Technostress Creators and Outcomes Among Egyptian Medical Staff and Students: A Multicenter Cross-Sectional Study of Remote Working Environment During COVID-19 Pandemic

Role and Status of Biomarkers in Technostress Research: A Systematic Review

The revolution in technology has impacted the work and personal lives of human beings greatly. While it has introduced the mankind to a more comfortable life, it has brought in the stress too in the form of technostress, the situation where a person fails to cope up with the ever-advancing technology and experiences stress symptoms. The increasing intensity of technostress calls for more research on technostress diving deeper into the causes and coping mechanisms. However, technostress research requires successful and reliable assessment of stress. It has been observed in recent years that biomarkers such as cortisol and salivary alpha amylase are reliable indicators of stress. There are several reports where the researchers have used questionnaires and surveys to assess the technostress, but the number of studies using biomarkers for technostress assessment is limited. It has been established that biomarker assessment is an important complement to the surveys to study the technostress. Here, we summarize the important studies done on technostress using the biomarkers along with the rationale of using these biomarkers.

Prospective associations of technostress at work, burnout symptoms, hair cortisol, and chronic low-grade inflammation

BACKGROUND

Working conditions in the age of digitalization harbor risks for chronic stress and burnout. However, real-world investigations into biological effects of technostress, that is stress in the context of digital technology use, are sparse. This study prospectively assessed associations between technostress, general work stress, burnout symptoms, hair cortisol, and chronic low-grade inflammation.

METHODS

Hospital employees (N = 238, 182 females, Mage = 28.5 years) participated in a prospective cohort study with two follow-ups six months apart (T2, T3). Participants answered standardized questionnaires on general job strain (job demand-control ratio), technostressors (work interruptions, multitasking, information overload), burnout symptoms (exhaustion, mental distance), and relevant confounders. Moreover, they provided capillary blood samples for C-reactive protein (CRP) and hair strands for hair cortisol concentration (HCC) analysis. Structural equation modelling was performed.

RESULTS

The factorial structure of survey measures was confirmed. Burnout symptoms (MT2 = 2.17, MT3 = 2.33) and HCC (MT2 = 4.79, MT3 = 9.56; pg/mg) increased over time, CRP did not (MT2 = 1.15, MT3 = 1.21; mg/L). Adjusted path models showed that technostress was negatively associated with HCC (β = -0.16, p =.003), but not with burnout and CRP. General work stress in contrast, was not significantly associated with burnout, HCC or CRP. Furthermore, there were reciprocal effects of CRP on HCC (β = 0.28, p =.001) and of HCC on CRP (β = -0.10, p ≤.001). Associations were robust in additional analyses including further confounders.

CONCLUSION

This is the first study on prospective effects of technostress on employees' endocrine and inflammatory systems. Results suggest differential effects of technostress on the hypothalamic-pituitary-adrenocortical axis activity. Given its key role for long-term health, the findings have important implications for occupational health and safety in digitalized work environments.

A systematic review of studies on stress during the COVID-19 pandemic by visualizing their structure through COOC, VOS viewer, and Cite Space software

Background

The COVID-19 epidemic generated different forms of stress. From this period, there has been a remarkable increase in the quantity of studies on stress conducted by scholars. However, few used bibliometric analyses to focus on overall trends in the field.

Purpose

This study sought to understand the current status and trends in stress development during COVID-19, as well as the main research drives and themes in this field.

Methods

2719 publications from the Web of Science(WOS) core repository on stress during COVID-19 were analyzed by utilizing Co-Occurrence (COOC), VOS viewer, and Cite Space bibliometric software. The overall features of research on stress during COVID-19 were concluded by analyzing the quantity of publications, keywords, countries, and institutions.

Results

The results indicated that the United States had the largest number of publications and collaborated closely with other countries with each other. University of Toronto was the most prolific institution worldwide. Visualization and analysis demonstrated that the influence of stress during COVID-19 on the work, life, mental and spiritual dimensions is a hot research topic. Among other things, the frequency of each keyword in research on stress during COVID-19 increased from 2021 to 2022, and the researchers expanded their scope and study population; the range of subjects included children, nurses, and college students, as well as studies focusing on different types of stress, and emphasizing the handling of stress.

Conclusion

Our findings reveal that the heat of stress research during COVID-19 has declined, and the main research forces come from the United States and China. Additionally, subsequent research should concern more on coping methods with stress, while using more quantitative and qualitative studies in the future.

