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Zia Ud Din M, Yuan Yuan X, Ullah Khan N, Estay C. The impact of public leadership on collaborative administration and public health delivery. BMC Health Serv Res 2024; 24:129. [PMID: 38263150 PMCID: PMC10807078 DOI: 10.1186/s12913-023-10537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND This research depicts the linkage of public leadership on public health delivery (PHD) and collaborative administration. The research is also focused to examine the effect of public leadership on public health delivery through the intervening variable of collaborative administration by using both social information processing theory and collaboration theory. METHODS This research is based on quantitative method. Data was collected from 464 public hospital administration in the context of Pakistan. This study evaluated data using SPSS, AMOS, and PROCESS Macro. RESULTS Public leadership has a positive profound effect on public health delivery and collaborative administration, and that collaborative administration significantly promotes public health delivery. The outcomes also exposed that public leadership has substantial influence on public health delivery through intervening collaborative administration. CONCLUSIONS Whilst public leadership demonstrated positive outcomes on public health delivery and collaborative administration, there is a need for more rigor studies on collaborative governance leadership, collaborative ethics and collaborative norms in the public health service.
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Affiliation(s)
- Muhammad Zia Ud Din
- School of Public Administration, Central South University, Yuelu District, Changsha, Hunan, 410017, China
| | - Xu Yuan Yuan
- School of Public Administration, Central South University, Yuelu District, Changsha, Hunan, 410017, China.
| | - Naqib Ullah Khan
- School of Public Administration, Central South University, Yuelu District, Changsha, Hunan, 410017, China.
| | - Christophe Estay
- FERRANDI Paris (France), Lirsa, Cnam, Hesam Université, Paris, France
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Li J, Kaltiainen J, Hakanen JJ. Overbenefitting, underbenefitting, and balanced: Different effort–reward profiles and their relationship with employee well-being, mental health, and job attitudes among young employees. Front Psychol 2023; 14:1020494. [PMID: 37051602 PMCID: PMC10083407 DOI: 10.3389/fpsyg.2023.1020494] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/24/2023] [Indexed: 03/28/2023] Open
Abstract
We aimed to identify different, both balanced and imbalanced, effort–reward profiles and their relations to several indicators of employee well-being (work engagement, job satisfaction, job boredom, and burnout), mental health (positive functioning, life satisfaction, anxiety, and depression symptoms), and job attitudes (organizational identification and turnover intention). We examined data drawn randomly from Finnish population (n = 1,357) of young adults (23–34 years of age) collected in the summer of 2021 with quantitative methods. Latent profile analysis revealed three emerging groups in the data characterized by different combinations of efforts and rewards: underbenefitting (16%, high effort/low reward), overbenefitting (34%, low effort/high reward), and balanced employees (50%, same levels of efforts and rewards). Underbenefitting employees reported poorest employee well-being and mental health, and more negative job attitudes. In general, balanced employees fared slightly better than overbenefitting employees. Balanced employees experienced higher work engagement, life satisfaction, and less depression symptoms. The findings highlight the importance of balancing work efforts with sufficient rewards so that neither outweighs the other. This study suggests that the current effort–reward model would benefit from conceptualizing the previously ignored perspective of overbenefitting state and from considering professional development as one of the essential rewards at work.
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Affiliation(s)
- Jie Li
- Finnish Institute of Occupational Health, Helsinki, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- *Correspondence: Jie Li,
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Schneider A, Hering C, Peppler L, Schenk L. Effort-reward imbalance and its association with sociocultural diversity factors at work: findings from a cross-sectional survey among physicians and nurses in Germany. Int Arch Occup Environ Health 2023; 96:537-549. [PMID: 36600024 PMCID: PMC9812741 DOI: 10.1007/s00420-022-01947-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 12/14/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Due to staff shortages and reports of high work stress, work conditions of hospital physicians and nurses receive wide attention. Additionally, sociocultural diversity of the workforce and patient population is increasing. Our study aim is to analyze how individual and organizational diversity-related factors are associated with the experience of staff's work stress. METHODS A cross-sectional online survey was conducted with healthcare staff from 22 acute hospitals operated by two healthcare organizations in Germany in 2018. Sociodemographic, occupational and organizational factors were surveyed. Participants further reported work conditions related to the sociocultural diversity of colleagues and patients. Effort-reward imbalance (ERI) was measured with the German short version. Multivariable regression models were calculated with ER ratio as an outcome. RESULTS N = 800 healthcare staff were included. Variables associated with higher ERI were longer work experience (β = 0.092, p < 0.05), not holding a leading position (0.122, < 0.01), being a witness (0.149, < 0.001) or victim (0.099, < 0.05) of discrimination at one's own ward, reporting frequent burden due to language barriers with patients (0.102, < 0.01) and colleagues (0.127, < 0.001), and having restricted access to translators at work (0.175, < 0.001). Factors associated with lower ERI were having a first generation migration background (- 0.095, < 0.05) and being a physician (- 0.112, < 0.05). CONCLUSIONS Catering to the needs of healthcare personnel in dealing with the additional effort related to language barriers at work, e.g., readily available translator services, and creating non-discriminatory work environments might be one cornerstone for the prevention of work-related ill health and retention of qualified hospital staff.
