Work-family conflict and job burn-out among Chinese doctors: the mediating role of coping styles

Work-Family Conflict and Depression Among Healthcare Workers: The Role of Sleep and Decision Latitude

BACKGROUND

Healthcare workers report a higher incidence of depression than the general population. Work-family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work-family conflict into depression.

METHODS

In 2018, a cross-sectional survey was collected from healthcare workers (n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants' work-family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables.

FINDINGS

There was a significant association between work-family conflict and depression (β = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family-conflict and depression was stronger among workers with low decision latitude.

CONCLUSIONS

Depression was prevalent among healthcare workers and was associated with work-family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association.

APPLICATION TO PRACTICE

Evidence-based interventions seeking to alleviate the effect of work-family conflict and improve healthcare workers' mental health should consider promoting employee sleep quality and improving employees' decision-making on the job.

Work-Family Conflict, Organizational Identification, and Professional Identification Among Chinese Nurses From a Resource Perspective

BACKGROUND

The miserable work conditions faced by many nurses around the world make them particularly prone to work-family conflict.

PURPOSE

This study was designed to explain from a resource perspective how and when nurses experiencing work-family conflict are more likely to exhibit decreased levels of organizational identification and professional identification.

METHODS

A time-separation research design was used, and data were collected from 322 nurses in five hospitals in China. All of the hypotheses were tested using conduct structural equation modeling.

RESULTS

The results showed that work-family conflict had negative effects on organizational identification and professional identification via emotional exhaustion. In addition, job meaningfulness may have a buffering effect on the negative impact of work-family conflict on emotional exhaustion, organizational identification, and professional identification.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The results advance knowledge on how and when work-family conflict damages organizational identification and professional identification. Providing family support, relieving emotional exhaustion, and enhancing job meaningfulness are necessary to support the organizational and professional identification of nurses.

Potentially traumatic events and post-traumatic growth among Chinese peacekeepers: A moderated mediation model

Peacekeepers are inherently exposed to potentially traumatic events (PTEs) in the line of duty. However, little is known about whether PTEs during peacekeeping missions may foster post-traumatic growth (PTG) among peacekeepers and its mechanisms. This study aimed to investigate the association between PTEs and PTG among Chinese peacekeepers, as well as the mediating role of coping style and the moderating role of resilience. Five hundred ninety-five Chinese peacekeepers completing the United Nations (UN) peacekeeping mission in South Sudan and returning to China were recruited to complete Peacekeeping Traumatic Stress Exposure Scale, Posttraumatic Growth Inventory, Simplified Coping Style Questionnaire and the Chinese version of Connor and Davidson's Resilience Scale. PTEs were positively associated with PTG among Chinese peacekeepers. Coping style partially mediated the association between PTEs and PTG. Resilience moderated the association between coping style and PTG. Specifically, at a lower level of resilience, positive coping style was more effective in predicting PTG. This study contributes to understanding the complex association between PTEs in peacekeeping missions, coping style, resilience and PTG by focusing on the experiences of Chinese peacekeepers and adds value to the current literature on psychological health in peacekeepers.

Helping others not always helps ourselves: the relationship between victim incivility and emergency workers' burnout through work-to-family conflict

Purpose

This study aims to analyse whether and when victim incivility may be related to work-to-family conflict and then burnout among emergency workers.

Design/methodology/approach

A total of 304 Italian emergency workers from five firehouses and six emergency rooms completed questionnaires, examining: victim incivility, work-to-family conflict, social support seeking and burnout symptoms. Descriptive analyses, confirmatory factor analyses and structural equation models were conducted.

Findings

Victim incivility was positively associated with burnout symptoms, both directly and indirectly, as mediated by work-to-family conflict. Additionally, social support seeking exacerbated (rather than mitigated) the impact of work-to-family conflict on burnout symptoms.

Practical implications

Organisations can greatly benefit from implementing family-friendly practices and providing their workers with training programmes on how to deal with difficult victims.

Originality/value

This study contributes to the existing literature on workplace incivility and work–life interface by supporting for the first time the notion that victim incivility can spill over into emergency workers' family domain and by clarifying how and when victim incivility is related to burnout symptoms.

Learning from adversity: Occupational therapy staff experiences of coping during Covid-19

Introduction

The Occupational Therapy profession is adaptable and flexible (Thorner (1991) and these characteristics have the potential to act as protective factors during the COVID-19 pandemic. Understanding the mechanisms that support coping during adversity can help promote future wellbeing. The aim of this study was to explore how Occupational Therapy staff felt and coped during the first peak of the pandemic.

