Job demands, job resources, and behavior in times of sickness: An analysis across German nursing homes

mHealth interventions to reduce stress in healthcare workers (fitcor): study protocol for a randomized controlled trial

BACKGROUND

Causes and consequences of chronic stress levels in the context of healthcare work are well examined. Nevertheless, the implementation and evaluation of high-quality interventions to reduce stress of healthcare workers is still missing. Internet and app-based interventions are a promising venue for providing interventions for stress reduction to a population that is otherwise difficult to reach due to shift work and time constraints in general. To do so, we developed the internet and app-based intervention (fitcor), a digital coaching of individual stress coping for health care workers.

METHODS

We applied the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement as a guideline for the present protocol. A randomized controlled trial will be conducted. There are five different intervention groups and one waiting control group. To achieve the sample sizes required by power analysis (G*Power) (β-error 80%; effect size 0.25), the sample sizes of the respective scenarios will be at best as follows: 336 care workers from hospitals, 192 administrative health personnel, 145 care workers from stationary elderly care homes, and 145 care workers from ambulatory care providers in Germany. Participants will randomly be assigned to one of five different intervention groups. A crossover design with a waiting control group is planned. Interventions will be accompanied by three measurement points, first a baseline measure, second a post-intervention measure directly after completion of the intervention, and a follow-up measure 6 weeks after completion of the intervention. At all three measurement points, perceived team conflict, work-related experience patterns, personality, satisfaction with internet-based training, and back pain will be assessed using questionnaires, as well as heart rate variability, sleep quality, and daily movement will be recorded using an advanced sensor.

DISCUSSION

Workers in the health care sector increasingly face high job demands and stress levels. Traditional health interventions fail to reach the respective population due to organizational constraints. Implementation of digital health interventions has been found to improve stress coping behavior; however, the evidence in health care settings has not been established. To the best of our knowledge, fitcor is the first internet and app-based intervention to reduce stress among nursing and administrative health care personnel.

TRIAL REGISTRATION

The trial was registered at DRKS.de on 12 July 2021, registration number: DRKS00024605.

Efficacy of Individualized Sensory-Based mHealth Interventions to Improve Distress Coping in Healthcare Professionals: A Multi-Arm Parallel-Group Randomized Controlled Trial

Detrimental effects of chronic stress on healthcare professionals have been well-established, but the implementation and evaluation of effective interventions aimed at improving distress coping remains inadequate. Individualized mHealth interventions incorporating sensor feedback have been proposed as a promising approach. This study aimed to investigate the impact of individualized, sensor-based mHealth interventions focusing on stress and physical activity on distress coping in healthcare professionals. The study utilized a multi-arm, parallel group randomized controlled trial design, comparing five intervention groups (three variations of web-based training and two variations of an app training) that represented varying levels of individualization to a control group. Both self-reported questionnaire data (collected using Limesurvey) as well as electrocardiography and accelerometry-based sensory data (collected using Mesana Sensor) were assessed at baseline and post-intervention (after eight weeks). Of the 995 eligible participants, 170 (26%) completed the post-intervention measurement (Group 1: N = 21; Group 2: N = 23; Group 3: N = 7; Group 4: N = 34; Group 5: N = 16; Control Group: N = 69). MANOVA results indicated small to moderate time-by-group interaction effects for physical activity-related outcomes, including moderate to vigorous physical activity (F(1,5) = 5.8, p = ≤0.001, η2p = 0.057) and inactivity disruption (F(1,5) = 11.2, p = <0.001, η2p = 0.100), in the app-based intervention groups, but not for step counts and inactivity. No changes were observed in stress-related heart rate variability parameters over time. Despite a high dropout rate and a complex study design, the individualized interventions showed initial positive effects on physical activity. However, no significant changes in stress-related outcomes were observed, suggesting that the intervention duration was insufficient to induce physiological adaptations that would result in improved distress coping.

Global prevalence of presenteeism in the nursing workforce: A meta-analysis of 28 studies from 14 countries

AIMS

This study aimed to estimate the overall presenteeism prevalence in the nursing workforce.

BACKGROUND

Nurses are more prone to presenteeism, which is associated with adverse outcomes for both nurses and patients. However, comprehensive information on the global prevalence of presenteeism in nursing workforce is lacking. Evaluation Seven databases were systematically searched without year or language restrictions in July 2021. Studies that reported the prevalence rate of presenteeism among nurses were included. A meta-analysis was performed using a random-effects model. Key issues A total of 28 studies from 14 countries were included. The overall pooled estimate of presenteeism prevalence among nursing workforce was 49.2% (95% CI: 0.411, 0.574). Subgroup analyses showed that the prevalence of presenteeism was higher when the reporting time frame was > 1 month and < 1 year compared with ≤ 1 month or ≥ 1 year.

CONCLUSION

The results of this meta-analysis showed the substantial prevalence of presenteeism in the nursing workforce with variations across different reporting time frames.

IMPLICATION FOR NURSING MANAGEMENT

The findings can be used to support nurse managers, administrators, and policymakers in recognizing the prevalence of presenteeism and developing relevant prevention strategies against presenteeism among global nursing workforce.

Presenteeism Among Nurses in Switzerland and Portugal and Its Impact on Patient Safety and Quality of Care: Protocol for a Qualitative Study

Background

Nurses dispense direct care in a wide variety of settings and are considered the backbone of the health care system. They often work long hours, face emotional stress, and are at a high risk of psychosocial and somatic illnesses. Nurses sometimes fall sick but work regardless, leading to presenteeism and subsequent risks to quality of care and patient safety due to the increased likelihood of patients falling, medication errors, and staff-to-patient disease transmission.

