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Cooper A, Teoh KRH, Madine R, Neal A, Jones A, Hussain A, Behrens DA. The last resort: reducing avoidable employee harm by improving the application of the disciplinary policy and process. Front Psychol 2024; 15:1350351. [PMID: 39100569 PMCID: PMC11294217 DOI: 10.3389/fpsyg.2024.1350351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 06/14/2024] [Indexed: 08/06/2024] Open
Abstract
Introduction There is growing evidence within the healthcare sector that employee investigations can harm individuals involved in the process, an organization's culture and the delivery of its services. Methods This paper details an intervention developed by an NHS Wales organization to reduce the number of its employee investigations through an organization-wide focus that promoted a 'last resort' approach and introduced the concept of 'avoidable employee harm'. A range of associated improvement initiatives were developed to support behavior change among those responsible for determining whether an employee investigation should be initiated. Results Over a 13-month period, organizational records showed an annual reduction of 71% in investigation cases post-intervention, resulting in an estimated 3,308 sickness days averted annually and total estimated annual savings of £738,133 (based on direct savings and costs averted). This indicates that the organization has started to embrace the "last resort" approach to using employee investigations to address work place issues. The programme was supported with training for those responsible for commissioning and leading the organization's employee investigations. Analysis of survey data from those who attended training workshops to support the programme indicated that participants showed an increased awareness of the employee investigation process post-workshop and an understanding of the concept of avoidable employee harm. Discussion The programme is congruent with the Healthy Healthcare concept, as the study illustrates how its practices and processes have a beneficial impact on staff, as well as potentially on patients. This study highlights wider issues for consideration, including the: (1) the role of Human Resources (HR), (2) taking a multi-disciplinary approach, (3) culture and practice, (4) the responsibility of the wider HR profession.
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Affiliation(s)
- Andrew Cooper
- Aneurin Bevan University Health Board, Newport, United Kingdom
- School of Nursing and Midwifery (Faculty of Health), University of Plymouth, Plymouth, United Kingdom
- Swansea Centre for Improvement and Innovation, Swansea University, Swansea, United Kingdom
| | | | - Ruth Madine
- Aneurin Bevan University Health Board, Newport, United Kingdom
| | - Adrian Neal
- Aneurin Bevan University Health Board, Newport, United Kingdom
- School of Nursing and Midwifery (Faculty of Health), University of Plymouth, Plymouth, United Kingdom
| | - Aled Jones
- School of Nursing and Midwifery (Faculty of Health), University of Plymouth, Plymouth, United Kingdom
| | - Ammarah Hussain
- Department of Clinical Health Psychology Services, North East London NHS Foundation Trust, London, United Kingdom
| | - Doris A. Behrens
- Aneurin Bevan University Health Board, Newport, United Kingdom
- Department of Economy and Health, University for Continuing Education, Krems, Austria
- School of Mathematics, Cardiff University, Cardiff, United Kingdom
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Aust B, Leduc C, Cresswell-Smith J, O'Brien C, Rugulies R, Leduc M, Dhalaigh DN, Dushaj A, Fanaj N, Guinart D, Maxwell M, Reich H, Ross V, Sadath A, Schnitzspahn K, Tóth MD, van Audenhove C, van Weeghel J, Wahlbeck K, Arensman E, Greiner BA. The effects of different types of organisational workplace mental health interventions on mental health and wellbeing in healthcare workers: a systematic review. Int Arch Occup Environ Health 2024; 97:485-522. [PMID: 38695906 PMCID: PMC11130054 DOI: 10.1007/s00420-024-02065-z] [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: 12/20/2023] [Accepted: 04/02/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To determine if and which types of organisational interventions conducted in small and medium size enterprises (SMEs) in healthcare are effective on mental health and wellbeing. METHODS Following PRISMA guidelines, we searched six scientific databases, assessed the methodological quality of eligible studies using QATQS and grouped them into six organisational intervention types for narrative synthesis. Only controlled studies with at least one follow-up were eligible. RESULTS We identified 22 studies (23 articles) mainly conducted in hospitals with 16 studies rated of strong or moderate methodological quality. More than two thirds (68%) of the studies reported improvements in at least one primary outcome (mental wellbeing, burnout, stress, symptoms of depression or anxiety), most consistently in burnout with eleven out of thirteen studies. We found a strong level of evidence for the intervention type "Job and task modifications" and a moderate level of evidence for the types "Flexible work and scheduling" and "Changes in the physical work environment". For all other types, the level of evidence was insufficient. We found no studies conducted with an independent SME, however five studies with SMEs attached to a larger organisational structure. The effectiveness of workplace mental health interventions in these SMEs was mixed. CONCLUSION Organisational interventions in healthcare workers can be effective in improving mental health, especially in reducing burnout. Intervention types where the change in the work environment constitutes the intervention had the highest level of evidence. More research is needed for SMEs and for healthcare workers other than hospital-based physicians and nurses.
