Job Demands and Resources, Positive and Negative Affect, and Psychological Distress of Social Workers in China

Feasibility, acceptability, and efficacy of a positive emotion regulation intervention to promote resilience for healthcare workers during the COVID-19 pandemic: A randomized controlled trial

INTRODUCTION

Burnout poses a substantial, ongoing threat to healthcare worker (HCW) wellbeing and to the delivery of safe, quality healthcare. While systemic and organization-level changes in healthcare are critically important, HCWs also need individual-level skills to promote resilience. The objective of this trial is to test feasibility, acceptability, and efficacy of PARK, an online self-guided positive affect regulation intervention, in a sample of healthcare workers during the COVID-19 pandemic.

DESIGN AND METHODS

In the context of the unprecedented rise in burnout during the COVID-19 pandemic, we conducted a randomized waitlist-controlled trial of the Positive Affect Regulation sKills (PARK) program-a five-week, online, self-guided coping skills intervention nested within an ongoing cohort of HCWs. N = 554 healthcare workers were randomly assigned to receive the intervention immediately or to receive the intervention after approximately 12 weeks. Outcomes included change in burnout, emotional wellbeing (positive affect, meaning and purpose, depression, anxiety) and sleep over approximately 12 weeks. Analyses included mixed-effects linear regression models comparing change over time in outcomes between intervention and control conditions.

RESULTS

One third (n = 554) of the participants in the cohort of HCWs consented to participate and enrolled in PARK in April 2022. Compared to those who did not enroll, participants in the trial reported higher burnout, poorer emotional wellbeing, and poorer sleep at baseline (April, 2022; all ps < .05). Intent-to-treat analyses showed that participants randomly assigned to the intervention immediately (PARK-Now) improved significantly on anxiety (within-group change on PROMIS T-score = -0.63; p = .003) whereas those in the waitlist (PARK-Later) did not (within group T-score change 0.04, p = 0.90). The between-group difference in change, however, was not statistically significant (B = -0.67 p = 0.10). None of the other wellbeing outcomes changed significantly in the intervention group compared to the waitlist. Additional as-treated analyses indicated that those participants who completed all 5 of the weekly online lessons (N = 52; 9.4%) improved significantly more on the primary outcome of positive affect compared to those who enrolled in PARK but completed zero lessons (n = 237; 42.8%; B = 2.85; p = .0001).

CONCLUSIONS

Online self-guided coping skills interventions like PARK can be effective in targeted samples and future work will focus on adaptations to increase engagement and tailor PARK for HCWs who could most benefit.

Evaluation of a Pilot Program to Prevent the Misuse of Prescribed Opioids Among Health Care Workers: Repeated Measures Survey Study

BACKGROUND

Overprescription of opioids has led to increased misuse of opioids, resulting in higher rates of overdose. The workplace can play a vital role in an individual's intentions to misuse prescription opioids with injured workers being prescribed opioids, at a rate 3 times the national average. For example, health care workers are at risk for injuries, opioid dispensing, and diversion. Intervening within a context that may contribute to risks for opioid misuse while targeting individual psychosocial factors may be a useful complement to interventions at policy and prescribing levels.

OBJECTIVE

This pilot study assessed the effects of a mobile-friendly opioid misuse intervention prototype tailored for health care workers using the preparation phase of a multiphase optimization strategy design.

METHODS

A total of 33 health care practitioners participated in the pilot intervention, which included 10 brief web-based lessons aimed at impacting psychosocial measures that underlie opioid misuse. The lesson topics included: addiction beliefs, addiction control, Centers for Disease Control and Prevention guidelines and recommendations, beliefs about patient-provider relationships and communication, control in communicating with providers, beliefs about self-monitoring pain and side effects, control in self-monitoring pain and side effects, diversion and disposal beliefs, diversion and disposal control, and a conclusion lesson. Using a treatment-only design, pretest and posttest surveys were collected. A general linear repeated measures ANOVA was used to assess mean differences from pretest to posttest. Descriptive statistics were used to assess participant feedback about the intervention.

RESULTS

After completing the intervention, participants showed significant mean changes with increases in knowledge of opioids (+0.459; P<.001), less favorable attitudes toward opioids (-1.081; P=.001), more positive beliefs about communication with providers (+0.205; P=.01), more positive beliefs about pain management control (+0.969; P<.001), and increased intentions to avoid opioid use (+0.212; P=.03). Of the 33 practitioners who completed the program, most felt positive about the information presented, and almost 70% (23/33) agreed or strongly agreed that other workers in the industry should complete a program like this.

CONCLUSIONS

While attempts to address the opioid crisis have been made through public health policies and prescribing initiatives, opioid misuse continues to rise. Certain industries place workers at greater risk for injury and opioid dispensing, making interventions that target workers in these industries of particular importance. Results from this pilot study show positive impacts on knowledge, attitudes, and beliefs about communicating with providers and pain management control, as well as intentions to avoid opioid misuse. However, the dropout rate and small sample size are severe limitations, and the results lack generalizability. Results will be used to inform program revisions and future optimization trials, with the intention of providing insight for future intervention development and evaluation of mobile-friendly eHealth interventions for employees.

