Do Challenge Stress and Hindrance Stress Affect Quality of Health Care? Empirical Evidence from China

Association between occupational stress and subclinical depression in Chinese primary healthcare workers

Background

Wellbeing of healthcare workers is crucial for the effective functioning of primary health systems. This study aimed to examine the association between occupational stress and subclinical depression among primary healthcare workers, and to establish the foundation for future preventive strategies.

Methods

A cross-sectional study was conducted in Tai'an City, Shandong Province, China. Data were collected from 832 medical staff in primary health institutions using a structured self-administered questionnaire. The participants completed the Challenge and Hindrance-Related Self-Reported Stress (C-HSS) Scale and Patient Health Questionnaire-9. Multivariable logistic regression analysis was conducted to explore the relationship between occupational stress and subclinical depression among primary healthcare workers.

Results

The prevalence of subclinical depression among primary healthcare workers was 11.66%. Participants with subclinical depression have a significant higher level of occupational stress (including challenge-stress and hindrance-stress). Regression analysis result indicated that higher level of occupational stress was significantly associated with more severe subclinical depression, and the risk of subclinical depression remained after adjusting other covariates (OR = 4.57, 95%CI, 3.14-6.63). The association between challenge-stress and subclinical depression was not statistically significant when controlling for hindrance-stress. Subgroup analysis showed that male healthcare workers who perceived higher level of challenge stress were more likely to develop subclinical depression than female healthcare workers.

Conclusion

The level of subclinical depression among Chinese primary healthcare workers was high, and occupational stress especially hindrance stress may contribute to subclinical depression. Findings were also robust in subgroup analysis after adjusting for other covariates. These findings emphasize the importance of occupational stress psychosocial interventions to decrease the risk of developing depression among the primary healthcare workers.

Impact of a digitized workflow for knee endoprothesis implantations on hospital-specific ratios

BACKGROUND: The continuous decrease of healthcare resources requires hospitals to improve efficiency while striving to improve quality standards that deliver better patient outcomes. OBJECTIVE: The objective of this study was to analyze whether the implementation of digital support systems during orthopedic surgery positively affected clinical processes and quality ratios. METHODS: A retrospective case-control study of 297 knee joint replacement procedures was conducted between 2015 and 2020. Thirty-five patients were allocated to the treatment and control groups after they were identified with exact matching and estimation of the propensity score. Both groups were balanced regarding the selected covariates. The effect of the surgical procedure manager (SPM) on the incidence of acute haemorrhagic anaemia between the two groups was evaluated with a t-test, and the odds ratio was calculated. RESULTS: SPM-supported surgery has no significant influence on the incidence of acute haemorrhagic anaemia but leads to significantly shorter hospital stay (1.93 days), changeover (4.14 minutes) and recovery room time (20.20 minutes). In addition, it reduces the standard deviation of operation room times. CONCLUSIONS: The study concludes that SPM enhances surgical efficiency and maintains quality outcomes. To overcome their increasing financial pressure hospital management should commercially evaluate the implementation of digital support systems.

Occupational stress, distributive justice and turnover intention among public hospital nurses in China: A cross-sectional study

AIM

To examine the mediating role of distributive justice on the relation between occupational stress and turnover intention, and the regional role in moderating the relationship between distributive justice and turnover intention.

BACKGROUND

Turnover intention is an effective indicator of job departure and has been widely studied. Identification of methods to reduce turnover intention among nurses is a focus of the new round of medical and health system reform in China and in the realization of the "Healthy China 2030" policy. However, few studies have examined the present situation of Chinese nurse's turnover intention and corresponding influencing factors.

METHODS

Data were collected on-site by using questionnaires designed by anonymous researchers. A total of 718 effective questionnaires were allocated from representative public hospitals. Data were collected for the "Challenge and Hindrance-Related Self-Reported Stress Scale", "Distributive Justice Scale" and "Turnover Intention Scale".

RESULTS

Challenge stress was significantly inversely correlated with turnover intention, while hindrance stress was significantly positively correlated with turnover intention. Moreover, there was a significant inverse correlation between the two types of occupational stress and distributive justice and an inverse correlation between distributive justice and turnover intention. Regional role had a moderating effect on the correlation between distributive justice and turnover intention.

CONCLUSIONS

Chinese nurses' turnover intention is directly or indirectly influenced by occupational stress and distributive justice. Managers should set reasonable goals to cope with challenging stress. Proper intervention measures should be designed such as reducing barrier pressure, increasing remuneration, and promoting the matching between workload and job value to reduce the turnover intention. Finally, balancing the treatment towards nurses in different regions may help achieve relative fairness.

