Mental health services need action on organisational culture and justice.

OBJECTIVE: A commentary on the usefulness of the concepts of organisational culture, organisational climate and justice on the quality and safety of mental health services and how conditions may be improved. CONCLUSIONS: Organisational culture, organisational climate and justice impact upon the quality and safety of care, as well as well-being of staff, in mental health services. Psychiatrists and trainees, should consider, act and advocate for improved organisational culture, climate and justice. Improvement in these organisational domains can be achieved, through a coordinated framework that acts across all levels of administration, mid-level management and frontline clinical staff.

Professional identity and emotional labour affect the relationship between perceived organisational justice and job performance among Chinese hospital nurses.

AIM: To investigate the influence of perceived organisational justice, professional identity and emotional labour on nurses' job performance. BACKGROUND: Previous studies have not explored the impact of professional identity and emotional labour on the relationship between perceived organisational justice and job performance. However, how to mobilize the enthusiasm of nurses and improve their job performance is the key for nursing managers to realize the sustainable development of hospitals. METHODS: A cross-sectional survey design was conducted. A total of 951 nurses from public hospitals in China participated in the survey from March-June 2021. The descriptive statistical approach, Pearson's correlation analysis and the PROCESS Macro Model 4 and 14 in regression analysis were used to analyse the available data. RESULTS: The results showed that nurses' perceived organisational justice, professional identity, emotional labour and job performance were significantly positive correlations between every two variables, with coefficients ranging between .24 and .75. Professional identity played a whole mediating role in perceived organisational justice and job performance, accounting for 98.04% of the total effect; meanwhile, this process was moderated by emotional labour. CONCLUSIONS: Perceived organisational justice positively predicted nurses' job performance; as a mediating mechanism with moderating, professional identity and emotional labour further explained how perceived organisational justice promoted the job performance of nurses. IMPLICATIONS FOR NURSING MANAGEMENT: This study highlighted the moderated mediation role of professional identity and emotional labour between nurses' perceived organisational justice and job performance. Understanding this mechanism has guiding significance for nursing managers to improve nurses' job performance.

Relationships of organisational justice, psychological capital and professional identity with job burnout among Chinese nurses: A cross-sectional study.

AIMS AND OBJECTIVES: The present study was aimed at describing the status of job burnout and exploring the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout. BACKGROUND: With the shortage of nurses all over the world, nurses' job burnout has become the focus of studies in recent years. However, limited published research has examined the mediating roles of psychological capital and professional identity on the association between organisational justice and job burnout within hospital contexts in China. DESIGN: A cross-sectional design. METHODS: A total of 1,009 nurses were enrolled from a major general hospital located in Qiqihar City in the northeast of China from March-July 2018, and asked to complete questionnaires regarding organisational justice, psychological capital, professional identity and job burnout. The STROBE checklist was adhered to in this study. RESULTS: It was observed that the overall proportion of nurses with job burnout was 58.8%. All the correlations among organisational justice, psychological capital, professional identity and job burnout were statistically significant, with coefficients ranging between -0.487-0.863. Psychological capital and professional identity had indirect effects equal to -0.072 and -0.142, respectively, on the association between organisational justice and job burnout, taking up 13.7% and 26.9% of the total effect, respectively. The serial indirect effect of psychological capital and professional identity was -0.129, accounting for 24.5% of the total effect. CONCLUSIONS: This study showed the necessity of addressing the status of job burnout among Chinese nurses. Psychological capital and professional identity may mediate the linkage between organisational justice and job burnout independently and accumulatively. RELEVANCE TO CLINICAL PRACTICE: Nursing managers should strengthen organisational justice and improve the psychological capital and professional identity of nurses through effective strategies to prevent the job burnout of nurses.

A qualitative study on the experiences of the first nurses assigned to COVID-19 units in Turkey.