Method

A questionnaire was developed to explore the experiences of Occupational Therapy staff during the first wave of the COVID-19 pandemic. The questions explored feelings, mechanisms of support and challenges to both practice and wellbeing. A total of 75 staff responded across one NHS Health Board and reflections were analysed using inductive content analysis.

Findings

Staff reflected on how their ability to adapt and remain flexible were protective factors. This combined with supportive family members, friends and colleagues led respondents to reflect on how well they coped. Barriers to coping included organisational challenges, personal challenges and professional challenges.

Conclusion

The importance of consistent communication, the need for staff to remain connected to their profession and the importance of engaging in meaningful occupations were highlighted as key to maintaining wellbeing during adversity.

The Influence of Work-Family Conflict on Burnout during the COVID-19 Pandemic: The Effect of Teleworking Overload

If there is any field that has experienced changes as a result of the COVID-19 pandemic, it is work, primarily due to the implementation of teleworking and the effort made by workers and families to face new responsibilities. In this context, the study aims to analyze the impact of work–family conflict on burnout, considering work overload, in teleworkers during the COVID-19 pandemic. To evaluate the hypotheses, we used data collected during the last week of July 2020 using an online survey. Work–family conflict and burnout were measured using the Gutek et al. (1991) and Shirom (1989) scales. We tested the hypotheses using a structural equation model (SEM). The results indicated, between other findings, that there was a positive relationship between work–family conflict and family–work conflict and all the dimensions of burnout. However, there was no effect of teleworking overload in the work–family conflict and burnout relationship. This article is innovative because it highlights the importance of the economic and regulatory conditions that have surrounded the modality of teleworking during the pandemic, and their influence on wellbeing and psychosocial risks in workers.

Perceived work ability and work-family conflict in healthcare workers: An observational study in a teaching hospital in Italy

Objective

The aim of the study was to investigate the variables associated with work ability, work‐family conflict and the relationship between these variables.

Methods

An observational prospective study was conducted and involved 436 employees of a Teaching Hospital in Rome. Data collection was performed using the following tools: the Work Ability Index (WAI) and the Work‐to‐family conflict and Family‐to‐work conflict Scale (WFC—FWC Scale). Data were analyzed through univariate analysis of variance (ANOVA) and multivariate linear regression, using the SPSS software version 25.

Results

A direct relationship of the WFC score with two variables (female gender and physicians) and an inverse relationship with other two variables (age and administrative staff) were found. There is a direct relationship between the FWC score and the variable “having sons”. The WFC and FWC scores showed a direct relationship between them.

The Work Ability presented an almost significant association only with the profession variable, in which administrative staff, followed by physicians, presented a higher WAI score with respect to other professional categories, such as nurses.

Conclusions

Wellbeing intervention for health workers should be directed mainly to women, older workers and those with sons. In addition, more attention should be given to nurses, who showed lower work ability scores.

Work-to-Family Conflict and its Associations With Workers' Burnout, Poor Self-Rated Health, and Minor Mental Disorder: A Survey of General Employees in Taiwan

OBJECTIVES

To examine the distribution of work-to-family conflict (W-FC) across socio-demographic groups and a wide spectrum of occupations, and its associations with workers' burnout, self-rated health, and mental health status by sex.

METHODS

A cross-sectional household survey of representative employees was conducted in 2013. A standardized questionnaire was administered to collect information.

RESULTS

W-FC was high in employees aged 35 to 44 years old and in certain occupational groups. Long working hours, rotating work shift, high work demands, high job control, low workplace justice, and family care burden were risk factors for W-FC, and high W-FC score was significantly associated with burnout, poor self-rated health, and minor mental disorder.

CONCLUSIONS

To improve workers' health, it is essential to identify high risk groups and adopt measures to reduce conflicts between work and family life.

Occupational burnout, job satisfaction and anxiety among emergency medicine doctors in Turkey

OBJECTIVE

The objective of the study was to investigate possible differences in the levels of anxiety, burnout and job satisfaction among emergency medicine doctors based on their age, gender, employment duration, job title and institution.

