Stress and Turnover Intentions Within Healthcare Teams: The Mediating Role of Psychological Safety, and the Moderating Effect of COVID-19 Worry and Supervisor Support

Effect of Music Listening on Neurocognition, Stress, and Performance in Neurosurgeons During Microsurgery

BACKGROUND

Stress in surgeons is well-known for its negative impact on neurocognition and surgical performance. Surgeons commonly use music for stress reduction, but its specific effects on neurosurgeons remain unclear. This study aims to investigate how listening to music during microsurgery affects neurocognitive (NC) functions, subjective anxiety, and stress levels in neurosurgeons.

METHODS

Conducted in 2 phases, the pilot phase involved 23 neurosurgeons completing a survey and rating compositions based on ragas of North Indian/Hindustani classical music for suitability during surgery. Five excerpts were selected for the main phase, which involved 3 neurosurgeons performing 16 surgeries, 8 with and 8 without music. Data collection included presurgery assessments of sleep, caffeine intake, subjective stress levels, perceived complexity of the surgery that was to be performed, and NC tasks. Postsurgery subjective stress levels, actual complexity, and surgeon experiences with music were recorded.

RESULTS

While there was a trend toward reduced stress and perceived complexity with music, statistical significance was not reached. NC tasks showed nonsignificant improvement with music, with a significant (at P < 0.001) speed-accuracy trade-off noted in response inhibition.

CONCLUSIONS

Music appears to reduce subjective stress and task complexity, influencing neurocognition, particularly through speed-accuracy trade-offs. Further research is needed to understand its mechanisms and appropriate contexts for use before widespread recommendation.

Insights into the Impact of Organizational Factors and Burnout on the Employees of a For-Profit Psychiatric Hospital during the Third Wave of the COVID-19 Pandemic

In this paper, we provide insights into the interplay among the organizational, job, and attitudinal factors and employees' intentions to resign during the third wave of the COVID-19 pandemic at a mental health hospital. We point out shortcomings in the relationship dynamics between executive administration and operational staff and propose a pathway to develop more effective leadership frameworks to increase job satisfaction. We integrate qualitative data from case information and open-ended questions posed to employees at a mental health hospital and quantitative data from a small-scale survey (n = 19). We highlight that the ability to achieve objectives, work autonomy, burnout, affective commitment, distributive and procedural justice, and job satisfaction are critical in determining individuals' intentions to resign. Individuals identified disconnectedness and moral distress as critical aspects, while highlighting empathy, compassion, satisfaction, and confidence as pivotal elements. Mental healthcare settings could benefit from enhancing the staff's ability to achieve objectives, work autonomy, affective commitment, and both distributive and procedural justice. Addressing burnout and implementing measures to increase job satisfaction are equally vital. Efficiently restructuring dynamics between various leadership levels and staff can significantly improve employee retention.

Understanding resident wellness: A path analysis of the clinical learning environment at three institutions

PURPOSE

The clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout.

MATERIALS AND METHODS

Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID. Psychological safety (PS) and perceived organizational support (POS) were used to capture the CLE, and the Mini-Z Scale was used to assess resident job stress and burnout. A total of 2,196 residents received a survey link; 889 responded (40% response rate). Path analysis explored both direct and indirect relationships between PS, POS, resident stress, and resident burnout.

RESULTS

Both POS and PS had significant negative relationships with experiencing a great deal of job stress; the relationship between PS and stress was noticeably stronger than POS and stress (POS: B= -0.12, p=.025; PS: B= -0.37, p<.001). The relationship between stress and residents' level of burnout was also significant (B = 0.38, p<.001). The overall model explained 25% of the variance in resident burnout.

CONCLUSIONS

Organizational support and psychological safety of the learning environment is associated with resident burnout. It is important for educational leaders to recognize and mitigate these factors.

Investigating Workplace Support and the Importance of Psychological Safety in General Surgery Residency Training

OBJECTIVE

Workplace interventions that increase support can mitigate burnout, improve workplace satisfaction, and increase well-being. Our aim is to provide evidence-based targets to inform future work for operationalizing support in general surgery residency.

DESIGN

This is a 2-part mixed-methods cross-sectional study. Part 1 analyzed qualitative data from focus groups (April 2021-May 2022). Part 2 comprised an online survey (informed by findings in Part 1) in May 2022 to assess the association between perceived psychological safety (PS) and flourishing, as well as PS and languishing.

