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Couser GP, Stevens AM, Arndt HD, Nation JL, Breitinger SA, Lafferty DS, Sawchuk CN. Improving Supervisor Confidence in Responding to Distressed Health Care Employees. Jt Comm J Qual Patient Saf 2024; 50:209-218. [PMID: 38071188 DOI: 10.1016/j.jcjq.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Professional distress and burnout are increasingly common among health professionals. This trend prompted stakeholders at a large multicenter health care system to survey supervisors for improvement opportunities. The stakeholders learned that workplace leaders lacked tools and direction for appropriately responding to distressed employees. The authors implemented a supervisor training video on providing resources to improve employee mental health. METHODS Using the DMAIC (Define, Measure, Analyze, Improve, and Control) methodology, the authors conducted key stakeholder interviews to identify strengths, weaknesses, opportunities, and threats. Next, an e-mail survey was administered to a representative sample of supervisors that asked about degree of confidence in responding appropriately to distressed employees, with the response options "very confident," "somewhat confident," and "not at all confident." After identifying factors contributing to low supervisor confidence, the research team developed and disseminated a six-minute, on-demand video to train supervisors to respond appropriately to employees during a mental health crisis. The same group of supervisors were surveyed using the same survey after exposure to the video, and responses were collected from those who had viewed the video but had not answered the preintervention survey. RESULTS The proportion of supervisors who responded "not at all confident" in the survey decreased from 7.1% (15/210) of responses to 0.8% (1/123), while the proportion of supervisors who chose "somewhat confident" increased significantly, from 62.9% (132/210) to 69.1% (85/123) (p = 0.03). Of the 28 supervisors who had not participated in the presurvey and viewed the video, none indicated that they were "not at all confident." The percentage of supervisors who felt distress "sometimes" or more frequently from navigating and supporting employee emotional concerns decreased nonsignificantly from 41.9% (88/210) to 37.4% (46/123) (p = 0.87). CONCLUSION Simple, on-demand supervisor training videos can improve the confidence of supervisors to respond appropriately to distressed employees, which may indirectly contribute to improved employee mental health.
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Schmidt-Stiedenroth K, Guthardt L, Genrich M, Köhne M, Stiawa M, Erschens R, Junne F, Maatouk I, Gündel H, Angerer P, Müller A. What helps hospital staff in times of crisis: qualitative results of a survey on psychosocial resources and stressors in German hospitals during the COVID-19 pandemic. Front Public Health 2023; 11:1260079. [PMID: 37869202 PMCID: PMC10585258 DOI: 10.3389/fpubh.2023.1260079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/07/2023] [Indexed: 10/24/2023] Open
Abstract
Background Even before the COVID-19 pandemic, hospital workers faced a tremendous workload. The pandemic led to different and additional strain that negatively affected the well-being of employees. This study aims to explore psychosocial resources and strategies that were used by hospital staff. Methods In the context of an intervention study, employees of three German hospitals were questioned in writing in summer and fall 2020. Five open-ended questions about the pandemic were asked to capture corresponding effects on daily work routine. Answers of 303 participants were evaluated using structuring qualitative content analysis. Results Significant stressors and resources were identified in the areas of work content and task, social relations at work, organization of work, work environment and individual aspects. Stressors included, for example, emotional demands, conflicts, an increased workload, time and performance pressure. Important resources mentioned were, among others, the exchange with colleagues and mutual support. Sound information exchange, clear processes and guidelines and a positive work atmosphere were also important. In addition, the private environment and a positive mindset were perceived as helpful. Conclusion This study contributes to a differentiated understanding of existing psychosocial resources of hospital staff in times of crisis. Identifying and strengthening these resources could reduce stress and improve well-being, making hospital staff better prepared for both normal operations and further crisis situations.