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Affiliation(s)
- Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Caleb Leduc
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Clíodhna O'Brien
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mallorie Leduc
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Arilda Dushaj
- Community Centre for Health and Wellbeing, Tirana, Albania
| | - Naim Fanaj
- Per Mendje Te Shendoshe (PMSH), Prizren, Kosovo
- Alma Mater Europaea Campus Rezonanca, Pristina, Kosovo
| | - Daniel Guinart
- CIBERSAM, Hospital del Mar Research Institute, Barcelona, Spain
- Institut de Salut Mental, Hospital del Mar, Barcelona, Spain
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professionals Research Unit, University of Stirling, Stirling, Scotland
| | - Hanna Reich
- German Foundation for Depression and Suicide Prevention, Leipzig, Germany
- Depression Research Centre of the German Depression Foundation, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Victoria Ross
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Anvar Sadath
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | | | - Mónika Ditta Tóth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Chantal van Audenhove
- KU Leuven, Louvain, Belgium
- Center for Care Research and Consultancy, LUCAS, Louvain, Belgium
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, Tilburg, The Netherlands
| | | | - Ella Arensman
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Australia
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Lundmark R, Agrell A, Abildgaard JS, Wahlström J, Tafvelin S. A joint training of healthcare line managers and health and safety representatives in facilitating occupational health interventions: a feasibility study protocol for the Co-pilot project. Front Psychol 2024; 15:1340279. [PMID: 38860038 PMCID: PMC11163036 DOI: 10.3389/fpsyg.2024.1340279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 05/13/2024] [Indexed: 06/12/2024] Open
Abstract
Healthcare employees are experiencing poor wellbeing at an increasing rate. The healthcare workforce is exposed to challenging tasks and a high work pace, a situation that worsened during and after the COVID-19 pandemic. In turn, exposure to these high demands contributes to poor health, increased turnover, reduced job satisfaction, reduced efficacy, and reduced patient satisfaction and safety. Therefore, it is imperative that we identify measures to mitigate this crisis. One piece of this puzzle is how to implement sustainable tools and processes to improve the work environment of healthcare organizations. In this paper, we present the study protocol for the outlining and piloting of a joint training for pairs of healthcare line managers and their associated health and safety representatives in a Swedish healthcare organization. The objective of the training is to aid and advance the implementation of interventions to improve the work environment at the unit level. Following recommendations in the literature, the training is based on a stepwise approach that considers the specific context and focuses on the involvement of employees in creating interventions based on their needs. A central component of the training is the development of the pairs' collaboration in prioritizing, developing, implementing, and evaluating the interventions. The training is based on an on-the-job train-the-trainer approach in which participants are progressively trained during four workshops in the steps of a participatory intervention process. Between these workshops, the pairs follow the same progressive steps together with their employees to develop and implement interventions at their unit. The pilot will involve four pairs (i.e., eight participants) representing different parts and functions of the organization and will be conducted over a period of three months. We will use a mixed method design to evaluate preconditions, the process, and proximal transfer and implementation outcome factors of the training. The overall aim of the pilot is to appraise its feasibility and be able to adjust the training before a potential scale-up.