SETTING

National multi-center study including 16 ACGME-accredited academic programs.

PARTICIPANTS

General surgery residents at various training levels, in both clinical and research.

RESULTS

A total of 28 residents participated in the focus groups which revealed both enhancers and inhibitors of support pertaining to PS in the workplace. Enhancers of support included those currently implemented (i.e., allyship of mentors) and those proposed by residents (i.e., nonpunitive analysis of mistakes). Inhibitors of support included both systems (i.e., wellness initiatives as a 'band-aid' for systems issues) and culture (i.e., indefatigability, stoicism). About 251 residents (31%) responded to the survey which revealed higher perception of PS was significantly associated with flourishing at the level of residency program and departmental leadership. Lower perception of PS was significantly associated with languishing at the level of residency program leadership only.

CONCLUSION

Our findings highlight the promotion of PS, such as expansion of mentorship to include advocacy (advocating on a resident's behalf, recognition when mistreated) and affirmation (i.e., soliciting opinions on controversial social matters/events, recognizing different life experiences), cultural acceptance of asking for help (without being perceived as weak), formal help navigating interpersonal dynamics (i.e., guidance from senior residents), and leadership presentations and modeling to destigmatize asking for help, as a means of operationalizing workplace support to increase flourishing and decrease languishing.

Psychological impact of COVID-19 pandemic and turnover intention: The moderating effect of employee work engagement

The study aimed to understand the relationship between the psychological impact of the COVID-19 pandemic and turnover intention and the moderating role of employee engagement. Data were collected via a structured questionnaire through both hand deliveries of printed questionnaires and Google docs from 187 frontline employees in the Ghanaian public sector. The hypotheses were tested using structural equation modeling. There exists a positive and significant relationship between the COVID-19 pandemic and employee turnover intentions. Out of the three dimensions of work engagement, vigor had a significant negative moderating effect on the relationship between psychological impact and turnover intentions. This implies that the positive effect of the psychological impact of COVID-19 on turnover intentions is minimized, where employees have high levels of energy and mental resilience while working, thus their vigor is high rather than low. The study contributes to literature on employee work engagement by using the Job demands-resources model to unravel the specific dimension of employee engagement that can minimize the negative impact of COVID-19 on employees' turnover intention in the public sector in a developing country.

Hotel Employees' Burnout and Intention to Quit: The Role of Psychological Distress and Financial Well-Being in a Moderation Mediation Model

Continuous changes, such as pandemics and increasing competition, as well as high workload, affect the workplace behavior of hotel organizations today, resulting in employee burnout and intention to quit. The purpose of this research was to investigate the effect of burnout on intention to quit among male hotel employees, integrating the mediating effect of psychological distress and moderating effect of financial well-being. Male employees in four- and five-star hotels in the UAE completed a total of 304 questionnaires. All direct relationships were positive and statistically significant, there was a partial mediating relationship, and only one of the moderating effects was statistically significant. This study found that burnout predicts the intention to quit as well as psychological distress. Psychological distress partially mediates the relationship between burnout and the intention to quit. Financial well-being moderates the relationship between burnout and psychological distress-making this relationship stronger for employees with high-income prospects-but not the relationship between burnout and intention to quit; regardless of the financial well-being of the employee, burnout will lead to the intention to quit their job. Hotel organizations must be aware of the consequences of employee burnout and concentrate on identifying and treating its causes.

Relationships among Healthcare Providers' Job Demands, Leisure Involvement, Emotional Exhaustion, and Leave Intention under the COVID-19 Pandemic

The COVID-19 pandemic has caused many medical issues. It has tested the impact of healthcare providers' job demands, emotional exhaustion, and other pressures related to the impact on organizational leave intention. Accordingly, the purpose of this study was to verify the relationship between healthcare providers' job demands, leisure involvement, emotional exhaustion, and leave intention under the COVID-19 pandemic. The questionnaire survey was used to address the issue of the present study. Convenience sampling was utilized to recruit 440 healthcare providers with a validity rate of 95%. Collected data were analyzed by structural equation modelling. Results indicated that healthcare providers' job demands do not significantly influence leisure involvement. Job demands significantly influence emotional exhaustion. Job demands significantly influence leave intention. Emotional exhaustion significantly influences leave intention. Emotional exhaustion has a significant mediating effect between job demands and leave intention. Finally, relevant practical suggestions are provided based on the study results.