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Affiliation(s)
- Anna Schneider
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian Hering
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Lisa Peppler
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- grid.6363.00000 0001 2218 4662Institute of Medical Sociology and Rehabilitation Science, Charité–Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Zhou L, Tetgoum Kachie AD, Xu X, Quansah PE, Epalle TM, Ampon-Wireko S, Nkrumah ENK. COVID-19: The effects of perceived organizational justice, job engagement, and perceived job alternatives on turnover intention among frontline nurses. Front Psychol 2022; 13:920274. [PMID: 36148111 PMCID: PMC9486381 DOI: 10.3389/fpsyg.2022.920274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/01/2022] [Indexed: 12/03/2022] Open
Abstract
Nurses' turnover intention has become a concern for medical institutions because nurses are more needed than ever under the prevalence of COVID-19. This research sought to investigate the effects of the four dimensions of organizational justice on COVID-19 frontline nurses' turnover intention through the mediating role of job engagement. We also tested the extent to which perceived job alternatives could moderate the relationship between job engagement and turnover intention. This descriptive cross-sectional study used an online survey to collect data from 650 frontline nurses working in appointed hospitals in Jiangsu province, China. Hierarchical regression was used to analyze the hypothesized relationships. Findings revealed that all organizational justice components significantly influenced job engagement and turnover intention. Job engagement also significantly affected nurses' turnover intention and mediated the relationships between organizational justice components and turnover intention. Besides, perceived job alternatives moderated the relationships between job engagement and turnover intention. The implications of this study include demonstrating that healthcare authorities should respect human rights through effective organizational justice as this approach could encourage nurses to appreciate their job and be more devoted to staying and achieving their institutional duties, especially under challenging circumstances.
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Affiliation(s)
- Lulin Zhou
- Centre for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, Zhenjiang, China
| | - Arielle Doris Tetgoum Kachie
- Centre for Medical Insurance, Hospital Management and Health Policy Research, School of Management, Jiangsu University, Zhenjiang, China
| | - Xinglong Xu
- School of Management, Jiangsu University, Zhenjiang, China
| | | | - Thomas Martial Epalle
- Department of Computer Engineering, School of International Business, Zhejiang International Studies University, Hangzhou, China
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Le AB, Shkembi A, Sturgis AC, Tadee A, Gibbs SG, Neitzel RL. Effort-Reward Imbalance among a Sample of Formal US Solid Waste Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116791. [PMID: 35682374 PMCID: PMC9179994 DOI: 10.3390/ijerph19116791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/04/2023]
Abstract
Background: Solid waste workers are exposed to a plethora of occupational hazards and may also experience work-related stress. Our study had three specific hypotheses: (1) waste workers experience effort−reward imbalance (ERI) with high self-reported effort but low reward, (2) unionized workers experience greater ERI, and (3) workers with higher income have lower ERI. Methods: Waste workers from three solid waste sites in Michigan participated in this cross-sectional study. We characterized perceived work stress using the short-version ERI questionnaire. Descriptive statistics and linear tests for trend were assessed for each scale. Linear regression models were constructed to examine the relationship between structural factors of work stress and ERI. Gradient-boosted regression trees evaluated which factors of effort or reward best characterize workers’ stress. Results: Among 68 participants, 37% of workers reported high effort and low reward from work (ERI > 1). Constant pressure due to heavy workload was most indicative of ERI among the solid waste workers. Union workers experienced 79% times higher ERI than non-unionized workers, while no significant differences were observed by income, after adjusting for confounders. Conclusions: Organizational-level interventions, such as changes related to workload, consideration of fair compensation, and increased support from supervisors, can decrease work stress.
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Affiliation(s)
- Aurora B. Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
- Correspondence: ; Tel.: +1-734-615-7105
| | - Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
| | - Anna C. Sturgis
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
| | - Anupon Tadee
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
| | - Shawn G. Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 77843, USA;
| | - Richard L. Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (A.S.); (A.C.S.); (A.T.); (R.L.N.)
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Jensen N, Lund C, Abrahams Z. Exploring effort-reward imbalance and professional quality of life among health workers in Cape Town, South Africa: a mixed-methods study. Glob Health Res Policy 2022; 7:7. [PMID: 35227327 PMCID: PMC8885139 DOI: 10.1186/s41256-022-00242-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the context of a growing appreciation for the wellbeing of the health workforce as the foundation of high-quality, sustainable health systems, this paper presents findings from two complementary studies to explore occupational stress and professional quality of life among health workers that were conducted in preparation for a task-shifting intervention to improve antenatal mental health services in Cape Town. METHODS This mixed-methods, cross-sectional study was conducted in public sector Midwife Obstetric Units and associated Non-Profit Organisations in Cape Town. Semi-structured interviews and a quantitative survey were conducted among facility-and community-based professional and lay health workers. The survey included demographic as well as effort-reward imbalance (ERI) and professional quality of life (PROQOL) questionnaires to examine overall levels of work-related psychosocial stress and professional quality of life, as well as differences between lay and professional health workers. Qualitative data was analysed using a thematic content analysis approach. Quantitative data was analysed using STATA 12. RESULTS Findings from 37 qualitative interviews highlighted the difficult working conditions and often limited reward and support structures experienced by health workers. Corroborating these findings, our quantitative survey of 165 professional and lay health workers revealed that most health workers experienced a mismatch between efforts spent and rewards gained at work (61.1% of professional and 70.2% of lay health workers; p = 0.302). There were few statistically significant differences in ERI and PROQOL scores between professional and lay health workers. Although Compassion Satisfaction was high for all health worker groups, lay health workers also showed elevated levels of burnout and compassion fatigue, with community-based health workers particularly affected. CONCLUSIONS Findings of this study add to the existing evidence base on adverse working conditions faced by South African public-sector health workers that should be taken into consideration as national and local governments seek to 're-engineer' South Africa's Primary Health Care system. Furthermore, they also highlight the importance of taking into consideration the wellbeing of health workers themselves to develop interventions that can sustainably foster resilient and high-quality health systems.
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Affiliation(s)
- N Jensen
- Department of Global Health and Social Medicine, King's College London, London, UK.
| | - C Lund
- Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's Global Health Institute, King's College London, London, UK
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - Z Abrahams
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
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AlKhars MA, AlFaraj TN, AlNasser AH. Exploring Determinants of Early Retirement Among Saudi Medical Staff. Front Psychol 2021; 12:743393. [PMID: 35002842 PMCID: PMC8732760 DOI: 10.3389/fpsyg.2021.743393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this research was to explore the relationship between the push, pull, anti-push, and anti-pull factors vs. early retirement intention among Saudi medical staff, and to investigate whether there are gender differences in the early retirement intention. To this end, we designed a correlational and cross-sectional study, for which data were collected through an online survey. A total of 680 responses were gathered, of which 221 valid responses constituted the final sample for the analysis. Logistics regression was used to test the hypotheses of the study. The results showed that approximately 58% of the respondents indicated early retirement intention. The significant factors in predicting this intention were the pull, anti-push, and anti-pull factors, whereas the push factors were found to be insignificant. Moreover, female medical staff tend to retire earlier than males. Strategies recommended to delay retirement are providing flexible work hours, working shorter shifts or on a part-time basis, offering programs for professional development, and according more recognition.