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Affiliation(s)
- Robert Lundmark
- Department of Psychology, Umeå University, Umeå, Sweden
- Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
| | - Alexander Agrell
- Department of Psychology, Umeå University, Umeå, Sweden
- Industrial Doctoral School for Research and Innovation, Umeå University, Umeå, Sweden
| | - Johan Simonsen Abildgaard
- Department of Organization, Copenhagen Business School, Copenhagen, Denmark
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | - Jens Wahlström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Brulin E, Lidwall U, Seing I, Nyberg A, Landstad B, Sjöström M, Bååthe F, Nilsen P. Healthcare in distress: A survey of mental health problems and the role of gender among nurses and physicians in Sweden. J Affect Disord 2023; 339:104-110. [PMID: 37433382 DOI: 10.1016/j.jad.2023.07.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/16/2023] [Accepted: 07/08/2023] [Indexed: 07/13/2023]
Abstract
INTRODUCTION The present article aimed to investigate 1) if mental health problems (depression and burnout including the dimensions; emotional exhaustion, mental distance and cognitive and emotional impairment) differed between nurses and physicians in Sweden, 2) if any differences were explained by differences in sex compositions, and 3) if any sex differences were larger within either of the two professions. METHOD Data were derived from a representative sample of nurses (n = 2903) and physicians (n = 2712) in 2022. Two scales were used to assess burnout (KEDS and BAT) and one to assess depression (SCL-6). The BAT scale has four sub-dimensions. Descriptive statistics and logistic regression were used to analyse each scale and dimension separately. RESULTS Results showed that 16-28 % of nurses and physicians reported moderate to severe symptoms of burnout. The prevalence differed between occupations across the scales and dimensions used. Nurses reported higher scores on KEDS while physicians reported higher scores on BAT including the four dimensions. Also, 7 % of nurses' and 6 % of physicians' scores were above the cut-off for major depression. The inclusion of sex in the models changed the odds ratios of differences between doctors and nurses in all mental health dimensions except mental distance and cognitive impairment. LIMITATIONS This study was based on cross-sectional survey data which has some limitations. CONCLUSION Our study suggests that the prevalence of mental health problems is prominent among nurses and physicians in Sweden. Sex plays an important role in the difference in the prevalence of mental health problems between the two professions.
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Affiliation(s)
- Emma Brulin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Sweden.
| | - Ulrik Lidwall
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department for Analysis, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Ida Seing
- Department of Behavioural Sciences and Learning, Linköping University, Sweden
| | - Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Bodil Landstad
- Faculty of Human Sciences, Mid Sweden University, Sweden; Unit of Research, Education and Development, Östersund Hospital, Sweden
| | - Malin Sjöström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Fredrik Bååthe
- Institute for Studies of the Medical Profession, LEFO, Oslo, Norway; Institute of Stress Medicine at Region Västra Götaland, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Per Nilsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden
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Vermeulen RCJM, van Leeuwen EH. Capturing dynamics in nursing: a diary study of nurses' job characteristics and ability and willingness to continue working. Front Psychol 2023; 14:1112530. [PMID: 37583602 PMCID: PMC10423898 DOI: 10.3389/fpsyg.2023.1112530] [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: 11/30/2022] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
Objectives This study aimed to gain insight into (1) the dynamics of job characteristics (demands and resources) of nurses and (2) how job characteristics relate to nurses' ability and willingness to continue working (understood as employability). Job characteristics are profession-specific and vary over time, but studies often overlook these dynamics. Moreover, job characteristics relate to nurses' employability, which is under pressure due to a rapidly changing work environment. It is necessary to gain insight into the dynamic job characteristics of nurses to develop targeted workplace interventions that help nurses remain employable. Methods This study adopted a mixed methods diary approach, with a strong emphasis on qualitative analysis. 46 Nurses from two hospitals in a large Dutch city completed a structured diary at six points over 3 weeks, resulting in 225 diary entries in total. The nurses used a custom-made application on their mobile devices to describe in their own words what they experienced as demanding and resourceful throughout the shifts and how they experienced their employability. Prior to the diaries, nurses completed an intake survey. Results A within-person analysis highlighted the day-to-day dynamics in the nursing profession. The job characteristics a nurse mentioned in the first diary entry often were completely different from the job characteristics the same nurse mentioned in the other diary entries. This analysis also showed variety within nurses' employability, demonstrating that perceptions of employability vary over time. A between-person analysis highlighted links between job characteristics and nurses' employability: social interactions strengthen a nurse's employability, a strict task approach threatens it, and aspects such as a strong drive to care, professional development, and autonomy (clustered as aspects that enable to "act professionally") create opportunities to enhance employability. Conclusion Insights from this study show that job characteristics typical to the nursing profession can be linked to nurses' perceptions of employability. Also, it stems from this research that not only job characteristics but also employability are dynamic in the short run. Understanding and enhancing employability in a nursing context requires capturing these dynamics, for instance by collecting data at several points in time or by using mixed-method studies to understand employability scores within their context.
