Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative.

Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The '5 critical moments' of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this study was to understand the determinants of nurses' hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses' hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence.

Using a theory of planned behaviour framework to explore hand hygiene beliefs at the '5 critical moments' among Australian hospital-based nurses.

BACKGROUND: Improving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses' beliefs associated with performing hand hygiene guided by the World Health Organization's (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses' decisions to perform hand hygiene according to the recently implemented national guidelines. METHODS: Thematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia. RESULTS: Important advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings. CONCLUSIONS: The belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses' hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses' hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient's surroundings continues to be reported as the most neglected opportunity for compliance.

Key beliefs of hospital nurses' hand-hygiene behaviour: protecting your peers and needing effective reminders.

ISSUES ADDRESSED: Hand hygiene in hospitals is vital to limit the spread of infections. This study aimed to identify key beliefs underlying hospital nurses' hand-hygiene decisions to consolidate strategies that encourage compliance. METHODS: Informed by a theory of planned behaviour belief framework, nurses from 50 Australian hospitals (n=797) responded to how likely behavioural beliefs (advantages and disadvantages), normative beliefs (important referents) and control beliefs (barriers) impacted on their hand-hygiene decisions following the introduction of a national '5 moments for hand hygiene' initiative. Two weeks after completing the survey, they reported their hand-hygiene adherence. Stepwise regression analyses identified key beliefs that determined nurses' hand-hygiene behaviour. RESULTS: Reducing the chance of infection for co-workers influenced nurses' hygiene behaviour, with lack of time and forgetfulness identified as barriers. CONCLUSIONS: Future efforts to improve hand hygiene should highlight the potential impact on colleagues and consider strategies to combat time constraints, as well as implementing workplace reminders to prompt greater hand-hygiene compliance. SO WHAT?: Rather than emphasising the health of self and patients in efforts to encourage hand-hygiene practices, a focus on peer protection should be adopted and more effective workplace reminders should be implemented to combat forgetting.

Do left and right asymmetries of hemispheric preference interact with attention to predict local and global performance in applied tasks?

Many cognitive neuroscience studies show that the ability to attend to and identify global or local information is lateralised between the two hemispheres in the human brain; the left hemisphere is biased towards the local level, whereas the right hemisphere is biased towards the global level. Results of two studies show attention-focused people with a right ear preference (biased towards the left hemisphere) are better at local tasks, whereas people with a left ear preference (biased towards the right hemisphere) are better at more global tasks. In a third study we determined if right hemisphere-biased followers who attend to global stimuli are likely to have a stronger relationship between attention and globally based supervisor ratings of performance. Results provide evidence in support of this hypothesis. Our research supports our model and suggests that the interaction between attention and lateral preference is an important and novel predictor of work-related outcomes.

Predicting Employee Participation in, and Satisfaction With, Wellness Programs: The Role of Employee, Supervisor, and Organizational Support.

OBJECTIVE: To examine the role of employee, supervisor, and organizational support in the prediction of employee participation in wellness programs. METHODS: Data were collected at two-time points (T1 and T2) from 194 Australian employees. RESULTS: Hierarchical binary logistic regressions revealed that higher levels of employee and supervisor support for wellness at T1 each predicted T2 participation, and high supervisor support was more effective when organizational support was high and did not compensate for when organizational support was low. Employees with higher perceptions of T1 poor general health had a lower likelihood of T2 participation, and higher levels of T1 supervisor support was a further deterrent to participation. CONCLUSIONS: Different sources of support for wellness predict employee attendance at wellness programs and it is important to ensure that supervisor and organizational support are aligned.

Praise and recognition from supervisors buffers employee psychological strain: A two-sample investigation with tourism workers.

