The effects of burnout and supervisory social support on the relationship between work‐family conflict and intention to leave: A study of Australian cancer workers

Work-family conflict among primary health workers during the COVID-19 pandemic: Its mediating role in the relationship between workload and job burnout

AIMS AND OBJECTIVES

This study explores the situation of workload, work-family conflict and job burnout among primary health workers in China in the context of COVID-19 and identifies the mediating effect of work-family conflict between workload and job burnout.

BACKGROUND

Since the breakout of the COVID-19 pandemic, primary health workers have been working on the frontline of the epidemic and may experience increasing workload, work-family conflict and job burnout. It is important to focus on the issue of how to alleviate job burnout of primary health workers.

DESIGN

A cross-sectional study (STROBE) was used.

METHODS

Data were collected from 785 primary health workers in China. Multiple regression analysis was used to examine the mediating effect of work-family conflict between workload and job burnout.

RESULTS

18.7%, 10.4% and 39.5% of respondents had high job burnout in the dimensions of emotional exhaustion, depersonalization and personal accomplishment, respectively. 34.6% of the respondents had high or very high workload, and 12.8% of the respondents had high or very high work-family conflict. Results of multiple regression analysis indicated that work-family conflict mediated the relationship between workload and job burnout. Workload (β = .163, CI = .207-.549) and work-family conflict (β = .211, CI = .311-.640) positively influenced job burnout, and workload (β = .428, CI = .375-.508) positively influenced work-family conflict.

CONCLUSION

The study indicated that primary health workers experienced a high level of job burnout, especially in the personal accomplishment dimension. Furthermore, this study verified the mediating effect of work-family conflict between workload and job burnout.

RELEVANCE TO CLINICAL PRACTICE

Some interventions for alleviating workload, work-family conflict and job burnout should be taken, including workplace assistance programmes, family-friendly policies and a well-integrated healthcare system.

NO PATIENT OR PUBLIC CONTRIBUTION

This study does not involve patient or public contribution in any part.

IMPACT STATEMENT

Nurses and other primary health workers are health gatekeepers of residents and play a vital role in the healthcare system. Due to the breakout of COVID-19, they have taken more work and are more vulnerable to work overload, work-family conflict and the consequent job burnout. Some interventions should be taken to effectively alleviate their job burnout and improve their health and performance.

Psychological capital and perceived supervisor social support as mediating roles between role stress and work engagement among Chinese clinical nursing teachers: a cross-sectional study

OBJECTIVE

This study aimed to investigate the work engagement of clinical nursing teachers and examine whether psychological capital and perceived supervisor social support mediates the association between role stress and work engagement among clinical nursing teachers.

DESIGN

A cross-sectional study design was used.

SETTING

This study was conducted in five tertiary hospitals affiliated with medical universities in Shandong Province, China.

PARTICIPANTS

A total of 412 clinical nursing teachers were recruited out of which 406 completed the questionnaires effectively.

METHODS

Questionnaires were administered offline and the items consisted of social demographic characteristics, scale related to role stress, psychological capital, perceived supervisor social support and work engagement. T-tests, one-way analysis of variance and Pearson's correlation analysis were conducted using SPSS, and mediation analysis was performed using structural equation modelling.

RESULTS

The work engagement scores of clinical nursing teachers were high, with an average score of 4.76±0.69. Structural equation modelling showed a good fit of the data to the hypothesised model. Role stress did not directly affect work engagement (β=0.057, p>0.001). However, a strong indirect effect of role stress on work engagement (β=-0.373, p<0.001) mediated by psychological capital and perceived supervisor social support was observed, with path coefficient of -0.319 (p<0.01) and -0.054 (p<0.01), respectively. The model explains 57% of the variance in work engagement.

CONCLUSION

Psychological capital and perceived supervisor social support fully mediated the relationship between role stress and work engagement among clinical nursing teachers. Thus, to promote the work engagement of clinical nursing teachers, their psychological capital needs to be improved. Furthermore, superiors should provide more support, particularly to clinical nursing teachers experiencing high role stress.