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Affiliation(s)
| | - Evelien Hanna van Leeuwen
- Utrecht University School of Governance, Utrecht University, Utrecht, Netherlands
- University Medical Center Utrecht, Utrecht, Netherlands
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6
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Brulin E, Ekberg K, Landstad BJ, Lidwall U, Sjöström M, Wilczek A. Money talks: performance-based reimbursement systems impact on perceived work, health and patient care for physicians in Sweden. Front Psychol 2023; 14:1216229. [PMID: 37484100 PMCID: PMC10361769 DOI: 10.3389/fpsyg.2023.1216229] [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: 05/03/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The study aimed to investigate in which way performance-based reimbursement (PBR) systems in Swedish healthcare services (1) subjectively impacted physicians' work and patient care and (2) were associated with the occurrence of stress-induced exhaustion disorders among physicians. Method The study applied a mixed-method design. Data were collected from a representative sample of Swedish physicians. In the questionnaire, respondents were asked to answer an open-ended question regarding their reflections on PBR. The answers to the open-ended question were analysed using thematic analysis. Respondents were also asked to rate the impact of PBR on their work. The association between PBR and self-rated stress-induced exhaustion disease was analysed with logistic regressions. Stress-induced exhaustion disorder was measured using the Burnout Assessment Scale. Results Thematic analysis resulted in four themes: (1) Money talks, (2) Patients are affected, (3) Medical morals are challenged, and (4) PBR increase the quantity of illegitimate tasks. Logistic regressions showed that physicians who experienced PBR had an impact on their work and had a two-fold higher risk of stress-induced exhaustion disorder. Discussion Our findings suggest that current reimbursement systems in Sweden play an essential role in Swedish healthcare and negatively influence physicians' work and health. Also, current PBR impact patients negatively. No previous study has explored the potentially harmful impact of PBR on how physicians perceive work, health and patient care. Results indicate that policymakers should be encouraged to deeply review PBR systems and focus on ways that they can limit the negative impact on physicians' work and health while meeting future challenges.
