Patterns of work-related stress and their predictors among emergency department nurses and emergency medical services staff in a time of crisis: a latent profile analysis

BACKGROUND

Previous studies have shown that a disease outbreak may cause high stress among healthcare workers. However, the vast majority of those studies applied a variable-centered approach, in which relationships between the variables are believed to be identical across the studied population. The main purpose of this study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the coronavirus disease 2019 (COVID-19) pandemic and to examine their predictors.

METHODS

A cross-sectional paper-and-pencil study was conducted among a convenience sample of 297 emergency department (ED) nurses and 219 emergency medical services (EMS) staff members working in 10 hospital EDs and 52 EMS centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT).

RESULTS

Using the latent profile analysis (LPA), five work-related stress profiles were identified: "high stress with a good understanding of one's job role" (11.1%), "moderate stress" (41.9%), "relatively high stress with average demands and a very low understanding of one's job role" (23.8%), "low stress" (18.0%), and "generally low stress but with very high job demands and relational conflicts" (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership.

CONCLUSION

The results of the study suggest the importance of incorporating various sources of stress and using the person-centered approach when investigating the work-related stress of healthcare workers during disease outbreaks. Identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions that will be better suited to healthcare workers' needs.

Psychometric properties of the HSE Indicator Tool: evidence from Argentina

BACKGROUND

The Health and Safety Executive's Management Standards Indicator Tool (MSIT) is a 35-item self-report questionnaire that assesses seven psychosocial risk factors associated with work-related stress. Although the instrument has been validated in the UK, Italy, Iran and Malta, no validation studies have been carried out in Latin America.

AIMS

To examine the factor structure, validity and reliability of the MSIT among Argentine employees.

METHODS

A sample of employees of different organizations from Rafaela and Rosario, Argentina, completed an anonymous questionnaire that included the Argentine MSIT and specific scales to measure job satisfaction, workplace resilience and perceived mental and physical health (12-item Short Form Health Survey). Confirmatory factor analysis was used to determine the factor structure of the Argentine MSIT.

RESULTS

A total of 532 employees participated in the study (74% response rate). After testing three measurement models, the final respecified model was composed of 24 items distributed in six factors (demands, control, manager support, peer support, relationships and role clarity), showing satisfactory fit indices. The original MSIT change factor was discarded. Composite reliability ranged from 0.70 to 0.82. Although all dimensions showed adequate discriminant validity, convergent validity for control, role clarity and relationships is a matter of concern (average variance extracted values ≤ 0.50). Criterion-related validity was demonstrated by significant correlations between the MSIT subscales and job satisfaction, workplace resilience and mental and physical health.

CONCLUSIONS

The Argentine version of the MSIT presents good psychometric properties for use among employees of the region. Further research is needed to provide more evidence on the convergent validity of the questionnaire.

How Much Does My Work Affect My Health? The Relationships between Working Conditions and Health in an Italian Survey

BACKROUND

Working condition surveys are widely recognized as useful tools for monitoring the quality of working life and the improvements introduced by health and safety policy frameworks at the European and national level. The Italian Workers' Compensation Authority carried out a national survey (Insula) to investigate the employer's perceptions related to working conditions and their impact on health.

METHODS

The present study is based on the data collected from the Italian survey on health and safety at work (INSULA) conducted on a representative sample of the Italian workforce (n = 8,000). This focuses on the relationship between psychosocial risk factors and self-reported health using a set of logistic and linear regression models.

RESULTS

Working conditions such as managerial support, job satisfaction, and role act as protective factors on mental and physical health. On the contrary, workers' risk perceptions related to personal exposure to occupational safety and health risks, concern about health conditions, and work-related stress risk exposure determine a poorer state of health.

CONCLUSIONS

This study highlights the link between working conditions and self-report health, and this aims to provide a contribution in the field of health at work. Findings show that working conditions must be object of specific preventive measures to improve the workers' health and well-being.

Musculoskeletal symptoms, psychosocial factors and work ability in Brazilian labor justice workers

BACKGROUND

The implementation of the electronic judicial process (PJe) in recent years is associated with an increase in workload and stricter control through productivity targets in the Brazilian labor judiciary.

OBJECTIVES

To evaluate the relations between musculoskeletal symptoms, psychosocial factors and work ability in civil servants of a labor justice body in the context of the PJe.

METHODS

A cross-sectional exploratory study with a quantitative approach involving 449 workers. Sociodemographic, occupational and related data were collected through questionnaires validated in the Brazilian context. Data analysis was conducted by descriptive and inferential statistics: Mann-Whitney test, Spearman's correlation coefficient and multiple linear regression.

