Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study.

Introduction: PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. Objectives: (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. Materials and methods: For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. Results: The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. Conclusion: The knowledge derived from this study could inform the design and implementation of future similar digital tools.

Work-family conflict among hotel housekeepers in the Balearic Islands (Spain).

The massive incorporation of women to the labour market has increased academic and applied interest on work-life issues throughout the years. This article aims to describe the domestic burden and difficulties in work-life balance (WLB) and to understand the intersection of work and family spheres among hotel housekeepers (HHs). A cross-sectional study was conducted through Primary Health Care in the Balearic Islands (Spain); 1,043 HHs were enrolled. 56.7% reported difficulties in WLB. Risk factors for perceiving difficulties in WLB were: living with someone else (regardless of the number of co-habitants), having difficulties making ends meet, being the main person in charge of domestic tasks, having a dependant, having an external locus of control, presenting higher levels of stress at work, working more hours a week and being younger. Protective factors from experiencing work-family conflict (WFC) were job and wage satisfaction. WFC is strongly influenced by individual, economic, labour and domestic factors: these relationships show that labour and domestic spheres are non-separate worlds.

Development of emotional intelligence and assertiveness in physiotherapy students and effects of clinical placements.

BACKGROUND: Emotional intelligence (EI) and assertiveness are key abilities for physiotherapists. Clinical placements seem to affect students' development of EI and assertiveness, and their construction of the professional role. PURPOSE: This study aims to compare the EI of physiotherapy students with students from other health professions and explore the evolution of EI and assertiveness in physiotherapy students throughout their university education, focusing on the influence of clinical practice. METHOD: Students (N = 753) completed a self-administered questionnaire to measure emotional intelligence (TMMS 24), assertiveness (CSES), and sociodemographic variables. RESULTS: EI levels were adequate and very similar across the three disciplines. Regarding assertiveness, physiotherapy students in year 4 obtained significantly higher levels than students in years 1, 2, and 3. Significant correlations (rs (207) = 0.35, p < .001) were found between assertiveness and the number of modules of clinical practice. CONCLUSION: This study contributes with further evidence on the improvement of assertiveness in physiotherapy students through their university education and, in particular, with clinical placements. Practical implications highlight the importance of training in EI and assertiveness during university, coupled with clinical placements, in order to prepare for an effective and satisfactory professional life.

Workplace bullying and sexual harassment at work among hotel housekeepers in the Balearic Islands (Spain).

Introduction: Hotel housekeepers are close to being a 100% feminized occupational group in Spain. This fact, coupled with some features of the job, places them at high risk of sexual harassment at work and bullying in the workplace. This study aims to explore experiences of sexual harassment at work and workplace bullying among hotel housekeepers in the Balearic Islands. Second, it aims to describe and estimate the prevalence of both phenomena. Methods: This is a mixed-methods study. Ten semi-structured interviews were conducted with key informants, and six focus groups were held with hotel housekeepers. Additionally, a quantitative cross-sectional study (n = 1,043) was undertaken. Results: Most participants in focus groups had been sexually harassed at work. However, they had normalized this kind of situations, not labeling themselves as victims of sexual harassment; and harassment events were seen as unimportant, normal, and unquestioned, as well as being part of their daily work. Hotel housekeepers who were sexually harassed indicated high levels of stress at work and low social support. The prevalence of different workplace bullying behaviors was quite high among hotel housekeepers working in the Balearic Islands. Some were associated with poorer self-rated health, less satisfaction with the job and the salary, lower social support, and higher levels of stress. Despite this, qualitative methods informed us that less severe behaviors were normalized and perceived by hotel housekeepers as intrinsic to their job. Discussion: The results show the high tolerance to less severe expressions of sexual harassment at work and workplace bullying, as well as difficulties in or reluctance to labeling this kind of experiences as such.

Telework satisfaction, wellbeing and performance in the digital era. Lessons learned during COVID-19 lockdown in Spain.

This study used a prospective design to examine the effects of telework satisfaction (time 1) on subjective wellbeing and self-reported performance (time 2) during the COVID-19 lockdown. Data were collected from 111 teleworkers through an online survey the first weeks of strict lockdown in Spain. Telework satisfaction showed positive direct effects on both subjective wellbeing and self-reported performance. Further, subjective wellbeing partially mediated the relationship between telework satisfaction and self-reported performance. Interestingly, employees with children felt less telework satisfaction but higher subjective wellbeing. The novelty of this study is that we evaluate the level of satisfaction with telework using a specific set of items that assess the employees' contentment with diverse telework facets. Given the spreading of telework and the increasing competitiveness of organizations, we discuss practical implications in times of crisis, both present and future.