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Affiliation(s)
- Emma Brulin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Ekberg
- Department of Health, Medicine, and Caring Sciences (HMV), Linköping University, Linköping, Sweden
| | - Bodil J. Landstad
- Faculty of Human Sciences, Mid Sweden University, Östersund, Sweden
- Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden
| | - Ulrik Lidwall
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Official Statistics Unit, Department for Analysis, Swedish Social Insurance Agency, Stockholm, Sweden
| | - Malin Sjöström
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Alexander Wilczek
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Teoh K, Singh J, Medisauskaite A, Hassard J. Doctors' perceived working conditions, psychological health and patient care: a meta-analysis of longitudinal studies. Occup Environ Med 2023; 80:61-69. [PMID: 36635099 DOI: 10.1136/oemed-2022-108486] [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: 05/20/2022] [Accepted: 11/17/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Studies have demonstrated an association between doctors' perceived working conditions, and their psychological well-being and patient care. However, few have examined inter-relationships among these three domains, and even fewer using longitudinal designs. Using meta-analytical structural equation modelling, we tested longitudinal relationships among doctors' perceived working conditions, their psychological well-being and patient care. We further tested if doctors' psychological well-being mediates the relationship between perceived working conditions and patient care. METHODS We carried out a systematic review using Academic Search Premier, Business Source Premier, PsycInfo, PsycArticles and Medline for the 20-year period between January 2000 and the start of the pandemic (January 2020). We included studies with practising doctors as participants, and that reported a quantifiable bivariate effect size between at least two of the three constructs of interest-perceived working conditions (ie, job demands, job resource), psychological well-being (ie, emotional exhaustion, work engagement) and patient care (ie, clinical care, patient safety). We pooled relationship effect sizes using random-effects meta-analysis, before testing for indirect effects using two-stage structural equation modelling. RESULTS Twenty-three samples from 11 countries representing 7275 doctors were meta-analysed. The results indicated that job resources predicted work engagement (ρ=0.18; 95% CI 0.11 to 0.24) and emotional exhaustion (ρ=-0.21; 95% CI -0.31 to -0.11), while job demands predicted emotional exhaustion (ρ=0.27; 95% CI 0.17 to 0.36). Better clinical care was also associated with higher levels of job resources (ρ=0.16; 95% CI 0.04 to 0.29), and lower levels of emotional exhaustion (ρ=-0.21; 95% CI -0.37 to -0.12) and job demands (ρ=-0.27; 95% CI -0.43 to -0.10). Both factors of the work environment were associated with clinical care through doctors' emotional exhaustion, but there were insufficient studies to test the indirect effects for work engagement or patient safety. CONCLUSION Our results demonstrate the need for a systems perspective to address working conditions to support both doctors' psychological well-being and patient care. Interventions should target doctors' job resources as they are more strongly associated with psychological well-being. However, given that job demands were strongly associated with emotional exhaustion, and in turn, clinical care, there is a need to better manage doctors' workload, conflict and pressure to support the current psychological well-being crises among this occupational group. PROSPERO REGISTRATION NUMBER CRD42020189070.
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Affiliation(s)
- Kevin Teoh
- Department of Organizational Psychology, Birkbeck University of London, London, UK
| | - Jasmeet Singh
- Psychology Department, Nottingham Trent University, Nottingham, UK
| | | | - Juliet Hassard
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
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van Dorssen-Boog P, van Vuuren T, de Jong J, Veld M. Healthcare workers' autonomy: testing the reciprocal relationship between job autonomy and self-leadership and moderating role of need for job autonomy. J Health Organ Manag 2022; 36:212-231. [PMID: 36135716 PMCID: PMC10424641 DOI: 10.1108/jhom-04-2022-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE While both perceived job autonomy and self-leadership are assumed to be important for optimal functioning of healthcare workers, their mutual relationship remains unclear. This cross-lagged study aims to theorize and test that perceived job autonomy and self-leadership have a reciprocal relationship, which is moderated by need for job autonomy. DESIGN/METHODOLOGY/APPROACH Two-wave panel data were used to measure cross-lagged relationships over a time period of three months. Self-leadership is indicated by both self-leadership strategies and self-leadership behavior. The data were analyzed using hierarchical multiple regression (HMR). FINDINGS Job autonomy was not causally nor reverse related to self-leadership strategies, but did relate to self-leadership behavior in both directions. Need for job autonomy did not influence the causal and reverse relationships between job autonomy and self-leadership (strategies and behavior). Instead, need for job autonomy discarded the influence of job autonomy on self-leadership behavior, and predicted self-leadership behavior over time. PRACTICAL IMPLICATIONS For optimizing healthcare jobs, human resource management (HRM) policy makers need to consider other interventions such as training self-leadership, or developing an autonomy supportive work environment, since job autonomy does not lead to more use of self-leadership strategies. ORIGINALITY/VALUE This study used a cross-lagged study design which gives the opportunity to investigate causal relationships between job autonomy and self-leadership. Both self-leadership strategies and self-leadership behavior are included.
