Job Demand-Control-Support Latent Profiles and Their Relationships with Interpersonal Stressors, Job Burnout, and Intrinsic Work Motivation

Electronic medication administration record (eMAR) in Swedish home healthcare-Implications for Nurses' and nurse Assistants' Work environment: A qualitative study

BACKGROUND

The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment.

AIM

The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration.

METHOD

We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model.

RESULTS

NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive.

CONCLUSION

Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare.

Flourishing and the Prioritization of Workplace Elements in General Surgery Residents

INTRODUCTION

To explore and begin to operationalize workplace elements that influence general surgery (GS) resident wellbeing. Tailoring workplace wellbeing interventions is critical to their success. Occupational science has revealed that a person-centered approach to identifying positive and negative workplace influences can inform tailoring while accounting for individual differences. To our knowledge, this approach has not been applied to the surgical training environment.

METHODS

A national sample of GS residents from 16 Accreditation Council for Graduate Medical Education training programs ranked the importance of workplace elements via an anonymous survey. Latent profile analysis was performed to identify shared patterns of workplace element prioritization and their relation to levels of flourishing, a measure of global wellbeing.

RESULTS

GS trainee respondents (n = 300, 34% response rate - average for studies with this sample population) expressed a hierarchy of workplace element importance which differed by gender and race. "Skills to manage stress" and "a team you feel a part of" were prioritized higher by non-males than males. Residents of color and residents underrepresented in medicine, respectively, prioritized "recognition of work/effort" and "skills to manage stress" more than White and overrepresented in medicine residents. Flourishing prevalence varied by 40% with small differences in the specific profile of workplace element prioritization.

CONCLUSIONS

Differences in prioritization of workplace elements reveal subtle but important differences that may guide the design of wellbeing interventions for different populations within surgery.

Antecedents and components of burnout among Hungarian teachers in a cross-sectional study: Development of the Burnout Antecedents and Components Questionnaire

BACKGROUND

Studies have focused more on the outcome than on the antecedents of burnout. We aimed to develop a new measurement tool for burnout, including the antecedents and different components drawing from theories of the developmental aspect of burnout.

METHODS

In this cross-sectional study we tested the Burnout Antecedents and Components Questionnaire on a convenience sample of teachers (n = 618, 83.9 % women; mean age 44.52 years). We used confirmatory factor analyses to test our measurement model. We examined the concurrent validity with the Maslach Burnout Inventory. We also tested construct validity with depression, overcommitment, demographic characteristics and work-related factors.

RESULTS

The confirmatory factor analyses supported our measurement model with seven primary factors (need to prove oneself, overload of tasks, neglecting one's needs, conflict between values, interpersonal conflicts, passivity, and emotional drain) and three second-order factors (excessive effort, conflict, and total depletion). The covariates in the Maslach Burnout Inventory showed that emotional exhaustion had a strong relationship with the first- and second-order factors. Overcommitment showed a stronger relationship with factors at the beginning whereas depression showed a stronger relationship with factors at the end of the process. Demographic characteristics and work-related factors did not show strong associations.

CONCLUSIONS

The Burnout Antecedents and Components Questionnaire is a promising measurement tool with good convergent validity. Future research should further validate our questionnaire for burnout research, prevention, and screening. It adds a new dimension to the measurement of burnout. The approach involving the antecedents in measuring burnout among teachers can guide future research and tailored prevention programs.

Workplace leave patterns among Victorian health care workers during the COVID-19 pandemic

We analysed aggregate work absences during the coronavirus disease 2019 (COVID-19) pandemic from two Victorian hospital sites and corresponding individual-level survey data to understand changes in the rates and types of workplace absence. We found changing reasons for workplace absences as the pandemic progressed and observed higher rates of annual and sick leave during the months coinciding with increased COVID-19 cases and workforce burnout.

Patterns of work-related stress and their predictors among emergency department nurses and emergency medical services staff in a time of crisis: a latent profile analysis

BACKGROUND

Previous studies have shown that a disease outbreak may cause high stress among healthcare workers. However, the vast majority of those studies applied a variable-centered approach, in which relationships between the variables are believed to be identical across the studied population. The main purpose of this study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the coronavirus disease 2019 (COVID-19) pandemic and to examine their predictors.

METHODS

A cross-sectional paper-and-pencil study was conducted among a convenience sample of 297 emergency department (ED) nurses and 219 emergency medical services (EMS) staff members working in 10 hospital EDs and 52 EMS centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT).

RESULTS

Using the latent profile analysis (LPA), five work-related stress profiles were identified: "high stress with a good understanding of one's job role" (11.1%), "moderate stress" (41.9%), "relatively high stress with average demands and a very low understanding of one's job role" (23.8%), "low stress" (18.0%), and "generally low stress but with very high job demands and relational conflicts" (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership.