Workplace bullying and turnover intentions of nurses: the multi-theoretic perspective of underlying mechanisms in higher-order moderated-serial-mediation model

PURPOSE

This study examines the relationship between workplace bullying (WPB) and the turnover intentions (TIs) of nurses, both directly and indirectly, i.e. through serial mediation of psychological contract violation (PCV) and poor employee wellbeing (EWB). And that with the moderating effect of servant leadership (SL) on its final path to TIs of nurses.

DESIGN/METHODOLOGY/APPROACH

A total of 285 nurses voluntarily participated in the survey through convenient sampling from 13 different district hospitals. The authors performed partial least squares structural equation modeling (PLS-SEM) to test the study's measurement and structural models.

FINDINGS

Overall, results indicated 62% prevalence rate of WPB and TIs of nurses had 67% variance explained by the exogenous factors. Workplace bullying was found to have direct as well as indirect relationship with TIs of nurses. For the latter, PCV and poor EWB were found to have partially mediated, both singly and serially. The moderating effect of SL on the serial mediation pathway was negative and significant.

ORIGINALITY/VALUE

Drawing on a tripartite theoretical perspective, this study illuminates the mechanism underlying WPB-TIs relationship with an advanced multivariate statistical technique in the nursing work setting in a developing country.

The role of emotional exhaustion among public healthcare professionals

Purpose

The nature of public healthcare highlights not only the need of understanding the role of emotional exhaustion in the relationship between employees’ job demands and desirable employees’ job attitudes, but also to adequate the combination of certain job resources and other organisational variables to moderate the employees’ feelings of emotional exhaustion. The paper aims to discuss this issue.

Design/methodology/approach

This viewpoint designs the theoretical approach that aims to understand the mediating role of emotional exhaustion among healthcare professionals and the capacity of certain variables to moderate it. The nature of the variables considered and the design of the theoretical model proposed highlights structural equation modelling as an optimal methodology to be used among a sample of European healthcare professionals.

Findings

Managers should be able to design strategies to mitigate, eliminate and prevent the causes of emotional exhaustion in public healthcare with the objective to improve the health and quality of life of healthcare professionals, and consequently the quality of the service provided to patients and their families.

Originality/value

This viewpoint highlights the importance of analysing the influence of employees’ emotional exhaustion on their attitudes in public healthcare. Direct relationships between emotional exhaustion and certain antecedents or consequences have been studied previously; however, studies analysing the mediating role of emotional exhaustion are very scarce and show mixed results. There are also few studies analysing the moderating role of certain job resources and other organisational variables in the relationships between employees’ job demands, employees’ emotional exhaustion and employees’ job attitudes.

Attitudes toward evidence-based practices, occupational stress and work-related social support among health care providers in China: A SEM analysis

Individuals' attitudes toward evidence-based practices (EBP) are critical in adopting, implementing and maintaining the EBP in clinical settings. Multiple empirical studies have examined how work context may shape perceptions and attitudes towards EBP. The current study aims to further explore how both work and family contexts, as assessed by three psychosocial indicators (i.e., occupational stress, work-related social support from coworkers, and work-related social support from family), may affect attitudes toward EBP among health care providers in HIV clinics in China. We analyzed cross-sectional survey data from 357 health care providers recruited from 40 HIV clinics across 16 cities/counties in Guangxi China. Structural equation model (SEM) was constructed to test the hypothesized relationships among key study variables. Occupational stress was negatively associated with work-related social support from coworkers (β = -.19, 95%CI = [-.31,-.12]), which in turn was positively associated with attitudes toward EBP (β = .17, 95%CI = [.04, .30]). Similarly, occupational stress was negatively related to work-related social support from family (β = -.34, 95%CI = [-.42,-.25]), which in turn was positively related to attitudes toward EBP (β = .23, 95%CI = [.12, .35]). Occupational stress was negatively associated with attitudes toward EBP, but the magnitude of association did not reach statistical significance at α = .05. Work-related social support from family partially mediated the association between occupational stress and attitudes toward EBP (Sobel's z = 3.27, p < .05). Our findings suggest the importance of integrating work and family contexts, especially family support into the strategies of facilitating the adoption and implementation of EBP. The current study also underscores the needs to reduce occupational stress and enhance work-related social support among health care providers who are in frequent contact with HIV patients. In addition, lack of work-related family support may be a main barrier preventing health care providers from developing a positive attitude toward EBP. Therefore, the interventions aiming for promoting adoption and utilization of EBP need to involve specific strategies to resolve work-family conflicts and improve family members' understanding and support for health care providers in China, especially those who work in a stressful work context such as HIV care.