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Zeng X, Huang Y, Zhao S, Zeng L. Illegitimate Tasks and Employees' Turnover Intention: A Serial Mediation Model. Front Psychol 2021; 12:739593. [PMID: 34777127 PMCID: PMC8580953 DOI: 10.3389/fpsyg.2021.739593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
In the historical and cultural context of developing countries, such as China, illegitimate tasks have become an important source of workplace pressure for employees. Guided by the framework of the stress-as-offense-to-self theory, we explored how illegitimate tasks increase turnover intention. A total of 474 employees from China effectively completed the online survey. The results showed a positive correlation between illegitimate tasks, effort-reward imbalance, work-family conflict, and turnover intention. Illegitimate tasks can affect intention to quit directly and through two indirect paths: the separate intermediary effect of work-family conflict and the continuous mediating role of effort-reward imbalance and work-family conflict. The results indicate that illegitimate tasks increase employees' intention to quit through the role of effort-reward imbalance and work-family conflict. This study contributes to our understanding of the mechanisms underlying the relationship between illegitimate tasks and workers' turnover intention in the context of Chinese history and culture. Additionally, the findings have implications for reducing attrition rate.
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Affiliation(s)
- Xiaoye Zeng
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Yafu Huang
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Shouying Zhao
- School of Psychology, Guizhou Normal University, Guiyang, China
| | - Lianping Zeng
- School of Psychology, Guizhou Normal University, Guiyang, China
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Nilsen P, Fernemark H, Seing I, Schildmeijer K, Ericsson C, Skagerström J. Working conditions in primary care: a qualitative interview study with physicians in Sweden informed by the Effort-Reward-Imbalance model. BMC FAMILY PRACTICE 2021; 22:149. [PMID: 34246243 PMCID: PMC8272309 DOI: 10.1186/s12875-021-01500-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Many problems with primary care physicians' psychosocial working conditions have been documented. Many studies on working condition have used the Effort-Reward-Imbalance (ERI) model, which posits that poor health and well-being may result from imbalances between the level of effort employees perceive that they put into their work and the rewards they receive. The model has not been used in qualitative research or applied to investigate primary care physicians' working conditions. The aim of this study was to apply the ERI model to explore the perceived efforts and rewards by primary care physicians in Sweden and approaches they take to cope with potential imbalances between these efforts and rewards. METHODS The study has a qualitative design, using semi-structured interviews. A purposeful sampling strategy was used to achieve a heterogeneous sample of primary care physicians who represented a broad spectrum of experiences and perceptions. We recruited 21 physicians; 15 were employed in public health care and 6 by private health care companies. RESULTS The analysis of the interviews yielded 11 sub-categories: 6 were mapped to the efforts category, 3 were attributed to the rewards category and 2 were approaches to coping with effort/reward imbalances. Many of the statements concerned efforts in the form of high workload, restricted autonomy and administrative work burden. They also perceived resource restrictions, unpredictability of work and high expectations in their role as physicians as efforts. Three types of rewards emerged; the physicians found their job to be stimulating and meaningful, and the work climate to be supportive. The physicians coped with imbalances by means of job enrichment and using decisional latitude. CONCLUSIONS Primary care physicians perceive numerous types of efforts in their job, which is consistent with research concerning work stress and associated consequences, such as poor subjective health and well-being. There are also rewards according to primary care physicians, but the findings suggest a lack of reciprocity in terms of efforts and rewards although firm conclusions cannot be drawn since the study did not investigate the magnitude of the various efforts and rewards or the effectiveness of the approaches the physicians use to cope with imbalances. The ERI model was found to be useful to explore physicians' primary care work and working conditions but its applicability likely depends on the type of work or professions being studied.
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Affiliation(s)
- Per Nilsen
- Department of Health, Medicine and Caring Sciences, Division of Health and Society, Linköping University, 581 83, Linköping, Sweden.
| | - Hanna Fernemark
- Department of Health, Medicine and Caring Sciences, Division of Health and Society, Linköping University, 581 83, Linköping, Sweden
| | - Ida Seing
- Department of Behavioral Science and Learning, Linköping University, 581 83, Linköping, Sweden
| | - Kristina Schildmeijer
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, Sweden
| | - Carin Ericsson
- Medicine Center, Region Östergötland, 581 85, Linköping, Sweden
| | - Janna Skagerström
- Research and Development Unit in Region Östergötland, Linköping, Sweden
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Arbeitsbelastung und Arbeitszufriedenheit rechtsmedizinisch tätiger Ärztinnen und Ärzte. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00465-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zusammenfassung
Hintergrund und Ziele
Das Fach Rechtsmedizin unterscheidet sich strukturell und inhaltlich sehr von anderen medizinischen Disziplinen. Da zu Arbeitsbelastung und Berufszufriedenheit der Rechtsmediziner*innen im deutschsprachigen Raum bislang wenig bekannt ist, wurden diese Aspekte über eine Online-Befragung untersucht.
Material und Methoden
Der Fragebogen wurde im September 2019 online an 436 rechtsmedizinisch tätige Ärzt*innen verschickt. Er enthielt je nach Antwortverhalten der Teilnehmer bis zu 53 Fragen zu den Themen Arbeitsbelastung und -zufriedenheit, Weiterbildung, Karriere, Forschung, Beruf vs. Privatleben und Generationenwandel. Die psychosoziale Arbeitsbelastung wurde anhand des Modells der beruflichen Gratifikationskrisen überprüft.