CONCLUSION

The results of the study suggest the importance of incorporating various sources of stress and using the person-centered approach when investigating the work-related stress of healthcare workers during disease outbreaks. Identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions that will be better suited to healthcare workers' needs.

The Effects of Job Demand-control-support Profiles on Presenteeism: Evidence from the Sixth Korean Working Condition Survey

Background

Presenteeism is closely related to work performance, work quality and quantity, and productivity at work. According to the job demand-control-support model, job demand, job control, and support play important roles in presenteeism. The present study investigated job characteristics profiles based on the job demand-control-support model and identify the association between job characteristics profiles and presenteeism.

Methods

This secondary data analysis used the Sixth Korean Working Condition Survey, a nationwide cross-sectional dataset. The study included 25,361 Korean wage workers employed in the workplace with two or more workers. Participants were classified into four job characteristics profiles based on the job demand-control-support model, using latent profile analysis, and logistic regression was performed to examine the association between study variables.

Results

Overall, 11.0 % of study participants reported experience of presenteeism in the past 12 months. Age, sex, location, monthly income, shift work, work hours, health problems, and sleep disturbances were significantly associated with presenteeism. The rate of presenteeism was the highest in the passive isolate group. The passive collective, active collective, and low-stain collective groups had a 23.0%, 21.0%, and 29.0% lower likelihood of experiencing presenteeism, respectively, than the passive isolate group.

Conclusions

The job demand-control-support profiles and the risk of presenteeism were significantly associated. The most significant group that lowered the experience of presenteeism was the low-strain collective group, which had a low level of demand and high levels of control and support. Therefore, we need a policy to reduce job demand and increase job control and support at the organizational and national levels.

Demand-Resource Profiles and Job Satisfaction in the Healthcare Sector: A Person-Centered Examination Using Bayesian Informative Hypothesis Testing

Work characteristics may independently and jointly affect well-being, so that whether job demands deplete or energize employees depends on the resources available in the job. However, contradictory results on their joint effects have emerged so far in the literature. We argue that these inconsistencies can be partially explained by two arguments in the contemporary literature in the field. First, most studies in the job design domain are based on classic variable-centered methodologies which, although informative, are not well suited to investigate complex patterns of interactions among multiple variables. Second, these studies have mainly focused on generic work characteristics (e.g., workload, control, support), and are lacking in occupational specificity. Thus, to overcome these limitations, in the current research we include generic and occupation-specific work characteristics and adopt a person-centered approach to (a) identify different patterns of interactions of job demands and resources in a sample of healthcare employees, and (b) determine the degree to which these patterns are associated with employee well-being. We involved a sample of 1513 Italian healthcare providers and collected data on key job demands (workload, emotional dissonance, patient demands and physical demands) and resources (control, management support and peers' support). We focused on job satisfaction as a broad indicator of well-being. Latent profile analysis revealed four profiles of job demands and resources: high strain-isolated, resourceless, resourceful and active job on the ward. The results of Bayesian informative hypothesis testing showed the highest support for the hypothesis stating that healthcare employees belonging to the active job on the ward profile (medium-high demands, high resources) were the most satisfied. Conversely, employees belonging to the high strain-isolated profile (high demands, low resources) and the resourceless profile (medium-low demands, low resources) were the least satisfied. Overall, our study confirms the key role played by job resources in determining well-being in high-risk sectors, demonstrating that job satisfaction can develop both in challenging and less demanding situations. On a practical level, mapping the complexity of the healthcare psychosocial work environment has important implications, allowing for a better assessment process of employee well-being and helping to identify the most effective and fitting interventions.

Paramedics' perceptions of job demands and resources in Finnish emergency medical services: a qualitative study

BACKGROUND

Paramedics' fatigue is rising. Stress factors show increased risk for burnout, fatigue, leaving the profession, decreased performance and risk for patient safety. Meanwhile, paramedics' strong community of practice, autonomy and a sense of professional respect are important factors in forming psychological resilience. We aimed to explore Finnish paramedics' perceptions of job demands and resources.

METHODS

Our study design was descriptive, inductive with a constructivist approach. Using reflexive thematic analysis, we analyse open-ended questions, from a web-based survey and essays written by Finnish paramedic masters-degree students. The study followed the SRQR checklist.

RESULTS

We identified paramedics' job demands as stress from a high workload, environmental factors and emotional burden. Performance expectations and a sense of inadequacy were further noted, as well as an organizational culture of hardiness, presenting lack of support and sense of inequality. Paramedics' job resources were pressure management strategies, which were expressed as positive coping mechanisms, agency to affect workload and professional self-actualization, expressed as psychologically safe work community, professional pride and internal drive to professional development.

CONCLUSIONS

Finnish paramedics exhibit resources and demands related to uncertainty and emotional burden as well as cultural hardiness and psychological safety in communities.