Using the job demands-resources approach to assess employee well-being in healthcare

The aim of this study is to advance a model to assess the overall level of well-being within healthcare organizations. Design/methodology/approach: The paper employs a job demands-resources approach by considering the multilevel model of employee well-being as theoretical framework, integrated with personal resources and health indicators. A specific case is built in the Italian context, with empirical data gathered from three Italian paediatric hospitals belonging to the same healthcare organizations. Findings: Results show that the job demand-resource model may well explain differences in the work environment, and that personality enables coping with negative effects of work environment settings. Originality/value. The paper contributes to extending the literature on well-being and the management of healthcare organizations, by providing interesting insights on the multilevel model of employee well-being. It also has interesting academic and practical implications, since it tries to put forward a model to assess employee well-being and provides an empirical application of a well-known theoretical model.

Voice of the Clinician: the case of an Australian health system

Purpose

The Voice of the Clinician project commenced during an era when practitioner burnout, dissatisfaction, and turnover became an increasingly global health workforce concern. One key problem is clinical staff not being empowered to voice their concerns to decision-makers, as was found in this case study of an Australian public health organization. The following research question informed the present study: What is a better committee system for clinician engagement in decision-making processes? The paper aims to discuss this issue.

Design/methodology/approach

The Mid North Coast Local Health District in New South Wales aspired to improve engagement between frontline clinicians and decision-makers. Social network analysis methods and mathematical modeling were used in the discovery of how committees are connected to each other and subsequently to other committee members.

Findings

This effort uncovered a hidden organizational architecture of 323 committees of 926 members which overall cost 84,729 person hours and AUD$2.923 million per annum. Furthermore, frontline clinicians were located far from centers of influence, just 37 percent of committees had terms of reference, and clinicians reported that meeting agendas were not being met.

Practical implications

In response to the findings, a technological platform was created so that the board of directors could visually see all the committees and the connections between them, thus creating ways to further improve communication, transparency of process, and – ultimately – clinician engagement.

Originality/value

The breakthrough idea is that all organizational meetings can be seen as a system of engagement and should be analyzed to determine and describe the points and pathways where clinician voice is blocked.

[Compatibility of Work and Family Life of Employees in the Healthcare Sector: An Issue in Health Services Research]

Hintergrund/Ziele

Beschäftigte im Gesundheitswesen sind mit besonderen beruflichen Rahmenbedingungen und Anforderungen konfrontiert, die sich auf das Verhältnis von Familie und Arbeit/Beruf auswirken können und mittelbar auch die Qualität der Gesundheitsversorgung beeinflussen. Ziel des vorliegenden Beitrags ist es, einen Überblick über den Forschungsstand zu diesem Thema zu geben. Dieser ist für die Versorgungsforschung von Relevanz. Er kann als Ausgangspunkt dafür dienen, Strukturen im Gesundheitswesen (auch in ländlichen Regionen) dahingehend zu verändern, dass sie eine bessere Vereinbarkeit von Familie und Beruf ermöglichen.

Methode

Es wurde eine systematische nationale und internationale Literaturrecherche in Form eines Scoping Review durchgeführt, um den aktuellen Forschungsstand zur Vereinbarkeit von Familie und Gesundheitsberuf zu dokumentieren. Als inhaltliche Suchkriterien wurden definiert: Vereinbarkeit von Beruf und Familie (allgemein); Vereinbarkeitserleben und -konflikte bei Gesundheitsberufen; Vereinbarkeit von Familie und Gesundheitsberuf im ländlichen Raum; Interventionsansätze zur Förderung der Vereinbarkeit von Beruf und Familie. Im Ergebnis eines mehrstufigen Selektionsprozesses wurden 145 Publikationen in die inhaltliche Auswertung einbezogen.

