Can compassionate leadership of senior hospital leaders help retain trainee doctors?

BACKGROUND: High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors. METHOD: A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences. A mixed method approach was employed. RESULTS: Structural equation modelling revealed that perceived compassionate leadership of hospital senior leaders (CLSL) (i.e., doctors in senior clinical and management positions, and senior managers) is directly and negatively associated with trainee doctors' burnout and intention to quit. We propose the associations may be indirectly strengthened through two mediating pathways: increased psychological contract fulfilment (PCF) of training/organisational support and reduced worry about the state of the NHS; however, only the former is supported. The model can explain a substantial 37% of the variance in reported burnout and 28% of intention to quit among trainee doctors. Being a Foundation Year (FY) trainee was significantly associated with poor PCF and burnout. Rich qualitative data further elaborated on their experiences in terms of senior leaders' awareness of their training/working experiences, listening to and acting on. CONCLUSIONS: Active and demonstrable CLSL plays a vital role in trainee doctors' retention. It has both direct (through support) and indirect effects through improving trainee doctors' PCF to reduce burnout and intention to quit. This seems particularly valuable among FY doctors. Implications for the development and management of the medical workforce are discussed.

The use of artificial intelligence in a military context: development of the attitudes toward AI in defense (AAID) scale.

Introduction: The use of artificial intelligence (AI) for national defense is a matter of high societal significance and ongoing public discourse, but very little is known about public acceptance of AI in defense contexts. Currently, there is no reliable and valid measure of attitudes towards AI in defense, and more general attitudinal measures on AI use are unlikely to capture relevant perceptions and opinions. A measure was therefore developed for the assessment of Attitudes towards AI in Defense (AAID), and this work presents the initial validation of this scale. Methods: A total of 1,590 participants (aged 19-75, M = 45.7, SD = 16.1) completed a self-report questionnaire which included an initial item pool of 29 attitudinal statements related to the use of AI in defense. An additional general attitude towards AI scale was also included to assess the concurrently validity of the AAID scale. The AAID underwent initial statistical validation via exploratory factor analysis and confirmatory factor analysis to test the underlying structure of the newly developed scale. Results: Items reduction and exploratory factor analysis resulted in a final scale consisting of 15 items. A final two factor solution explained 42.52% of the variance (Factor 1 = 22.35%, Factor 2 = 20.17%). Factor 1 was termed "Positive outcomes" and reflected the potential and anticipated consequences of implementing AI in defense. Factor 2 was termed "Negative Outcomes" and reflected the potential negative outcomes for AI in defense. The scale also exhibited acceptable internal reliability and current validity. Discussion: The newly developed AAID presents a new measurement tool which has the capacity to assess current attitudes towards AI in defense. Such work is essential if further developments in AI in defense are to continue with the support of the public. However, the work also notes that there are some key concerns and barriers that could block further developments in the area, with further work needed to explore how such anxieties are driven by narratives related to the topic.

High-performance work systems and individual performance: a longitudinal study of the differential roles of happiness and health well-being.

As a part of the growing strand of employee-centered HRM research, employee well-being is suggested to be a key mechanism that may help to explain the relationship between HRM and performance. To investigate how an employee's well-being mediates the HRM-performance relationship, we distinguish between two types of well-being identified in prior work, happiness well-being and health well-being, and present arguments for differences in their effects on individual performance. Building on Job Demands-Resources (JDR) theory, we propose that happiness well-being positively mediates the relationship between perceived High-Performance Work Systems (HPWS) and individual task performance, while health well-being negatively mediates this focal relationship. Thus, happiness well-being fits the "mutual gains" perspective. In contrast, health well-being fits the "conflicting outcomes" perspective, and thus may be harmed by the HPWS to enhance the performance. We find partial support for our arguments in an analysis of longitudinal survey data of 420 participants spanning a total of four waves of data collection.

Embedding Physical Activity into Community-Based Peer Support Groups for those Severely Affected by Mental Illness.

Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.

Becoming a Distance Manager: Managerial Experiences, Perceived Organizational Support, and Job Satisfaction During the COVID-19 Pandemic.