Ergebnisse
Von 199 bearbeiteten Fragebogen waren 181 vollständig ausgefüllt und konnten ausgewertet werden. Der Großteil der Befragten war zufrieden mit der Routinetätigkeit. Die Hälfte der Weiterbildungsassistent*innen (WBA) war zufrieden mit den institutsinternen Weiterbildungsbedingungen. Nur etwas mehr als ein Drittel der Befragten war zufrieden mit der wissenschaftlichen Tätigkeit; die Hälfte der befragten Ärzt*innen forschte aktiv. Die psychosoziale Arbeitsbelastung war bei einem mittleren ER-Quotienten von 1,24 insgesamt eher hoch. Es zeigten sich keine Unterschiede bezüglich Arbeitsbelastung und -zufriedenheit zwischen Assistenz- und Fachärzt*innen. Nur wenige WBA strebten eine zukünftige Leitungsposition an.
Diskussion
Die (hohe) psychosoziale Arbeitsbelastung der Rechtsmediziner*innen ist vergleichbar mit anderen medizinischen Fachrichtungen. Die gleichzeitig hohe Arbeitszufriedenheit könnte für eine Inkaufnahme der (Mehr‑)Belastung aufgrund einer hohen intrinsischen Motivation sprechen. Aus den erhobenen Daten lässt sich Handlungsbedarf zur Etablierung optimierter Bedingungen für Forschung und institutsinterne Weiterbildung ableiten.
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Leineweber C, Bernhard‐Oettel C, Eib C, Peristera P, Li J. The mediating effect of exhaustion in the relationship between effort-reward imbalance and turnover intentions: A 4-year longitudinal study from Sweden. J Occup Health 2021; 63:e12203. [PMID: 33543549 PMCID: PMC7862986 DOI: 10.1002/1348-9585.12203] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/09/2020] [Accepted: 01/20/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Earlier studies suggest that imbalance between effort and reward at work associates with exhaustion. Others have found that exhaustion increases turnover intentions; an important precursor of actual turnover that also associates with counterproductive work behaviors. Few, however, have studied the associations between effort-reward imbalance (ERI) and employees' intentions to leave their current employment, and whether exhaustion is underpinning that relationship. Here, we investigate the mediating role of exhaustion in the effort-reward imbalance - turnover intentions relationship. METHODS Data from three waves covering a time span of four years from the Swedish Longitudinal Occupational Survey of Health (SLOSH) were analysed using structural equation modeling. Cross-lagged mediation analyses were conducted to estimate if associations from ERI to subsequent turnover intentions were mediated by exhaustion. Other causal directions (direct and reversed direct effects, reversed mediation) were also examined. RESULTS A direct path from ERI T1 to turnover intentions T2 was found, but not from ERI T2 to turnover intentions T3. Additionally, results showed that ERI at time points T1/T2 associated significantly with exhaustion two years later (T2/T3). Also, exhaustion at T1 showed a small but statistically significant direct association with turnover intentions at T2 (no association was found between exhaustion T2 and turnover intentions T3). A small, but statistically significant indirect effect from ERI to turnover intentions was found (estimate 0.005; 95% CI 0.002-0.010). CONCLUSIONS Providing a good balance between effort and reward for workers is essential to protect employee health and help retain employees in the organization.
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Affiliation(s)
| | | | - Constanze Eib
- Department of PsychologyUppsala UniversityUppsalaSweden
| | | | - Jian Li
- Department of Environmental Health SciencesFielding School of Public HealthSchool of NursingUniversity of CaliforniaLos Angeles (UCLA)CAUSA
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Sharififard F, Asayesh H, Rahmani-Anark H, Qorbani M, Akbari V, Jafarizadeh H. Intention to Leave the Nursing Profession and Its Relation with Work Climate and Demographic Characteristics. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2019; 24:457-461. [PMID: 31772921 PMCID: PMC6875889 DOI: 10.4103/ijnmr.ijnmr_209_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 08/11/2019] [Accepted: 08/24/2019] [Indexed: 12/05/2022]
Abstract
BACKGROUND Because of the importance of staff shortage in health systems, considering the intention to leave the job and its related factors among nurses is very important. The aim of this study was to identify the association between the intention to leave the nursing profession and work climate and demographic characteristics. MATERIALS AND METHODS A cross-sectional survey was conducted among 206 nurses, by random sampling method from six hospitals (response rate = 92%). A set of self-administered questionnaires were applied for the evaluation of intention to leave and work climate. RESULTS The high level of intention to leave the profession was expressed by 23.70% of the participants; 25.10% of the participants had the moderate intention. Data analysis revealed that work climate, type of employment, marital status, and overtime working were significant predictors of nurses' intention to leave after controlling other independent variables (R2 = 0.10, p < 0.001). CONCLUSIONS It was found that work climate and some demographic characteristics can be seen as indicators for intention to leave among nurses; therefore, considering the so-called variables is required. Further studies are needed to identify other aspects of the issue.