Wellbeing Convene during COVID-19: A pilot intervention for improving wellbeing and social connectedness for staff, students, residents, and faculty

Background

Canada is facing its worst crisis among healthcare workers in recent healthcare history. Anxiety, depression, suicidal ideation, and severe burnout are higher than before the COVID-19 pandemic. University Faculties of Medicine (FoMs) are vital to healthcare systems. Not only are they responsible for training personnel, but clinicians and staff from FoMs often work directly within healthcare systems. FoMs include students, staff, residents, faculty members, residents, researchers, and others, many experiencing higher stress levels due to pandemic tensions. Most FoMs emphasize cognitive and psychomotor learning needs. On the other hand, affective learning needs are not as well addressed within most FoMs. Finding innovative means to ameliorate mental and emotional health status, particularly at this critical juncture, will improve health and wellness, productivity, and retention. This article discusses a pilot program, Wellbeing Convene during COVID-19, in a Canadian FoM, which aimed to (1) provide staff, faculty, residents, and students with a toolkit for greater wellbeing and (2) build a sense of community during isolating times.

Results

Participants found the program beneficial in both regards. We recommend that these kinds of programs be permanently available to all members in FoMs, at no cost. Wellness programs alone, however, will not solve the root causes of mental and emotional stress, often based on concerns related to finances, hierarchical workplace structures, and nature of the work itself, among other factors.

Conclusion

Addressing the mental and emotional health of people in FoMs is vital to improving productivity and reducing stress of FoMs, healthcare professionals, and, ultimately, patients.

Emotional intelligence, workplace conflict and job burn-out among critical care physicians: a mediation analysis with a cross-sectional study design in Egypt

OBJECTIVES

This study aimed to examine the association between the effect of emotional intelligence on job burn-out and the mediating effect of workplace conflict management among critical care physicians.

DESIGN AND SETTING

A cross-sectional study design was deployed.

PARTICIPANTS

The studied sample comprised 144 critical care physicians working at two Egyptian tertiary care public hospitals.

MEASURES

The participants' responses to three questionnaires were studied, including the Maslach Burnout Inventory, the Emotional Intelligence Questionnaire and the Conflict Management Formative Questionnaire, in addition to assessing coenzyme Q10 (CoQ10) levels.

RESULTS

Among the anaesthesiologists and critical care specialists examined, burn-out was reported by 63.9% of them. The findings of this study indicated that emotional intelligence played a notable role in predicting job burn-out, with a negative impact. Further analysis revealed that workplace conflict management acted as a mediator between emotional intelligence and the three components of job burn-out. Additionally, age and years of experience were found to have a negative correlation with burn-out and a positive correlation with conflict management. Furthermore, CoQ10 levels showed a negative correlation with burn-out, while displaying positive correlations with emotional intelligence and conflict management.

CONCLUSION

Conflict management acted as a mediator in reducing burn-out by demonstrating a significant negative relationship between emotional intelligence and burn-out. Initial findings indicated that possessing good emotional intelligence and conflict management skills had a positive influence on the immune system, as evidenced by higher CoQ10 levels. However, burn-out had the opposite effect, depleting the body's CoQ10 stores and negatively impacting immune-protective mechanisms. Therefore, it is crucial to implement emotional management educational programmes and update educational policies and pedagogical practices to enhance the emotional capabilities of healthcare providers, especially in demanding fields like critical care, to effectively address conflicts.

Creating work-life balance among physicians in the age of digitalization: the role of self-consciousness and communication - a qualitative study

BACKGROUND

Besides the positive effects of using digital health solutions, digitalization can affect the healthcare worker burnout. The ability to coordinate different aspects of life (WLB) also plays a significant role in the development of burnout among medical workers. The aim of our study is to show, through qualitative interviews, the impact of digitalization on work-life balance in Hungarian physicians.

METHODS

62 semi-structured interviews were conducted between October 2021 and June 2022, of which, a total of 31 interviews were used for the analysis, which were all related to the theme of work-life balance. Purposive sampling and inductive thematic approach were used to collect and analyse the data and identify patterns of the themes.

