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BACKGROUND: Nurses show a high prevalence of exhaustion and increased leaving intentions. With this study, we integrate established research about turnover intention with recent burnout literature and present a theoretical model that combines both. The aim of this study was to examine job demands (time pressure, social conflicts) and resources (job control, supervisor support, task identity, person-organisation fit) as drivers and health and age as moderators for the relationships between exhaustion and nurses' organisational and professional leaving intentions. METHODS: We analysed data from a standardised paper-pencil questionnaire survey with a prospective, two-wave (12 months apart) study design. In total, 584 nurses participated at Time 1 (t1). The final sample at Time 2 (t2) was n = 222 nurses (38%; age: M = 41.1 years, SD = 11.0; 88% females). RESULTS: We identified time pressure as job demand and job control, task identity, and person-organisation fit as resources that drive the relationships of exhaustion (mean between both times of measures) and organisational and professional leaving intentions. The relationships to organisational leaving intentions decreased with nurses' age and the relationships to professional leaving intentions increased for nurses who had poorer self-rated health. We found indirect effects of exhaustion for relationships between job demands and nurses' leaving intentions. Relationships to exhaustion remained significant after adjusting for depressive mood. CONCLUSION: Insights from this study can be used both by employers and employees. Redesigning work might be a promising approach to improve nurses' well-being and retention in this profession. Geriatric care facilities should include the concept of person-organisation fit into their personnel selection process.
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Agotamiento Profesional , Enfermeras y Enfermeros , Femenino , Humanos , Anciano , Masculino , Intención , Actitud del Personal de Salud , Satisfacción en el Trabajo , Modelos Teóricos , Encuestas y Cuestionarios , Agotamiento Profesional/epidemiologíaRESUMEN
AIMS: To explore differences in the prevalence, psychosocial risk factors and the connection to annual sick leave of nurses' emotional exhaustion depending on the care setting. DESIGN: Quantitative study. METHODS: We conducted a secondary data analysis of a cross-sectional, representative survey with German nurses (BIBB/BAuA-Employment Survey 2018). We analysed data from three groups of nurses (hospital care HC: n = 333, nursing homes NH: n = 143, home health care HHC: n = 109). We calculated prevalence estimates for all psychosocial risk factors and emotional exhaustion and utilized Χ2 -tests to explore differences relating to the care setting. We calculated risk estimates using logistic regression analyses. RESULTS: Forty-four per cent of all nurses reported symptoms of emotional exhaustion. Care settings did not affect prevalence estimates (HC: 45.3%, NH: 37.8%, HHC: 50.5%). Weekend work was a risk factor for exhaustion. Being at the limit of efficiency was the only work-related psychosocial risk factor being independent of the care setting. Emotional demands were a significant risk factor for nurses working in HC and NH, and low team cooperation was a risk factor for nurses working in NH. Nurses' emotional exhaustion is associated with more sick leave days. CONCLUSIONS: The high prevalence of nurses' emotional exhaustion is independent of the care setting. This threatens nurses' health and negatively affects the organization and society due to the relation to sick leave. Weekend work and quantitative demands relate to exhaustion independently of the care context. Emotional demands and low team cooperation show context-specific correlations. IMPACT: Organizational interventions that limit quantitative demands are needed to prevent exhaustion among nurses. In HC and NH, measures are needed to improve coping with emotional demands and to strengthen team cooperation. Policymakers and nursing managers should take action to address nurses' emotional exhaustion. NO PATIENT OR PUBLIC CONTRIBUTION: Due to the study design.
