Team Climate and Procedural Justice as Predictors of Occupational Strain1

Organizational Justice and Health: Reviewing Two Decades of Studies

Organizational justice refers to employees’ perceptions of the fairness of decision-making rules and policies in the workplace. Lack of justice is suggested to be a significant psychosocial risk factor that affects employees’ attitudes and health. The aim of this narrative review was to compile the evidence available about the effects of organizational justice on health. To this end, a literature search was carried out using the Web of Science, PubMed, and PsycINFO databases. The final sample consisted of 103 articles that studied the effects of justice on mental health (40 results), job stress (26), sickness absence (15), physical health (14), absenteeism/presenteeism (3), safety at work (3), and health of third parties (2). The results show that perceptions of workplace justice predict employees’ mental health, stress-related health problems, and lower levels of sickness absence were relatively compelling. Future studies should focus on less-researched outcomes and on how these associations are modified by other variables for a better understanding of how justice affects health, with a view to being able to carry out preventive measures more efficiently.

A hybrid decision-making framework to manage occupational stress in project-based organizations

According to recent studies in the field of human resource management (HRM), especially in project-based organizations (PBOs), stress is recognized as a factor that has a paramount significance on the performance of staff. Previous studies in organizational stress management have mainly focused on identifying job stressors and their effects on organizations. Contrary to the previous studies, this paper aims to propose a comprehensive decision-support system that includes identifying stressors, assessing organizational stress levels, and providing solutions to improve the performance of the organization. A questionnaire is designed and distributed among 170 senior managers of a major project-based organization in the field of the energy industry in Iran to determine organizational stressors. Based on the questionnaire results and considering the best worst method (BWM) as an approach to determine the weighting vector, the importance degree of each stressor is calculated. In the next stage, a decision-support model is developed to assess the stress level of a PBO through fuzzy inference systems (FIS). Some main advantages of the proposed hybrid decision-support model include (i) achieving high-reliable results by not-so-time-consuming computational volume and (ii) maintaining flexibility in adding new criteria to assess the occupational stress levels in PBOs. Based on the obtained results, six organizational stressors, including job incongruity, poor organizational structure, poor project environment, work overload, poor job promotion, and type A behavior, are identified. It is also found that the level of organizational stress is not ideal. Finally, some main recommendations are proposed to manage occupational stresses at the optimum level in the considered sector.

Organizational Justice, Professional Identification, Empathy, and Meaningful Work During COVID-19 Pandemic: Are They Burnout Protectors in Physicians and Nurses?

Burnout has been recognized as a serious health problem. In Portugal, before COVID-19 Pandemic, there were strong indicators of high prevalence of burnout in physicians and nurses. However, the Portuguese Health Care Service was able to efficiently respond to the increased demands. This study intends to understand how psychosocial variables might have been protective factors for burnout in physicians and nurses in Portugal. Specifically, we considered several psychosocial variables that have been found to be protective factors for burnout in previous research and we compared their predictive and unique impact in the prediction of burnout. These variables are perceptions of justice (distributive, procedural, justice from colleagues, justice from patients, and their families), professional identification, meaningful work and empathy. We also included workload, as a risk factor, and controlled other variables that can be confounds for burnout, such as socio-demographic variables, ideological variables (religiosity, political orientation), and specific variables related with COVID-19 pandemic. The sample of the present study is composed by 229 physicians (aged between 23 and 70 years old, M = 36.54; SD = 10.72; 48% male and 52% female) and 268 nurses (aged between 22 and 69 years old, M = 34.96; SD = 9.52; 27% male and 73% female). An online survey was created using Qualtrics and participants were recruited via Facebook and LinkedIn. The data were collected during 29 days (between the 45th and the 74th days after the first diagnosed case of COVID-19 in Portugal). The results showed that workload was a significant risk factor, except for disengagement in physicians. The most consistent protectors across samples were procedural justice (for both dimensions of burnout, both in physicians and nurses) and professional identification (for disengagement, both in physicians and nurses; for exhaustion only in physicians). This study suggests that decreasing workload and promoting procedural justice and professional identification are key factors that might be simultaneously and independently addressed in interventions for reducing the risk of burnout or preventing it from occurring in the first place.

Which factors are related to Finnish home care workers' job satisfaction, stress, psychological distress and perceived quality of care? - a mixed method study

BACKGROUND

The desire to increase the role of home care in Finland has created problems in home care work. Working conditions have deteriorated, the quality of care experienced is low, and staff members suffer from time pressure and stress, amongst other things. The aim of this article is to explore the challenges, stressors, teamwork and management factors that are associated with home care staff members' well-being, job satisfaction and experienced care quality, and further, how staff members experience their work.

METHODS

A survey was sent to home care workers in two case organizations that participated in the study. In addition, semi-structured theme interviews with home care workers were conducted. The data from the survey was analysed using analysis of covariance, and interview data was analysed using the Grounded Theory-based method from Gioia et al. RESULTS: Respondents of the survey and the interview participants were mainly female practical nurses. The results from the survey showed, for example, that time pressure was associated with higher stress and psychological distress, and interruptions were associated with lower job satisfaction and higher stress. In addition, variables related to teamwork, such as participative safety, were shown to explain the variation in quality of care. The analysis of the interview data further brought up dissatisfaction with management practices, which seems to have led to a decrease in job satisfaction. Exhaustion and strain were present among staff members, which originated from an insufficient number of carers.

