Determinants of emergency physician wellness in Belgium.
ABSTRACT: Objectives:This cross-sectional study examines first whether emergency physicians differ from a comparison group of surgeons, more specifically general surgeons and orthopedic surgeons, in terms of job and organizational characteristics and second to what extent these characteristics are determinants of professional well-being outcomes in emergency physicians. Methods:Belgian emergency physicians (n = 346) were invited to participate in this study. Forty-three percent of the eligible participants completed a questionnaire. The survey instrument contained 48 questions on determinants (personal characteristics, job conditions [Job Demand Control Support], organizational and environmental work conditions) as well as 39 questions on outcomes (job satisfaction, turnover intention, subjective fatigue, psychological distress, work-home interference, work engagement) by means of the Leiden Quality of Work Questionnaire for Medical Doctors, the Checklist Individual Strength, the Brief Symptom Inventory, and the Utrecht Work Engagement Scale. Hierarchical multiple regression analyses were used to examine the association between the determinants and each of the outcomes. Results:Emergency physicians reported higher job demands, lower job control, and less adequate work conditions compared with the group of surgeons. High job demands increased turnover intention, subjective fatigue, psychological distress, work-home interference in emergency physicians, but lack of job control, lack of social support from the supervisor, and inadequate communication also contributed in an unfavorable way to some of these outcomes. Conclusion:Emergency medicine departments must reduce the constant exposure to high job demands by allowing emergency physicians to have enough time for both physical and mental recovery. Work motivation and work conditions might be improved by increasing job control over job demands by giving emergency physicians more decision latitude and autonomy, improving good communication and teamwork and adequate social support from the supervisor and providing good material resources. These interventions can improve professional well-being outcomes in emergency physicians.
Project description:The primary prevention of occupational burnout should be considered as a public health priority worldwide. The aim of this study was to evaluate the prevalence of burnout and its associations with the work environment among hospital physicians in the Kaunas region, Lithuania. The cross-sectional study was carried out in 2018. The Job Content Questionnaire (JCQ) and the Copenhagen Burnout Inventory (CBI) were administered to examine occupational stress and personal, work-related, and client-related burnout among 647 physicians. Logistic regression analysis was applied to determine the association between dependent variable burnout and psychosocial environment among physicians, adjusting for potential confounders of age and gender. The prevalence rate of client-related, work-related, and personal burnout was 35.1%, 46.7%, and 44.8%, respectively. High job control, lack of supervisor, coworker support, job demands, and job insecurity were significantly associated with all three sub-dimensions of burnout. High job demands increased the probability of all three burnout dimensions, high job control reduced the probability of work-related, and client-related burnout and high job insecurity increased the probability of client-related burnout. The confirmed associations suggest that optimization of job demands and job control and the improvement of job security would be effective preventive measures in reducing occupational burnout among physicians.
Project description:Purpose To explore supervisors' perspectives and decision-making processes in the accommodation of back injured workers. Methods Twenty-three semi-structured, in-depth interviews were conducted with supervisors from eleven Canadian organizations about their role in providing job accommodations. Supervisors were identified through an on-line survey and interviews were recorded, transcribed and entered into NVivo software. The initial analyses identified common units of meaning, which were used to develop a coding guide. Interviews were coded, and a model of supervisor decision-making was developed based on the themes, categories and connecting ideas identified in the data. Results The decision-making model includes a process element that is described as iterative "trial and error" decision-making. Medical restrictions are compared to job demands, employee abilities and available alternatives. A feasible modification is identified through brainstorming and then implemented by the supervisor. Resources used for brainstorming include information, supervisor experience and autonomy, and organizational supports. The model also incorporates the experience of accommodation as a job demand that causes strain for the supervisor. Accommodation demands affect the supervisor's attitude, brainstorming and monitoring effort, and communication with returning employees. Resources and demands have a combined effect on accommodation decision complexity, which in turn affects the quality of the accommodation option selected. If the employee is unable to complete the tasks or is reinjured during the accommodation, the decision cycle repeats. More frequent iteration through the trial and error process reduces the likelihood of return to work success. Conclusion A series of propositions is developed to illustrate the relationships among categories in the model. The model and propositions show: (a) the iterative, problem solving nature of the RTW process; (b) decision resources necessary for accommodation planning, and
Project description:We tested the effects of a work-family intervention on employee reports of safety compliance and organizational citizenship behaviors in 30 health care facilities using a group-randomized trial. Based on conservation of resources theory and the work-home resources model, we hypothesized that implementing a work-family intervention aimed at increasing contextual resources via supervisor support for work and family, and employee control over work time, would lead to improved personal resources and increased employee performance on the job in the form of self-reported safety compliance and organizational citizenship behaviors. Multilevel analyses used survey data from 1,524 employees at baseline and at 6-month and 12-month postintervention follow-ups. Significant intervention effects were observed for safety compliance at the 6-month, and organizational citizenship behaviors at the 12-month, follow-ups. More specifically, results demonstrate that the intervention protected against declines in employee self-reported safety compliance and organizational citizenship behaviors compared with employees in the control facilities. The hypothesized mediators of perceptions of family-supportive supervisor behaviors, control over work time, and work-family conflict (work-to-family conflict, family-to-work conflict) were not significantly improved by the intervention. However, baseline perceptions of family-supportive supervisor behaviors, control over work time, and work-family climate were significant moderators of the intervention effect on the self-reported safety compliance and organizational citizenship behavior outcomes.