Due to the COVID-19 pandemic having radically changed the way we now work, many recent studies have focused on employees' experiences and well-being, their performance and job satisfaction (JSA), and ways to ensure the best support for them when working from home (WFH). However, less attention has been given to managers' experiences in adapting to the new role of distance management and supporting them with this transition. This study aims to explore how managers experienced distance management, and the perceived organizational support (POS), and the effect of organizational support has on their JSA during the first year of the COVID-19 pandemic. Data from 1,016 line, middle and top managers in Danish workplaces were collected in March 2021, 1 year after the start of the COVID-19 pandemic. We applied descriptive statistics, ANOVA, and partial least square structural equation modeling to investigate the relation of perceived organizational support (POS) and the JSA of distance managers. Control variables were the respondents' demographic characteristics, specifically gender, age, and management level. The study offers insights into the managerial experiences of becoming a distance manager, helps to understand the relationship between POS and managers' JSA, and shows a positive relationship similarly for the managers as for employees. The study shows that most managers found their work as distance managers more demanding and worked more hours. The data demonstrate that managers received the most support from their own employees and manager peers, whereas administrative support was largely lacking. The data also show that the majority (67%) of the managers prefer to manage from the office, but similarly, they can continue managing from a distance if needed post-pandemic. The study adds to the literature on workplaces' transitioning to distance management and hybrid work and contributes to understanding the role of POS and managers' JSA during this transition. Consequently, if an organization aims to offer hybrid work, improving support from top management and in-house support functions would help maintain or increase managers' JSA.

The health-performance framework of presenteeism: A proof-of-concept study.

There is emerging research that considers presenteeism as a neutral behavior that has both positive and negative predictors and outcomes for individuals and organizations. This neutral perspective diverges from the traditional negative view of presenteeism and is aligned with the Health-Performance Framework of Presenteeism (HFPF) in which presenteeism is considered to be an adaptive behavior that aims to balance health limitations and performance demands. This proof-of-concept study aims to investigate the existence of different profiles of presentees based on their common health problems (mental and physical) and performance, and differences in attendance and job stressors among these subgroups. Latent profile analysis with 159 clerical employees and managers from the UK private sector supported the HPFP and revealed four profiles: those reporting a good health and high performance were labeled functional presentees (who represented 19% of the sample), those with poor health and low performance were the dysfunctional presentees (14%), those with relatively high performance but poor health were labeled overachieving presentees (22%), and those with average scores on both dimensions were the average Joe/Jane presentees (45%; a new profile based on this sample). There was no profile in the present sample that corresponded to therapeutic presenteeism, characterized by low performance but relatively good health. Although average Joe/Jane presentees were comparable to functional presentees in exposure to most job stressors, they reported poorer pay and benefits, and more health problems than the latter. Average Joe/Jane presentees reported the lowest number of days of presenteeism. No difference was found in absenteeism across profiles, highlighting difficulties in measuring presenteeism using a count-measure, since three profiles presented a similar number of days of presenteeism yet contrasted health-performance configurations. Dysfunctional presentees were systematically more exposed to job stressors compared to functional presentees. The results support the HPFP proposition for different subgroups of presentees who are influenced by their work environment. The study takes a person-centered approach, disentangle presenteeism from the total count of presenteeism days, offering implications for management and intervention practice. Presenteeism can have a bright side and be functional in certain contexts when the appropriate resources are available.

The Impact of Quality of Work Organization on Distress and Absenteeism among Healthcare Workers.

The quality of work organization may be responsible not only for reduced productivity but also for an increased risk of mental and physical disorders. This study was aimed at testing this hypothesis. Workers of a local health unit in Italy were asked to fill out the Work Organization Assessment Questionnaire (WOAQ) during their periodic medical examinations in the second half of 2018. On the same occasion, they also completed the Demand/Control/Support (DCS) measure of job strain, the Effort/Reward Imbalance (ERI) questionnaire, and the General Health Questionnaire (GHQ12) to assess psychological health. A total of 345 workers (85.8%) completed the survey. Linear regression analysis showed that the quality of work organization was inversely proportional to psychological health problems (p < 0.001). Occupational stress, measured both by job strain and ERI, was a moderating factor in this relationship. The relationship between the WOAQ and psychological health, moderated by job strain or ERI, remained highly significant even after adjustment for sex, age, social support, and overcommitment. Regression models explained over 40% of the shared variance of the association between quality of work organization and psychological health. The quality of work organization significantly predicted the risk of sickness absence for musculoskeletal disorders (OR = 0.984, CI95% 0.972-0.996) and for other health problems (OR = 0.977, CI95% 0.967-0.988). A continuous improvement of work organization must consider not only the clients' or production needs but also the well-being of workers.

Development and validation of an individual job performance questionnaire (IJPQ).

