Risk Factors and Leadership in a Digitalized Working World and Their Effects on Employees' Stress and Resources: Web-Based Questionnaire Study

Association between constant connectivity to work during leisure time and insomnia: does work engagement matter?

PURPOSE

The influx of communication media to contemporary workplaces has exposed workers to be always connected to their work. Constant connectivity to work (CCW) refers to the condition in which workers are always connected to work, even during their non-work hours, and are not detached from the work situation. We investigated the association between CCW and insomnia and the moderating effect of work engagement.

METHODS

A total of 29,512 nationally representative samples of workers in Korea were used. Insomnia was assessed by the Minimal Insomnia Symptom Scale. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The additive interaction between CCW and low work engagement was estimated by calculating Relative Excess Risk due to Interaction (RERI).

RESULTS

Exposure to CCW was related to insomnia (OR [95% CI] 1.33 [1.22-1.46]). Additionally, a significant negative interaction between CCW and work engagement was observed. The effects of CCW were mitigated in those with high work engagement. The OR of the combined effect of CCW exposure and low work engagement was 2.52 (95% CI 2.22-2.87). RERI between exposure to CCW and low work engagement was 0.69 (95% CI 0.38-0.99), indicating that there is a supra-additive interaction.

CONCLUSION

Our study found that CCW is related to an increased risk of insomnia and that high work engagement can mitigate the effect of CCW. Our study suggests that improving work engagement and disconnecting from work outside of work hours can help protect employees' sleep quality.

Digital stressors and resources perceived by emergency physicians and associations to their digital stress perception, mental health, job satisfaction and work engagement

BACKGROUND

Digital technologies are increasingly being integrated into healthcare settings, including emergency departments, with the potential to improve efficiency and patient care. Although digitalisation promises many benefits, the use of digital technologies can also introduce new stressors and challenges among medical staff, which may result in the development of various negative work and health outcomes. Therefore, this study aims to identify existing digital stressors and resources among emergency physicians, examine associations with various work- and health-related parameters, and finally identify the potential need for preventive measures.

METHODS

In this quantitative cross-sectional study, an online questionnaire was used to examine the relationship between digital stressors (technostress creators), digital resources (technostress inhibitors), technostress perception as well as mental health, job satisfaction and work engagement among 204 physicians working in German emergency medicine departments. Data collection lasted from December 2022 to April 2023. Validated scales were used for the questionnaire (e.g. "Technostress"-scale and the Copenhagen Psychosocial Questionnaire (COPSOQ). Descriptive and multiple regression analyses were run to test explorative assumptions.

RESULTS

The study found medium levels of technostress perception among the participating emergency physicians as well as low levels of persisting technostress inhibitors. The queried physicians on average reported medium levels of exhaustion symptoms, high levels of work engagement and job satisfaction. Significant associations between digital stressors and work- as well as health-related outcomes were analyzed.

CONCLUSION

This study provides a preliminary assessment of the persistence of digital stressors, digital resources and technostress levels, and their potential impact on relevant health and work-related outcomes, among physicians working in German emergency departments. Understanding and mitigating these stressors is essential to promote the well-being of physicians and ensure optimal patient care. As digitisation processes will continue to increase, the need for preventive support measures in dealing with technology stressors is obvious and should be expanded accordingly in the clinics. By integrating such support into everyday hospital life, medical staff in emergency departments can better focus on patient care and mitigate potential stress factors associated with digital technologies.

Stressors, Resources, and Strain Associated with Digitization Processes of Medical Staff Working in Neurosurgical and Vascular Surgical Hospital Wards: A Multimethod Study

The digitization of German hospitals is proceeding continuously, leading to the implementation of new digital technologies, such as electronic health records (EHRs) or other technologies, used for the purpose of medical documentation tasks. Even though the replacement of paper documentation through digitized documentation in general promises to come along with plenty of benefits, the daily utilization of technologies might also lead to stresses and strains among the medical staff, eventually possibly leading to the development of different negative work and health-related outcomes. This study, therefore, aims at identifying persisting digitization-associated stressors and resources among medical hospital staff, examining their influences on different work and health-related outcomes, and finally, identifying potential needs for preventive measures. A quantitative study in the form of an online questionnaire survey was conducted among physicians working in the medical field of neuro- and vascular surgery in German hospitals. The study was carried out between June and October 2022 utilizing an online questionnaire based on several standardized scales, such as the technology acceptance model (TAM) and the technostress model, as well as on several scales from the Copenhagen Psychosocial Questionnaire (COPSOQ). The study found medium levels of technostress among the participating physicians (n = 114), as well as low to medium levels of persisting resources. The queried physicians, on average, reported low levels of burnout symptoms, generally described their health status as good, and were mostly satisfied with their job. Despite the prevalence of technostress and the low levels of resources among the surveyed physicians, there is little awareness of the problem of digital stress, and preventive measures have not been widely implemented yet in the clinics, indicating a needs gap and the necessity for the strategic and quality-guided implementation of measures to effectively prevent digital stress from developing.