Objective

This study aims to understand presenteeism among frontline nurses and nurse managers in acute, primary, and long-term health care settings and to contribute to the development of future interventional studies and recommendations.

Methods

A qualitative study based on online focus group discussions will explore the perceptions of, attitudes to, and experiences with presenteeism among frontline nurses and nurse managers. Using a pilot-tested interview guide, 8 focus group discussions will involve nurses working in acute care hospitals, primary care settings, and long-term residential care facilities in Switzerland’s French-speaking region and Portugal’s Center region. The data collected will be examined using a content analysis approach via NVivo 12 QSR International software.

Results

The University of Applied Sciences and Arts Western Switzerland’s School of Health Sciences and the Polytechnic of Leiria’s School of Health Sciences in Portugal have both approved funding for the study. The research protocol has been approved by ethics committees in both countries. Study recruitment commenced in February 2021. The results of the data analysis are expected by September 2021.

Conclusions

This present study aims to gain more insight into the dilemmas facing nurses as a result of all causes of presenteeism among frontline nurses and nurse managers in different health care settings. The researchers will prepare manuscripts on the study’s findings, publish them in relevant peer-reviewed journals, exhibit them in poster presentations, and give oral presentations at appropriate academic and nonscientific conferences. Regarding further knowledge transfer, researchers will engage with stakeholders to craft messages focused on the needs of nurses and nurse managers and on disseminating our research findings to deal with the issue of nursing presenteeism.

International Registered Report Identifier (IRRID)

PRR1-10.2196/27963

Exploring Hong Kong nurses' decision-making processes around presenteeism

BACKGROUND

Presenteeism among nurses is the common behaviour of being physically present at work when one should not be due to personal health and well-being, a stressful work environment, lack of work-life balance, or a sense of professional identity or obligation.

AIMS

To explore nurses' decision-making process related to presenteeism in a large Hong Kong public hospital.

METHODS

As part of a larger study on nurse presenteeism in Hong Kong, we conducted focus groups with nurses to understand their considerations related to working sick.

RESULTS

Eleven major themes emerged from the focus groups, which we grouped into three organizational domains reflecting nurses' decision-making process around presenteeism: consideration for colleagues, organizational factors and professional identity.

CONCLUSIONS

Presenteeism was a familiar behaviour among Hong Kong nurses in our study. We found both overlap and divergence with prior presenteeism research in the domains and themes identified. Loyalty to colleagues, written and unwritten rules and professional identity as nurses all seemed to encourage presenteeism among Hong Kong nurses. Organizations seeking to discourage presenteeism should evaluate policies such as sick leave certificates, ensure appropriate coverage for all nurse ranks and address subcultural norms encouraging presenteeism.

Nurses' perceived work performance and health during presenteeism: Cross-sectional associations with personal and organisational factors

AIM

To determine personal and organisational factors associated with work performance and illness outcomes during presenteeism in a cohort of nurses.

BACKGROUND

Presenteeism is prevalent in nursing populations. It is known to be associated with impaired health and performance loss. Knowledge about the factors associated with presenteeism may help foster better health and performance in this group.

METHODS

A survey (N = 270) was conducted in a population of nurses working with older adults. Hierarchical multiple regression was used to explore factors associated with performance loss and illness outcomes during presenteeism.

RESULTS

Work performance and illness outcomes were often reported as poor during presenteeism. Less negative illness perceptions and work engagement were associated with better work performance and illness outcomes. Older age and manager support were also associated with better work performance. Non-organisational causes of illness were associated with better illness outcomes.

CONCLUSION

Performance levels and illness outcomes during presenteeism are associated with a combination of illness-related, individual, attitudinal and organisational factors.

IMPLICATIONS FOR NURSING MANAGEMENT

Fostering engagement, support, good relationships and a hazard-free environment may improve performance and health during presenteeism.

Teamwork in a pandemic: insights from management research

Background

Amidst the unprecedented outbreak of COVID-19, it is both critical and increasingly difficult for healthcare professionals to engage in the teamwork that will underlie an effective response to the pandemic. The simultaneous need for and challenge to teamwork, though, is not unique to healthcare.

Results

Drawing on management and organisational research conducted in healthcare as well as other industries, this article offers an overview of key, and robust, findings that highlight both what teamwork looks like and how to achieve it. I focus on two aspects of teamwork (the coordination of expertise and communication), and I review how leaders can jumpstart them by leveraging mechanisms including framing the work, using communication structures and engaging in leader inclusiveness.

Sickness presenteeism: Are we sure about what we are studying? A research based on a literature review and an empirical illustration

BACKGROUND

There has been an increasing interest in studying sickness presenteeism (SP). An ever-increasing amount of scientific literature is published using this term, yet there appears to be considerable heterogeneity in how it is assessed, which could result in substantial differences in the definition and interpretation of the phenomenon really being studied. We aim to discuss what really is being studied, depending on how the phenomenon is operationalized, measured, and analyzed.

METHODS

A study based on a literature review and an empirical illustration using data of the third Spanish Psychosocial Risks Survey (2016).

RESULTS

Differences are observed based on the population in which SP is measured, the cut-off points used to define a worker as presenteeist, the reasons for an SP episode and even an analysis of the phenomenon treated as a count or as a dichotomous.

CONCLUSIONS

Without being completely exclusive, it seems that restricting the population of analysis to only those workers who consider that they should not have gone to work due to their health, and/or establishing low cut-off points to define someone as presenteeist, would more clearly delimit the study of SP to the exercise of a right to sick leave. In contrast, working with the entire population or using high cut-off points appears to relate the study of SP more with health status and less with the exercise of rights. On the other hand, taking the reasons for SP into account would probably help to improve interpretation of the phenomenon.