Ergebnisse

Die dokumentierte Literatur bezieht sich schwerpunktmäßig auf die Berufsgruppen Ärzte und beruflich Pflegende, für andere Berufsgruppen liegen kaum Arbeiten vor. Die methodische Qualität der Studien ist meist niedrig, Metaanalysen liegen nicht vor. Mehrere Arbeiten dokumentieren eine Unzufriedenheit bei Ärzten und beruflich Pflegenden bzgl. Möglichkeiten der Vereinbarkeit von Familie und Beruf. Es konnten nur wenige Interventionsstudien zur Förderung der Vereinbarkeit von Familie und Beruf gefunden werden, diese sind wiederum nur teilweise spezifisch auf Gesundheitsberufe ausgerichtet. Defizite bestehen zudem hinsichtlich der Vernetzung mit Fragen der Verbesserung der Gesundheitsversorgung in ländlichen Gebieten.

Schlussfolgerung

Zur Thematik „Vereinbarkeit von Familie und Gesundheitsberuf“ existiert national wie international nur wenig systematische Forschung. Insbesondere zur Evaluation von Maßnahmen bestehen Defizite. Der Literaturüberblick ermöglicht die Ableitung von Ansatzpunkten, um eine Verbesserung der Vereinbarkeit von Familie und Beruf zu erreichen.

Social supports and mental health: a cross-sectional study on the correlation of self-consistency and congruence in China

Background

Psychosocial job characteristics require nursing staff with high self-consistency and good mental health. However, the attention and effort of such study remained very limited in China.

Methods

A self-administered questionnaire was distributed to the bedside nurses in an affiliated hospital of Hebei Medical University, China. Of 218 registered bedside nurses eligible to participate in the survey anonymously, the data producing sample of 172 subjects resulted in a 79 % of effective response rate.. The Social Support Rating Scale was used to measure social support, and the Self-Consistency and Congruence Scale were used to measure mental health.

Results

Compared with the normal referenced group of college students, higher self-flexibility scores, lower self-conflict and self-stethoscope scores from the sample group were obtained with statistical significance in self-conflict scores. The close correlations were observed between participants’ social support and Self-Consistency and Congruence Scale score. The difference of Social Support Rating Scale score was significant in demographic features including years of work, marital status, only child family, and levels of cooperation with other health worker.

Conclusions

Bedside nurses in this study show a better inner harmony, and their Self-Consistency and Congruence closely correlates with the levels of social support. Thus, it is substantial to improve inner perception of support and external factors, such as the workplace support, and offer beneficial social environment to improve the bedside nurse’s sub-health symptoms and decrease the high turnover rate.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-016-1463-x) contains supplementary material, which is available to authorized users.

The role of coworker and supervisor support on job burnout and job satisfaction

Purpose

This study investigates the role of coworker and supervisor support on three aspects of burnout (emotional exhaustion, depersonalization, perceived lack of personal accomplishment) and job satisfaction. The authors argue that different sources of social support at work can influence these three aspects of burnout differently.

Design/methodology/approach

Questionnaires were delivered to supervisors of each campus department at two state universities in South Texas asking them to encourage their employees to complete the survey. The sample consisted of 174 personnel.

Findings

The results show that coworker support was negatively associated with emotional exhaustion and depersonalization but not with perceived lack of personal accomplishment while supervisor support was negatively associated with all aspects of burnout. The analysis also confirmed the direct and indirect effects of coworker and supervisor support on job satisfaction.

Practical implications

Due to the detrimental consequences of burnout to employee satisfaction, organizations need to make sure that employees receive sufficient support from their coworkers and supervisors to avoid this burnout problem.

Originality/value

Even though the role of social support on job burnout has been previously investigated, existing studies tended to combine three dimensions of burnout into a single measure. Using an aggregated measure of burnout as an outcome variable can limit our understanding about the role that social support plays on each individual dimension of burnout. By employing burnout as a multidimensional construct, the present study can determine whether coworker support and supervisor support can have a different impact on each of the three dimensions of burnout.

Can clinical supervision sustain our workforce in the current healthcare landscape? Findings from a Queensland study of allied health professionals

OBJECTIVE

Clinical supervision is widely recognised as a mechanism for providing professional support, professional development and clinical governance for healthcare workers. There have been limited studies about the effectiveness of clinical supervision for allied health and minimal studies conducted within the Australian health context. The aim of the present study was to identify whether clinical supervision was perceived to be effective by allied health professionals and to identify components that contributed to effectiveness. Participants completed an anonymous online questionnaire, administered through the health service's intranet.