RESULTS

Based on this analysis, 5 main themes emerged: (1) the use of digital health tools, (2) Impact of digital tools on everyday work, (3) Work-life balance, (4) Setting and maintaining work-life boundaries, (5) Potential solutions. With the spread of digital communication, most of the respondents feel that their working hours increased even at the expense of their private life. The majority considers constant availability as a serious problem, however, several physicians indicated that as a result of a learning curve, they are able to change and set the necessary boundaries. Respondents were divided on whether or not they were successful in setting and maintaining boundaries. The 2 most important factors of establishing WLB in a digital age are self-consciousness and communication. However, these skills are not self-evident: the responses also show that in many cases there is a need for external support, but also for health professionals to actively reflect from time to time on their role as healers and their relationship with technology.

CONCLUSION

Basic principles and tools for establishing successful digital work-life balance in healthcare should be involved in the training curriculum of future physicians and healthcare professionals, while institutions should elaborate specific policies to include digital work-life balance in the institutional setting, as part of the preventive measures against burnout.

Social support as a mediator in the relationship between technostress or academic stress and health: analysis by gender among university students

Introduction

This research aims to study the role of social support as a mediator in the relationship between technostress or academic stress and health in university students.

Methods

A descriptive, quantitative cross-sectional study has been carried out through a self-reported survey answered by 389 students during March and April 2022. The current level of health was the outcome variable. Technostress and academic stress were the criterion variables. Perceived social support was the mediator variable. The sociodemographic variables and ICT use at the educational level were the independent variables.

Results

Women have higher levels of technostress and academic stress than men. Social support significantly and positively mediates the relationship between academic stress and self-perceived health in men.

Discussion

There is a clear need to develop new social management strategies that assist students in developing stable and long-lasting social networks, which can reduce stress during the student period and provide personal tools for later working life.

Digitalization in Urology-A Multimethod Study of the Relationships between Physicians' Technostress, Burnout, Work Engagement and Job Satisfaction

The potential influences of digitization on the mental health of personnel in the healthcare sector are increasingly coming into the scientific focus in the healthcare sector, especially in terms of the use of information and communication technologies. To date, there have been no German studies of the effects of technostress in healthcare. This cross-sectional study examined the relationships between technostress, burnout, work engagement, and job satisfaction among physicians in the field of urology. Data were collected via an online survey based on the job demands-resources model and the concept of technostress. The survey was sent to German urologists working in inpatient clinics. The participating physicians experienced moderate levels of technostress (M = 2.67, SD = 0.69). The results, based on a general linear model analysis, showed that technostress is significantly positively associated with burnout (β = 0.293; p < 0.001) and negatively associated with work engagement (β = -0.175; p < 0.001) and job satisfaction (β = -0.206; p < 0.001). This study also identified stress and strain factors associated with the use of ICT and assessed institutional support offers as coping mechanisms. The results of this study and its formulated practical implications can serve as a basis for discussing sustainable digitalization strategies in hospitals, taking into consideration technostress and its impact on physicians' burnout, work engagement and job satisfaction.

Associations of technostressors at work with burnout symptoms and chronic low-grade inflammation: a cross-sectional analysis in hospital employees

OBJECTIVE

Despite the increasing scholarly interest in the phenomenon technostress, associated biological effects on employee health are under-researched. Chronic low-grade inflammation is suggested as a central pathway linking stress experience to disease development. The aim of this study was to assess associations of technology-related work stressors (technostressors) with low-grade inflammation and burnout symptoms.

METHODS

N = 173 (74.6% women, M_age = 31.0 years) university hospital employees participated in a cross-sectional study. Self-report questionnaires were used for the assessment of general psychosocial working conditions (work overload, job control, social climate), a range of different technostressors, burnout symptoms, and relevant confounders. Participants provided capillary blood samples, and high-sensitivity C-reactive protein (hs-CRP) as an inflammatory biomarker was analyzed from dried blood spots.

RESULTS

Based on a factor analysis, we identified four underlying dimensions of technostressors: techno- and information overload, techno-complexity, interruptions and multitasking as well as usability and technical support. In multivariate linear regressions, techno-/information overload and techno-complexity were associated with core (exhaustion, mental distance) and secondary (psychosomatic complaints) symptoms of burnout. Techno-/information overload was a significant predictor of burnout core symptoms, even when general work overload was controlled for. The technostressors were not associated with hs-CRP.

CONCLUSION

This is the first study on technology-related stress at work and chronic low-grade inflammation. The results suggest that (information) overload caused by digital technology use is a distinct work stressor with genuine consequences for psychological health. To what extent these effects also manifest on a physiological level needs to be subjected to future studies, ideally with prospective designs.