Factors Affecting Health-Related Quality of Life among Healthcare Workers during COVID-19: A Cross-Sectional Study

Background and Objectives: Healthcare workers are threatened by psychological well-being and mental health problems in disasters related to new infectious diseases, such as COVID-19, and this can also have a negative impact on health-related quality of life. Health-related quality of life of healthcare workers should not be neglected because it is closely related to patient safety. This study aimed to identify the relationship between mental health problems, psychological safety, sleep quality, and health-related quality of life of healthcare workers and factors that influence health-related quality of life during the COVID-19 pandemic. Materials and Methods: Data were collected from 301 healthcare workers working in five general hospitals with more than 300 beds in two provinces from 5 July 2021 to 16 July 2021. Data were analyzed using SPSS WIN 27.0. The data were analyzed using t-test, one-way analysis of variance, and stepwise multiple regression. Results: Our results showed that there was a significant difference in regular exercise, religion, economic status, and sleep quality. The DASS-21 stress, economic status, and alcohol consumption were factors affecting the total health-related quality of life. In the subcategories, the physical component score was influenced by DASS-21 stress and economic status, while the mental component score was influenced by DASS-21 depression, economic status, alcohol consumption, and sleep quality. Conclusions: Health care workers need continuous and active monitoring of their health level and quality of life, as they are at a risk of increasing work burden and infection due to prolonged exposure to COVID-19 as well as mental health issues such as stress and depression. Additionally, at the individual level, active participation in various programs that can raise awareness of health-related quality of life along with physical health promotion activities should be encouraged. At the organizational level, it is necessary to prepare a compensation system, such as adjusting the workload of healthcare workers and ensuring break time; at the government level, disaster-related policies are needed to ensure a safe working environment for health care workers.

Fear and Trembling While Working in a Pandemic: an Exploratory Meta-Analysis of Workers' COVID-19 Distress

The global COVID-19 pandemic has disrupted the lives of workers and taken its toll on health and well-being. In line with recent calls for more inductive and abductive occupational health science research, we exploratorily meta-analyzed workers' COVID-19 distress, defined as psychological and psychosomatic strain contextualized to experiencing the virus and pandemic broadly. We identified many existing COVID-19 distress measures (e.g., Fear of COVID-19 Scale by Ahorsu et al., International Journal of Mental Health and Addiction, 2020; Coronavirus Anxiety Scale by Lee, Death Studies, 44(7), 393-401, 2020a) and correlates, including demographic variables (viz., gender, marital status, whether worker has children), positive well-being (e.g., quality of life, perceived social support, resilience), negative well-being (e.g., anxiety, depression, sleep problems), and work-related variables (e.g., job satisfaction, burnout, task performance). Additionally, we found preliminary evidence of subgroup differences by COVID-19 distress measure and country-level moderation moderators (viz., cultural values, pandemic-related government response) as well as COVID-19 distress's incremental validity over and above anxiety and depression. The findings-based on k = 135 independent samples totaling N = 61,470 workers-were abductively contextualized with existing theories and previous research. We also call for future research to address the grand challenge of working during the COVID-19 pandemic and ultimately develop a cumulative occupational health psychology of pandemics.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41542-022-00131-x.

Organizational support, training and equipment are key determinants of burnout among dialysis healthcare professionals during the COVID-19 pandemic

INTRODUCTION

Burnout was already found to be an important factor in the professional landscape of nephrology prior to the COVID-19 outbreak and is expected to worsen during the pandemic.

OBJECTIVES

The aim of our study was to assess pandemic experiences, perceptions, and burnout among Polish dialysis unit professionals in the COVID-19 period.

PARTICIPANTS AND METHODS

A survey, which consisted of a Pandemic Experiences and Perceptions Survey (PEPS) and a Maslach Burnout Inventory was distributed online to Polish dialysis units. The study group comprised 379 participants (215 nurses, 148 physicians, and 16 respondents of other professions).

RESULTS

The pandemic largely affected or completely dominated the work of dialysis units according to 53.4% and 25.5% of nurses responding to the PEPS, respectively. Among physicians, the prevalence was 55.5% and 15.4% of participants, respectively. Serious or life-threatening risk was perceived by 72.1% and 11.9% of dialysis healthcare professionals, respectively. Furthermore, 74.6% of the study participants stated that their work in a dialysis setting amidst the pandemic was felt to be associated with serious risk for their relatives. Adequate personal protective equipment and information from management decreased burnout among dialysis staff. Burnout was lower in all dimensions among those participants who felt more in control of their exposure to infection, provided by proper training, equipment, and support (p = 0.0004 for emotional exhaustion, p = 0.0007 for depersonalization, and p < 0.0001 for feelings of personal accomplishment).