BACKGROUND: Developing reliable tools to tap into all the behavioral dimensions of individual job performance and identifying the right sub-dimensions is necessary for both research and practice. OBJECTIVE: This study aimed at developing and validating an IJPQ that addresses shortcomings of existing questionnaires. METHODS: After a comprehensive systematic literature review, a framework consisting of four dimensions, including task performance (TP), contextual performance (CP), counterproductive work behavior (CWB), and adaptive performance (AP) was structured for measuring IJP. As well, 45 sub-dimensions were identified for measuring IJP's dimensions. Content and face validity were evaluated, and item impact score (IS), content validity index (CVI), Kappa, and content validity ratio (CVR) were calculated. For reliability and confirmatory factor analysis (CFA), 525 workers completed the validated questionnaire and Cronbach alpha and goodness of fit indexes were determined, respectively. RESULTS: Of the 62 items generated to measure dimensions, 53 were approved. Based on item-level CVI, of the 53 items, only 45 items were accepted. Finally, the results of item level CVR led to the extraction of 27 questions to evaluate IJP. The obtained scale level CVI and scale level CVR were 0.91 and 0.68, respectively. Based on the results obtained from 525 Iranian workers, values of Cronbach's Alpha, X2/df, RMSEA, and P-value were in the acceptable range. CONCLUSIONS: Conclusively, a questionnaire containing 20 items was developed and validated for measuring IJP of Iranian worker's culture. The four dimensions of TP, CO, CWB, and AP consisted of 6, 5, 5, and 4 items each, respectively. Overall, IJPQ is a theory-based, reliable, and valid instrument for assessing job performance.

Teleworking While Sick: A Three-Wave Study of Psychosocial Safety Climate, Psychological Demands, and Presenteeism.

Introduction: The COVID-19 pandemic has led to a significant increase in the proportion of employees for whom teleworking became mandatory. Presenteeism, or the behavior of working while ill, has hardly been studied in the context of telework. The pandemic forced millions of workers to abruptly transition to working from home for a prolonged period of time, leaving employers often unaware of their health status or work capacity of the workers. This change also eroded the work experience itself, the workplace, and their protective impact on both individual health and work outcomes. This study focused on the longitudinal relationships among psychosocial safety climate (PSC), a lead indicator of workplace conditions, psychological demands, an indicator of quality of work, and presenteeism among a representative sample of teleworkers. PSC was expected to have an indirect impact on presenteeism with psychological demands as a mediator of this impact. Method: We collected the data from a representative sample of teleworkers in the first months (T1: April, T2: June, and T3: December 2020) of the pandemic using a three-wave online survey (n = 275). We tested a model of PSC as a determinant of presenteeism in teleworkers with psychological demands as a mediator. A cross-lagged panel model was estimated to test cross-sectional and longitudinal relationships. Findings: As expected, psychological demands increased over time. Contrary to expectations, the prevalence of presenteeism remained unchanged while PSC increased over time. The data fully supported the mediating effect of psychological demands such that a higher evaluation of PSC at T1 led to lower psychological demands at T2, which led to reduced presenteeism at T3. We also found a reciprocal relationship, with higher psychological demands at T2 leading to decreased evaluation of PSC at T3. These results show that the perception of teleworkers on their organization as giving a high priority to their psychological health is an important determinant of their work experience, ultimately influencing their decision to work while ill. The context of the pandemic has highlighted the importance of a positive workplace climate and working conditions for reducing the behaviors that can be harmful to health and productivity. Implications for theory and practice, beyond the pandemic, are discussed.

The Role of Organizational Culture and Climate for Well-Being among Police Custody Personnel: A Multilevel Examination.

United Kingdom Police custody is one of the most challenging of work environments, liable to excessive demands and reduced well-being. Being difficult to access, it is also a much-neglected area of research that has focused on one or two roles, rather than the full range available, and on individual-level research, rather than a more comprehensive multilevel understanding of how organizational culture and climate can simultaneously influence a range of well-being outcomes. The present longitudinal study explored all types of roles, in both the public and private sectors, across seven English police forces and 26 custody sites (N = 333, response rate 46.57%, with repeated returns = 370). The Integrated Multilevel Model of Organizational Culture and Climate (IMMOCC) was applied to examine the organizational-level influences on individual well-being. Results indicated that (1) custody sergeants were most vulnerable to low well-being, followed by publicly contracted detention officers; (2) shared leadership (a source of team cohesion) was linked to four of six well-being outcomes; (3) two sub-components of culture reflected tensions never acknowledged before, especially in respect of role; and (4) reverse relationships existed between well-being outcomes and the dimensions of culture and climate. The findings inform practical recommendations, including resilience training and the need to raise the status of police custody, while also highlighting concerns about private sector scrutiny that may be relevant to other professions.

