Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion.

This study focuses on Intensive Care Units (ICU) and aims to test whether daily job demands are related to daily emotional exhaustion and secondary traumatic stress (STS) after work through the experience of passion at work and whether personal resources in ICU, such as empathy and self-compassion, moderate these relationships. A diary study was designed to assess day-level job demands, passion, empathy, self-compassion at work; and day-level emotional exhaustion and STS after work. The sample was 97 healthcare workers from ICU from different Spanish hospitals being selected by the snowball technique. This sample was assessed 5 days x two moments per day through a diary questionnaire. The multilevel analysis showed a negative mediational effect of harmonious passion between daily job demands and both emotional exhaustion and STS. Also, in predicting emotional exhaustion, a moderator effect of empathy on harmonious passion was found, as well as a moderator effect of self-compassion on obsessive passion. In predicting STS, a direct positive effect was found in empathy. Our findings highlight the vocational work of these healthcare workers, considering job demands as challenging and enhancing their harmonious passion to overcome the drawbacks. Moreover, empathy revealed to have a negative effect whereas self-compassion the contrary. Thus, increase the awareness on these personal resources and how to train them could be considered as valuable preventative measures.

Observers' reactions to workplace incivility in the masculine domain: How does role congruency explain gender bias in future workers?

Based on Role Congruity Theory, we tested the hypothesis of gender bias by examining gender differences in observers' evaluations of the awareness and acceptability of workplace incivility gender-dyad interaction. Three hundred and ninety-six Spanish high school students (55.3% female) read one scenario of overt incivility (publicly humiliates and openly doubts the employee's judgment) or covert (omits and pays little attention) from a leader (female vs. male) toward a subordinate (female vs. male) in engineering. Results indicated gender differences among observers. From the leader actor of incivility, males were more aware and accepted less the incivility when performed by a female leader in a male domain; whereas females were more aware and accepted less incivility than males in all cases. Regarding the subordinate target of incivility, only females were more aware and accepted less incivility, and both males and females were more aware and accepted less covert incivility. Our results reveal practical implications for interventions from a gender perspective.

Incivility at work, upset at home? Testing the cross-level moderation effect of emotional dysregulation among female nurses from primary health care.

Workplace incivility is a growing problem in nursing. However, most studies that explore this psychosocial risk and its consequences do so considering a single level and a between-person perspective. The aims of the study were to explore whether the effects of experiencing incivility during work-time could explain the daily levels of well-being of nurses at home; and to analyze if that relationship could be moderated by their levels of emotional dysregulation as a trait. This is a multilevel study with diary methodology. The study was carried out in 18 primary health-care centers belonging to Madrid and the Basque Country, in Spain. Ninety-four nurses completed a general questionnaire and 54 of them a diary booklet over five consecutive working days in two different moments, immediately after work and at bedtime. The results showed that nurses' emotional dysregulation moderated the relationship between daily workplace incivility and daily fatigue, and positive affect at night at home. However, there were no direct effects of daily incivility on these outcome variables. In conclusion, the presence of difficulties in emotional regulation among nurses can increase the negative effects of daily workplace incivility on their health and well-being.

Expanding the occupational health methodology: A concatenated artificial neural network approach to model the burnout process in Chinese nurses.

Artificial neural networks are sophisticated modelling and prediction tools capable of extracting complex, non-linear relationships between predictor (input) and predicted (output) variables. This study explores this capacity by modelling non-linearities in the hardiness-modulated burnout process with a neural network. Specifically, two multi-layer feed-forward artificial neural networks are concatenated in an attempt to model the composite non-linear burnout process. Sensitivity analysis, a Monte Carlo-based global simulation technique, is then utilised to examine the first-order effects of the predictor variables on the burnout sub-dimensions and consequences. Results show that (1) this concatenated artificial neural network approach is feasible to model the burnout process, (2) sensitivity analysis is a prolific method to study the relative importance of predictor variables and (3) the relationships among variables involved in the development of burnout and its consequences are to different degrees non-linear. PRACTITIONER SUMMARY: Many relationships among variables (e.g., stressors and strains) are not linear, yet researchers use linear methods such as Pearson correlation or linear regression to analyse these relationships. Artificial neural network analysis is an innovative method to analyse non-linear relationships and in combination with sensitivity analysis superior to linear methods.