CONCLUSIONS

The COVID-19 pandemic has largely affected the work in dialysis units. Providing proper training, equipment, and support may decrease burnout among dialysis staff.

An individual perspective on psychological safety: The role of basic need satisfaction and self-compassion

Psychological safety is important for the well-being and productivity of people in the workplace. Psychological safety becomes even more important and even more difficult to maintain in times of uncertainty. Previous research mainly focused on the influence of and on interpersonal relationships. This study applies an individual perspective by investigating what is needed on an individual level in order to build psychological safety. The expectation was that self-compassion induces an individual to experience higher positive affect, and this advances the development of positive relations and social acceptance. Moreover, we assumed that the mediation of the relationship between self-compassion and positive relations and social acceptance by positive affect is moderated by the level of basic need satisfaction. Participants (N = 560) from the Netherlands and Belgium completed an online questionnaire about their level of self-compassion, basic need satisfaction, positive affect and positive relations and social acceptance. Using hierarchical regression analyses for moderated mediation analysis, results showed that self-compassion and positive affect had a significant positive effect on positive relations and social acceptance. Positive affect significantly mediated the relationship between self-compassion and positive relations and social acceptance, when basic need satisfaction was low, but not when basic need satisfaction was high. Our research showed that individuals need either their basic needs satisfied or self-compassion so they can build the high-quality relations needed to stimulate psychological safety. This finding shifts attention from the dyadic relationship to the individual and highlights important factors at the individual level which advance the development of high-quality relationships with others.

The Survey Measure of Psychological Safety and Its Association with Mental Health and Job Performance: A Validation Study and Cross-Sectional Analysis

OBJECTIVES

This study validated the Japanese version of O'Donovan et al.'s (2020) composite measure of the psychological safety scale and examined the associations of psychological safety with mental health and job-related outcomes.

METHODS

Online surveys were administered twice to Japanese employees in teams of more than three members. Internal consistency and test-retest reliability were tested using Cronbach's α and intra-class correlation coefficient (ICC), respectively. Structural validity was examined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Convergent validity was tested using Pearson's correlation coefficients. Multiple linear regression analyses were conducted to examine the relationship between psychological safety and psychological distress, work engagement, job performance, and job satisfaction.

RESULTS

Two hundred healthcare workers and 200 non-healthcare workers were analyzed. Internal consistency, test-retest reliability, and convergent validity were acceptable. CFA demonstrated poor fit, and EFA yielded a two-factor structure, with team leader as one factor and peers and team forming the second factor. The total score showed significant and expected associations with all outcomes in the adjusted model for all workers.

CONCLUSIONS

The Japanese version of the measure of the psychological safety scale presented good reliability and validity. Psychological safety is important for employees' mental health and performance.

Do You Feel Safe Here? The Role of Psychological Safety in the Relationship between Transformational Leadership and Turnover Intention Amid COVID-19 Pandemic

Despite their significant role in the performance of hotel industry, hotel workers are suffering from high rates of turnover, due to several reasons, particularly amid the COVID-19 pandemic. The pandemic has had numerous negative consequences on hotel workers, including their intention to leave the job or/and career. This study is an attempt to investigate the impact of transformational leadership on turnover intention amid COVID-19 and how psychological safety can intermediate this relationship. The study used a quantitative research approach via a pre-test instrument, self-distributed and collected from hotel workers at different regions in the Kingdom of Saudi Arabia (KSA). Valid responses from 1228 workers, analyzed through a structural equation modeling (SEM) of AMOS version 23, showed that transformational leadership has a significant negative impact on turnover intention as hypothesized. Nevertheless, it has a significant positive impact on psychological safety, whereas psychological safety has a significant negative impact on turnover intention. The most important finding of this study was the perfect mediating effect of psychological safety in the link between transformational leadership and workers’ turnover intention. This finding confirms that psychological safety has the ability to change the above-mentioned link. In other words, the presence of psychological safety ensures negative turnover intention, even if transformational leadership practices do not exist. The findings have implications for scholars and practitioners, especially in tourism and hotel context, in relation to the role of psychological safety and transformational leadership in creating a sustainable working environment to maintain a lower turnover intention.