METHODS

General practitioners, residents, specialists and faculty members working in emergency departments (ED) in Turkey were invited to participate in this questionnaire-based study through an e-mail link between September 2018 and January 2019. A total of 141 doctors from different cities of Turkey who completely filled the questionnaire with their own will were recruited for the study. The Maslach Burnout Inventory(MBI) was used to measure occupational burnout levels, the State-Trait Anxiety Inventory(STAI) to measure anxiety levels and the Short Form Minnesota Satisfaction Questionnaire(SFMSQ) to measure job satisfaction levels of doctors working in EDs. In assessing MBI; Emotional Exhaustion score(EE) is considered low for 0-11 points, moderate for 12-17 points and high >17 points; Depersonalization score is considered low for 0-5 points, moderate for 6-9 points and high ≥ 10 points; , Feeling of low personal accomplishment(PA) is considered low for 0-21 points, moderate for 22- 25 points and high ≥ 26 points. In Assessing STAI; 20- 49 points were considered low/ moderate anxiety and 50- 80 points considered high/ very high anxiety. In assessing SFMSQ neutral job satisfaction point was reported 3; so individuals are considered extremely dissatisfied/ not satisfied (low) if job satisfaction point <3 and very/ extremely satisfied (high) if job satisfaction point >3.

RESULTS

The mean age of the study group was 33.3 (±7.3) and mean employment duration was 8.37 (±6.89). In the overall study population, the emotional exhaustion(EE) was high while depersonalization(DP) and reduction of personal accomplishment(PA) were detected at medium level in the evaluation of MBI subscales. In evaluating overall study population for STAI, state and trait anxiety scores both showed the presence of mild to moderate anxiety. The overall study population evaluation results for SFMSQ were, high levels of general and intrinsic job satisfaction and low levels of extrinsic job satisfaction was measured. Younger the age and shorter the duration of employment is found to be associated with a significant increase in EE and DP and a significant decrease in PA.

CONCLUSION

In this study, scale results showed that doctors working in EDs had high levels of occupational burnout and anxiety, while job satisfaction levels were low. In addition, a significant relationship was found between the decrease in "age and employment duration" and the increase in "depersonalization".

The prevalence and stressors of job burnout among medical staff in Liaoning, China: a cross-section study

BACKGROUND

Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators.

METHODS

The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors.

RESULTS

The prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30-39 years old, had a master's degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively.

CONCLUSION

The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.

Reliability and validity of the Chinese version of the Work-Family-School Role Conflicts Scale among nurses

Objective

To translate and validate the Chinese version of the Work-Family-School Role Conflicts Scale (WFSRCs-S) among nurses with multiple roles.

Methods

A sample of 233 registered nurses pursuing an advanced degree was recruited from 8 university hospitals in 5 cities in China from March to July 2016. The original scale of WFSRCs-S was translated into Chinese and revised to reflect cultural meaning, using standard translation methodology, and its reliability and validity were assessed.

Results

The content validity index of the 12-item WFSRCs-S-Chinese was 0.83, and the item level of content validity index ranged from 0.79 to 1.00. The exploratory factor analysis yielded a three-factor solution (work-school-to-family role conflict, family-school-to-work role conflict, and work-family-to-school role conflict) and explained 71.9% of the total variance for WFSRCs-S-Chinese. The Cronbach’s α coefficients for the total scale and the three sub-scales were 0.87, 0.79, 0.78, and 0.87. The confirmatory factor analysis revealed that the measurement model was satisfied, and the test-retest reliability of WFSRCs-S-Chinese was 0.85. The WFSRCs-S-Chinese score was positively associated with burnout (r = 0.36, P < 0.001) and negatively related to role-related social support (r = −0.18, P = 0.046), thereby establishing concurrent validity.

Conclusion

The reliability and construct validity of the WFSRCs-S-Chinese suggest that this scale could be useful to assess inter-role conflicts among nurses with multiple roles in China.

Family incivility and work-engagement: moderated mediation model of personal resources and family-work enrichment

Research on work incivility has been abundant while that on family incivility is still in infancy stage. The current research attempts to bridge this gap. Using Ten Brummelhuis and Bakker’s (2012) Work-Home Resources model (W-HR model), this study tested the role of active coping and self-efficacy in moderating the impact of family incivility on work engagement mediated through family-work enrichment. Data from 478 university faculty in different educational institutions across India tend to suggest that active coping and self-efficacy assist this sample in negating the negative impact of family incivility on work engagement through family-work enrichment. The mediated relationship between family incivility, family-work enrichment and work engagement was found to be stronger for those respondents with the dual resources of active coping and self - efficacy. The study found significant support for core propositions of the W-HR model and puts forward both theoretical and several practical implications. Future directions are also presented.