BACKGROUND: Focusing on employees with psychological strain, this research draws on Fredrickson's 'undoing hypothesis' to examine praise and recognition from one's supervisor as an organizational resource. OBJECTIVE: A model is tested in which psychological strain is a mediator in the positive relationship between role demands and employees' intentions to take sick leave and seek medical advice, and positions supervisor praise and recognition as a buffer of psychological strain on such intentions. METHODS: The model was tested using two Australian samples in the tourism sector, consisting of motel workers (n = 104) and museum workers (n = 168). RESULTS: For museum workers, but not motel workers, there was a positive indirect effect of each role demand on sick leave intentions through psychological strain that weakened as a function of supervisor praise and recognition. The proposed moderated mediated model was supported for both samples in regards to intentions to seek medical advice. CONCLUSIONS: This research contributes new evidence regarding the antecedents of employees' intentions to take sick leave and seek medical advice for work stress-related problems. It also contributes to the limited evidence regarding supervisor praise and recognition as a protective factor for employees exhibiting the symptoms of psychological strain.

Employee Musculoskeletal Complaints and Supervisor Support: Implications for Behavioral Stress Reactions.

OBJECTIVE: This research investigated the moderating role of supervisor support for employees with musculoskeletal complaints and their intentions to seek medical advice; take sick leave; transfer jobs; and resign. METHODS: Cross-sectional questionnaire data were collected from 1024 Australian employees. RESULTS: Regressions with bootstrapping revealed no support for the buffering role of supervisor support. In contrast to expectations, high supervisor support heightened, rather than lowered, musculoskeletal complaints on intentions to transfer jobs. For sick leave and resignation intentions, high supervisor support buffered the negative effects of musculoskeletal complaints for full-timers but exacerbated such intentions for part-timers. Furthermore, full-timers with high musculoskeletal complaints appeared more vulnerable to the exacerbating effects of low supervisor support compared with part-timers. CONCLUSIONS: Supervisor support for employees with musculoskeletal complaints both weakens and strengthens behavioral stress reactions, depending on employment status.

Employees' perceptions of their own and their supervisor's emotion recognition skills moderate emotional demands on psychological strain.

This research builds on prior studies showing the role of employee emotion recognition in the stress process to be mixed and conflicting. As such, it was proposed that the extent to which employees' emotion recognition skills buffer or exacerbate emotional demands depends on the extent to which employees believe their supervisor also is skilled in emotion recognition. Two samples of Australian employees completed cross-sectional questionnaires. Sample 1 consisted of 149 employees in a medical research institution, and Sample 2 consisted of 161 government employees in an equipment supplies and logistics service. A three-way interaction among emotional demands, employee emotion recognition, and perceived supervisor emotion recognition was found on psychological strain in both samples and on job dissatisfaction in Sample 1. As predicted, when employee emotion recognition was high, those who perceived their supervisor to be high in emotion recognition were buffered from emotional demands. In contrast, stress-exacerbating effects were found when employees were high in emotion recognition, but supervisors were perceived to be low in emotion recognition. Overall, these results highlight the importance of emotion recognition in the stress process, and that the same skill set needs to be perceived in one's supervisor, an interpersonal resource, for this intrapersonal resource to be adaptive for employees.

The importance of supervisor emotion recognition for praise and recognition for employees with psychological strain.

Background: The present study examined the role of praise and recognition from one's supervisor in mitigating the extent to which employees with psychological strain intend to engage in stress-related behavioral intentions. Design: Two studies, each using a cross-sectional design, are presented. Method: Both studies utilized self-report data from local government employees (n = 313 Study 1; n = 244 Study 2). Results: In Study 1, moderated regressions with bootstrapping showed a strong positive association between psychological strain and stress-related behavioral intentions for employees with low levels of supervisor praise and recognition. In contrast, this relationship was less marked at high levels of supervisor praise and recognition. Study 2 replicated these findings and further demonstrated that praise and recognition, when given by a supervisor perceived to be high in emotion recognition skills, was the optimal combination. Of particular interest was the finding that high and low combinations of these two supervisor attributes did not compensate for each other and were just as detrimental as supervisors perceived to be low in both. Conclusions: Overall, results suggest that the effectiveness of appreciative behavior from supervisors depends on their emotion recognition skills.