Intercultural communication competence and job burnout in MNC employees: the mediation role of job stress

This study examined the relationship between intercultural communication competence (ICC) and job burnout, as well as the mediating effects of job stress, using data collected from employees (n = 1,064) from a Chinese multinational corporation in Brunei. Through regression analysis and mediation effect tests, we found that ICC was negatively associated with job burnout (β = -0.19, p < 0.001) and job stress (β = -0.08, p < 0.001). Job stress was positively associated with job burnout (β = 0.65, p < 0.001). Job stress played a partial mediating role between ICC and job burnout. The total effect of ICC on job burnout was -0.19, the direct effect was -0.14, and the indirect effect of ICC via job stress was -0.05. The findings call for ICC training for employees in multinational corporations.

Depression, professional self-efficacy, and job performance as predictors of life satisfaction: the mediating role of work engagement in nurses

Background

The life satisfaction and job performance of nursing professionals are affected by a multitude of factors, including work engagement, self-efficacy, and depression. The Job Demands-Resources (JD-R) model provides a theoretical framework to explore these relationships.

Objective

Our study aimed to analyze the primary goal of this research, which is to examine the mediating role of work engagement in the relationship between depression, professional self-efficacy, job performance, and their impact on life satisfaction in nurses, using the JD-R theory as a guide.

Methods

This cross-sectional study involved 579 participants aged between 21 to 57 years (M = 39, SD = 9.95). Mediation analysis was used to examine the influence of depression, self-efficacy, and job performance on work engagement, and in turn, its effect on life satisfaction.

Results

Findings indicated that work engagement plays a crucial mediating role between depression, self-efficacy, job performance, and life satisfaction. Interventions to increase work engagement could assist nurses in better managing depression and improving their performance and life satisfaction.

Conclusions

Our study highlights the need for workplace policies and strategies that foster work engagement and self-efficacy among nurses while effectively managing job demands to prevent depression. Moreover, these findings underscore the importance of the JD-R theory to understand and improve nurses' job satisfaction and performance, and suggest areas for future research, including exploring other potential factors and applying these findings across different contexts and cultures.

Primary care physicians' work conditions and their confidence in managing multimorbidity: a quantitative analysis using Job Demands-Resources Model

BACKGROUND

Multimorbidity is a global issue that presents complex challenges for physicians, patients, and health systems. However, there is a lack of research on the factors that influence physicians' confidence in managing multimorbidity within primary care settings, particularly regarding physicians' work conditions.

OBJECTIVES

Drawing on the Job Demands-Resources Model, this study aims to investigate the level of confidence among Chinese primary care physicians in managing multimorbidity and examine the predictors related to their confidence.

METHODS

Data were collected from 224 physicians working in 38 Community Healthcare Centres (CHCs) in Shanghai, Shenzhen, Tianjin, and Jinan, China. Work-family conflict (WFC) perceived organizational support (POS), self-directed learning (SDL), and burnout were measured. Physicians' confidence was assessed using a single item. Mediation effect analysis was conducted using the Baron and Kenny method.

RESULTS

The results showed that the mean confidence score for physicians managing multimorbidity was 3.63 out of 5, only 20.10% rating their confidence level as 5. WFC negatively related physicians' confidence and POS positively related physicians' confidence in multimorbid diagnosis and treatment. Burnout fully mediated the relationship between WFC and physicians' confidence, and SDL partially mediated the relationship between POS and physicians' confidence.

CONCLUSIONS

The confidence level of Chinese primary care physicians in managing multimorbidity needs improvement. To enhance physicians' confidence in managing multimorbid patients, CHCs in China should address WFC and burnout and promote POS and SDL.

The moderation of satisfaction with working conditions in the association between workload and mental health among healthcare workers collecting test samples in the post-COVID-19 era

Background

This study aimed to examine the associations between workload and satisfaction with working conditions and mental health (i.e., anxiety disorder, depression, and somatization) of healthcare workers collecting test samples during the local outbreaks of COVID-19, and explore satisfaction with working conditions as a moderator of these relationships.

Methods

A total of 1,349 participants were obtained via an online survey in Zhengzhou, Henan Province, China. Multivariate regression was used to assess the associations between workload and satisfaction with working conditions and anxiety disorder, depression, and somatization. The simple slope analysis and Johnson-Neyman technique were used to assess the effect value and change trend of the moderator.