Studying daily fluctuations of emotional effort among nurses of intensive care units: the establishment of latent profiles and its relationship with daily secondary traumatic stress and vitality.

Introduction: Nursing professionals working in Intensive Care Units (ICU) face significant challenges that can result in secondary traumatic stress (STS). These challenges stem from witnessing patients' suffering and managing difficult tasks (i.e. communication with patients' relatives). Furthermore, these professionals encounter emotional demands, such as emotional effort, which is the dissonance between the emotion felt and the emotion that should be expressed to meet work expectations. Consequently, we aimed to investigate whether different profiles exist concerning nurses' levels of emotional effort over a five-day period and whether these profiles are related to daily STS and vitality. Methods: The sample comprised 44 nursing professionals from ICUs in Spanish hospitals. They were assessed daily, using a package of questionnaires twice per day for five working days: a) immediately after their shift and b) at a later time after working. Results: The findings revealed three distinct profiles based on emotional effort levels: high (Profile 1), moderate (Profile 2), and low (Profile 3). These profiles were found to be negative predictors for both daily shattered assumptions and symptomatology. Discussion: This study underscores the importance of assessing daily emotional demands in an ICU setting. Such assessments are crucial for establishing preventive measures to help nursing professionals manage lower-level emotional demands.

Work Intensification and Its Effects on Mental Health: The Role of Workplace Curiosity.

Work intensification is a psychosocial risk that has been increasing in recent decades and may have been accentuated after the COVID-19 pandemic. Its effects on health are negative, but they can be moderated by contextual and personal factors. The aim of this study was twofold: to analyze the effect of work intensification on workers' stress, anxiety, and depression and to explore the role of workplace curiosity in these relationships. The study design was cross-sectional, and a total of 766 Spanish workers (58.9% female) with different occupations completed the survey. The results showed that work intensification was associated with the symptomatology of stress, anxiety, and depression, with a medium effect size. Women workers showed higher work intensification, but its association with mental health was equally strong for both genders. Workers with higher levels of the workplace curiosity dimension "stress tolerance" showed less impaired mental health in the presence of work intensification. However, workers with higher levels of the workplace curiosity dimension "deprivation sensitivity" showed more symptoms of stress, anxiety, and depression when faced with high work intensification. The results were discussed in terms of their contributions to the field of study of work intensification, the future research they could inspire, and the prevention and intervention measures they could motivate.

Spanish Adaptation of the Intensified Job Demands Scale (IDS).

BACKGROUND: The Intensification of Job Demands Scale (IDS) is a multidimensional instrument designed to capture the phenomenon of work intensification that characterizes modern Western societies. However, in Spain the instrument has not been validated to assess this phenomenon. The aim of this study was to examine the psychometric properties of the IDS adaptation with a heterogeneous sample of Spanish workers. METHOD: The sample consisted of 722 Spanish workers (57.8% female, 42.2% male) who completed a survey between January and April 2022. RESULTS: A five-factor correlated model, as in the original IDS, had an optimal fit with 15 items, and displayed invariance across gender, level of education, and organizational tenure. Reliability coefficients were all satisfactory, and scale adaptation showed evidence of convergent, discriminant, and incremental validity. CONCLUSIONS: The Spanish adaptation of the IDS is a valid, reliable measure for analyzing the phenomenon of work intensification and intensified job demands in Spain.

Factors Associated with Obstetric Violence Implicated in the Development of Postpartum Depression and Post-Traumatic Stress Disorder: A Systematic Review.