AIM: To explore the experiences of the first nurses assigned to work in COVID-19 units with the onset of the outbreak in Turkey. BACKGROUND: Even though the risks faced by nurses while performing a dangerous task during the epidemic are similar, their experiences may differ. METHOD: This qualitative study was carried out with 17 nurses. The interviews were carried out individually and online. The data were analysed using Colaizzi's phenomenological method. RESULTS: From the analyses of the data, four key themes have emerged as follows: 'needs', 'anger', 'questioning' and 'decision'. Needs include visibility, support, adaptation and sleep/rest. Nurses were angry because of their unmet expectations, feelings of injustice, and selfish and insensitive behaviours they faced. They questioned their profession and decided to either alienate from the profession or continue with the gains they had made. CONCLUSION: This study found that nurses perceived an imbalance between their efforts and their achievements. IMPLICATIONS FOR NURSING MANAGEMENT: This study provides evidence for nursing managers to anticipate problems that may arise both during and after the outbreak. Nurses should be made to feel that they are valued members of the health care institution, and effective strategies should be implemented to improve their perceptions of organisational justice.

Effects of organisational justice, work engagement and nurses' perception of care quality on turnover intention among newly licensed registered nurses: A structural equation modelling approach.

AIMS AND OBJECTIVES: To investigate turnover intention among newly licensed registered nurses and to clarify the impact pathways of organisational justice, work engagement and nurses' perception of care quality on turnover intention. BACKGROUND: Nurse shortage is an ongoing and urgent issue worldwide, in which nurse turnover could exacerbate the situation. Newly licensed registered nurses will become the main nursing workforce in the future; however, previous studies have not revealed the specific reasons underlying their turnover intentions. DESIGN: A descriptive cross-sectional design. METHODS: A total of 569 newly licensed registered nurses undertaking direct care were recruited from thirteen hospitals from October to November 2018 across Beijing, China. Based on the job demands-resources model, we advanced a hypothetical model, linking the paths between organisational justice, work engagement, nurses' perception of care quality and turnover intention. Structural equation modelling was used to examine the hypothetical model. The study adhered to the STROBE statement for observational studies. RESULTS: In total, 22.3% of newly licensed registered nurses had a high turnover intention. The final model had an acceptable fit and could explain 58% of the variance in turnover intention. The organisational justice was directly related to high work engagement, great nurses' perception of care quality and low turnover intention. Additionally, organisational justice also had indirect effects on great nurses' perception of care quality and low turnover intention, which were partially mediated by work engagement. However, the effect of nurses' perception of care quality on turnover intention was not significant. CONCLUSION: The improvement of organisational justice could enhance work engagement, and nurses' perception of care quality, and reduce turnover intention, which is crucial to improving care quality and addressing the shortage of nurses. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence for policymakers and hospital administrators to take targeted measures to enhance work engagement, foster high-quality care and create better defences against losing nurses.

From organisational justice to turnover intention among community nurses: A mediating model.

AIMS AND OBJECTIVES: To identify the situation of organisational justice, organisational support, work engagement and turnover intention among community nurses and clarify the relationship among them. BACKGROUND: Nurse shortage has become a worldwide issue, and the shortage of community nurses is more serious. Nurse turnover is one important factor for this situation. While previous studies about turnover intention mostly focused on hospital nurses, few involved community nurses. DESIGN: A descriptive, cross-sectional design was adopted. METHODS: Questionnaire investigation was implemented among 410 community nurses to collect data about organisational justice, organisational support, work engagement and turnover intention. Structural equation modelling was applied to test the hypothesised model. The STROBE statement for observational studies was followed. RESULTS: Results showed the average score of turnover intention was 2.50 ± 0.75. The final model indicated: (a) work engagement had a direct negative effect on turnover intention; (b) organisational support had both direct and indirect effects on turnover intention, and the indirect effect was mediated by work engagement; and (c) organisational justice had an indirect effect on turnover intention mediated by organisational support. CONCLUSION: Turnover intention could be reduced directly or indirectly by improving work engagement, organisational support and organisational justice. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence for community health centre managers and policymakers to improve the level of nurses' engagement and to retain more nurses in primary healthcare service.

Personality traits and perceptions of organisational justice.

This study examined the association between five-factor model personality traits and perceptions of organisational justice. The sample for the study comprised 903 participants (35-50 years old; 523 women) studied in 2007 and 2012. Measures used were the Neuroticism, Extraversion, Openness, Five-Factor Inventory questionnaire and the short organisational justice measure. The results showed that high neuroticism was associated with low distributive, procedural and interactional justice. Furthermore, high agreeableness was associated with high procedural and interactional justice and high openness with high distributive justice. This study suggests that neuroticism, agreeableness and openness are involved in perceptions of organisational justice and that personality should be considered in research and in practices at the workplace.