The effects of digitalisation on health and social care work: a qualitative descriptive study of the perceptions of professionals and managers

BACKGROUND

Today, digitalisation is strongly present in health and social care, and it increasingly affects the organisation of work, work requirements, tasks and tools. Due to the constant change in work, up-to-date knowledge is needed about these micro-level effects of digitalisation and how professionals experience the effects in their work. Furthermore, even though managers play a key role in implementing new digital services, their perceptions of the effects of digitalisation and whether they match the views of professionals remain unknown. This study examined how health and social care professionals and managers perceive the effects of digitalisation on the work of professionals.

METHODS

We used a qualitative approach and conducted eight semi-structured focus group interviews with health and social care professionals (n = 30) and 21 individual interviews with managers in 2020 in four health centres in Finland. The qualitative content analysis included both an inductive and a deductive approach.

RESULTS

Digitalisation was perceived to have changed professionals' 1) workload and pace, 2) the field and nature of work, 3) work community communication and interaction, and 4) information flow and security. Both professionals and managers identified effects such as accelerated work, reduction in workload, constant learning of technical skills, complicated work due to vulnerable information systems, and reduction in face-to-face encounters. However, managers did not bring up all the effects that professionals considered important, such as the creation of new work tasks, increased and duplicated work, or insufficient time to get acquainted with the systems.

CONCLUSIONS

The findings suggest that some of the effects of digitalisation on professionals' work and changes in the workplace may receive too little or no recognition from managers. This increases the risk that the potential negative effects may be overlooked and that managers will adopt systems that do not support the work of professionals. To reach a common understanding of the effects of digitalisation, continuous discussions between employees and different management levels are required. This contributes to professionals' well-being and adaptation to changes, as well as the provision of quality health and social services.

What difference does it make? A laboratory experiment on the effectiveness of health-oriented leadership working on-site compared to the digital working context

BACKGROUND

Health-oriented leadership (HoL) represents an important workplace resource for employees. However, as opportunities to work from home increase, the question arises, whether leadership is more or less effective in digital working contexts compared to working on-site.

METHODS

The current research investigates, whether the effectiveness of health-oriented leadership in terms of staff care is influenced by the working context. In a laboratory experiment with a 2 (no staff care vs. staff care) x 2 (working on-site vs. digital) mixed design (N = 60), a moderating effect of the working context on the relationship between staff care and employees' mental exhaustion, heart rate, heart rate variability, engagement and job satisfaction was tested.

RESULTS

Results uncovered positive effects of staff care on employees' mental exhaustion and work-related attitudes in both conditions (d = 1.09-1.91). As expected, the results indicate that the effects on employees' engagement (d = 0.65) and job satisfaction (d = 0.72) are weaker when working digital.

CONCLUSION

Findings show that the effectiveness of staff care might differ between working on-site and working digital. In order to maintain the effectiveness of staff care, leaders and employees should keep regular face-to-face contact also when mainly working from home. The study ties in with research on digital leadership and leadership effectiveness, and contributes to the deeper understanding of situational contingencies of health-specific leadership during the process of digitization.

Increasing digitalization is associated with anxiety and depression: A Google Ngram analysis

The prevalence of anxiety disorders and depression are rising worldwide. Studies investigating risk factors on a societal level leading to these rises are so far limited to social-economic status, social capital, and unemployment, while most such studies rely on self-reports to investigate these factors. Therefore, our study aims to evaluate the impact of an additional factor on a societal level, namely digitalization, by using a linguistic big data approach. We extend related work by using the Google Books Ngram Viewer (Google Ngram) to retrieve and adjust word frequencies from a large corpus of books (8 million books or 6 percent of all books ever published) and to subsequently investigate word changes in terms of anxiety disorders, depression, and digitalization. Our analyses comprise and compare data from six languages, British English, German, Spanish, Russian, French, and Italian. We also retrieved word frequencies for the control construct "religion". Our results show an increase in word frequency for anxiety, depression, and digitalization over the last 50 years (r = .79 to .89, p < .001), a significant correlation between the frequency of anxiety and depression words (r = .98, p < .001), a significant correlation between the frequency of anxiety and digitalization words (r = .81, p < .001), and a significant correlation between the frequency of depression and anxiety words (r = .81, p < .001). For the control construct religion, we found no significant correlations for word frequency over the last 50 years and no significant correlation between the frequency of anxiety and depression words. Our results showed a negative correlation between the frequency of depression and religion words (r = -.25, p < .05). We also improved the method by excluding terms with double meanings detected by 73 independent native speakers. Implications for future research and professional and clinical implications of these findings are discussed.