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Affiliation(s)
- Fatemeh Sharififard
- Department of Anesthesiology Nursing, School of Paramedic, Qom University of Medical Sciences, Qom, Iran
| | - Hamid Asayesh
- Medical Emergencies, School of Paramedic, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Rahmani-Anark
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Golestan University of Medical Sciences, Gorgan, Iran,, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Kara, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Valiollah Akbari
- Department of Psychiatry, School of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Hossein Jafarizadeh
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Leineweber C, Eib C, Bernhard-Oettel C, Nyberg A. Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health. WORK AND STRESS 2019. [DOI: 10.1080/02678373.2019.1666434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
| | - Constanze Eib
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | - Anna Nyberg
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Scharf J, Vu-Eickmann P, Li J, Müller A, Angerer P, Loerbroks A. Work-Related Intervention Needs and Potential Occupational Outcomes among Medical Assistants: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132260. [PMID: 31248036 PMCID: PMC6651363 DOI: 10.3390/ijerph16132260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 11/16/2022]
Abstract
Medical assistants' (MAs) working conditions have been characterized as precarious, and workplace-related intervention needs have been identified. However, strategies to change the MAs adverse working conditions are mostly seen on an individual level, including leaving the employer or even the profession. Since such intentions are antecedents of actual turnover, we aimed to quantify the potential link of reported unmet intervention needs with unfavorable occupational outcomes. Data were collected by means of a nationwide survey among medical assistants (n = 994) in Germany (September 2016-April 2017). The three subscales working conditions, reward from the supervisor, and task-related independence were derived from a 12-item instrument regarding work-related interventions needs (the independent variables). We used subscale-specific z-scores and a total needs z-score. The four outcome variables (i.e., intention to leave the employer, intention to leave the MA profession, choosing MA profession again, and recommending MA profession to young people) were dichotomized, and logistic regression analyses were performed and limited to MAs in employment (n = 887). We found that increasing needs according to the categorized total needs score were associated with increasing odds of all occupational outcomes. Needs pertaining to working conditions and reward from the supervisor were the strongest determinants of MAs' consideration of leaving their employer or profession (Odds ratios: 1.55-2.61). In summary, our study identified unmet work-related intervention needs that are associated with unfavorable occupational outcomes. In light of staffing shortage in health care, the identified needs should be addressed to ensure that sufficient recruitment of junior staff in the profession of medical assistants remains feasible and that experienced staff is retained.
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Affiliation(s)
- Jessica Scharf
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Patricia Vu-Eickmann
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
- Department of Environmental Health Sciences, Fielding School of Public Health; School of Nursing, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141 Essen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany.
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Bianchi R, Mayor E, Schonfeld IS, Laurent E. Burnout and depressive symptoms are not primarily linked to perceived organizational problems. PSYCHOL HEALTH MED 2018; 23:1094-1105. [DOI: 10.1080/13548506.2018.1476725] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Renzo Bianchi
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, NE, Switzerland
| | - Eric Mayor
- Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, NE, Switzerland
| | - Irvin Sam Schonfeld
- Department of Psychology, The City College of the City University of New York, New York City, NY, USA
| | - Eric Laurent
- Laboratory of Psychology (EA 3188), Bourgogne Franche-Comté University, Besançon, France
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Associations of psychosocial working conditions with health outcomes, quality of care and intentions to leave the profession: results from a cross-sectional study among physician assistants in Germany. Int Arch Occup Environ Health 2018; 91:643-654. [PMID: 29691658 DOI: 10.1007/s00420-018-1309-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/18/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Numerous epidemiological studies among health care staff have documented associations of adverse psychosocial working conditions with poorer health-related outcomes, a reduced quality of patient care and intentions to leave the profession. The evidence for physician assistants in Germany remains limited though. METHODS We surveyed a total of 994 physician assistants between September 2016 and April 2017. Psychosocial working conditions were measured by the established effort-reward imbalance (ERI) questionnaire and by a questionnaire specifically developed to capture psychosocial working conditions among physicians. Health outcomes (i.e., self-rated health, depression, anxiety), self-rated quality of care and the intention to leave the profession were assessed by established measures. We ran multivariable logistic regression analyses. RESULTS The prevalence of work stress in terms of ERI equalled 73.77%. Work stress according to the ERI model was associated with significantly poorer self-rated health [odds ratio (OR) 3.62], elevated symptoms of depression (OR 8.83) and anxiety (OR 4.95), poorer quality of care (OR for medical errors 4.04; OR for interference of work with patient care 3.88) and an increased intention to leave one's current profession (OR 3.74). The PA-specific questionnaire showed similar, albeit weaker, associations (all ORs > 1.22). CONCLUSIONS Our results are in line with previous findings among health care staff and provide specific and novel evidence for physician assistants. Interventions aiming at the improvement of working conditions seem needed given their potential adverse consequences in terms of employee health, quality of care, and personnel policy.
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Ashley C, Peters K, Brown A, Halcomb E. Work satisfaction and future career intentions of experienced nurses transitioning to primary health care employment. J Nurs Manag 2018; 26:663-670. [DOI: 10.1111/jonm.12597] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Christine Ashley
- School of Nursing; Faculty of Science, Medicine and Health; University of Wollongong; NSW Australia
| | - Kath Peters
- School of Nursing & Midwifery; Western Sydney University; Penrith NSW Australia
| | - Angela Brown
- School of Nursing; Faculty of Science, Medicine and Health; University of Wollongong; NSW Australia
| | - Elizabeth Halcomb
- School of Nursing; Faculty of Science, Medicine and Health; University of Wollongong; NSW Australia
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18
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Abstract
Background: Work stress among nurses has increased in recent years due to the demands of clinical nursing. Objectives: To investigate psychosocial work stress among nurses using the effort-reward imbalance (ERI) model with assessment malondialdehyde (MDA) as an oxidative stress marker and total antioxidants. Methods: The present study was conducted on 204 registered nurses worked at two tertiary hospitals in Menoufia governorate, Egypt through the period from the 1st of February to the end of July 2016. Two questionnaires were applied including general demographic and occupational histories as well as effort-reward questionnaire. Blood analysis was performed to assess MDA and total antioxidant levels. Results: ERI was prevalent among the study participants (72.5%). ERI was more prevalent among young married nurses who worked more than 10 years. Nurses that worked at ICUs complained more of ERI (43.2%) while nurses that worked at operation rooms complained more of overcommitment (62.5%). MDA levels were significantly positively correlated with E/R ratios (rho = 0.350, P ≤ 0.001). Conclusions: Work stress was prevalent among the studied nurses as revealed by the high ERI and MDA levels. Young married female nurses complained more of work stress. ICUs and operating rooms were the most stressful departments at the studied hospitals. Hence, implementing programs and strategies that eliminate stressful working conditions at hospitals is critical to the reduction and prevention of work stress among nurses.