Project description:The balance of personal life with professional life is a topical issue that is increasingly worrisome due to globalization, the rapid introduction of new technologies into all areas of human life, the overlap between time between work and family, new organizational systems, and changes in the nature of work. This problem is accentuated by professions subjected to intense labor demands, as is the case of nurses. Adopting the Job Demand-Control-Support model, the main purpose of this research is to analyze how these factors lead to a greater or lesser degree of work-life balance. The research proposes a logistic regression model, which was constructed with a sample of 991 nursing professionals from the V European Working Conditions Survey. The results obtained confirm, on the one hand, that there is a significant effect of physical demands (but not psychological demands) on work-life balance. On the other hand, the moderating effects of job control are partially confirmed for psychological demands, and those of supervisor support (but not co-worker support) are partially confirmed for physical demands. In conclusion, the present research shows that effective management of nurses' work context can decisively contribute to finding the difficult balance between personal and professional time.
Project description:Schedule control and supervisor support for family and personal life are work resources that may help employees manage the work-family interface. However, existing data and designs have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (a) training supervisors on the value of demonstrating support for employees' personal lives and (b) prompting employees to reconsider when and where they work. We find statistically significant, though modest, improvements in employees' work-family conflict and family time adequacy and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brings greater benefits to employees more vulnerable to work-family conflict. This study advances our understanding of the impact of social structures on individual lives by investigating deliberate organizational changes and their effects on work resources and the work-family interface with a rigorous design.
Project description:Purpose of review:Symptoms of burnout affect approximately half of pediatricians and pediatric subspecialists at any given time, with similarly concerning prevalence of other aspects of physician distress, including fatigue, depressive symptoms, and suicidal ideation. Physician well-being affects quality of care, patient satisfaction, and physician turnover. Organizational factors influence well-being, stressing the need for organizations to address this epidemic. Recent findings:Organizational characteristics, policies, and culture influence physician well-being, and specific strategies may support an environment where physicians thrive. We highlight four organizational opportunities to improve physician well-being: developing leaders, cultivating community and organizational culture, improving practice efficiency, and optimizing administrative policies. Leaders play a key role in aligning organizational and individual values, promoting professional fulfillment, and fostering a culture of collegiality and social support among physicians. Reducing documentation burden and improving practice efficiency may help balance job demands and resources. Finally, reforming administrative policies may reduce work-home conflict, support physician's efforts to attend to their own well-being, and normalize use of supportive resources. Summary:Physician well-being is critical to organizational success, sustainment of an adequate workforce, and optimal patient outcomes. Because burnout is primarily influenced by organizational factors, organizational interventions are key to promoting well-being. Developing supportive leadership, fostering a culture of wellness, optimizing practice efficiency, and improving administrative policies are worthy of organizational action and further research.
Project description:Faced with the challenge of population aging, a prolonged working life is increasingly important in today's society. Maintaining work ability of employees is one of the effective ways to cope with the challenges to sustainability of the workforce presented by population aging. Researchers have shown ongoing interest in exploring the determinants of restricted work ability. The aim of this study was to evaluate the effects of work stress on work ability among power supply workers in Guangdong, China.A cross-sectional study was conducted among power supply workers during August 2014 to September 2014. A total of 805 subjects were enrolled in the study. Work stress was assessed by the Job Content Questionnaire and the Effort Reward Imbalance Questionnaire. Work ability was assessed by the Work Ability Index (WAI). The structural equation model was applied to test the relationship between different work stress components and work ability simultaneously using the Job Demands-Resources model as a framework.Job resources (measured by job control, reward and social support) were positively and directly associated with work ability (β = 0.70, P < 0.001). The association between job demands and work ability was also statistically significant (β = -0.09, P = 0.030). In addition, the findings also supported previous studies in that job demands were correlated with job resources (β = -0.26, P < 0.001).Our findings suggest that decision makers and health care providers should consider increasing job resources available to power supply workers. Consideration of organizational changes related to the design of the job task also would be useful to improve the employees' work ability.