CONCLUSIONS

Current working conditions and work practices in Finnish home care are experienced stressful. The results from this study indicate that having more autonomy at work was associated with job satisfaction, according to both analyses. Team climate and idea implementation were related to quality of care. Therefore, increasing self-organizing team practices might be a possible development method for improving working conditions and staff members' well-being. Implementing self-organizing team practices could possibly also attract employees to work in home care and prevent turnover.

Linking Organizational Justice to Burnout: Are Men and Women Different?

This study tested the links from organizational justice with burnout and the moderating role of sex in these relationships. A total of 279 contact employees (149 men and 130 women) were surveyed in 59 hotels. A questionnaire was used to measure distributive, procedural, and interactional justice as well as employees' burnout (exhaustion, cynicism, and efficacy). Hierarchical regression models, calculated to test the hypothesized effects, indicated the predominance of procedural justice over distributive and interpersonal with regard to the direct relationships between organizational justice and burnout. Analysis also showed that links from interactional justice with exhaustion and cynicism were greater for women than for men. In contrast, there were no significant sex differences on the efficacy dimension.

The Impact of Psychological Science on Policing in the United States

The May 2015 release of the report of the President’s Task Force on 21st Century Policing highlighted a fundamental change in the issues dominating discussions about policing in America. That change has moved discussions away from a focus on what is legal or effective in crime control and toward a concern for how the actions of the police influence public trust and confidence in the police. This shift in discourse has been motivated by two factors—first, the recognition by public officials that increases in the professionalism of the police and dramatic declines in the rate of crime have not led to increases in police legitimacy, and second, greater awareness of the limits of the dominant coercive model of policing and of the benefits of an alternative and more consensual model based on public trust and confidence in the police and legal system. Psychological research has played an important role in legitimating this change in the way policymakers think about policing by demonstrating that perceived legitimacy shapes a set of law-related behaviors as well as or better than concerns about the risk of punishment. Those behaviors include compliance with the law and cooperation with legal authorities. These findings demonstrate that legal authorities gain by a focus on legitimacy. Psychological research has further contributed by articulating and demonstrating empirical support for a central role of procedural justice in shaping legitimacy, providing legal authorities with a clear road map of strategies for creating and maintaining public trust. Given evidence of the benefits of legitimacy and a set of guidelines concerning its antecedents, policymakers have increasingly focused on the question of public trust when considering issues in policing. The acceptance of a legitimacy-based consensual model of police authority building on theories and research studies originating within psychology illustrates how psychology can contribute to the development of evidence-based policies in the field of criminal law.

Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes

OBJECTIVE

Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties.

DATA SOURCES

We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies.

STUDY ELIGIBILITY

Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams.

STUDY APPRAISAL AND SYNTHESIS METHODS

Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated.

RESULTS

Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes.

LIMITATIONS

Review is limited to quantitative assessments of teamwork in internal medicine.

CONCLUSIONS

There is strong validity evidence for several published tools assessing teamwork in internal medicine. However, few teamwork assessments have been directly linked to patient outcomes.

Team climate and attitudes toward information and communication technology among nurses on acute psychiatric wards

Objectives: To describe the association of team climate with attitudes toward information and communication technology among nursing staff working on acute psychiatric wards. Background: Implementation of ICT applications in nursing practice brings new operating models to work environments, which may affect experienced team climate on hospital wards. Method: Descriptive survey was used as a study design. Team climate was measured by the Finnish modification of the Team Climate Inventory, and attitudes toward ICT by Burkes' questionnaire. The nursing staff (N = 181, n = 146) on nine acute psychiatric wards participated in the study. Results: It is not self-evident that experienced team climate associates with attitudes toward ICT, but there are some positive relationships between perceived team climate and ICT attitudes. The study showed that nurses' motivation to use ICT had statistically significant connections with experienced team climate, participative safety (p = 0.021), support for innovation (p = 0.042) and task orientation (p = 0.042). Conclusion: The results suggest that asserting team climate and supporting innovative operations may lead to more positive attitudes toward ICT. It is, in particular, possible to influence nurses' motivation to use ICT. More attention should be paid to psychosocial factors such as group education and co-operation at work when ICT applications are implemented in nursing.

Differences in well-being between GPs, medical specialists, and private physicians: the role of psychosocial factors

OBJECTIVE

To examine the well-being differences among physicians working in different health care sectors and to test whether psychosocial stressors account for these differences. The well-being indicators used were psychological distress, self-rated health, and work ability.

DATA SOURCES/STUDY SETTING

A total of 2,841 randomly selected Finnish physicians (response rate 57 percent) returned the postal questionnaire, of which 2,047 (1,241 women) fulfilled all the participant criteria.

STUDY DESIGN

This is a cross-sectional questionnaire study.