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Affiliation(s)
- Eman A Salem
- Public Heath and Community Medicine, Faculty of Medicine, Menoufia University
| | - Sabah M Ebrahem
- Psychiatric Nursing, Faculty of Nursing, Menoufia University
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19
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Keisu BI, Öhman A, Enberg B. Employee effort - reward balance and first-level manager transformational leadership within elderly care. Scand J Caring Sci 2017; 32:407-416. [PMID: 28851057 DOI: 10.1111/scs.12475] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/04/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Negative aspects, staff dissatisfaction and problems related to internal organisational factors of working in elderly care are well-known and documented. Much less is known about positive aspects of working in elderly care, and therefore, this study focuses on such positive factors in Swedish elderly care. We combined two theoretical models, the effort-reward imbalance model and the Transformational Leadership Style model. The aim was to estimate the potential associations between employee-perceived transformational leadership style of their managers, and employees' ratings of effort and reward within elderly care work. METHODS The article is based on questionnaires distributed at on-site visits to registered nurses, occupational therapists, physiotherapists (high-level education) and assistant nurses (low-level education) in nine Swedish elderly care facilities. In order to grasp the positive factors of work in elderly care, we focused on balance at work, rather than imbalance. RESULTS We found a significant association between employees' effort-reward balance at work and a transformational leadership style among managers. An association was also found between employees' level of education and their assessments of the first-level managers. CONCLUSIONS We conclude that the first-level manager is an important actor for achieving a good workplace within elderly care, since she/he influences employees' psychosocial working environment. We also conclude that there are differences and inequalities, in terms of well-being, effort and reward at the work place, between those with academic training and those without, in that the former group to a higher degree evaluated their first-level manager to perform a transformational leadership style, which in turn is beneficial for their psychosocial work environment. Consequently, this (re)-produce inequalities in terms of well-being, effort and reward among the employees at the work place.
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Affiliation(s)
- Britt-Inger Keisu
- Department of Sociology, Umeå University, Umeå, Sweden.,Umeå Centre for Gender Studies, Umeå University, Umeå, Sweden
| | - Ann Öhman
- Umeå Centre for Gender Studies, Umeå University, Umeå, Sweden.,Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Birgit Enberg
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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Herr RM, Li J, Loerbroks A, Angerer P, Siegrist J, Fischer JE. Effects and mediators of psychosocial work characteristics on somatic symptoms six years later: Prospective findings from the Mannheim Industrial Cohort Studies (MICS). J Psychosom Res 2017; 98:27-33. [PMID: 28554369 DOI: 10.1016/j.jpsychores.2017.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 03/29/2017] [Accepted: 05/03/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Ample evidence documented the adverse health effects of work stressors, and recent research has increasingly focused on somatic symptoms which are very common and costly. Prospective evidence is however sparse and yielded mixed findings. Furthermore, there is reason to assume that depression and anxiety might mediate the effects of adverse psychosocial work conditions on somatic symptoms. This study aimed to investigate longitudinal effects of work stressors on somatic symptoms and the potential mediation by anxiety and/or depression. METHODS Six year follow-up data from 352 individuals - free of potentially stress-related chronic disease - were utilized. Somatic symptoms were assessed by 19 items of an established list of complaints at baseline and follow-up. The effort-reward-imbalance (ERI) model measured adverse psychosocial work conditions and over-commitment (OC). Linear regressions adjusted for socio-demographics, social status, lifestyle, and baseline symptoms estimated the effects of the ERI ratio, effort, reward, OC, and the ERI ratio×OC interaction on somatic symptoms six years later. Furthermore, single and multiple mediation by anxiety and/or depression was investigated. RESULTS There was a strong longitudinal effect of the ERI ratio, as well as of its subcomponents, and OC on somatic symptoms (all Bs≥|0.49|; p-values ≤0.004). Moreover, the ERI ratio×OC interaction was significant (p-value=0.047). Multiple mediation analyses revealed especially anxiety to mediate the effect of work stressors on somatic symptoms (Sobel test=0.007). CONCLUSION Adverse psychosocial work conditions seem to longitudinally affect somatic symptoms, potentially moderated by OC, and mediated by anxiety.
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Affiliation(s)
- Raphael M Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany; Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Johannes Siegrist
- Senior Professorships on Work Stress Research, Life Science Center, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Germany.
| | - Joachim E Fischer
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Germany.