A systematic review of stakeholder views of selection methods for medical schools admission.

BACKGROUND: The purpose of this paper is to systematically review the literature with respect to stakeholder views of selection methods for medical school admissions. METHODS: An electronic search of nine databases was conducted between January 2000-July 2014. Two reviewers independently assessed all titles (n = 1017) and retained abstracts (n = 233) for relevance. Methodological quality of quantitative papers was assessed using the MERSQI instrument. The overall quality of evidence in this field was low. Evidence was synthesised in a narrative review. RESULTS: Applicants support interviews, and multiple mini interviews (MMIs). There is emerging evidence that situational judgement tests (SJTs) and selection centres (SCs) are also well regarded, but aptitude tests less so. Selectors endorse the use of interviews in general and in particular MMIs judging them to be fair, relevant and appropriate, with emerging evidence of similarly positive reactions to SCs. Aptitude tests and academic records were valued in decisions of whom to call to interview. Medical students prefer interviews based selection to cognitive aptitude tests. They are unconvinced about the transparency and veracity of written applications. Perceptions of organisational justice, which describe views of fairness in organisational processes, appear to be highly influential on stakeholders' views of the acceptability of selection methods. In particular procedural justice (perceived fairness of selection tools in terms of job relevance and characteristics of the test) and distributive justice (perceived fairness of selection outcomes in terms of equal opportunity and equity), appear to be important considerations when deciding on acceptability of selection methods. There were significant gaps with respect to both key stakeholder groups and the range of selection tools assessed. CONCLUSIONS: Notwithstanding the observed limitations in the quality of research in this field, there appears to be broad concordance of views on the various selection methods, across the diverse stakeholders groups. This review highlights the need for better standards, more appropriate methodologies and for broadening the scope of stakeholder research.

The employee retention triad in health care: Exploring relationships amongst organisational justice, affective commitment and turnover intention.

AIMS AND OBJECTIVES: To increase understanding of the relationships between organisational justice, affective commitment and turnover intention in health care. BACKGROUND: Turnover in health care is a serious concern, as it contributes to the global nursing shortage and is associated with declines in quality of care, patient safety and patient outcomes. Turnover also impacts care teams and is associated with decreased staff cohesion and morale. METHODS: A survey was developed and administered to frontline nurses working in the Province of Ontario, Canada. The data were used to test a hypothetical model developed from a review of the literature. The relationships amongst the three constructs were evaluated using structural equation modelling and mediation analysis. RESULTS: The hypothesised model was generally supported, although we were limited to considerations of interpersonal justice, affective commitment to one's organisation and turnover intention. Interpersonal justice is associated with affective commitment to one's organisation, which is negatively associated with turnover intention. Interpersonal justice was also found to be directly and negatively associated with turnover intention. Affective commitment to one's organisation was also found to mediate the relationship between interpersonal justice and turnover intention. CONCLUSIONS: The examination of relationships within the "employee retention triad" in a single, comprehensive model is novel and provides new information regarding relational complexity and insights into what healthcare leaders can do to retain employees. RELEVANCE TO CLINICAL PRACTICE: Reducing turnover may help to decrease some of the stressors related to turnover for clinical staff remaining at the organisation such as constant onboarding and orientation of new hires, working with less experienced staff and increased workload due to decreased staffing.

Exploring predictors and consequences of embitterment in the workplace.

Research on the feeling of embitterment at work is still in its infancy. The present study investigated the predictors and consequences of the feeling of embitterment at work. It was hypothesised that organisational injustice as well as over-controlling supervision would predict embitterment at work and that embitterment would be associated with work-related rumination. Three hundred and thirty-seven employees completed an online survey. Regression analysis revealed that procedural injustice and over-controlling supervision were significant predictors of embitterment and that embitterment contributed significantly to the prediction of increased affective rumination and reduction in detachment. Mediation analysis indicated that embitterment at work was a significant mechanism through which organisational injustice and over-controlling supervision exerted their effect on affective rumination, which is indicative of insufficient recovery from work. Findings suggest that breaches in organisational justice can generate feelings of embitterment at work, which in turn can interfere with employees' ability to adequately recover from work. Practitioner Summary: The purpose of this study was to investigate predictors and consequences of embitterment in the workplace using an online questionnaire. Findings suggest that perceived unfairness, because of structural and organisational aspects, predicts feelings of embitterment and that feeling embittered at work can prevent employees from adequately recovering from work.