Postpartum depression (PPD) and post-traumatic stress disorder (PTSD) continue to be prevalent, and disabling women with mental disorders and obstetric violence (OV) may be a trigger for them, particularly during maternity. We aimed to analyze the association between manifestations of OV with the development of PPD and PTSD during pregnancy, childbirth, and postpartum. This systematic review was based on the PRISMA 2020 statement and explored original articles published between 2012 and 2022. A total of 21 articles were included in the analysis, and bias was assessed by the Effective Public Health Practice Project's Quality Assessment Tool. The highest rate of PPD symptoms appeared in women under 20 years old, multiparous, and with low education levels. The higher PTSD ratio was present in women under 35 years, primiparous, and with secondary studies. The mode of labor (instrumental or C-section) was identified as a major risk factor of PPD, being mediator variables of the informal coercion of health professionals and dissatisfaction with newborn healthcare. Instead, partner support during labor and high satisfaction with healthcare during birth were protective factors. Regarding PTSD, the mode of labor, several perineal tears, and the Kristeller technique were risk factors, and loss of autonomy and coercion modulated PTSD symptomatology. The protective factors for PTSD were respect for the labor plan, adequate communication with health professionals, social support during labor, and the skin-to-skin procedure. This systematic review provides evidence that OV contributes to PPD and PTSD, being important in developing standardized tools to prevent it. This study recommends changes in maternal healthcare policies, such as individualized healthcare assistance, humanized pregnancy protocols, and women's mental health follow-up, and improvements in the methodological quality of future research.

Elucidating the role of recovery experiences in the job demands-resources model.

Based on the Job Demands-Resources (JD-R) model, the current study examined the moderating role of recovery experiences (i.e., psychological detachment from work, relaxation, mastery experiences, and control over leisure time) on the relationship between one job demand (i.e., role conflict) and work- and health-related outcomes. Results from our sample of 990 employees from Spain showed that psychological detachment from work and relaxation buffered the negative impact of role conflict on some of the proposed outcomes. Contrary to our expectations, we did not find significant results for mastery and control regarding moderating effects. Overall, findings suggest a differential pattern of the recovery experiences in the health impairment process proposed by the JD-R model.

Satisfied as professionals, but also exhausted and worried!!: The role of job demands, resources and emotional experiences of Spanish nursing home workers during the COVID-19 pandemic.

Nursing home workers have been exposed to great physical and mental burdens during the COVID-19 pandemic. Although this has generated high levels of exhaustion, it may also have contributed to feelings of professional satisfaction. The objective of this study was to explore the levels of satisfaction among nursing home workers during the COVID-19 pandemic, as well as the role of job demands, resources and emotional experiences in explaining their levels of satisfaction. This cross-sectional study was conducted in Spain between March and May 2020. Three hundred and thirty-five nursing home workers participated. A quantitative analysis was conducted, as was a content analysis of the responses to an open-ended question about the respondents' perceptions of job demands and resources during the crisis. The results showed that workers had very high levels of satisfaction. Social pressure from work, contact with death and suffering, and emotional exhaustion were negatively associated with satisfaction. Moreover, under conditions of extensive contact with suffering people and great fear of contagion, social support at work was shown to promote professional satisfaction. In conclusion, nursing home workers in Spain experienced high rates of satisfaction during the COVID-19 crisis despite the high job demands, lack of job resources, fear of contagion and exhaustion. The main practical implication of this study is the importance of ensuring optimal working conditions in the nursing home sector in order to guarantee professional satisfaction, prevent burnout, reduce turnover and promote post-crisis resilience.

Daily Beneficial Effects of Work-to-Family Facilitation on Employees' Recovery and General Health: Is More Work Engagement Always Better?

This study of 104 Chilean employees examines the process of WFF-recovery-general health on a daily basis. Drawing on the work-home resources (W-HR) model, we hypothesized that daily work-to-family facilitation and work engagement predict recovery experiences during off-job time in the evening (i.e., detachment from work and relaxation) and subsequent general health at night. Furthermore, we explored whether daily work engagement moderates the relationships between daily work-to-family facilitation and recovery experiences during off-job time in the evening and general health at night. In addition, we expected employees' detachment from work to have a lagged effect on next-day general health at night. Participants completed a survey and a diary booklet over 5 consecutive working days (N = 520 occasions). Multilevel analyses show that, as expected, daily work-to-family facilitation predicted recovery experiences during off-job time in the evening (i.e., detachment from work and relaxation). However, contrary to our expectations, daily work engagement only predicted general health at night. Moreover, as expected, a moderation effect of daily work engagement shows that on days that employees experience low levels of daily work engagement, daily work-to-family facilitation is strongly related to detachment from work and relaxation during off-job time in the evening and to general health at night. Unexpectedly, on days on which employees experienced high levels of daily work engagement, daily work-to-family facilitation was weakly related to these outcomes. Finally, in accordance with our expectations, detachment from work had a lagged effect on next-day general health at night. These findings offer support for the W-HR model and have theoretical and practical implications for research and organizations.