Relaxation during the evening and next-morning energy: The role of hassles, uplifts, and heart rate variability during work.

Being able to psychologically relax after work in the evening is important to the day-to-day recovery process and should enable employees to wake up feeling energized for the next workday. Drawing on affective events theory and allostatic load theory, we expected that employees will be able to psychologically relax when they get home from work if during work (a) they experienced less work-related goal-frustration events and more work-related goal-achievement events and (b) if they were adaptively regulating physiological stress arousal (as indexed by heart rate variability). As such, this research considers that work events, as well as a physiological indicator of parasympathetic regulation, can be important antecedents to off-the-job recovery. Over the course of 5 consecutive workdays, 72 employees completed daily surveys (on waking, at work, and in the evening) and wore an ambulatory electrocardiograph to measure their heart rate variability while at work that afternoon. Multilevel mediation analyses revealed support for our hypotheses at the within-person level, except for the role of goal-attainment events. The finding that goal-frustration events and heart rate variability both contribute to evening relaxation, and then indirectly to next-morning energy, provides initial insights on how both mind and body impact off-the-job recovery. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Comparing different approach and avoidance models of learning and personality in the prediction of work, university, and leadership outcomes.

Jackson (2005) developed a hybrid model of personality and learning, known as the learning styles profiler (LSP) which was designed to span biological, socio-cognitive, and experiential research foci of personality and learning research. The hybrid model argues that functional and dysfunctional learning outcomes can be best understood in terms of how cognitions and experiences control, discipline, and re-express the biologically based scale of sensation-seeking. In two studies with part-time workers undertaking tertiary education (N = 137 and 58), established models of approach and avoidance from each of the three different research foci were compared with Jackson's hybrid model in their predictiveness of leadership, work, and university outcomes using self-report and supervisor ratings. Results showed that the hybrid model was generally optimal and, as hypothesized, that goal orientation was a mediator of sensation-seeking on outcomes (work performance, university performance, leader behaviours, and counterproductive work behaviour). Our studies suggest that the hybrid model has considerable promise as a predictor of work and educational outcomes as well as dysfunctional outcomes.

Social support and fires in the workplace: a preliminary investigation.

Workers who experience fire in the workplace are faced with disruption to their work routine, as well as the emotional strain of the fire. In the broader occupational stress literature, researchers have suggested that social support will be most effective at reducing the negative effects of stressors on strain when the type of support matches the type of stressor being experienced (either instrumental or emotional). This study was a preliminary investigation into employee responses to less routine stressors, such as workplace fires, and the role of different sources of social support in predicting coping effectiveness. This study also was a first attempt at considering the influence of the social context (in terms of group identification) on the effectiveness of social support as a predictor of coping effectiveness. Specifically, it was predicted that social support would be more effective when it came from multiple sources within the organization, that it would be especially effective when provided from a group that workers identified more strongly with, and that simply feeling part of a group would improve adjustment. Both quantitative and qualitative data were collected from 33 employees who had recently experienced a significant fire in their workplace. Results suggested that the type of stressors experienced and the type of support were mismatched, but despite this, coping effectiveness was generally moderate to high. There was mixed support for predictions about the effects of social support-no moderating effect of group identification on coping effectiveness was observed for measures of workplace support, although it did moderate the effects of family support on this adjustment indicator.

Associations between individual and workplace risk factors for self-reported neck pain and disability among female office workers.