Does Servant Leadership Moderate the Relationship between Job Stress and Physical Health?

High school teachers experience high levels of job stress, which could lead to serious health problems. This study focused on Chinese high school teachers, as they have to manage negative stress and health issues. The research aimed to: (1) investigate the relationship between hindrance job stress, depersonalization, and physical health; (2) investigate if servant leadership, in fact moderates the relationship between hindrance job stress and depersonalization, as well as physical health. The study desisgn was cross-sectional and data analyses were conducted by using SPSS 21 and Mplus 7. The sample consisted of 857 high school teachers across Southern China. The results showed that hindrance stress is related to depersonalization among high school teachers (β = 0.63, p < 0.01). Both hindrance job stress (β = 0.32, p < 0.01) and depersonalization (β = 0.16, p < 0.01) are positively related to physical health. In addition, servant leadership moderates the relationship between hindrance job stress and physical health among the Chinese high school teachers (β = −0.09, p < 0.01). However, the results did not find that the effect of hindrance job stress on depersonalization is moderated by servant leadership (β = 0.02, p = 0.53). It is suggested that Chinese high schools recruit and train leaders in servant leadership, relieve teachers’ stress, and promote their health to ensure the sustainable development of schools.

How Can Work Addiction Buffer the Influence of Work Intensification on Workplace Well-Being? The Mediating Role of Job Crafting

Despite growing attention to the phenomenon of intensified job demand in the workplace, empirical research investigating the underlying behavioral mechanisms that link work intensification to workplace well-being is limited. In particular, a study on whether these behavioral mechanisms are dependent on certain type of individual difference is absent. Using data collected from 356 Chinese health care professionals, this study utilized a dual-path moderated mediation model to investigate the mediating role of job crafting behavior between work intensification and workplace well-being, and the moderating role of work addiction on this indirect path. The results demonstrated that although work intensification was negatively associated with workplace well-being, this effect was more likely to take place for non-workaholics. Specifically, compared with non-workaholics, workaholics were more prone to engage in job crafting behavior in terms of seeking resources and crafting towards strengths, and therefore less likely to have reduced well-being experience. Results are discussed in terms of their implications for research and practice.

Factors that affect the health status of health care providers-A cross-sectional design

AIM

To explore the factors that affect the health status of health care providers.

BACKGROUND

There is a lack of studies that address the stress, resilience, social support and health status of health care providers.

METHODS

Using a cross-sectional study design, 500 participants were recruited from three hospitals which were operated by one entity in southern Taiwan. Data were collected with structured questionnaires. A logistic regression analysis was performed to explore the factors that might affect the health status of health care providers.

RESULTS

Among the 500 health care providers, 345 were healthy and 155 were unhealthy. Health status was not significantly correlated with any demographic characteristics, but was significantly correlated with work stress, resilience and social support, with work stress being an important factor influencing the health status of health care providers.

CONCLUSIONS

Health care providers with health issues had higher work stress, less resilience and less social support than did healthy medical personnel. Moreover, work stress was the main factor affecting the health of health care providers.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital administrators should conduct a series of health management programmes to identify high-risk employees who might need assistance. Such programmes promoting healthy workplaces are necessary, as well as studies that examine the effectiveness of such strategies.

When Do Employees Speak Up Under Job Stressors? Exploring the Potential U-Shaped Relationship Between Hindrance Stressors and Voice Behavior

Drawing upon the conservation of resources theory, we intend to examine the relationships between voice behaviors and job stressors. Specifically, we propose a non-linear relationship between hindrance stressors and prohibitive and promotive voice behaviors. Furthermore, we argue that challenge stressors moderate the non-linear relationship between hindrance stressors and voice behaviors. Based on a sample of 361 employees in China, our results indicate that the relationship between hindrance stressors and prohibitive and promotive voice is U-shaped. The relationships between challenge stressors and prohibitive and promotive voice are linearly positive. Moreover, challenge stressors moderate the relationships between hindrance stressors and voice behaviors; thus, when challenge stressors are high, hindrance stressors are negatively linear related to prohibitive and promotive voice behaviors, and when challenge stressors are low, hindrance stressors are curvilinearly related to prohibitive and promotive voice behaviors. The theoretical and practical implications of these results are discussed.

Emerging Issues in Occupational Safety and Health

Working environments have various risks, which result in accidents and casualties. [...].