Overwhelmed by Emotional Job Demands in High Vigor Days! Its Detrimental Effects on Daily Recovery from Work among Health-Care Workers.

The objective of this study is twofold: first, to analyze whether the daily level of energy in terms of vigor at work could explain the way in which workers psychologically detach from their work, relax, practice challenging activities, and have the feeling of having control over their leisure time when arriving home. Second, to check if the daily emotional job demands could hinder that relationship, reversing the positive effect of vigor in recovery. For this purpose, a multilevel study with a diary methodology was designed. In total, 94 nurses from various hospital and primary care centers in Madrid and Basque Country (Spain) participated in this study. They completed daily questionnaires twice a day (in the afternoon after work and at night before going to bed) for five consecutive workdays from Monday to Friday (N = 94*5 = 470). The results revealed that on days that vigor at work was high, nurses experienced more psychological detachment, relaxation, feelings of mastery, and time control at home. Moreover, on days that emotional job demands were high, vigor was more negatively related to psychological detachment and time control at home. Additionally, vigor was more positively related to all recovery experiences at home in days that emotional demands were low. Therefore, daily vigor can act as an energy resource that helps the worker to recover. However, this effect can occur in situations in which stressors are not present in high intensity. These results have clear practical implications for both health organizations and workers.

Daily Work-Family Conflict and Burnout to Explain the Leaving Intentions and Vitality Levels of Healthcare Workers: Interactive Effects Using an Experience-Sampling Method.

There is an intensification of work in global health systems, a phenomenon that could increase work-family conflict, exhaustion, and intentions to leave among healthcare workers. The main objective of this study is to analyze if daily work-family conflict and burnout could explain the daily leaving intentions and vitality of healthcare workers. This is a diary study, which employs an experience-sampling methodology (ESM). A total of 56 physicians, nurses, and nursing aides from intensive care and nephrology units filled out various quantitative scales during 5 working days (56 × 5 = 280 observations). Multilevel hierarchical analysis showed that daily work-family conflict and burnout were significantly associated with higher daily intentions of leaving the profession, and with lower levels of daily vitality. In addition, those workers who experienced more work-family conflict and depersonalization on a daily basis were those who showed more intentions to leave and less daily vitality, showing an interactive effect. The results highlight the importance of examining the psychosocial risks experienced by healthcare workers by employing experience-sampling methodologies, which could help us to deepen our understanding of the proximal antecedents of their intentions to leave and their psychological well-being.

Maternal Psychological and Biological Factors Associated to Gestational Complications.

Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life-work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; p-value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; p-value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; p-value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; p-value = 0.03) and life-work conflicts (OR = 1.92 [1.04; 3.75]; p-value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work-life conflicts could prevent fetal complications.

The Job Demands and Resources Related to COVID-19 in Predicting Emotional Exhaustion and Secondary Traumatic Stress Among Health Professionals in Spain.

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress (STS). This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of 221 health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources (MHRP), challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting (1) emotional exhaustion through the workload and (2) on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences.

The Role of Healthcare Professionals' Passion in Predicting Secondary Traumatic Stress and Posttraumatic Growth in the Face of COVID-19: A Longitudinal Approach.

COVID-19 has increased the likelihood of healthcare professionals suffering from Secondary Traumatic Stress (STS). However, the difficulty of this crisis may lead these professionals to display personal resources, such as harmonious passion, that could be involved in posttraumatic growth. The goal of this study is to examine the STS and posttraumatic growth among healthcare professionals and the demands and resources related to COVID-19. A longitudinal study was carried out in April 2020 (T1) and December 2020 (T2). The participants were 172 health professionals from different health institutions and they reported their workload, fear of contagion, lack of staff and personal protection equipment (PPE), harmonious passion, STS and posttraumatic growth. The results revealed that workload and fear of contagion in T2 were positive predictors for STS, whereas harmonious passion was a negative predictor. Fear of contagion of both times seemed to positively predict posttraumatic growth, as well as harmonious passion. One moderation effect was found concerning the lack of staff/PPE, as posttraumatic growth was higher when the workload was high, especially in those with a high lack of staff/PPE. All in all, these findings pointed out the need for preventative measures to protect these professionals from long-term negative consequences.

Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health.

Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family-work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (ß = 0.08 ± 0.03, p-value = 0.003), cholesterol (ß = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (ß = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (ß = -0.14 ± 0.09, p-value = 0.010) and life satisfaction (ß = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (ß = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (ß = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (ß = 370.2 ± 97.0, p-value = 0.001), red blood cells (ß = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (ß = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.

Stressors, Job Resources, Fear of Contagion, and Secondary Traumatic Stress Among Nursing Home Workers in Face of the COVID-19: The Case of Spain.

This study aimed to analyze the psychological consequences of the COVID-19 pandemic on nursing home workers, as well as the influence of certain related stressors and job resources. Two-hundred twenty-eight nursing home workers in Spain participated in this cross-sectional study. High levels of workload, social pressure from work, contact with suffering, and fear of contagion were found. In nursing homes where cases of COVID-19 had been detected, workers experienced higher levels of secondary traumatic stress. Social pressure from work, high doses of exposure to suffering, lack of personnel and personal protective equipment, and minimal supervisor support were significant in explaining traumatic stress. Supervisor and coworker support moderated some of these relationships. The results are discussed in terms of the need to implement urgent psychosocial protection strategies and to provide personal protective equipment (PPE) to help prevent future psychological disorders in this worker population.

[Adaptation of the "Recovery Experience Questionnaire" in a Spanish sample]. / Adaptación del "Cuestionario de Experiencias de Recuperación" a una muestra española.

The aim of this work was to examine the psychometric properties of the Spanish version of the "Recovery Experience Questionnaire" developed by Sonnentag and Fritz. The sample was made up of 941 professionals from the security sector. Results from the exploratory factor analysis suggested the possibility of considering a four-factor structure. Confirmatory factor analysis showed that the four-factor model with three correlated items each provided the best fit to the data (CFI=0.97, GFI=0.96, NNFI=0.96, RMSEA=0.05 y AIC=171.76). Therefore, the questionnaire maintains the four recovery experiences -psychological detachment from work, relaxation, mastery experiences and control over leisure time--but with 12 items instead of 16 items as in the original scale. Reliability analysis showed good internal consistency for this scale with Cronbach alpha coefficients for the factors ranging from .75 to .88. Significant correlations were found between the recovery experiences and various external variables, providing evidence of construct validity. Thus, this Spanish version shows adequate psychometric properties and may help to achieve a better understanding of this topic.

The Moderator Role of Passion for Work in the Association between Work Stressors and Secondary Traumatic Stress: A Cross-Level Diary Study among Health Professionals of Intensive Care Units.

BACKGROUND: Secondary traumatic stress (STS), a construct formed by compassion fatigue, shattered assumptions, and symptomatology, has been scarcely studied in intensive care units (ICU). In these units, healthcare workers encounter daily work stressors which impact on their health and well-being. Also, previous literature revealed a passion for caring among these workers, finding two types: harmonious passion, which may protect them against negative outcomes, and obsessive passion, which may boost negative consequences. We aim to study whether both types of passion could moderate the relationships between daily work stressors and STS. METHODS: In all, 265 assessments were collected at ICUs from different hospitals in Spain through a diary approach (53 health workers × 5 days at two time points per day). RESULTS: First, daily work stressors were positive predictors of symptomatology; secondly, dispositional harmonious passion was a negative predictor of both compassion fatigue and shattered assumptions, also presenting a buffering effect between daily work stressors and daily shattered assumptions. Finally, dispositional obsessive passion showed positive relationships with both shattered assumptions and symptomatology, also presenting a boosting effect between daily work stressors and daily symptomatology. CONCLUSIONS: This study allows us to deepen our understanding of STS in ICUs and to boost preventive proposals. Practical implications are discussed.