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Affiliation(s)
| | - Tinka van Vuuren
- Open Universiteit
, Heerlen,
The Netherlands
- Loyalis
, Heerlen,
The Netherlands
| | - Jeroen de Jong
- Nijmegen School of Management
,
Institute for Management Research
,
Radboud University
, Nijmegen,
The Netherlands
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Dunning A, Teoh K, Martin J, Spiers J, Buszewicz M, Chew-Graham C, Taylor AK, Gopfert A, Van Hove M, Appleby L, Riley R. Relationship between working conditions and psychological distress experienced by junior doctors in the UK during the COVID-19 pandemic: a cross-sectional survey study. BMJ Open 2022; 12:e061331. [PMID: 35998957 PMCID: PMC9402444 DOI: 10.1136/bmjopen-2022-061331] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/20/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This paper explored the self-reported prevalence of depression, anxiety and stress among junior doctors during the COVID-19 pandemic. It also reports the association between working conditions and psychological distress experienced by junior doctors. DESIGN A cross-sectional online survey study was conducted, using the 21-item Depression, Anxiety and Stress Scale and Health and Safety Executive scale to measure psychological well-being and working cultures of junior doctors. SETTING The National Health Service in the UK. PARTICIPANTS A sample of 456 UK junior doctors was recruited online during the COVID-19 pandemic from March 2020 to January 2021. RESULTS Junior doctors reported poor mental health, with over 40% scoring extremely severely depressed (45.2%), anxious (63.2%) and stressed (40.2%). Both gender and ethnicity were found to have a significant influence on levels of anxiety. Hierarchical multiple linear regression analysis outlined the specific working conditions which significantly predicted depression (increased demands (β=0.101), relationships (β=0.27), unsupportive manager (β=-0.111)), anxiety (relationships (β=0.31), change (β=0.18), demands (β=0.179)) and stress (relationships (β=0.18), demands (β=0.28), role (β=0.11)). CONCLUSIONS The findings illustrate the importance of working conditions for junior doctors' mental health, as they were significant predictors for depression, anxiety and stress. Therefore, if the mental health of junior doctors is to be improved, it is important that changes or interventions specifically target the working environment rather than factors within the individual clinician.
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Affiliation(s)
- Alice Dunning
- Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Kevin Teoh
- Department of Organizational Psychology, Birkbeck University of London, London, UK
| | - James Martin
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Johanna Spiers
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Marta Buszewicz
- Research Department of Primary Care and Population Health, University College London, London, UK
| | | | | | - Anya Gopfert
- School of Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Maria Van Hove
- London School of Hygiene & Tropical Medicine, London, UK
| | - Louis Appleby
- Department of Psychiatry & Behavioral Sciences, The University of Manchester Faculty of Medical and Human Sciences, Manchester, UK
| | - Ruth Riley
- School of Health Sciences, University of Surrey, Guildford, UK
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10
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Teoh KRH, Kinman G, Harriss A, Robus C. Recommendations to support the mental wellbeing of nurses and midwives in the United Kingdom: A Delphi study. J Adv Nurs 2022; 78:3048-3060. [PMID: 35832013 DOI: 10.1111/jan.15359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 02/02/2023]
Abstract
AIM To use the Delphi technique to identify and prioritize recommendations for research and practice to improve the mental wellbeing of nurses and midwives in the United Kingdom (UK). BACKGROUND Although there is evidence that self-reported mental wellbeing among nurses and midwives in the UK is poor, interventions have not adequately considered the wider context in which they work. The wide range of individual, organizational, occupational and wider sector-level factors that can influence wellbeing requires the involvement of different stakeholders to identify the most pressing actions required. DESIGN A three-round Delphi technique was conducted in 2019. METHODS In the first round, 16 subject matter experts generated, reviewed and discussed recommendations from a review of the research evidence with potential to support the mental wellbeing of nurses. A second group with 23 stakeholder representatives then rated and provided feedback on the developed recommendations through two additional rounds. Recommendations that received an 'essential' or 'important' rating from at least 80% of participants were retained and prioritized. RESULTS In total, 45 recommendations met the consensus agreement and were retained. More than half (57%) involved action at the organizational level, 27% to public policy and 13% to research. Only one recommendation is related to the individual. Collectively, these recommendations highlight the importance of taking direct action to tackle poor mental wellbeing among the workforce and initiating change at the policy and organizational level. CONCLUSION Our findings emphasize the need to take a systemic approach to improving the mental health of nurses and midwives in the UK with input from different stakeholders. There is a clear consensus that action is needed at the organization and policy levels, rather than at the individual level as is current practice. IMPACT This study provides a framework, alongside a set of practical recommendations, that provides a starting point for different stakeholders to understand, address and support the mental wellbeing of nurses and midwives. Although UK-focused, it has relevance to healthcare workforces internationally.