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Affiliation(s)
- Kira Schmidt-Stiedenroth
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Lisa Guthardt
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - Mara Köhne
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Duisburg, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
- University Hospital for Psychosomatic Medicine and Psychotherapy, University Hospital Magdeburg, Magdeburg, Germany
| | - Imad Maatouk
- Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | | | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas Müller
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Duisburg, Germany
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Heming M, Siegrist J, Erschens R, Genrich M, Hander NR, Junne F, Küllenberg JK, Müller A, Worringer B, Angerer P. Managers perception of hospital employees' effort-reward imbalance. J Occup Med Toxicol 2023; 18:8. [PMID: 37280659 DOI: 10.1186/s12995-023-00376-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE Hospitals are frequently associated with poor working conditions that can lead to work stress and increase the risk for reduced employee well-being. Managers can shape and improve working conditions and thereby, the health of their teams. Thus, as a prerequisite, managers need to be aware of their employees' stress levels. This study had two objectives: At first, it aimed to test the criterion validity of the Effort-Reward Imbalance (ERI) questionnaire measuring psychosocial workload in hospital employees. Secondly, mean scales of the ERI questionnaire filled in by employees were compared with mean scales of an adapted ERI questionnaire, in which managers assessed working conditions of their employees. METHODS Managers (n = 141) from three hospitals located in Germany assessed working conditions of their employees with an adapted external, other-oriented questionnaire. Employees (n = 197) of the mentioned hospitals completed the short version of the ERI questionnaire to assess their working conditions. Confirmatory factor analyses (CFA) were applied to test factorial validity, using the ERI scales for the two study groups. Criterion validity was assessed with multiple linear regression analysis of associations between ERI scales and well-being among employees. RESULTS The questionnaires demonstrated acceptable psychometric properties in terms of internal consistency of scales, although some indices of model fit resulting from CFA were of borderline significance. Concerning the first objective, effort, reward, and the ratio of effort-reward imbalance were significantly associated with well-being of employees. With regard to the second objective, first tentative findings showed that managers' ratings of their employees' effort at work was quite accurate, whereas their reward was overestimated. CONCLUSIONS With its documented criterion validity the ERI questionnaire can be used as a screening tool of workload among hospital employees. Moreover, in the context of work-related health promotion, managers' perceptions of their employees' workload deserve increased attention as first findings point to some discrepancies between their perceptions and those provided by employees.
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Affiliation(s)
- Meike Heming
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - Johannes Siegrist
- Institute of Medical Sociology, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, University of Tuebingen, 72076, Tuebingen, Baden-Wuerttemberg, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141, Essen, Germany
| | - Nicole R Hander
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Albert- Einstein-Allee 23, 89081, Ulm, Germany
| | - Florian Junne
- University Clinic for Psychosomatic Medicine and Psychotherapy, University Medicine, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Janna K Küllenberg
- Institute for Medical Psychology, Centre for Psychosocial Medicine, University Heidelberg, University Hospital Heidelberg, Bergheimer Straße 20, 69115, Heidelberg, Germany
- Institute for Research and Development of Collaborative Processes, FHNW School of Applied Psychology, Riggenbachstrasse 16, Olten, 4600, Switzerland
| | - Andreas Müller
- Institute of Psychology, Work and Organisational Psychology, University of Duisburg-Essen, Universitätsstr. 2, 45141, Essen, Germany
| | - Britta Worringer
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Peter Angerer
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
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Andersen DR, Karlsen IL, Jaspers SØ, Pedersen AHM, Andersen LPS, Aust B. Experiences of preventing violence in two high-risk sectors: A qualitative study of front-line workers. Work 2023:WOR220151. [PMID: 36710701 DOI: 10.3233/wor-220151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Exposure to workplace violence is associated with physical and/or psychological trauma. Despite its significant impact, little is known about front-line workers' experiences of preventing workplace violence. OBJECTIVE This study aimed to identify what workers identify as important to preventing workplace conflicts from escalating into violence. METHODS We conducted seventeen qualitative focus-group interviews with fifty-eight workers at the Danish Prison and Probation Service and psychiatric hospitals. We applied thematic analysis to identify types of violence-prevention practices, and prerequisites for successfully preventing workplace violence. RESULTS We identified two main categories of violence-prevention practices, and one main category of prerequisites for violence-prevention practices. Main category A), "the individual worker's violence-prevention practices" included the sub-categories, 1) identify the causes of workplace violence and potentially violent situations, 2) establish relationships, state rules, and set clear boundaries and 3) display empathy and communicate respectfully. Main category B), "collaborative practices for preventing workplace violence" included 4) communicate with co-workers, and share information and observations, 5) coordinate work, avoid being played off against colleagues, and support colleagues. Main category C), "prerequisites for violence-prevention practices" included 6) managing one's emotions, and 7) having sufficient time to do the job, and being a part of a stable team, whose members know each other and the inmates/patients". CONCLUSION This study contributes to a better understanding of the interplay among individual, collaborative, and contextual aspects of preventing workplace violence. We believe that an increased understanding of the complexity of preventing workplace violence in high-risk sectors is useful when designing comprehensive violence-prevention strategies.