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21
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Weiß EE, Süß S. Protective faith? The role of religiosity in the stressor-strain relationship in helping professions. INTERNATIONAL JOURNAL OF HUMAN RESOURCE MANAGEMENT 2017. [DOI: 10.1080/09585192.2017.1325387] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eva-Ellen Weiß
- Chair of Business Administration, Organization Studies and Human Resource Management, Heinrich-Heine-University of Duesseldorf, Düsseldorf, Germany
| | - Stefan Süß
- Chair of Business Administration, Organization Studies and Human Resource Management, Heinrich-Heine-University of Duesseldorf, Düsseldorf, Germany
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Pierce H, Perry L, Gallagher R, Chiarelli P. Urinary incontinence, work, and intention to leave current job: A cross sectional survey of the Australian nursing and midwifery workforce. Neurourol Urodyn 2017; 36:1876-1883. [DOI: 10.1002/nau.23202] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 11/23/2016] [Accepted: 11/27/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Heather Pierce
- Faculty of Health; University of Technology Sydney; Sydney NSW Australia
| | - Lin Perry
- Faculty of Health; University of Technology Sydney; Sydney NSW Australia
- Professor of Nursing Research and Practice Development; Prince of Wales Hospital, Sydney Eye Hospitals, Faculty of Health, University of Technology Sydney; Sydney NSW Australia
| | - Robyn Gallagher
- Faculty of Health; University of Technology Sydney; Sydney NSW Australia
- Professor of Nursing, Charles Perkins Centre, Sydney School of Nursing, University of Sydney; Faculty of Health, University of Technology; Sydney Australia
| | - Pauline Chiarelli
- Conjoint Associate Professor School of Health Sciences (Physiotherapy); University of Newcastle; Newcastle Australia
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de Oliveira DR, Griep RH, Portela LF, Rotenberg L. Intention to leave profession, psychosocial environment and self-rated health among registered nurses from large hospitals in Brazil: a cross-sectional study. BMC Health Serv Res 2017; 17:21. [PMID: 28068999 PMCID: PMC5223488 DOI: 10.1186/s12913-016-1949-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/14/2016] [Indexed: 12/05/2022] Open
Abstract
Background Nurses’ intention to leave their profession is a worldwide concern. Studies have shown that it can take the form of a chain reaction: many nurses first leave the unit, then the hospital, and finally the profession. Organisation and other labour factors, personal and conjunctural, have been associated with the intention to quit nursing. This study aimed to examine the factors associated with the intention to leave the profession among registered nurses (RNs) at large public hospitals in Brazil. Methods This was a cross-sectional study, conducted from 2010 to 2011: all RNs at Rio de Janeiro’s 18 largest public hospitals (>150 beds) were invited to participate. The study sample comprised 3,229 RNs (82.7% of those eligible), who answered a self-completed, multidimensional paper questionnaire. The outcome was defined as thoughts of leaving the profession sometimes a month or more. We based the analyses on hierarchical logistic regression models, considering three blocks of determinants: socio-demographic data (block I), occupational factors (block II), and health conditions (block III). Results Of the study population, 22.1% indicated the intention to leave the profession. In the final model after adjustment, the variables associated with the intention to leave were as follows: male sex (odds ratio [OR] = 1.65), not holding a leadership position (OR = 1.28), highly demanding work (OR = 2.49), passive work (OR = 2.10), effort-reward imbalance (OR = 2.00), poor self-rated health (OR = 1.92), over-commitment to the job (OR = 1.87), and poor supervisor support (OR = 1.33). The likelihood of expressing the intention to leave increased with age (OR = 0.98 for the oldest). Conclusions Self-rated health and factors connected with the work environment, particularly those that generate psychosocial strain, were most strongly associated with the intention to leave the profession. From the profiles of nurses who wished to leave the profession, we found that for many people who go into nursing—especially men and younger entrants—their prospects of remaining in the profession are poor. The potential role of psychosocial job characteristics and self-rated health indicates the need for long-term action involving all stakeholders, i.e. managers, employers, and workers.
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Affiliation(s)
- Daiana Rangel de Oliveira
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute (IOC/FIOCRUZ), Pav Lauro Travassos. Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute (IOC/FIOCRUZ), Pav Lauro Travassos. Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
| | - Luciana Fernandes Portela
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute (IOC/FIOCRUZ), Pav Lauro Travassos. Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil. .,National School of Public Health, Oswaldo Cruz Foundation (ENSP/FIOCRUZ), Pav Lauro Travassos, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil.
| | - Lucia Rotenberg
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute (IOC/FIOCRUZ), Pav Lauro Travassos. Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil
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Renard M, Snelgar RJ. The engagement and retention of non-profit employees in Belgium and South Africa. SOUTH AFRICAN JOURNAL OF HUMAN RESOURCE MANAGEMENT 2016. [DOI: 10.4102/sajhrm.v14i1.795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Orientation: A lack of qualitative research exists that investigates work engagement and retention within Belgium and South Africa, particularly within the non-profit sector.Research purpose: The study aimed to gather in-depth qualitative data pertaining to the factors that promote work engagement and retention amongst non-profit employees working within these two countries.Motivation for the study: Because of scarce funding and resources, non-profit organisations are pressured to retain their talented employees, with high levels of turnover being a standard for low-paid, human-service positions. However, when individuals are engaged in their work, they display lower turnover intentions, suggesting the importance of work engagement in relation to retention.Research design, approach and method: Non-probability purposive and convenience sampling was used to organise in-depth interviews with 25 paid non-profit employees working on either a full-time or a part-time basis within Belgium and South Africa. Thematic analysis was used to analyse the qualitative data produced.Main findings: Participants were found to be absorbed in, dedicated to and energised by their work, and revealed numerous aspects promoting their retention including working towards a purpose, finding fulfilment in their tasks and working in a caring environment.Practical/managerial implications: Non-profit organisations should develop positive work environments for their employees to sustain their levels of work engagement, as well as place significance on intrinsic rewards in order to retain employees.Contribution: This study provides insights into the means by which non-profit employees across two nations demonstrate their enthusiasm, pride and involvement in the work that they perform. It moreover sheds light on the factors contributing to such employees intending to leave or stay within the employment of their organisations.
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Perry L, Gallagher R, Duffield C, Sibbritt D, Bichel‐Findlay J, Nicholls R. Does nurses’ health affect their intention to remain in their current position? J Nurs Manag 2016; 24:1088-1097. [DOI: 10.1111/jonm.12412] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 01/12/2023]
Affiliation(s)
- Lin Perry
- Faculty of Health University of Technology Sydney Sydney NSW Australia
| | - Robyn Gallagher
- Charles Perkins Centre Sydney Nursing School University of Sydney Sydney NSW Australia
| | - Christine Duffield
- University of Technology Sydney Sydney NSW Australia
- Edith Cowan University Perth WA Australia
| | - David Sibbritt
- Faculty of Health University of Technology Sydney Sydney NSW Australia
| | - Jen Bichel‐Findlay
- Health Services Management Faculty of Health University of Technology Sydney Sydney NSW Australia
| | - Rachel Nicholls
- Faculty of Health University of Technology Sydney Sydney NSW Australia
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Satoh M, Watanabe I, Asakura K. Occupational commitment and job satisfaction mediate effort-reward imbalance and the intention to continue nursing. Jpn J Nurs Sci 2016; 14:49-60. [DOI: 10.1111/jjns.12135] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 02/24/2016] [Accepted: 03/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Miho Satoh
- Faculty of Nursing; Tokyo Health Care University; Tokyo Japan
| | - Ikue Watanabe
- Faculty of Health Sciences; Tohoku Fukushi University; Sendai Japan
| | - Kyoko Asakura
- Department of Nursing Education and Administration; Graduate School of Medicine, Tohoku University; Sendai Japan
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27
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Siegrist J, Li J. Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:432. [PMID: 27104548 PMCID: PMC4847094 DOI: 10.3390/ijerph13040432] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 11/18/2022]
Abstract
Mainstream psychological stress theory claims that it is important to include information on people’s ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI) differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers’ health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence, with a special focus on the distinct contribution of its intrinsic component, the coping pattern “over-commitment”, towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. Results based on 51 reports document an independent explanatory role of “over-commitment” in explaining workers’ health in a majority of studies. However, support in favour of the interaction hypothesis is limited and requires further exploration. In conclusion, the findings of this review support the usefulness of a work stress model that combines extrinsic and intrinsic components in terms of scientific explanation and of designing more comprehensive worksite stress prevention programs.