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Affiliation(s)
- Kevin Rui-Han Teoh
- Department of Organizational Psychology, Birkbeck, University of London, London, UK
| | - Gail Kinman
- Department of Organizational Psychology, Birkbeck, University of London, London, UK
| | - Anne Harriss
- Society of Occupational Medicine, London, UK.,Royal College of Nursing, London, UK
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Bayliss A. Commentary: Nurses' intention to stay in the work environment in acute healthcare: a systematic review. J Res Nurs 2022; 27:398-400. [PMID: 35832881 DOI: 10.1177/17449871221087312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Anda Bayliss
- Organizational Psychologist and Social Science Researcher, RNIB, UK
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Teoh KRH, Vasconcelos AG, Lima EP. Work and Nonwork Contributory Factors to Health Care Workers' Mental Health. Am J Public Health 2022; 112:703-705. [PMID: 35417214 PMCID: PMC9010910 DOI: 10.2105/ajph.2022.306789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Kevin R H Teoh
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alina G Vasconcelos
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo P Lima
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Dolgoy N, Driga A, Brose JM. The Essential Role of Occupational Therapy to Address Functional Needs of Individuals Living with Advanced Chronic Cancers. Semin Oncol Nurs 2021; 37:151172. [PMID: 34275707 DOI: 10.1016/j.soncn.2021.151172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Medical progress in cancer care has led to increased life expectancy outcomes across all stages of cancer, including in advanced cancers. People now living with advanced chronic cancers have unique, ongoing functional and quality-of-life needs. This article explores the functional considerations of individuals living with advanced chronic cancers in terms of managing chronic palliative care needs, assessing and intervening for functional issues, and consistently using occupational therapy in shared service provision together with medical and nursing teams. The unique and changing functional needs of these individuals may be effectively addressed through consideration of chronic palliative approaches to care; earlier access to occupational therapy services to facilitate continued engagement in everyday activities; and shared service provision with nursing to address both medical wellness and functional status. DATA SOURCES These include key databases (Pubmed, CINAHL), international guidelines, and professional guidance documents. CONCLUSION Individuals living with advanced chronic cancer have ongoing and fluctuating functional needs that should be addressed in palliative care service provision. The inclusion of occupational therapy as part of inter- and multidisciplinary teams can facilitate maximization of function for individuals living with advanced chronic cancer. IMPLICATIONS FOR NURSING PRACTICE Timely early referrals to occupational therapy can address functional issues as they arise, and can prepare individuals for future functional considerations.
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Affiliation(s)
- Naomi Dolgoy
- University of Alberta and Canadian Lymphedema Framework, Edmonton, Alb, Canada.
| | - Amy Driga
- Alberta Health Services, Edmonton, Alb, Canada
| | - Julie M Brose
- Research Centre for Palliative Care, Death & Dying, Flinders University, Adelaide, SA, Australia
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