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Björk L, Corin L, Akerstrom M, Jonsdottir IH, Innocenti AD, Wijk H, Ahlstrom L. Under pressure - The working situation of Swedish healthcare managers during the first wave of COVID-19. Front Psychol 2023; 13:1052382. [PMID: 36710753 PMCID: PMC9874142 DOI: 10.3389/fpsyg.2022.1052382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction The aim of this study is to provide insight into the psychosocial work situation of hospital managers during the first wave of the COVID-19 pandemic. Methods Mixed-effect modelling was used on survey data on job demands, job resources, job motivation, and work-life balance among over 500 managers working in 55 departments of a large Swedish university hospital in 2019 and 2020. Responses from 6011 employees were then used to stratify the analysis for COVID-19 exposure. Inductive content analysis was applied to open-ended questions on the managers' views on organisational prerequisites during the onset of the pandemic. Results The proportion of managers reporting difficulties with role clarity, quantitative demands, decision-making authority, and emotional support, time for recovery at work, motivation deficits, or problems with work-life balance clearly increased during the first wave of the pandemic. The proportion of managers reporting negative responses was higher in departments with high COVID-19 exposure. The qualitative analysis shows that overall governance in terms of clear, fair, and well-communicated routines, resource allocation, and division of responsibilities constituted an important framework for managerial during the crisis. First-line managers also require a mandate to re-organize their roles and their teams to successfully adapt to the situation. Organisational and social support was also important resources. Discussion This is the first study investigating healthcare managers' work situation during the first wave of the COVID-19 pandemic in a Swedish context. As expected, it indicates an increasingly strained work situation during the crisis, but it also provides findings on organisational prerequisites that allow healthcare managers to cope with stressful situations. In line with previous research on organisational resilience, the study provides suggestions for how higher-level managers can act in order to provide front-line managers with the organisational prerequisites they need to adapt, learn and develop successfully during times of unpredictability, insecurity, and rapid change in order to offer the best possible support to health care workers.
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Affiliation(s)
- Lisa Björk
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden,*Correspondence: Lisa Björk, ✉
| | - Linda Corin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H. Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl Innocenti
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Orthopedics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Johansson M, Finizia C, Innocenti AD, Ryden A. Is a line the same as a box? Speech assessment by VAS is not superior to Likert scales in laryngeal cancer patients. Med Sci Monit 2007; 13:CR481-CR487. [PMID: 17968295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The primary purpose was to assess if VAS or Likert was relatively more suitable when assessing self-ratings of voice and speech in patients treated for laryngeal cancer. An additional purpose was to investigate whether the scales differed in measuring change after treatment. MATERIAL/METHODS Using both VAS and Likert, 71 patients answered three questions at baseline and 12 months after treatment began. For test-retest analyses, additional data were used from 21 subjects. Non-parametric statistical methods suitable for comparing scales with different numbers of response alternatives were applied. RESULTS Test-retest reliability was strongest for the Likert scale. From baseline to follow-up, both scales detected significant improvements. However, for some Likert scores the associated VAS values varied across a wide range, and this was true for assessments at baseline, at follow-up, and for score changes. At baseline the inter-scale concordance showed a greater number of disordered pairs than at follow-up and on both occasions the older group produced a greater number of disordered pairs. CONCLUSIONS No support for the superiority of VAS over Likert was found. However, VAS may produce instability in response patterns. When using self-ratings of voice and speech to identify a need of further rehabilitation, Likert scales seem better suited.
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Affiliation(s)
- Mia Johansson
- Department of Otolaryngology, Sahlgrenska University Hospital, Goteborg, Sweden
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