METHODS

A cross-sectional study was conducted with community allied health workers (n = 82) 8 months after implementation of structured clinical supervision. Demographic data (age, gender), work-related history (profession employment level, years of experience), and supervision practice (number and length of supervision sessions) were collected through an online survey. The outcome measure, clinical supervision effectiveness, was operationalised using the Manchester Clinical Supervision Scale-26 (MCSS-26). Data were analysed with Pearson correlation (r) and independent sample t-tests (t) with significance set at 0.05 (ie the probability of significant difference set at P < 0.05).

RESULTS

The length of the supervision sessions (r(s) ≥ 0.44), the number of sessions (r(s) ≥ 0.35) and the total period supervision had been received (r(s) ≥ 0.42) were all significantly positively correlated with the MCSS-26 domains of clinical supervision effectiveness. Three individual variables, namely 'receiving clinical supervision', 'having some choice in the allocation of clinical supervisor' and 'having a completed clinical supervision agreement', were also significantly associated with higher total MCSS-26 scores (P(s) < 0.014).

CONCLUSION

The results of the study demonstrate that when clinical supervision uses best practice principles, it can provide professional support for allied health workers, even during times of rapid organisational change.

Relationship of work-family conflict with burnout and marital satisfaction: cross-domain or source attribution relations?

Background: The present study was conducted to examine the relationship between two dimensions of work-family conflict (WFC) with marital satisfaction and burnout in a society in which few studies have been done about the consequences of WFC.

Methods: A cross-sectional study was conducted in 2015. Surveys were distributed to 420 employed married women with various jobs living in Bushehr province, Iran. Data were collected using a questionnaire for demographic characteristic, the Netmeyer’s WFC questionnaire, Maslach Burnout Inventory: General Survey (MBI-GS), and Enrich maritalsatisfaction questionnaire. The data were analyzed using descriptive and inferential statistics.

Results: There was a negatively significant association between work interference with family(WIF) and overall burnout as well as emotional exhaustion (P < .01). Family interference with work (FIW) was significantly associated with depersonalization (P < .01). The overall marital satisfaction and its subscales were significantly associated with WIF (P < .01) and FIW (P < .01 for overall marital satisfaction and P < .05 for its subscales).

Conclusion: In terms of practical implication, to avoid creating disadvantages of WIF and FIW,facilitation in two domains of improving work and family conditions can be a useful means to prevent WFC and its consequences.

Work engagement and job burnout within the disability support worker population

The aim of this study was to explore work engagement and job burnout within the disability support worker (DSW) population, using the job demands-resources (JD-R) model as a guiding theory. The research measured a set of work-related demands and resources related to working within the disability sector in order to assess which demands/resources account for a significant portion of unique variance when used to model DSW engagement and burnout. This study sampled 258 DSWs from across Australia who completed an online or paper questionnaire that included measures of engagement, burnout and the demands/resources of interest. With regard to demands, role ambiguity was significantly associated with the three engagement scores and the three burnout scores. It also accounted for the most unique variance in the three engagement scores (vigour [VI], dedication [DE] and absorption [AB]), and the personal accomplishment (PA) burnout score. With regard to resources, job feedback was significantly associated with two of the engagement scores (VI and DE) and all three burnout scores. It accounted for the most unique variance in VI and DE, and PA. In conclusion, this research adds to the existing disability workforce literature as it represents one of the first comprehensive investigations of work engagement within this population. Improved job descriptions, on-the-job feedback and the creation of specialist support workers are offered as recommendations to improve the psychosocial health of DSWs.

Expanding the boundaries of work—family research: A review and agenda for future research

Given the dominance of work—family research within the context of the United States and a disparate and fractured understanding of the dynamic interplay between work and family for those who live and work beyond the borders of the United States, we review and synthesize 219 empirical work—family studies that have targeted employees outside of the United States. Our review answers four questions about international work—family research. First, what constitutes the work—family interface and is there consensus about how to measure it? Second, what theories have researchers used to explain the work—family interface? Third, which antecedents and consequences of the work—family interface are common across countries and which are unique to particular countries? Fourth, what can we learn from this review that will inform future research in this area? Based on our review, a universal theoretical framework that integrates both work—family conflict and facilitation is provided. Future research directions are also discussed.