A Systematic Review of Job Demands and Resources Associated with Compassion Fatigue in Mental Health Professionals.

Psychosocial hazards in mental healthcare contribute to the development of compassion fatigue in mental health professionals. Compassion fatigue has a negative impact on the mental health and wellbeing of professionals that can impair the quality of services provided to clients. The majority of research on compassion fatigue has focused on individual-level variables such as gender, history of trauma and age, among others. It is also imperative to understand the role played by alterable work-related characteristics in contributing to the development of compassion fatigue in order to attenuate its impact on mental health professionals and their clients. The present review examined articles exploring work-related factors associated with compassion fatigue. Fifteen quantitative studies were included and their quality was assessed using a checklist. An inductive content-analysis approach was adopted to synthesise the themes emerging from the data. The results suggested a theoretical model consistent with the Job Demands-Resources model, wherein job demands (such as workplace trauma, workload and therapeutic settings) are associated with compassion fatigue, and job resources (such as supervisors', coworkers' and organisational support) mitigate the impact of job demands. In addition to person-oriented factors, work-related factors are critical for the prevention of compassion fatigue.

Research priorities for the COVID-19 pandemic and beyond: A call to action for psychological science.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has caused the coronavirus disease 2019 (COVID-19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter- and longer-term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID-19 pandemic to facilitate immediate and longer-term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high-quality, open, and rigorous research standards.

Cross-Validation of the Work Organization Assessment Questionnaire Across Genders: A Study in the Australian Health Care Sector.

OBJECTIVES: The main aim of this study was to examine the measurement invariance of the Work Organization Assessment Questionnaire (WOAQ) across genders in a group of health care employees, using bifactor modeling. There is a very limited research that uses invariance testing of bifactor models, despite their usefulness. Establishing validity of the WOAQ in this way is important for demonstrating its relevance for both men and women. METHODS: A bifactor modeling procedure was used here to examine the validity of the WOAQ with a sample of 946 paramedics employed in a large Australian organization in the health care sector. RESULTS: The results of this study show that the WOAQ has good psychometric properties across genders in health care settings. In addition, there were significant mean differences between men and women in their perceptions of "quality of relationships with colleagues," and "reward and recognition." There were no differences between men and women in the remaining factors: "quality of relationships with the management," "quality of relationships with colleagues," and "quality of the physical environment." CONCLUSIONS: The use of bifactor modeling to establish the cross-validity of the WOAQ across male and female paramedics adds to evidence for the measure's good psychometric properties. The findings confirm those of previous research that has used higher order confirmatory factor analysis. Moreover, mean differences between men and women were found to be significant in two of the five WOAQ subscales. These findings have practical implications for health care organizations, in terms of assessing work characteristics and developing activities to support the health and well-being of their employees.

The Psychosocial Work Environment, Employee Mental Health and Organizational Interventions: Improving Research and Practice by Taking a Multilevel Approach.

Although there have been several calls for incorporating multiple levels of analysis in employee health and well-being research, studies examining the interplay between individual, workgroup, organizational and broader societal factors in relation to employee mental health outcomes remain an exception rather than the norm. At the same time, organizational intervention research and practice also tends to be limited by a single-level focus, omitting potentially important influences at multiple levels of analysis. The aims of this conceptual paper are to help progress our understanding of work-related determinants of employee mental health by the following: (1) providing a rationale for routine multilevel assessment of the psychosocial work environment; (2) discussing how a multilevel perspective can improve related organizational interventions; and (3) highlighting key theoretical and methodological considerations relevant to these aims. We present five recommendations for future research, relating to using appropriate multilevel research designs, justifying group-level constructs, developing group-level measures, expanding investigations to the organizational level and developing multilevel approaches to intervention design, implementation and evaluation. Copyright © 2014 John Wiley & Sons, Ltd.

Sickness presenteeism determines job satisfaction via affective-motivational states.

