1 showed that staff care mitigates the effect of job demands on strain and health complaints. Study 2 found that staff care also buffered the effect of job demands on general health and job satisfaction.

Practical implications

Particularly under high job demands, staff care is an important resource for employees' health and satisfaction. Organizations should promote leaders' staff care.

Originality/value

Findings provide further evidence for the beneficial role of leaders in terms of HoL.

Association of working conditions including digital technology use and systemic inflammation among employees: study protocol for a systematic review

BACKGROUND

With the dynamic advancement of digitalization, working environments are changing and risk for employee stress may be increasing. Work stress has been associated with a dysregulation of inflammatory processes as a component of immune function. Systemic low-grade inflammation is discussed as a key player in the relation between stress exposure and chronic illness, such as cardiovascular diseases. The objective of this investigation will be to evaluate the association of working conditions including digital technology use and systemic inflammation among employees.

METHODS

We designed and registered a study protocol for a systematic review of randomized controlled trials and prospective non-randomized studies (e.g., cohort, interrupted time series, or before-after studies). We will include studies conducted among adult workers reporting associations of working conditions and inflammatory activity. The outcome will be biomarkers of systemic low-grade inflammation on cell, plasma molecule and intracellular level, such as C-reactive protein, or different types of leukocytes, cytokines, etc. Literature searches will be conducted in several electronic databases (from January 1982 onwards), including PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and CENTRAL. Two reviewers will independently screen all retrieved records, full-text articles, and extract data. The study methodological quality (or bias) will be appraised using appropriate tools. Our results will be described qualitatively. Random effects meta-analysis will be conducted, if feasible and appropriate. Additional analyses will be performed to explore potential sources of heterogeneity.

DISCUSSION

This systematic review and meta-analysis will provide a synthesis of studies evaluating the association of working conditions and systemic inflammation. We anticipate our findings to identify knowledge gaps in the literature that future research should address. Moreover, results of our review may provide implications for corporate and public policy action for employee health promotion and prevention of occupational stress.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO ID: CRD42020166887.

Does Servant Leadership Moderate the Relationship between Job Stress and Physical Health?

High school teachers experience high levels of job stress, which could lead to serious health problems. This study focused on Chinese high school teachers, as they have to manage negative stress and health issues. The research aimed to: (1) investigate the relationship between hindrance job stress, depersonalization, and physical health; (2) investigate if servant leadership, in fact moderates the relationship between hindrance job stress and depersonalization, as well as physical health. The study desisgn was cross-sectional and data analyses were conducted by using SPSS 21 and Mplus 7. The sample consisted of 857 high school teachers across Southern China. The results showed that hindrance stress is related to depersonalization among high school teachers (β = 0.63, p < 0.01). Both hindrance job stress (β = 0.32, p < 0.01) and depersonalization (β = 0.16, p < 0.01) are positively related to physical health. In addition, servant leadership moderates the relationship between hindrance job stress and physical health among the Chinese high school teachers (β = −0.09, p < 0.01). However, the results did not find that the effect of hindrance job stress on depersonalization is moderated by servant leadership (β = 0.02, p = 0.53). It is suggested that Chinese high schools recruit and train leaders in servant leadership, relieve teachers’ stress, and promote their health to ensure the sustainable development of schools.

Linking Diversity and Mental Health: Task Conflict Mediates Between Perceived Subgroups and Emotional Exhaustion

Diversity and psychological health issues at the workplace are pressing issues in today’s organizations. However, research linking two fields is scant. To bridge this gap, drawing from team faultline research, social categorization theory, and the job-demands resources model, we propose that perceiving one’s team as fragmented into subgroups increases strain. We further argue that this relationship is mediated by task conflict and relationship conflict and that it is moderated by psychological empowerment and task interdependence. Multilevel structural equation models on a two-wave sample consisting of 536 participants from 107 work teams across various industries and work contexts partially supported the hypotheses: task conflict did indeed mediate the positive relationships between perceived subgroups and emotional exhaustion while relationship conflict did not; effects on stress symptoms were absent. Moreover, contrary to our expectations, neither empowerment, nor task interdependence moderated the mediation. Results indicate that team diversity can constitute a job demand that can affect psychological health. Focusing on the mediating role of task conflict, we offer a preliminary process model to guide future research at the crossroads of diversity and psychological health at work.