Virtual leadership in relation to employees' mental health, job satisfaction and perceptions of isolation: A scoping review

Background

The significant increase of digital collaboration, driven by the current COVID-19 pandemic, is resulting in changes in working conditions and associated changes in the stress-strain perception of employees. Due to the evident leadership influence on employees' health and well-being in traditional work settings, there is a need to investigate leadership in virtual remote work contexts as well. The objective of this scoping review was to assess the extent and type of evidence concerning virtual leadership in relation to employees' mental health, job satisfaction and perceptions of isolation.

Method

A search was undertaken in five databases, PubMed, Cochrane Library, PsycINFO, PSYNDEX and Web of Science, as well as reference lists of included articles on 9th February 2021 and an update on 28th September 2021. The search strategy was limited to English, German and French language, peer reviewed journal articles published from January 2000 onwards. This scoping review was conducted in accordance with the JBI methodology for scoping reviews. The methodological quality of the included studies was assessed using the JBI critical appraisal tools. A narrative synthesis was conducted.

Results

Nineteen studies met the eligibility criteria for this review. Overarching review findings suggested a positive link between virtual leadership and well-being, job satisfaction, and a negative link to psychological strain, stress and perceptions of isolation of digitally collaborating employees.

Conclusions

By mapping the available evidence on virtual leadership in relation to health and work-related employee outcomes, the review identified many research gaps in terms of content and methodology. Due to limited data, causal relationships were not derived. Future research is needed to examine the complex cause-and-effect relationships of virtual leadership in more detail.

Influence of algorithmic management practices on workplace well-being – evidence from European organisations

Purpose

Existing literature on algorithmic management practices – defined as autonomous data-driven decision making in people's management by adoption of self-learning algorithms and artificial intelligence – suggests complex relationships with employees' well-being in the workplace. While the use of algorithms can have positive impacts on people-related decisions, they may also adversely influence job autonomy, perceived justice and – as a result – workplace well-being. Literature review revealed a significant gap in empirical research on the nature and direction of these relationships. Therefore the purpose of this paper is to analyse how algorithmic management practices directly influence workplace well-being, as well as investigating its relationships with job autonomy and total rewards practices.

Design/methodology/approach

Conceptual model of relationships between algorithmic management practices, job autonomy, total rewards and workplace well-being has been formulated on the basis of literature review. Proposed model has been empirically verified through confirmatory analysis by means of structural equation modelling (SEM CFA) on a sample of 21,869 European organisations, using data collected by Eurofound and Cedefop in 2019, with the focus of investigating the direct and indirect influence of algorithmic management practices on workplace well-being.

Findings

This research confirmed a moderate, direct impact of application of algorithmic management practices on workplace well-being. More importantly the authors found out that this approach has an indirect influence, through negative impact on job autonomy and total rewards practices. The authors observed significant variation in the level of influence depending on the size of the organisation, with the decreasing impacts of algorithmic management on well-being and job autonomy for larger entities.

Originality/value

While the influence of algorithmic management on various workplace practices and effects is now widely discussed, the empirical evidence – especially for traditional work contexts, not only gig economy – is highly limited. The study fills this gap and suggests that algorithmic management – understood as an automated decision-making vehicle – might not always lead to better, well-being focused, people management in organisations. Academic studies and practical applications need to account for possible negative consequences of algorithmic management for the workplace well-being, by better reflecting complex nature of relationships between these variables.

Football Fandom as a Platform for Digital Health Promotion and Behaviour Change: A Mobile App Case Study

Background: The last decade has seen a dramatic shift toward the study of fitness surveillance, thanks in part to the emergence of mobile health (mHealth) apps that allow users to track their health through a variety of data-driven insights. This study examines the adoption trends and community mediation of the mobile fitness application ‘FanFit’, a platform aimed at promoting physical activity among sports fans by creating a fitness app branded to their favourite team for health promotion. Objective: Our study looked at the impact of a specially designed mobile app (FanFit) as a digital health intervention for initiating and maintaining physical activity as part of football club membership. Our analysis indicates that app users will adopt healthier behaviours as a result of the app’s sense of fan community and behaviour change. Methods: The findings reported here are based on an implementation of the FanFit app and, in particular, on those who participated in a more in-depth study (n = 30). These participants were Rangers FC supporters with a mix of genders (n = 19 males and n = 11 females). Focus groups and interviews were conducted with participants to ascertain users’ perspectives on the most effective methods for nudging users toward adopting and maintaining a pattern of fitness behaviours. Results: The findings show that the user community was interested in fitness and wanted to live a ‘healthy lifestyle,’ which was augmented and fuelled by the app’s competitive architecture design. Furthermore, the data reveal a new fan-health discourse about a person’s developing wants, talents, and identities as embodied beings. Conclusions: We have developed and presented valid links between the use of sports club apps and health programmes. The app could be useful for sports programmes and club providers looking for mHealth applications that provide community support through fan discourse with opportunities for both male and female fans.