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Affiliation(s)
- Dorte R Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Iben L Karlsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sofie Ø Jaspers
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anna Helene M Pedersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Lars Peter S Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Birgit Aust
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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Tsarouha E, Stuber F, Seifried-Dübon T, Radionova N, Schnalzer S, Nikendei C, Genrich M, Worringer B, Stiawa M, Mulfinger N, Gündel H, Junne F, Rieger MA. Reflection on leadership behavior: potentials and limits in the implementation of stress-preventive leadership of middle management in hospitals - a qualitative evaluation of a participatory developed intervention. J Occup Med Toxicol 2021; 16:51. [PMID: 34844608 PMCID: PMC8628435 DOI: 10.1186/s12995-021-00339-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Mental health and stress prevention aspects related to workplace in hospitals are gaining increasingly more attention in research. The workplace hospital is characterized by high work intensity, high emotional demands, and high levels of stress. These conditions can be a risk for the development of mental disorders. Leadership styles can hinder or foster work-related stress and influence the well-being of employees. Through leadership interventions, leaders may be encouraged to develop a stress-preventive leadership style that addresses both, the well-being of the leaders and of the subordinates. A comprehensive qualitative description of leaders’ experiences with interventions on the topic of stress-preventive leadership is yet missing in the literature. Therefore, we address leaders of middle management regarding the development of stress-preventive leadership styles through supporting interventions. The research questions are: How do leaders of middle management perceive their leadership role in terms of effectiveness in stress prevention? Which potentials and limits in the implementation of stress-preventive leadership are experienced? Methods The study follows a qualitative research design and content analysis. We conducted individual interviews with leaders of middle management (n = 30) of a tertiary hospital in Germany for the participatory development of an intervention. This intervention, consisting of five consecutive modules, addressed leaders of middle management in all work areas within one hospital. After participation in the intervention, the leaders were asked to reflect on and evaluate the implementation of the contents learned within focus group discussions. Overall 10 focus group discussions with leaders (n = 60) were conducted. Results The results demonstrate that leaders of middle management perceived potentials for a stress-preventive leadership style (e.g., reflection on leadership role and leadership behavior, awareness/mindfulness, and conveying appreciation). However, limits were also mentioned. These can be differentiated into self-referential, subordinate-related, and above all organizational barriers for the implementation of stress-preventive leadership. Conclusions Some of the organizational barriers can be addressed by mid-level leadership interventions (e.g., lack of peer-exchange) or possibly by adapted leadership interventions for top management (e.g., lack of stress-preventive leadership styles in top level management). Other organizational limits are working conditions (e.g., staff shortage) that can only be influenced by health policy decisions. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-021-00339-7.
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Affiliation(s)
- Elena Tsarouha
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Felicitas Stuber
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.
| | - Tanja Seifried-Dübon
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany
| | - Natalia Radionova
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | | | - Christoph Nikendei
- Department for General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Melanie Genrich
- Institute of Psychology, Work and Organizational Psychology, University of Duisburg-Essen, Essen, Germany
| | - Britta Worringer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy II, Ulm University, Guenzburg, Germany
| | - Nadine Mulfinger
- Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Harald Gündel
- Clinic of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tuebingen, Tuebingen, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, Faculty of Medicine, University Hospital Tuebingen, Tuebingen, Germany
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Arnetz JE, Goetz CM, Arnetz BB, Arble E. Nurse Reports of Stressful Situations during the COVID-19 Pandemic: Qualitative Analysis of Survey Responses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8126. [PMID: 33153198 PMCID: PMC7663126 DOI: 10.3390/ijerph17218126] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 01/21/2023]
Abstract
The coronavirus disease (COVID-19) pandemic has exposed nurses to conditions that threaten their health, well-being, and ability to work. It is therefore critical to study nurses' experiences and well-being during the current crisis in order to identify risk groups for ill health and potential sources of organizational intervention. The aim of this study was to explore perceptions of the most salient sources of stress in the early stages of the coronavirus pandemic in a sample of U.S. nurses. A cross-sectional online survey was conducted among a sample of 695 U.S. nurses in May 2020. Content analysis was conducted on nurses' responses (n = 455) to an open-ended question on the most stressful situations they had experienced during the pandemic. Six distinct themes emerged from the analysis: exposure/infection-self; illness/death-others; workplace; personal protective equipment/supplies; unknowns; opinions/politics. Two sub-themes concerned restrictions associated with the pandemic and feelings of inadequacy/helplessness regarding patients and their treatment. More than half of all comments concerned stress related to problems in workplace response to the pandemic. Healthcare institutions should provide opportunities for nurses to discuss the stress they are experiencing, support one another, and make suggestions for workplace adaptations during this pandemic.
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Affiliation(s)
- Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (C.M.G.); (B.B.A.)
| | - Courtney M. Goetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (C.M.G.); (B.B.A.)
| | - Bengt B. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI 49503, USA; (C.M.G.); (B.B.A.)
| | - Eamonn Arble
- Department of Psychology, Eastern Michigan University, Ypsilanti, MI 48197, USA;
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