Human resource practices and employee wellbeing from a gender perspective: The role of organizational justice / Prácticas de recursos humanos y bienestar de los empleados desde una perspectiva de género: el papel de la justicia organizacional

Abstract Introduction/objective: HR practices have been widely studied in the literature. However, critical research gaps remain unexplored. Little attention has been paid to the relationship between HR practices and well-being, or the mechanisms that explain the effect of HR on employees' wellbeing, and the role of gender in this relationship. Hence, this study aims to examine the relationship between HR practices and well-being (eudemonic and hedonic) through organizational justice, taking into account gender. Method: A convenience sampling technique was used in a correlational design. The sample was composed of 1647 employees from 42 Spanish organizations. Our measures were HR practices, organizational justice, and hedonic and eudemonic wellbeing. Multi-group structural equation models were computed. Results: The results supported our hypothesis, which mainly stated that (1) organizational justice (distributive, procedural and interactional justice) mediated the relationship between HR practices and eudemonic and hedonic well-being; (2) there were differences between men and women in this mediation. Conclusions: Human resource practices and organizational justice offer tools to HR managers in order to maintain and improve employees' well-being levels within their organizations.

Resumen Introducción/objetivo: Las prácticas de recursos humanos (RRHH) han sido ampliamente estudiadas en la literatura. Sin embargo, existen importantes carencias de investigación al respecto. Por ejemplo, se ha prestado poca atención a la relación entre las prácticas de RRHH y el bienestar, al mecanismo que explica el efecto de los RRHH en los empleados, y se ha pasado por alto el papel del género en las prácticas de RRHH. Por tanto, este estudio se dirige a examinar la relación entre las prácticas de RRHH y el bienestar (eudemónico y hedónico) por medio de la justicia organizacional, teniendo en cuenta el género. Método: Se utilizó un muestreo por conveniencia en un diseño correlacional. La muestra se compuso de 1647 trabajadores de 42 organizaciones españolas. Los instrumentos utilizados midieron prácticas de RRHH, justicia organizacional, y bienestar hedónico y eudemonico. Se realizaron modelos de ecuaciones estructurales multigrupo. Resultados: Los resultados confirmaron nuestras hipótesis, que afirmaban principalmente que (1) la justicia organizacional (justicia distributiva, de procedimiento e interactiva) mediaba la relación entre las prácticas de RRHH y el bienestar eudemónico y hedónico; (2) hay diferencias entre hombres y mujeres en esta mediación. Conclusiones: Las prácticas de RRHH y la justicia organizacional ofrecen herramientas a los directores de RRHH sobre cómo actuar para mantener y mejorar los niveles de bienestar de los empleados dentro de sus organizaciones.

A Mobile Phone-Based Intervention to Reduce Mental Health Problems in Health Care Workers During the COVID-19 Pandemic (PsyCovidApp): Randomized Controlled Trial.

BACKGROUND: The global health emergency generated by the COVID-19 pandemic is posing an unprecedented challenge to health care workers, who are facing heavy workloads under psychologically difficult situations. Mental mobile Health (mHealth) interventions are now being widely deployed due to their attractive implementation features, despite the lack of evidence about their efficacy in this specific population and context. OBJECTIVE: The aim of this trial is to evaluate the effectiveness of a psychoeducational, mindfulness-based mHealth intervention to reduce mental health problems in health care workers during the COVID-19 pandemic. METHODS: We conducted a blinded, parallel-group, controlled trial in Spain. Health care workers providing face-to-face health care to patients with COVID-19 were randomly assigned (1:1) to receive the PsyCovidApp intervention (an app targeting emotional skills, healthy lifestyle behavior, burnout, and social support) or a control app (general recommendations about mental health care) for 2 weeks. The participants were blinded to their group allocation. Data were collected telephonically at baseline and after 2 weeks by trained health psychologists. The primary outcome was a composite of depression, anxiety, and stress (overall score on the Depression Anxiety Stress Scale-21 [DASS-21]). Secondary outcomes were insomnia (Insomnia Severity Index), burnout (Maslach Burnout Inventory Human Services Survey), posttraumatic stress (Davidson Trauma Scale), self-efficacy (General Self-Efficacy Scale), and DASS-21 individual scale scores. Differences between groups were analyzed using general linear modeling according to an intention-to-treat protocol. Additionally, we measured the usability of the PsyCovidApp (System Usability Scale). The outcome data collectors and trial statisticians were unaware of the treatment allocation. RESULTS: Between May 14 and July 25, 2020, 482 health care workers were recruited and randomly assigned to PsyCovidApp (n=248) or the control app (n=234). At 2 weeks, complete outcome data were available for 436/482 participants (90.5%). No significant differences were observed between the groups at 2 weeks in the primary outcome (standardized mean difference -0.04; 95% CI -0.11 to 0.04; P=.15) or in the other outcomes. In our prespecified subgroup analyses, we observed significant improvements among health care workers consuming psychotropic medications (n=79) in the primary outcome (-0.29; 95% CI -0.48 to -0.09; P=.004), and in posttraumatic stress, insomnia, anxiety, and stress. Similarly, among health care workers receiving psychotherapy (n=43), we observed improvements in the primary outcome (-0.25; 95% CI -0.49 to -0.02; P=.02), and in insomnia, anxiety, and stress. The mean usability score of PsyCovidApp was high (87.21/100, SD 12.65). After the trial, 208/221 participants in the intervention group (94.1%) asked to regain access to PsyCovidApp, indicating high acceptability. CONCLUSIONS: In health care workers assisting patients with COVID-19 in Spain, PsyCovidApp, compared with a control app, reduced mental health problems at 2 weeks only among health care workers receiving psychotherapy or psychotropic medications. TRIAL REGISTRATION: ClinicalTrials.gov NCT04393818; https://clinicaltrials.gov/ct2/show/NCT04393818.