PRINCIPAL FINDINGS

General practitioners and medical specialists experienced lower well-being than private physicians and this difference was partly explained by differences in psychosocial stressors.

CONCLUSIONS

General practitioners and medical specialists report more problems in well-being than private physicians. It is of particular importance to be aware of the sector-specific difficulties in work environments.

Burnout em professores universitários: impacto de percepções de justiça e comprometimento afetivo

Esta pesquisa objetivou analisar o poder mediacional do comprometimento organizacional afetivo na relação entre as percepções de justiça distributiva, processual e interacional e o burnout. Participaram da pesquisa 233 professores universitários. Foram aplicados os instrumentos avaliativos Maslach Burnout Inventory, Escala de Percepção de Justiça Organizacional e Organizational Commitment Questionnaire. Analisou-se o poder mediacional do comprometimento na relação entre a percepção de justiça e o burnout, a partir da regressão hierárquica. O poder mediacional do comprometimento se confirmou na relação entre percepção de justiça distributiva e exaustão. Concluiu-se que a percepção de injustiça na forma de distribuição de recursos pode levar o professor universitário à exaustão, o que pode ter probabilidade aumentada diante da falta de comprometimento.

Factors predicting team climate, and its relationship with quality of care in general practice

Background

Quality of care in general practice may be affected by the team climate perceived by its health and non-health professionals. Better team working is thought to lead to higher effectiveness and quality of care. However, there is limited evidence available on what affects team functioning and its relationship with quality of care in general practice. This study aimed to explore individual and practice factors that were associated with team climate, and to explore the relationship between team climate and quality of care.

Methods

Cross sectional survey of a convenience sample of 14 general practices and their staff in South Tyneside in the northeast of England. Team climate was measured using the short version of Team Climate Inventory (TCI) questionnaire. Practice characteristics were collected during a structured interview with practice managers. Quality was measured using the practice Quality and Outcome Framework (QOF) scores.

Results

General Practitioners (GP) had a higher team climate scores compared to other professionals. Individual's gender and tenure, and number of GPs in the practice were significantly predictors of a higher team climate. There was no significant correlation between mean practice team climate scores (or subscales) with QOF scores.

Conclusion

The absence of a relationship between a measure of team climate and quality of care in this exploratory study may be due to a number of methodological problems. Further research is required to explore how to best measure team functioning and its relationship with quality of care.

Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

BACKGROUND

Type 2 diabetes is an increasingly prevalent chronic illness and is an important cause of avoidable mortality. Patients are managed by the integrated activities of clinical and non-clinical members of the primary care team. Studies of the quality of care for patients with diabetes suggest less than optimum care in a number of areas.

AIM

The aim of this study is to improve the quality of care for patients with diabetes cared for in primary care in the UK by identifying individual, team, and organisational factors that predict the implementation of best practice.

DESIGN

Participants will be clinical and non-clinical staff within 100 general practices sampled from practices who are members of the MRC General Practice Research Framework. Self-completion questionnaires will be developed to measure the attributes of individual health care professionals, primary care teams (including both clinical and non-clinical staff), and their organisation in primary care. Questionnaires will be administered using postal survey methods. A range of validated theories will be used as a framework for the questionnaire instruments. Data relating to a range of dimensions of the organisational structure of primary care will be collected via a telephone interview at each practice using a structured interview schedule. We will also collect data relating to the processes of care, markers of biochemical control, and relevant indicator scores from the quality and outcomes framework (QOF). Process data (as a proxy indicator of clinical behaviours) will be collected from practice databases and via a postal questionnaire survey of a random selection of patients from each practice. Levels of biochemical control will be extracted from practice databases. A series of analyses will be conducted to relate the individual, team, and organisational data to the process, control, and QOF data to identify configurations associated with high quality care.

STUDY REGISTRATION

UKCRN ref:DRN120 (ICPD).

Team climate, intention to leave and turnover among hospital employees: prospective cohort study

Background

In hospitals, the costs of employee turnover are substantial and intentions to leave among staff may manifest as lowered performance. We examined whether team climate, as indicated by clear and shared goals, participation, task orientation and support for innovation, predicts intention to leave the job and actual turnover among hospital employees.

Methods

Prospective study with baseline and follow-up surveys (2–4 years apart). The participants were 6,441 (785 men, 5,656 women) hospital employees under the age of 55 at the time of follow-up survey. Logistic regression with generalized estimating equations was used as an analysis method to include both individual and work unit level predictors in the models.

Results

Among stayers with no intention to leave at baseline, lower self-reported team climate predicted higher likelihood of having intentions to leave at follow-up (odds ratio per 1 standard deviation decrease in team climate was 1.6, 95% confidence interval 1.4–1.8). Lower co-worker assessed team climate at follow-up was also association with such intentions (odds ratio 1.8, 95% confidence interval 1.4–2.4). Among all participants, the likelihood of actually quitting the job was higher for those with poor self-reported team climate at baseline. This association disappeared after adjustment for intention to leave at baseline suggesting that such intentions may explain the greater turnover rate among employees with low team climate.

Conclusion

Improving team climate may reduce intentions to leave and turnover among hospital employees.