Project description:BACKGROUND:Organizational features can affect how staff view their quality of work life. Determining staff perceptions about quality of work life is an important consideration for employers interested in improving employee job satisfaction. The purpose of this study was to identify organization specific predictors of job satisfaction within a health care system that consisted of six independent health care organizations. METHODS:5,486 full, part and causal time (non-physician) staff on active payroll within six organizations (2 community hospitals, 1 community hospital/long-term care facility, 1 long-term care facility, 1 tertiary care/community health centre, and 1 visiting nursing agency) located in five communities in Central West Ontario, Canada were asked to complete a 65-item quality of work life survey. The self-administered questionnaires collected staff perceptions of: co-worker and supervisor support; teamwork and communication; job demands and decision authority; organization characteristics; patient/resident care; compensation and benefits; staff training and development; and impressions of the organization. Socio-demographic data were also collected. RESULTS:Depending on the organization, between 15 and 30 (of the 40 potential predictor) variables were found to be statistically associated with job satisfaction (univariate analyses). Logistic regression analyses identified the best predictors of job satisfaction and these are presented for each of the six organizations and for all organizations combined. CONCLUSIONS:The findings indicate that job satisfaction is a multidimensional construct and although there appear to be some commonalities across organizations, some predictors of job satisfaction appear to be organization and context specific.
Project description:Abstract Objective Although burnout has been linked to negative workplace?level effects, prior studies have primarily focused on individuals rather than job?related characteristics. This study sought to evaluate variation in burnout between agencies and to quantify the relationship between burnout and job?related demands/resources among emergency medical services (EMS) professionals. Methods An electronic questionnaire was sent to all licensed, practicing EMS professionals in South Carolina. Work?related burnout was measured using the Copenhagen Burnout Inventory. Multivariable generalized estimating equations were used to estimate odds ratios (ORs) for specific job demands and resources while adjusting for confounding variables. Composite scores were used to simultaneously assess the relationship between burnout and job?related demands and resources. Results Among 1271 EMS professionals working at 248 EMS agencies, the median agency?level burnout was 35% (interquartile range [IQR]: 13% to 50%). Job?related demands, including time pressure, were associated with increased burnout. Traditional job?related resources, including pay and benefits, were associated with reduced burnout. Less tangible job resources, including autonomy, clinical performance feedback, social support, and adequate training demonstrated strong associations with reduced burnout. EMS professionals facing high job demands and low job resources demonstrated nearly a 10?fold increase in odds of burnout compared with those exposed to low demands and high resources (adjusted OR [aOR]: 9.50, 95% confidence interval [CI]: 6.39–14.10). High job resources attenuated the impact of high job demands. Conclusion The proportion of EMS professionals experiencing burnout varied substantially across EMS agencies. Job resources, including those reflective of organizational culture, were associated with reduced burnout. Collectively, these findings suggest an opportunity to address burnout at the EMS agency level.
Project description:This study examines whether the relationship between the employees' perceived job autonomy may be prone to the contextual influence of supervisor support and presenteeism climate in explaining the attendance behaviors of presenteeism-the employees' decision to attend work despite being ill or not feeling well. Does work context play a role on presenteeism climate and the specific act of presenteeism? This study includes 213 health care employees (e.g., nurses, doctors) working in one private hospital in Lebanon. We used the ordinary least squared (OLS) regressions path analytical framework and bootstrapping methods to estimate the hypothesized moderated-mediation models. Our findings indicate that healthcare job resources (job autonomy) is correlated with the presenteeism climate and the occurrence of presenteeism attendance behaviors. We also found that this relationship is mediated by presenteeism climate and that supervisor support moderates the observed indirect relationship. This study extends the organizational attendance research domain to presenteeism climate by explaining for both doctors and nurses how contextual variables explains the relationship between jobs resources and presenteeism attendance behaviors. Supervisor support plays an important role in encouraging task autonomy and thus allowing employees increase their perception of empowerment to manage their actions at work. Overall, healthcare managers should ensure that employees understand their roles and duties and have an up-to-date, clearly defined role (e.g., job description) so that they can meet their organizations' goals.