Factors affecting performance and productivity of nurses: professional attitude, organisational justice, organisational culture and mobbing.

AIM: To identify relationships among variables affecting nurses' performance and productivity, namely professional attitudes, organisational culture, organisational justice and exposure to mobbing. BACKGROUND: The determination of the factors affecting performance and productivity is important for providing efficient nursing services. These factors have been investigated in the literature independently, but the relationship among them has not been clearly identified. METHODS: This cross-sectional questionnaire study included 772 nurses working in a University Hospital accredited by Joint Commission International. RESULTS: The professional attitude score of the nurses was high (4.35 ± 0.63). However, their organisational justice (2.22 ± 1.26) and organisational culture (2.47 ± 0.71) scores were low. Nurses were subjected to mobbing at a high level (0.82 ± 0.78). As the organisational justice increased, the organisational culture increased and the mobbing decreased. As the organisation culture decreased, the mobbing increased. CONCLUSIONS: There was a positive correlation between organisation culture and organisational justice of the nurses and a negative correlation with mobbing. IMPLICATIONS FOR NURSING MANAGEMENT: The results of the study are essential for improving nurses' performance and productivity.

The impact of emotional intelligence on work engagement of registered nurses: the mediating role of organisational justice.

AIMS AND OBJECTIVES: To explore the impact of emotional intelligence and organisational justice on work engagement in Chinese nurses and to examine the mediating role of organisational justice to provide implications for promoting clinical nurses' work engagement. BACKGROUND: The importance of work engagement on nurses' well-being and quality of care has been well documented. Work engagement is significantly predicted by job resources. However, little research has concentrated simultaneously on the influence of both personal and organisational resources on nurses' work engagement. DESIGN: A descriptive, cross-sectional design was employed. METHODS: A total of 511 nurses from four public hospitals were enrolled by multistage sampling. Data collection was undertaken using the Wong and Law Emotional Intelligence Scale, the Organizational Justice questionnaire and the Utrecht Work Engagement Scale-9. We analysed the data using structural equation modelling. RESULTS: Emotional intelligence and organisational justice were significant predictors and they accounted for 44% of the variance in nurses' work engagement. Bootstrap estimation confirmed an indirect effect of emotional intelligence on work engagement via organisational justice. CONCLUSIONS: Emotional intelligence and organisational justice positively predict work engagement and organisational justice partially mediates the relationship between emotional intelligence and work engagement. RELEVANCE TO CLINICAL PRACTICE: Our study supports the idea that enhancing organisational justice can increase the impact of emotional intelligence. Managers should take into account the importance of emotional intelligence and perceptions of organisational justice in human resources management and apply targeted interventions to foster work engagement.

In need of each other: the moderator of task interdependence between LMX variability and justice.

AIM: This study examined how leader-member exchange differentiation could affect nurses' perception of organisational justice as well as the moderating effect of task interdependence on this link. BACKGROUND: Teams are essential to the health-care industry. However, the perception of injustice may lead to a high level of nurse turnover. METHOD: Data was collected from 187 nurses distributed in eight units in a mid-western hospital in the USA. Hierarchical linear modeling was used to analyze the cross-level interaction of leader-member exchange variability and task interdependence on individual-level perceptions of justice. RESULTS: Leader-member exchange variability was significantly related to distributive justice and interactional justice but not significantly related to procedural justice. The interaction term was significantly related to interpersonal justice, but not to procedural justice or distributive justice. CONCLUSION: This study showed that if leaders demonstrated a variation in treatment of different subordinates, nurses could perceive this as unfair regarding distribution and interaction; when the group was highly task interdependent, this kind of perception of 'unfairness,' particularly regarding interpersonal treatment, became even more salient. IMPLICATIONS FOR NURSING MANAGEMENT: Preferential and inconsistent treatment by them within the work group could introduce nurses' perceptions of unfair treatment. It is of crucial importance to provide training for supervisors on how to display relatively consistent behaviour towards nurses, particularly when the teams are highly task interdependent.