Effect of a mobile-based intervention on mental health in frontline healthcare workers against COVID-19: Protocol for a randomized controlled trial.

AIM: To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness-based approaches on the mental health of healthcare workers at the frontline against COVID-19 in Spain. DESIGN: We will carry out a two-week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention or control App intervention. METHODS: The PsyCovidApp intervention will include five modules: emotional skills, lifestyle behaviour, work stress and burnout, social support, and practical tools. Healthcare workers having attended patients with COVID-19 will be randomized to receive the PsyCovidApp intervention (intervention group) or a control App intervention (control group). A total of 440 healthcare workers will be necessary to assure statistical power. Measures will be collected telephonically by a team of psychologists at baseline and immediately after the 2 weeks intervention period. Measures will include stress, depression and anxiety (DASS-21 questionnaire-primary endpoint), insomnia (ISI), burnout (MBI-HSS), post-traumatic stress disorder (DTS), and self-efficacy (GSE). The study was funded in May 2020, and was ethically approved in June 2020. Trial participants, outcome assessors and data analysts will be blinded to group allocation. DISCUSSION: Despite the increasing use of mobile health interventions to deliver mental health care, this area of research is still on its infancy. This study will help increase the scientific evidence about the effectiveness of this type of intervention on this specific population and context. IMPACT: Despite the lack of solid evidence about their effectiveness, mobile-based health interventions are already being widely implemented because of their low cost and high scalability. The findings from this study will help health services and organizations to make informed decisions in relation to the development and implementation of this type of interventions, allowing them pondering not only their attractive implementability features, but also empirical data about its benefits. CLINICAL TRIAL REGISTRATION: NCT04393818 (ClinicalTrials.gov identifier). APPROVED FUNDING: May 2020.

Perceived Factors of Stress and Its Outcomes among Hotel Housekeepers in the Balearic Islands: A Qualitative Approach from a Gender Perspective.

Tourism is the main economic sector in the Balearic Islands (Spain) and hotel housekeepers (HHs) are a large occupational group, in which stress is becoming a major issue. This study aims at exploring in-depth factors perceived as stressors by HHs and key-informants, and their effects on work-life balance (WLB). A qualitative design with phenomenological approach was used, conducting six focus groups with 34 HHs and 10 individual interviews with key-informants. Results were analyzed adopting the job demands-resources model and a gender perspective. High demands, e.g., work overload, time pressure, physical burden…, lack of enough resources and little control, derived from role conflict, unexpected events…, were the most important factors explaining HHs' stress. Additionally, this imbalance was perceived as leading to health problems, mainly musculoskeletal disorders. Working schedule was mentioned as a facilitator to WLB, whereas an imbalance between job demands and resources led to work-home conflict, preventing them from enjoying leisure time. Multiple roles at work and at home increased their stress. HHs experienced their job as invisible and unrecognised. Regarding practical implications, our recommendations for hotel organization include reducing workload and increasing resources, which would improve the job demands-resource balance, diminish negative mental and physical outcomes and improve WLB.

Happy-Productive Teams and Work Units: A Systematic Review of the 'Happy-Productive Worker Thesis'.

The happy-productive worker thesis (HPWT) assumes that happy employees perform better. Given the relevance of teams and work-units in organizations, our aim is to analyze the state of the art on happy-productive work-units (HPWU) through a systematic review and integrate existing research on different collective well-being constructs and collective performance. Research on HPWU (30 studies, 2001-2018) has developed through different constructs of well-being (hedonic: team satisfaction, group affect; and eudaimonic: team engagement) and diverse operationalizations of performance (self-rated team performance, leader-rated team performance, customers' satisfaction, and objective indicators), thus creating a disintegrated body of knowledge about HPWU. The theoretical frameworks to explain the HPWU relationship are attitude-behavior models, broaden-and-build theory, and the job-demands-resources model. Research models include a variety of antecedents, mediators, and moderating third variables. Most studies are cross-sectional, all propose a causal happy-productive relationship (not the reverse), and generally find positive significant relationships. Scarce but interesting time-lagged evidence supports a causal chain in which collective well-being leads to team performance (organizational citizenship behavior or team creativity), which then leads to objective work-unit performance. To conclude, we identify common issues and challenges across the studies on HPWU, and set out an agenda for future research.