The Role of Coping in the Wellbeing and Work-Related Quality of Life of UK Health and Social Care Workers during COVID-19

The coronavirus disease 2019 (COVID-19) was declared a global pandemic in early 2020. Due to the rapid spread of the virus and limited availability of effective treatments, health and social care systems worldwide quickly became overwhelmed. Such stressful circumstances are likely to have negative impacts on health and social care workers' wellbeing. The current study examined the relationship between coping strategies and wellbeing and quality of working life in nurses, midwives, allied health professionals, social care workers and social workers who worked in health and social care in the UK during its first wave of COVID-19. Data were collected using an anonymous online survey (N = 3425), and regression analyses were used to examine the associations of coping strategies and demographic characteristics with staff wellbeing and quality of working life. The results showed that positive coping strategies, particularly active coping and help-seeking, were associated with higher wellbeing and better quality of working life. Negative coping strategies, such as avoidance, were risk factors for low wellbeing and worse quality of working life. The results point to the importance of organizational and management support during stressful times, which could include psycho-education and training about active coping and might take the form of workshops designed to equip staff with better coping skills.

COVID-19 Outbreak Can Change the Job Burnout in Health Care Professionals

Background: The outbreak of COVID-19 in China was a sudden bio-disaster, which may bring a negative impact on the job burnout of health care professionals (HCPs). Objective: We aim to find out the association factors, especially those closely related to this outbreak, of job burnout in Chinese HCPs. Method: The cross-sectional survey about HCPs' job burnout based on a network platform was conducted in high and low infection regions during the COVID-19 outbreak in China. The demographic characteristics, medical-work-related factors, risk of getting infected due to occupational exposure, and family factors were collected by the self-reported questionnaire. The Chinese version of the Maslach Burnout Inventory (CMBI) and the Trait Coping Style Questionnaire (TCSQ) were employed in this study to evaluate the job burnout and coping style, respectively. Furthermore, statistical analysis was done to find out the associated factors of job burnout. Results: We collected 880 complete questionnaires from doctors and nurses from February 9, 2020 to February 11, 2020. In this study, the positive rates of three dimensions of burnout (emotional exhaustion, depersonalization, and reduced personal accomplishment) and overall burnout were 9.09, 50.57, 56.59, and 73.98%, respectively. After the statistical analysis, we found that several factors can independently affect the dimensions. Working in the high infection region and negative coping styles can affect all three dimensions at once. More night shift quantity and having symptoms could increase emotional exhaustion and depersonalization, while higher work intensity and senior title could increase emotional exhaustion and reduce personal accomplishment, respectively. Conclusion: The rate of moderate and severe burnout had increased due to the outbreak. More attention should be paid to burnout in HCPs, especially those with negative coping. There were some potential ways to reduce burnout, such as reducing their workload and providing better protection from the virus.

Burnout is associated with work-family conflict and gratification crisis among German resident physicians

BACKGROUND

Studies investigating the longitudinal predictive value of burnout on both effort-reward imbalance (within the working place) and work-family conflict (between work and private life) in residents are lacking. Former cross-sectional studies showed an association of effort-reward imbalance and work family conflict with an elevated burnout risk in physicians.

METHODS

Data acquisition was carried out within the multi-centric, longitudinal, and prospective "KarMed" study in Germany from 2009 until 2016. Yearly surveys including validated scales: the Maslach Burnout Inventory with its three subscales (emotional exhaustion, personal accomplishment, depersonalisation), the Work-Family Conflict Scale, and the Effort-Reward Imbalance Inventory. Further independent variables were gender and parental status.The analyses were based on general linear models and general linear mixed models with repeated measures designs.

RESULTS

Significant time-fixed effects were found for all three subscales of the Maslach Burnout Inventory, with gender effects on the subscales emotional exhaustion and depersonalisation. The parental status had no significant effect on burnout. All estimated means for burnout during 6 years of post-graduate training were higher when work-family conflict and gratification crisis were taken into account. Personal accomplishment increased continuously over time as well showing neither gender differences nor influences by the parental status.

CONCLUSIONS

Personal accomplishments might act as a buffer compensating to some extent for the physicians' stress experience. Given that burnout may be associated with poor patient care, there is a need to reduce burnout rates and their associated factors in resident physicians.