A cross-sectional survey of female office workers (n=333) was undertaken to determine the level of neck pain and disability (Neck Disability Index-NDI) and to explore the relationship between individual and workplace risk factors with the NDI score and the presence of pain. Workers reported nil (32%), mild (53%), moderate (14%) and severe (1%) neck pain. There were more risk factors associated with the NDI score than the presence of neck pain. The presence of neck pain was associated with a history of neck trauma (OR: 4.8), using a graduated lens (OR: 4.6), and negative affectivity (OR: 2.7) in the multiple regression model. Factors associated with higher NDI score were using the computer mouse for more than 6h per day, higher negative affectivity, older age and an uncomfortable workstation. These results suggest that measuring the level of neck pain and disability rather than just the presence of neck pain provides more specific directives for the prevention and management of this disorder.

Interaction effects among multiple job demands: an examination of healthcare workers across different contexts.

BACKGROUND AND OBJECTIVES: Simultaneous exposure to time, cognitive, and emotional demands is a feature of the work environment for healthcare workers, yet effects of these common stressors in combination are not well established. DESIGN: Survey data were collected from 125 hospital employees (Sample 1, Study 1), 93 ambulance service employees (Sample 2, Study 1), and 380 aged care/disability workers (Study 2). METHODS: Hierarchical multiple regressions were conducted. RESULTS: In Sample 1, high cognitive demand exacerbated high emotional demand on psychological strain and job burnout, whereas the negative effect of high emotional demand was not present at low cognitive demand. In Sample 2, a similar pattern between emotional demand and time demand on stress-remedial intentions was observed. In Study 2, emotional demand × time demand and time demand × cognitive demand interactions again revealed that high levels of two demands were stress-exacerbating and low levels of one demand neutralized the other. A three-way interaction on job satisfaction showed the negative impact of emotional demand was exacerbated when both time and cognitive demands were high, creating a "triple disadvantage" of job demands. CONCLUSIONS: The results demonstrate that reducing some job demands helps attenuate the stressful effects of other job demands on different employee outcomes.

Threat of resource loss: The role of self-regulation in adaptive task performance.

Changes at work are often accompanied with the threat of, or actual, resource loss. Through an experiment, we investigated the detrimental effect of the threat of resource loss on adaptive task performance. Self-regulation (i.e., task focus and emotion control) was hypothesized to buffer the negative relationship between the threat of resource loss and adaptive task performance. Adaptation was conceptualized as relearning after a change in task execution rules. Threat of resource loss was manipulated for 100 participants undertaking an air traffic control task. Using discontinuous growth curve modeling, 2 kinds of adaptation--transition adaptation and reacquisition adaptation--were differentiated. The results showed that individuals who experienced the threat of resource loss had a stronger drop in performance (less transition adaptation) and a subsequent slower recovery (less reacquisition adaptation) compared with the control group who experienced no threat. Emotion control (but not task focus) moderated the relationship between the threat of resource loss and transition adaptation. In this respect, individuals who felt threatened but regulated their emotions performed better immediately after the task change (but not later on) compared with those individuals who felt threatened and did not regulate their emotions as well. However, later on, relearning (reacquisition adaptation) under the threat of resource loss was facilitated when individuals concentrated on the task at hand.

Reactions to changes in work control: Implications for self-determined and non-self-determined individuals.

We investigate the extent to which individuals' global motivation (self-determined and non-self-determined types) influences adjustment (anxiety, positive reappraisal) and engagement (intrinsic motivation, task performance) in reaction to changes to the level of work control available during a work simulation. Participants (N = 156) completed 2 trials of an inbox activity under conditions of low or high work control-with the ordering of these levels varied to create an increase, decrease, or no change in work control. In support of the hypotheses, results revealed that for more self-determined individuals, high work control led to the increased use of positive reappraisal. Follow-up moderated mediation analyses revealed that the increases in positive reappraisal observed for self-determined individuals in the conditions in which work control was high by Trial 2 consequently increased their intrinsic motivation toward the task. For more non-self-determined individuals, high work control (as well as changes in work control) led to elevated anxiety. Follow-up moderated mediation analyses revealed that the increases in anxiety observed for non-self-determined individuals in the high-to-high work control condition consequently reduced their task performance. It is concluded that adjustment to a demanding work task depends on a fit between individuals' global motivation and the work control available, which has consequences for engagement with demanding work. (PsycINFO Database Record

Change in Psychosocial Work Factors Predicts Follow-up Employee Strain: An Examination of Australian Employees.