RESULTS

There was a correlation between musculoskeletal symptoms and psychosocial factors (p < 0.05), as well as between both musculoskeletal symptoms and psychosocial factors with reduced work ability (p < 0.05). The multiple linear regression model pointed to the female gender and the dimensions "demands", "control" and "peer support" as related to the musculoskeletal symptoms.

CONCLUSION

We highlight the importance of a broader approach, involving psychosocial factors in preventive actions related to musculoskeletal disorders considering the important relationship with work ability.

Co-Creating and Evaluating an App-Based Well-Being Intervention: The HOW (Healthier Outcomes at Work) Social Work Project

Stress and mental health at work are the leading causes of long-term sickness absence in the UK, with chronically poor working conditions impacting employee physiological and psychological health. Social workers play a significant part in the fabric of UK society, but have one of the most stressful occupations in the country. The aim of this project was to work with UK social workers to co-develop, implement, and evaluate a series of smartphone-based mental health initiatives. A Participatory Action Research (PAR) approach, consisting of semi-structured interviews and focus group and steering group discussions, was utilized to design the mental health and well-being interventions. Study efficacy was evaluated via a pre- and post-intervention survey and post-intervention semi-structured interviews. Interventions developed were psycho-educational, improved top-down and bottom-up communication, and provided access to a Vocational Rehabilitation Assistant for those struggling and at risk of sickness absence. Six months following dissemination, surveys demonstrated significant improvements in communication, and mean score improvements in four other working conditions. This project, therefore, demonstrates that co-developed initiatives can be positively impactful, despite post-intervention data collection being impacted by COVID-19. Future studies should build upon these findings and broaden the PAR approach nationally while taking a robust approach to evaluation.

Moral or Dirty Leadership: A Qualitative Study on How Juniors Are Managed in Dutch Consultancies

Professional service firms in Western Europe have a reputation for putting huge pressures on their junior employees, resulting in very long work hours, and as a consequence health risks. This study explores moral leadership as a possible response to the stigma of such dirty leadership. We conducted semi-structured interviews with 12 consultant managers and with each one of their juniors, and found that managers put several pressures on their juniors; these pressures bring high levels of stress, lowered wellbeing and burnout. Society considers such a pressuring leadership style morally dirty. To counteract the experience of being seen as morally dirty, we found that consultant managers were normalizing such criticisms as commonly assumed in dirty work literature. However, they also employed several moral leadership tactics to counteract the negative consequences criticized in society. However, in addition to the well-known individual-level tactics, consultant managers and their juniors also reported moral leadership support at the organizational level, like institutionalized performance talks after every project, trainings, specific criteria for hiring juniors, and policies to recognize and compliment high performance. Still, we cannot conclude these moral leadership approaches are moral by definition. They can be used in an instrumental way as well, to further push performance.

To Be or Not to Be (Stressed): The Critical Role of a Psychologically Healthy Workplace in Effective Stress Management

This article explains how key practices pertaining to the psychologically healthy workplace can be used to develop a comprehensive approach to stress management in contemporary organizations. Specifically, we demonstrate the ways in which employee involvement, recognition, work-life balance, health and safety, and growth and development practices can be used to assist in the reduction of work stress and the proactive management of strain. Although many organizations strive to establish a positive environment conducive to work and well-being, identifying where to begin can often seem like a daunting task. Currently, many stress management efforts emphasize individual-level interventions that are simply implemented alongside existing organizational practices. We propose that a broader perspective allows for a better understanding of the stress process, resulting in the ability to consider a wider range of changes to organizational processes. Combining knowledge regarding psychologically healthy workplace practices, stress management intervention levels and the personal resource allocation framework, we present a comprehensive framework for approaching workplace stress management, which can be tailored to the unique needs of various organizations, departments and employees. By adopting this broader perspective, we believe organizations can more strategically address employee stress, resulting in more effective stress management and a profound impact on stress-related outcomes.

Psychosocial risk assessment in organizations: Concurrent validity of the brief version of the Management Standards Indicator Tool

The Management Standards Indicator Tool (MSIT) is a 35-item self-report measure of the psychosocial work environment designed to assist organizations with psychosocial risk assessment. It is also used in work environment research. Edwards and Webster presented a 25-item version of the MSIT based on the deletion of items having a factor loading of < .65. Stress theory and research suggest that psychosocial hazard exposures may result in harm to the health of workers. Thus, using data collected from three UK organizations (N = 20,406) we compared the concurrent validity of the brief and full versions of the MSIT by exploring the strength of association between each version of the instrument and a measure of psychological wellbeing (GHQ-12 and Maslach Burnout Inventory). Analyses revealed that the brief instrument offered similar but not always equal validity to that of the full version. The results indicate that use of the brief instrument, which would be less disruptive for employees, would not elevate the risk of false negative or false positive findings in risk assessment.