PATIENT OR PUBLIC CONTRIBUTION

This study was done based on survey data collected and analysed by the authors. No patient or public contribution was utilized for this study.

Authentic leadership and personal and job demands/resources: A person-centered approach and links with work-related subjective well-being

The job demands-resources theory considers an open group of personal and job demands and resources. Thus, it allows us to include personal resources not yet covered (i.e., vigor at work) or less explored (i.e., emotional abilities), as well as personal demands not yet explored (i.e., overcommitment). Additionally, from this theory, it is proposed that leaders may influence employee wellbeing. Therefore, of particular interest is to analyze positive leadership styles, such as authentic leadership (AL). This study addresses three research objectives: 1) to identify profiles of employees from a person-centered approach, combining personal resources (self-perception of emotional abilities, vigor at work and self-efficacy) and personal demands (overcommitment) with job resources and demands; 2) to analyze the relation of the identified profiles with indicators of work-related subjective well-being; and 3) to acknowledge whether the AL style determines the pertaining to a profile probability. A large heterogeneous sample of Spanish employees (N = 968) responded to a questionnaire. Data were analyzed by adopting a person-centered approach using latent profile analysis. The results revealed five patterns of job and individual characteristics: Profile 5 (very low personal resources, and low job resources and demands); Profile 4 (low resources and high demands); Profile 3 (mid-level personal resources, high job resources and low demands); Profile 2 (high personal resources, mid-level job resources and high demands); and Profile 1 (high resources and low demands). Analyses showed that workers differed significantly in well-being depending on their profile membership, with Profile 1 having the highest well-being. Profiles that yielded the worst outcomes were Profile 4 and Profile 5, especially the latter. Finally, the results indicated that AL increased the probability that a profile would show a high well-being level.

Effort-reward imbalance and job strain index associated with health-related quality of life for civil servants in a national survey: the mediation effect of job support and over-commitment

OBJECTIVES

Work-related stress (WRS) is significantly associated with health-related quality of life (HRQoL), but the amounts of evidence on differences of effort-reward imbalance (ERI) and job strain index (JSI) remain sparse and have limited generalizability. Therefore, we aimed to assess the association between ERI and JSI with HRQoL and assess the mediation effect of social support (JS) and over-commitment (OC) on this association in Taiwan's civil servants.

MATERIAL AND METHODS

A cross-sectional national survey was given to registered civil servants in Taiwan - 20 046 civil servants from 647 institutions were enrolled using multistage stratified random cluster sampling. A web-questionnaire collected demographic information, job characteristics, and different indexes of ERI and job-control-demand-support (JCDS) models. Structural equation model (SEM) was used to examine the association between ERI and JSI with HRQoL, and the mediation effect of JS and OC on the associations.

RESULTS

In the ERI model, ERI and OC were consistently negatively associated with the mental component score (MCS) (r = -0.46 and r = -0.37) and physical component score (PCS) (r = -0.45 and r = -0.34), which were higher than job demand (r = -0.28 and r = -0.22) and JSI (r = -0.38 and r = -0.29). Using hierarchical multiple regression analyses, ERI was significantly correlated with MCS and PCS, which was consistently higher than JSI. The ERI and JSI were significantly correlated with MCS (β = -0.170 and β = -0.140) and PCS (β = -0.150 and β = -0.082) using SEM analysis, whereas ERI was considerably higher than in JSI. In addition, OC and JS mediated the association between The ERI and JSI with HRQoL.

CONCLUSIONS

We found the ERI index is significantly correlated with HRQoL superior to JSI, in particular among Taiwan civil servants. Further longitudinal studies are needed to determine the causality and spatiotemporal relation of these differences. Int J Occup Med Environ Health. 2022;35(4):425-36.

Psychosocial working conditions of shiftworking nurses: A long-term latent transition analysis

AIM

This study aimed to identify profiles of working conditions to which nurses were exposed to over time and investigate how changes in working conditions relate to shiftworking and health.

BACKGROUND

Previous studies rarely addressed the issue of working conditions development over long periods and the effects of such development on nurses' health.

METHODS

Data from a national cohort of nurses in Sweden (N = 2936) were analysed using a person-centred analytical approach-latent profile and latent transition analysis.

RESULTS

Nurses report better psychosocial working conditions as they progress into mid-career. Shiftworking nurses experience poorer working conditions than their dayworking counterparts and tend to move from shiftwork to daywork as they progress into mid-career. In mid-career, nurses in work environments characterized by low autonomy and support tend to report poorer health outcomes.

CONCLUSION

Current analyses suggest that shiftworking nurses are particularly in need of interventions that address poor work environments. Not only do they experience more negative psychosocial working conditions than their dayworking counterparts, but they do so while having to contend with demanding schedules.

IMPLICATIONS FOR NURSING MANAGEMENT

The findings highlight that organisational interventions should target different aspects of the work environment for nurses in diverse stages of their careers.