Results

The prevalence of anxiety disorder, depression, and somatization were 8.6, 6.9, and 19.2% of healthcare workers collecting test samples, respectively. High levels of workload were associated with an increased risk of an anxiety disorder (OR = 1.81, 95%CI = 1.17-2.78), depression (OR = 1.92, 95%CI = 1.19-3.10), and somatization (OR = 1.90, 95%CI = 1.40-2.57), while high satisfaction of working conditions was associated with a reduction in the risk of these outcomes, and ORs (95%CI) were 0.35 (0.20-0.64), 0.27 (0.13-0.56), and 0.32 (0.21-0.48), respectively. The findings also indicated that a weaker association between workload and anxiety disorder, as well as depression and somatization, has been reported in those with a high level of satisfaction with working conditions.

Conclusion

Workload significantly increased the risk of healthcare workers suffering from psychological problems, while satisfaction with working conditions alleviated these negative effects, and effective resource support was crucial for healthcare workers.

Supervision Effects on Negative Affect and Psychological Distress: Evidence from Social Workers in China

Supervision is an imperative practice within the social work field. It provides social workers with support systems, ensures that social workers are adhering to professional standards, and protects clients. Research has also shown that quality supervision can improve social workers' professional capacity and reduce work stress. However, most of this research has been confined to social workers' experiences within Western countries and has been largely qualitative in nature. Thus, this study aims to examine the experience of 489 social workers based in Guangzhou, China to understand how supervision affects their negative affect and psychological distress. The findings indicate that supervision not only reduces negative affect and psychological distress amongst Chinese social workers, but also is especially effective for social workers with high job demands. When job demands are high, social workers who receive both individual and group supervision also appear to have lower negative affect and psychological distress as compared to social workers who only receive individual supervision. These findings emphasize the significance of supervision as a buffer factor to reduce negative affect and psychological distress amongst Chinese social workers who face high job demands.

How perceived school culture relates to work engagement among primary and secondary school teachers? Roles of affective empathy and job tenure

Evidence suggests that perceived school culture is the most powerful predictor of teachers' work performance. However, studies to date have paid little attention to the potential mechanisms behind this association. On the basis of the job demands-resources (JD-R) model, the present study explored the mediating role of affective empathy and the moderating role of job tenure in the association between perceived school culture and teachers' work engagement. 647 primary and secondary school teachers completed questionnaires measuring perceived school culture, affective empathy, and work engagement. After gender and educational level were included as covariates, the results showed that perceived school culture positively correlated with teachers' work engagement, and more importantly, this association was partially mediated by affective empathy. In addition, job tenure significantly moderated the direct association between perceived school culture and work engagement. Specifically, there was a stronger association between perceived school culture and work engagement for teachers with shorter job tenure than those with longer job tenure. The findings suggested the direct effect of perceived school culture on work engagement, and the indirect effect of perceived school culture on work engagement through the mediating role of affective empathy. These findings enrich our understanding of how perceived school culture associates with work engagement, and highlight the moderating role of job tenure in the direct association between perceived school culture and work engagement.

Psychological wellbeing and the association with burnout in a cohort of healthcare workers during the COVID-19 pandemic

Burnout, depression, and anxiety are prevalent among healthcare workers (HCWs) during the COVID-19 pandemic and have been previously shown to contribute to poor health outcomes and reduced quality of care. Positive psychological constructs such as positive affect and meaning and purpose are related to resilience in the face of significant stress. No studies have examined these associations among a cohort of HCWs during this pandemic. The purpose of this study was to examine the association of depression, anxiety, positive affect, and meaning and purpose with burnout among HCWs during the COVID-19 pandemic. We utilized data from a cross-sectional survey conducted between September 29-December 8, 2021, among a cohort of 2,411 HCWs from a large, tertiary academic health care system in the Chicago area. We employed the Patient-Reported Outcomes Measurement Information System (PROMIS) measures for depression, anxiety, positive affect, and meaning and purpose and burnout was measured by the Oldenburg Burnout Inventory (OLBI). The majority (80.88%) of HCWs in this study identified as White, Non-Hispanic race/ethnicity, female sex (82.37%), and roughly one third were between ages 30-39 years old (30.98%). Registered nurses (26.96%) accounted for the largest single occupation group. The mean burnout score was 36.87 (SD = 7.65), with 53.38% of participants classified as having burnout, and registered nurses demonstrating the highest proportions of burnout (63.54%). Higher depression (coef = 0.15, SE = 0.03, p < 0.001) and anxiety (coef = 0.25, SE = 0.02, p < 0.001) scores were associated with higher burnout in multivariable linear regression models. Increased positive affect (coef= -0.19, SE= 0.02, p < 0.001) and meaning and purpose (coef= -0.12, SE= 0.01, p < 0.001) scores were significantly associated with reduced burnout. Positive affect and meaning and purpose were inversely associated with burnout among a cohort of HCWs during the COVID-19 pandemic. Previous studies of positive affect and meaning and purpose suggest the potential buffering effect that these indices may have on burnout. Future research is needed to examine the effect of positive affect and meaning and purpose on mitigating the negative impacts of burnout, depression, and anxiety among HCWs as they cope with the stress of the COVID-19 pandemic and beyond.