The role of perceived organisational justice in the experience of pain among male and female employees.

This study examined the association of organisational justice with pain among employees of a large organisation. Employees (n = 1829) completed measures of pain, fair pay, organisational justice, job satisfaction and stress. Logistic regression analyses found that organisational justice was unrelated to pain among women, but men with higher perceptions of fair pay were more likely to report chronic pain as were men with lower perceptions of distributive justice. This is the first study indicating that fair pay and distributive justice are both unique predictors of chronic pain in men. The findings have implications for supporting employees with chronic pain.

Organisational Justice and Political Agency among Nurses in Public Healthcare Organisations: A Qualitative Study Protocol.

Nurses are rarely treated as equals in the social, professional, clinical, and administrative life of healthcare organisations. The primary objective of this study is to explore nurses' perceptions of organisational justice in public healthcare institutions in Majorca, Balearic Islands, Spain, and to analyse the ways in which they exercise their political agency to challenge the institutional order when it fails to reflect their professional ethos. An ethnomethodological approach using critical discourse analysis will be employed. The main participants will be nurses occupying different roles in healthcare organisations, who will be considered central respondents, and physicians and managers, who will be considered peripheral respondents. Data generation techniques include semi-structured interviews, a sociodemographic questionnaire, and the researcher's field diary. This is one of the first studies to address organisational justice in healthcare organisations from a macrostructural perspective and to explore nurses' political agency. The results of this study have the potential to advance knowledge and to ensure that healthcare organisations are fairer for nurses, and, by extension, for the patients in their care.

Understanding Gender Equality Policy and Practice Gaps Through the Lens of Organisational Justice: Development of an Employee Alignment Model.

Policies and actions to address gender inequalities are widespread across a range of institutional and organisational contexts. Concerns have been raised about the efficacy and impacts of such measures in the absence of sustained evaluation of these activities. It has been proposed that important contextual factors may propel or inhibit measures to promote gender equality, including a critical mass of women, role models, diverse leaders and inclusive organisational cultures. This paper explores relationships between organisational justice and equality interventions to better understand gaps between equality policies and practices using a comparative case study approach in a male-dominated sector. A combination of questionnaire and interview data analysis with employees in three case organisations in the construction sector are used to outline links between perceptions of gender equality initiatives and organisational justice, and the mechanisms used to reinforce in-group dominance. The findings culminate in the development of an Employee Alignment Model and a discussion of how this relates to the organisational climate for gender equality work. The findings suggest that the development of interactional organisational justice is an important precursor for successful gender equality interventions in organisations. These findings have implications for those looking to minimize unintentional harm of policies or interventions to improve gender equality.

A One-Year Prospective Study of Work-Related Mental Health in the Intensivists of a COVID-19 Hub Hospital.

The COVID-19 pandemic has severely tested the physical and mental health of health care workers (HCWs). The various stages of the epidemic have posed different problems; consequently, only a prospective study can effectively describe the changes in the workers' health. This repeated cross-sectional study is based on a one-year investigation (spring 2020 to spring 2021) of intensive care physicians in one of the two COVID-19 hub hospitals in Central Italy and aims to study the evolution of the mental health status of intensivists during the pandemic. Changes in their work activity due to the pandemic were studied anonymously together with their perception of organisational justice, occupational stress, sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and intention to quit. In May-June 2021, one year after the baseline, doctors reported an increased workload, isolation at work and in their social life, a lack of time for physical activity and meditation, and compassion fatigue. Stress was inversely associated with the perception of justice in safety procedures and directly correlated with work isolation. Occupational stress was significantly associated with anxiety, depression, burnout, dissatisfaction, and their intention to quit. Procedural justice was significantly associated with happiness. Doctors believed vaccinations would help control the problem; however, this positive attitude had not yet resulted in improved mental health. Doctors reported high levels of distress (73%), sleep problems (28%), anxiety (25%), and depression (64%). Interventions to correct the situation are urgently needed.

Depression symptoms mediate the association between workplace stress and interleukin 6 in women, but not men: The Whitehall II study.