Job Burnout Among Primary Healthcare Workers in Rural China: A Multilevel Analysis

The health workers in rural primary care systems are at the increasing risk of job burnout. To explore the prevalence and associated factors of the job burnout among the primary healthcare worker in rural China, a cross-sectional survey was conducted among 15,627 participants in 459 township hospitals from six provinces. A combination of stratified multi-stage sampling and cluster sampling method, and a self-administrated questionnaire with the Chinese version of the Maslach Burnout Inventory-General Scale (MBI-GS) were used in the investigation. Multilevel regression analyses were used to examine the potential associated factors on both individual and organisational levels. 47.6% of respondents were experiencing moderate burnout, and 3.3% were in severe burnout. Professionals working for over 40 h per week, at young age, with a college degree, and with professional titles at medium or high rank reported a higher degree of job burnout. At the institutional level, the high ratio of performance-based salary was associated with a higher level of depersonalization. Burnout has become prevalent among the primary healthcare workers in rural China, and multiple strategies are needed to reduce the work stress and some high-risk groups’ vulnerability to job burnout.

Development of the Nurses' Occupational Stressor Scale

Although nurses work in stressful environments, stressors in such environments have yet to be clearly assessed. This study aimed to develop a Nurses’ Occupational Stressor Scale (NOSS) with high reliability and validity. Candidate questions for the NOSS were generated by expert consensus following focus group feedback, and were used to survey in 2013. A shorter version was then developed after examination for validity and reproducibility in 2014. The accuracy of the short version of the NOSS for predicting nurses’ stress levels was evaluated based on receiver operating characteristic curves to compare existing instruments for measuring stress outcomes, namely personal burnout, client-related burnout, job dissatisfaction, and intention to leave. Examination for validity and reproducibility yielded a shorter version of NOSS with only 21 items was considered sufficient for measuring stressors in nurses’ work environments. Nine subscales were included: (1) work demands, (2) work–family conflict, (3) insufficient support from coworkers or caregivers, (4) workplace violence and bullying, (5) organizational issues, (6) occupational hazards, (7) difficulty taking leave, (8) powerlessness, and (9) unmet basic physiological needs. The 21-item NOSS proved to have high concurrent and construct validity. The correlation coefficients of the subscales for test-retest reliability ranged from 0.71 to 0.83. The internal consistency (Cronbach’s α) coefficients ranged from 0.35 to 0.77. The NOSS exhibited accurate prediction of personal burnout, client-related burnout, job dissatisfaction, and intention to leave.

Prevalence and Influencing Factors of Anxiety and Depression Symptoms in the First-Line Medical Staff Fighting Against COVID-19 in Gansu

BACKGROUND

The outbreak of novel coronavirus pneumonia (COVID-19) has brought enormous physical and psychological pressure on Chinese medical staff. It is extremely important to understand the prevalence and influencing factors of anxiety and depression symptoms in first-line anti-epidemic medical staff and their coping styles for these negative emotions.

METHODS

A cross-sectional survey was conducted in Gansu (China), with a questionnaire packet which consisted of the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and the simplified coping style questionnaire (SCSQ). A total of 79 doctors and 86 nurses participated in the survey. Correlation analysis was performed to explore the relationship between SAS, SDS, and SCSQ score. A linear regression model was used to determine the influencing factors for anxiety or depression symptoms.

RESULTS

The prevalence rates of anxiety and depression symptoms among doctors was 11.4% and 45.6%, respectively. History of depression or anxiety (T=-2.644, p= 0.010, 95%CI: -10.514~-1.481) was shown to be a risk factor for anxiety symptoms in doctors, while being male (T=2.970, p=0.004, 95%CI: 2.667~13.521) was a protective factor for depression. The prevalence rate of anxiety and depression symptoms among nurses was 27.9% and 43.0%, respectively. History of depression or anxiety was a common risk factor for anxiety symptoms (T=-3.635, p=0.000, 95%CI: -16.360~-4.789) and depression symptoms (T=-2.835, p=0.005, 95%CI:-18.238~-3.254) in nurses. The results of partial correlation analysis (controlled for gender and history of depression or anxiety) indicated that the total score of positive coping was negatively correlated with the total score of anxiety (r=-0.182, p=0.002) and depression (r=-0.253, p=0.001).

CONCLUSIONS

The first-line anti-epidemic medical staff have high anxiety and depression symptoms and adopting positive coping styles will help to improve their negative emotions.