Enforced home-working under lockdown and its impact on employee wellbeing: a cross-sectional study

Background

The Covid-19 pandemic precipitated a shift in the working practices of millions of people. Nearly half the British workforce (47%) reported to be working at home under lockdown in April 2020. This study investigated the impact of enforced home-working under lockdown on employee wellbeing via markers of stress, burnout, depressive symptoms, and sleep. Moderating effects of factors including age, gender, number of dependants, mental health status and work status were examined alongside work-related factors including work-life conflict and leadership quality.

Method

Cross-sectional data were collected over a 12-week period from May to August 2020 using an online survey. Job-related and wellbeing factors were measured using items from the COPSOQIII. Stress, burnout, somatic stress, cognitive stress, and sleep trouble were tested together using MANOVA and MANCOVA to identify mediating effects. T-tests and one-way ANOVA identified differences in overall stress. Regression trees identified groups with highest and lowest levels of stress and depressive symptoms.

Results

81% of respondents were working at home either full or part-time (n = 623, 62% female). Detrimental health impacts of home-working during lockdown were most acutely experienced by those with existing mental health conditions regardless of age, gender, or work status, and were exacerbated by working regular overtime. In those without mental health conditions, predictors of stress and depressive symptoms were being female, under 45 years, home-working part-time and two dependants, though men reported greater levels of work-life conflict. Place and pattern of work had a greater impact on women. Lower leadership quality was a significant predictor of stress and burnout for both men and women, and, for employees aged > 45 years, had significant impact on level of depressive symptoms experienced.

Conclusions

Experience of home-working under lockdown varies amongst groups. Knowledge of these differences provide employers with tools to better manage employee wellbeing during periods of crisis. While personal factors are not controllable, the quality of leadership provided to employees, and the ‘place and pattern’ of work, can be actively managed to positive effect. Innovative flexible working practices will help to build greater workforce resilience.

Technostress and Digital Competence Among Health Professionals in Swiss Psychiatric Hospitals: Cross-sectional Study

BACKGROUND

Psychiatric hospitals are becoming increasingly digitized because of the disruptive rise in technical possibilities. This digitization leads to new tasks and demands for health professionals, which can have an impact on technostress. It is unclear whether digital competence reduces technostress and how technostress affects health professionals' mental and physical health.

OBJECTIVE

This study aims to assess the association between digital competence and technostress, considering individual characteristics and the association between technostress and long-term consequences for health professionals.

METHODS

Cross-sectional data from 3 Swiss psychiatric hospitals were analyzed using multiple linear regression. The dependent variables for the models were digital competence, technostress, and long-term consequences (intention to leave the organization or the profession, burnout symptoms, job satisfaction, general health status, quality of sleep, headaches, and work ability). One model was calculated for each long-term consequence. The mean scores for technostress and digital competence could range between 0 (fully disagree) and 4 (fully agree), where a high value for technostress indicated high technostress and a high value for digital competence indicated high digital competence.

RESULTS

The sample comprised 493 health professionals in psychiatric hospitals. They rated their technostress as moderate (mean 1.30, SD 0.55) and their digital competence as high (mean 2.89, SD 0.73). Digital competence was found to be significantly associated with technostress (β=-.20; P<.001). Among the individual characteristics, age (β=.004; P=.03) and profession were significantly associated with both digital competence and technostress. Technostress is a relevant predictor of burnout symptoms (β=10.32; P<.001), job satisfaction (β=-6.08; P<.001), intention to leave the profession (β=4.53; P=.002), organization (β=7.68; P<.001), general health status (β=-4.47; P<.001), quality of sleep (β=-5.87; P<.001), headaches (β=6.58; P<.001), and work ability (β=-1.40; P<.001).

CONCLUSIONS

Physicians and nurses who have more interaction with digital technologies rate their technostress higher and their digital competence lower than those in other professions. Health professionals with low interaction with digital technologies appear to overestimate their digital competence. With increasing digitization in psychiatric hospitals, an increase in the relevance of this topic is expected. Educational organizations and psychiatric hospitals should proactively promote the digital competence of health professionals to manage expected disruptive changes.