OBJECTIVE: This research undertook a time-ordered investigation of Australian employees in regards to their experiences of change in psychosocial work factors across time (decreases, increases, or no change) in the prediction of psychological, physical, attitudinal, and behavioral employee strain. METHODS: Six hundred and ten employees from 17 organizations participated in Time 1 and Time 2 psychosocial risk assessments (average time lag of 16.7 months). Multi-level regressions examined the extent to which change in exposure to six demands and four resources predicted employee strain at follow-up, after controlling for baseline employee strain. RESULTS: Increases in demands and decreases in resources exacerbated employee strain, but even constant moderate demands and resources resulted in poor employee outcomes, not just constant high or low exposure, respectively. CONCLUSIONS: These findings can help employers prioritize hazards, and guide tailored psychosocial organizational interventions.

Turnover Intentions of Employees With Informal Eldercare Responsibilities: The Role of Core Self-Evaluations and Supervisor Support.

As longevity increases, so does the need for care of older relatives by working family members. This research examined the interactive effect of core self-evaluations and supervisor support on turnover intentions in two samples of employees with informal caregiving responsibilities. Data were obtained from 57 employees from Australia (Study 1) and 66 employees from the United States and India (Study 2). Results of Study 1 revealed a resource compensation effect, that is, an inverse relationship between core self-evaluations and turnover intentions when supervisor care support was low. Results of Study 2 extended these findings by demonstrating resource boosting effects. Specifically, there was an inverse relationship between core self-evaluations and subsequent turnover intentions for those with high supervisor work and care support. In addition, employees' satisfaction and emotional exhaustion from their work mediated the inverse relationship between core self-evaluations and subsequent turnover intentions when supervisor work support and care support were high. Overall, these findings highlight the importance of employee- and supervisor-focused intervention strategies in organizations to support informal caregivers.

A longitudinal study of employee adaptation to organizational change: the role of change-related information and change-related self-efficacy.

This study examined the role of information, efficacy, and 3 stressors in predicting adjustment to organizational change. Participants were 589 government employees undergoing an 18-month process of regionalization. To examine if the predictor variables had long-term effects on adjustment, the authors assessed psychological well-being, client engagement, and job satisfaction again at a 2-year follow-up. At Time 1, there was evidence to suggest that information was indirectly related to psychological well-being, client engagement, and job satisfaction, via its positive relationship to efficacy. There also was evidence to suggest that efficacy was related to reduced stress appraisals, thereby heightening client engagement. Last, there was consistent support for the stress-buffering role of Time 1 self-efficacy in the prediction of Time 2 job satisfaction.

Time pressure and coworker support mediate the curvilinear relationship between age and occupational well-being.

As the proportion of older employees in the workforce is growing, researchers have become increasingly interested in the association between age and occupational well-being. The curvilinear nature of relationships between age and job satisfaction and between age and emotional exhaustion is well-established in the literature, with employees in their late 20s to early 40s generally reporting lower levels of occupational well-being than younger and older employees. However, the mechanisms underlying these curvilinear relationships are so far not well understood due to a lack of studies testing mediation effects. Based on an integration of role theory and research from the adult development and career literatures, this study examined time pressure, work-home conflict, and coworker support as mediators of the relationships between age and job satisfaction and between age and emotional exhaustion. Data came from 771 employees between 17 and 74 years of age in the construction industry. Results showed that employees in their late 20s to early 40s had lower job satisfaction and higher emotional exhaustion than younger and older employees. Time pressure and coworker support fully mediated both the U-shaped relationship between age and job satisfaction and the inversely U-shaped relationship between age and emotional exhaustion. These findings suggest that organizational interventions may help increase the relatively low levels of occupational well-being in certain age groups.