Workplace stress and depression are positively related with inflammation, and each other. Low-grade inflammation and concurrent high levels of workplace stress or depression has been related with future morbidity. The potential pathway between constructs however, remains elusive. For the first time, this study explored the concurrent relationship between workplace stress, depressive symptomology and low-grade inflammation, and considered the role of gender in these relationships. Data from the Whitehall II cohort study (N â€‹= â€‹2528, Mage â€‹= â€‹57.01, 23.7% females) provided measures of workplace stress (job demand-control; JDC), depressive symptomology (Centre for Epidemiological Studies Depression scale; CES-D) and circulating inflammatory markers, interleukin-6 (IL-6) and C-reactive protein (CRP) collected on the same day from a single time point. Females had higher workplace stress, depressive symptoms and lower serum IL-6 concentrations. For males, higher workplace stress was associated with higher depressive symptoms. For females, higher depressive symptoms were related with elevated IL-6 levels, and both higher workplace stress and IL-6 levels were associated with higher depressive symptoms. Higher depressive symptoms were related with higher CRP levels in men only. Higher depressive symptoms statistically mediated the relationship between higher workplace stress and IL-6 levels in females only, b â€‹= â€‹0.016, CI [0.002, 0.039]. Females in this large cohort had higher levels of job strain, depression and lower IL-6 concentrations than males. In females, higher depressive symptoms were associated with higher serum IL-6 levels and workplace stress was not. Considered together, these findings suggest that low job control may be more apparent in females than males, but it is primarily negative affect that drives the positive relationship between work stress and serum IL-6 concentrations in females. Replicating the current design with a suitably proximal follow-up is required to determine if the associations identified are causal.

The effect of perceived organisational justice on job satisfaction and burnout levels of haemodialysis nurses.

BACKGROUND: Organisational justice influences job satisfaction, the performance of individuals and the functioning of institutions. The lack of evidence-based studies investigating the relationship between hemodialysis nurses' perceptions of organisational justice, job satisfaction and burnout has created a research gap in this area. OBJECTIVE: To investigate the effect of perceived organisational justice on professional satisfaction and burnout levels of haemodialysis nurses and to identify any relation ship with individual and organisational factors. MATERIAL AND METHODS: The study was designed as a multi-centre descriptive study. The data were collected using the 'personal information form', the Organisational Justice Scale', the 'Maslach Burnout Inventory' and the 'Minnesota Satisfaction Questionnaire'. RESULTS: The distributive justice scores decreased as the depersonalisation scores of the nurses increased. As the personal accomplishment scores of the nurses increased, the interactional justice scores also increased. It was observed that the job satisfaction scores increased as the sub-dimensional scores of the organisational justice scale increased and exhaustion decreased. CONCLUSION: It was detected that there was a significant relationship between the organisational justice perception of nurses and their job satisfaction and level of burnout. Institutions are encouraged to adopt a fair policy towards nurses and promote personal development.

Organisational Justice, Burnout, and Engagement in University Students: A Comparison between Stressful Aspects of Labour and University Organisation.

Burnout, engagement, and organisational justice concepts are usually studied in the context of labour organisations, but not in universities. For this, the objective of this research is to identify the students' empirically evidenced relationships in the employment context, such as levels of organisational justice, stress indicators, burnout and work commitment. On the other hand, engagement is analysed as a mediating variable that explains the relationship between organisational justice and burnout. A sample of 543 students from three Spanish universities, selected by purposive sampling, is used ensuring voluntary and anonymous participation. The instruments used to measure the four variables to analyse are a protocol for data collection, MBI-SS instrument for Academic Burnout, Utrecht Work Engagement Student Scale (UWES) for Engagement and the Scale of Organisational Justice for Organisational Justice. As a result, college students show behaviours that promote academic achievement, and they feel more engaged when they are treated fairly. As for the burnout syndrome dimensions, average levels of emotional exhaustion and academic efficacy, and high levels of cynicism are revealed. In addition, the proposed structural equation model supports the main hypothesis; engagement is a mediating variable in the organisational justice and burnout relationship. To conclude, academic stress and its explanatory framework cannot be conceived only from an organisational perspective, where the context of each student must be considered. The adoption of organisational preventive measures can be relevant in ensuring a healthy and conducive academic performance in our students.