INTRODUCTION: Research on the consequences of sickness presenteeism, or the phenomenon of attending work whilst ill, has focused predominantly on identifying its economic, health, and absenteeism outcomes, in the process neglecting important attitudinal-motivational outcomes. PURPOSE: A mediation model of sickness presenteeism as a determinant of job satisfaction via affective-motivational states (specifically engagement with work and addiction to work) is proposed. This model adds to the current literature, by focussing on (i) job satisfaction as an outcome of presenteeism, and (ii) the psychological processes associated with this. It posits sickness presenteeism as psychological absence and work engagement and work addiction as motivational states that originate in that. METHODS: An online survey on sickness presenteeism, work engagement, work addiction, and job satisfaction was completed by 158 office workers. RESULTS: The results of bootstrapped mediation analysis with observable variables supported the model. Sickness presenteeism was negatively associated with job satisfaction. This relationship was fully mediated by both engagement with work and addiction to work, explaining a total of 48.07% of the variance in job satisfaction. Despite the small sample, the data provide preliminary support for the model. CONCLUSIONS: Given that there is currently no available research on the attitudinal consequences of sickness presenteeism, these findings offer promise for advancing theorising in this area.

Leader-Member Exchange across two hierarchical levels of leadership: concurrent influences on work characteristics and employee psychological health.

Leader-Member Exchange (LMX) theory suggests that the quality of the leader-employee relationship is linked to employee psychological health. Leaders who reside at different hierarchical levels have unique roles and spheres of influence and potentially affect employees' work experiences in different ways. Nevertheless, research on the impact of leadership on employee psychological health has largely viewed leaders as a homogeneous group. Expanding on LMX theory, we argue that (1) LMX sourced at the levels of the line manager (LM) and senior management (SM) team will be differentially linked to employee psychological health (assessed as worn-out) and that (2) these relationships will be mediated by perceived work characteristics (reward and recognition, workload management, quality of relationships with colleagues and physical environment). Structural equation modelling on data from 337 manual workers partially supported the hypotheses. Perceptions of the physical environment mediated the relationship between LMX at the LM level and employee psychological health, whereas perceptions of workload management mediated the relationship between LMX at the SM level and psychological health. These findings corroborate arguments that leaders are not a uniform group and as such the effects of LMX on employees will depend on leadership hierarchy. Implications for expanding leadership theory are discussed.

Contextualising over-engagement in work: Towards a more global understanding of workaholism as an addiction.

Purpose Despite increasing empirical research into workaholism, no single definition or conceptualisation has emerged, and current understandings of workaholism are arguably problematic. The primary purpose of this paper is to clarify some of these issues, by defining and contextualising over-engagement in work that leads to severe negative consequences (i.e., workaholism) as a genuine behavioural addiction. Approach By conceptualising work behaviours as manifestations of behavioural engagement and placing them on a continuum from withdrawal/under-engagement (e.g., persistent absenteeism) to over-engagement (e.g., work conflicting with all other activity), this paper argues that workaholism is an extreme negative aspect of behavioural engagement. It then examines the extent to which workaholism can be viewed as a genuine addiction by using criteria applied to other more traditional behavioural addictions (e.g., gambling addiction, exercise addiction), before briefly outlining an approach towards a more global understanding of workaholism. Findings The framework presented here helps to contextualise over-engagement to work as a genuine addiction. It presents more comprehensive understanding of workaholism that takes into account the individual factors of the employee, situational factors of the working environment, and structural factors of the work activity itself. It provides theoretically derived links between workaholism and other work behaviours that can be empirically demonstrated. Practical implications Viewing workaholism as an addiction that comprises extreme and prolonged behavioural over-engagement can be invaluable for promoting healthy work engagement. A clearer understanding of the underpinnings of workaholism can allow for a better assessment and management by practitioners. Originality/value This paper is one the first to contextualise workaholism in relation to other work behaviours, conceptualise it as a genuine behavioural addiction, and to apply clinical criteria for addiction to understand workaholism as prolonged and extreme behavioural engagement.

Examination of the Work Organization Assessment Questionnaire in public sector workers.

OBJECTIVE: To investigate the utility of the Work and Organization Assessment Questionnaire (WOAQ) for public sector data. METHODS: A cross-sectional survey was performed in public sector organizations measuring demographics, work characteristics, work perceptions (WOAQ), sickness absence, and work performance. RESULTS: Confirmatory factor analysis of the WOAQ showed that factor structure derived for the manufacturing sector, for which the questionnaire was developed, could be replicated moderately well with public sector data. The study then considered whether a better more specific fit for public sector data was possible. Principal components analysis of the public sector data identified a two-factor structure linked to four of the five scales of the WOAQ assessing Management and Work Design, and Work Culture. These two factors may offer a context-sensitive scoring method for the WOAQ in public sector populations. These two factors were found to have good internal consistency, and correlated with the full WOAQ scales and the measures of performance and absence. CONCLUSIONS: The WOAQ is a useful and potentially transferable tool. The modified scoring may be used to assess work and organizational factors in the public sector.