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Affiliation(s)
- Johannes Siegrist
- Senior Professorship on Work Stress Research, Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
| | - Jian Li
- Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstrasse 1, Düsseldorf 40225, Germany.
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28
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Söderberg M, Härenstam A, Rosengren A, Schiöler L, Olin AC, Lissner L, Waern M, Torén K. Psychosocial work environment, job mobility and gender differences in turnover behaviour: a prospective study among the Swedish general population. BMC Public Health 2014; 14:605. [PMID: 24927628 PMCID: PMC4073185 DOI: 10.1186/1471-2458-14-605] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 06/09/2014] [Indexed: 11/10/2022] Open
Abstract
Background Throughout the literature, substantial evidence supports associations between poor psychosocial work characteristics and a variety of ill-health outcomes. Yet, few reports strategies workers carry out to improve detrimental work conditions and consequently their health, such as changing jobs. The aim of this study was to examine if adverse psychosocial work exposure, as measured with the job demand-control and effort-reward imbalance models, could predict job mobility over a 5 years observation period. Method Participants were working men and women (n = 940; 54.3% women), aged 24–60 years from the population of Gothenburg and surrounding metropolitan area. Job demand-control and effort-reward variables were compared with independent t-tests and chi2-test in persons with and without job mobility. Multivariate logistic regression was used to analyse whether psychosocial factors could predict job mobility. All regression analyses were stratified by gender. Results Exposure to a combination of high demands-low control or high imbalance between effort and reward was related to increased odds of changing jobs (OR 1.63; CI 1.03-2.59 and OR 1.46; CI 1.13-1.89 respectively). When analysing men and women separately, men had a higher OR of changing jobs when exposed to either high demands-low control (OR 2.72; CI 1.24-5.98) or high effort-reward imbalance (OR 1.74; CI 1.11-2.72) compared to reference values. The only significant associations for women was slightly decreased odds for turnover in high reward jobs (OR 0.96; CI 0.92-0.99). Conclusions The results indicate that workers will seek to improve poor work environment by changing jobs. There were notable gender differences, where men tended to engage in job mobility when exposed to adverse psychosocial factors, while women did not. The lack of measures for mechanisms driving job mobility was a limitation of this study, thus preventing conclusions regarding psychosocial factors as the primary source for job mobility.
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Affiliation(s)
- Mia Söderberg
- Department of Occupational and Environmental Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 405 30, Gothenburg, Sweden.
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The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study. J Occup Environ Med 2014; 55:809-16. [PMID: 23787570 DOI: 10.1097/jom.0b013e31828acb19] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. METHODS We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. RESULTS We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. CONCLUSIONS Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.
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Kao CC, Wang RH, Ying JC, Lin YH, Chang FY, Chen KY. Psychometric analysis of the Short-Form Chinese Health and Safety Executive's Management Standards Indicator Tool among nurses in Taiwan. J Health Psychol 2013; 20:1497-508. [PMID: 24371041 DOI: 10.1177/1359105313515292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of the study was to develop a Short-Form Chinese version of the Health and Safety Executive's Management Standards Indicator Tool that can be used to measure work-related stress among nurses in Taiwan. Three subscales (supportive climate, role perception, and workload) were developed from an exploratory factor analysis. The three-factor confirmatory factor analysis indicated that the model fit the data well. The evidence based on convergent validity was supported by a significant correlation between the Short-Form Chinese version of the Health and Safety Executive's Management Standards Indicator Tool and the job satisfaction subscale of the Chinese Patient Safety Attitude Questionnaire. Cronbach's α values demonstrated internal item consistency for the Short-Form Chinese version of the Health and Safety Executive's Management Standards Indicator Tool.
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Homburg V, van der Heijden B, Valkenburg L. Why do nurses change jobs? An empirical study on determinants of specific nurses' post-exit destinations. J Nurs Manag 2013; 21:817-26. [DOI: 10.1111/jonm.12142] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Vincent Homburg
- Public Administration; Erasmus University Rotterdam; Rotterdam the Netherlands
| | - Beatrice van der Heijden
- Nijmegen School of Management; Institute for Management Research; Radboud University Nijmegen; Nijmegen the Netherlands
- School of Management; Open Universiteit in the Netherlands; Heerlen the Netherlands
- School of Management and Governance; Business Administration; Department of Strategic HRM; University of Twente; Enschede the Netherlands
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Piers RD, Van den Eynde M, Steeman E, Vlerick P, Benoit DD, Van Den Noortgate NJ. End-of-Life Care of the Geriatric Patient and Nurses’ Moral Distress. J Am Med Dir Assoc 2012; 13:80.e7-13. [DOI: 10.1016/j.jamda.2010.12.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 12/15/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
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Li J, Galatsch M, Siegrist J, Müller BH, Hasselhorn HM. Reward frustration at work and intention to leave the nursing profession—Prospective results from the European longitudinal NEXT study. Int J Nurs Stud 2011; 48:628-35. [DOI: 10.1016/j.ijnurstu.2010.09.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 07/23/2010] [Accepted: 09/10/2010] [Indexed: 10/18/2022]
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