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Agotamiento Profesional , Enfermeras y Enfermeros , Personal de Enfermería en Hospital , Humanos , Satisfacción en el Trabajo , Personal de Enfermería en Hospital/psicología , Ausencia por Enfermedad , Estudios Transversales , Prevalencia , Encuestas y Cuestionarios , Empleo , Factores de Riesgo , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicologíaRESUMEN
Improving nurses' staff retention is highly needed since risks of turnover are high in this profession. Prior research uncovered job demands as important driver and job resources as protective factor for the development of nurses' organizational leaving intentions. However, research on beneficial effects of rest break design as an important job resource on nurses' leaving intentions is sparse and their interactions with present job demands have been widely neglected. Therefore, we aimed to examine if different rest break characteristics (i.e. break length, break disturbances, and social breaks) predict nurses' organizational leaving intentions while also considering job demands (i.e. quantitative, cognitive, and emotional demands, and social conflicts) and other well-known person-related and work-related turnover antecedents. We conducted a cross-sectional paper-pencil survey study with 167 nurses from Germany. We found a positive relation between rest break disturbances and organizational leaving intentions even after adjusting for person-related and work-related confounders. Rest break length and the frequency of social breaks were no significant predictors when considering all rest break characteristics in combination. Moreover, high quantitative demands and high social conflicts at work related to higher leaving intentions. Fewer rest break disturbances increased the negative relation between cognitive demands and leaving intentions. In order to reduce nurses' organizational leaving intentions and to improve staff retention, nursing management should prevent disturbances of nurses' rest breaks in addition to other work design interventions such as reducing quantitative demands and social conflicts and especially when implementing cognitive challenging tasks.
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Intención , Enfermeras y Enfermeros , Actitud del Personal de Salud , Estudios Transversales , Humanos , Satisfacción en el Trabajo , Reorganización del Personal , Encuestas y CuestionariosRESUMEN
Presenteeism is problematic since it relates to lower health and productivity. Prior research examined many work and attitudinal variables relating to presenteeism at the individual level. Here, we conceptualize presenteeism as multilevel phenomenon also shaped by the overall attendance behavior (absenteeism and presenteeism) at the work unit. We surveyed employees at a manufacturing plant on presenteeism, health-related lost productive time (HLPT) and absenteeism (N = 911, 22 units) and collected preceding (past 12-7 and 6 months) objective absence data aggregating it at unit level. Considering the individual-level antecedents only higher physical demands predicted higher absence duration. Presenteeism related positively to physical demands, a burdensome social environment, and organizational identification and negatively to ease of replacement, and core self-evaluations. These relationships were similar for HLPT as outcome. Regarding unit-level factors, preceding unit-level absence frequency (but not duration) negatively related to presenteeism. The negative relationship between core self-evaluations and individual presenteeism decreased under a stronger presenteeism context supporting the hypothesized cross-level effect of unit-level presenteeism context strength. Moreover, individual and unit-level presenteeism correlated, as expected, more strongly with health complaints than absenteeism. Our study demonstrates the value of a contextual, multilevel approach for understanding antecedents and consequences of attendance behavior.
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BACKGROUND: Teachers often face high job demands that might elicit strong stress responses. This can increase risks of adverse strain outcomes such as mental and physical health impairment. Psychological detachment has been suggested as a recovery experience that counteracts the stressor-strain relationship. However, psychological detachment is often difficult when job demands are high. The aims of this study were, first, to gain information on the prevalence of difficulties detaching from work among German teachers, second, to identify potential person-related/individual (i.e., age, sex), occupational (e.g., tenure, leadership position), and work-related (e.g., overload, cognitive, emotional, and physical demands) risk factors and, third, to examine relationships with mental and physical health impairment and sickness absence. METHODS: A secondary analysis of cross-sectional data from a national and representative survey of German employees was conducted (BIBB/BAuA Employment Survey 2018). For the analyses data from two groups of teachers (primary/secondary school teachers: n = 901, other teachers: n = 641) were used and compared with prevalence estimates of employees from other occupations (n = 16,266). RESULTS: Primary/secondary school teachers (41.5%) and other teachers (30.3%) reported more difficulties detaching from work than employees from other occupations (21.3%). Emotional demands and deadline/performance pressure were the most severe risk factors in both groups of teachers. In the group of primary/secondary school teachers multitasking demands were further risk factors for difficulties to detach from work whereas support from colleagues reduced risks. In both groups of teachers detachment difficulties can be linked to an increase in psychosomatic and musculoskeletal complaints and, additionally, to a higher risk of sickness absence among primary/secondary school teachers. CONCLUSIONS: Difficulties detaching from work are highly prevalent among German teachers. In order to protect them from related risks of health impairment, interventions are needed which aim at optimizing job demands and contextual resources (i.e., work-directed approaches) or at improving coping strategies (i.e., person-directed approaches).
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Empleo , Evaluación de Resultado en la Atención de Salud , Estudios Transversales , Humanos , Prevalencia , Factores de Riesgo , Estrés Psicológico/epidemiología , Encuestas y CuestionariosRESUMEN
OBJECTIVES: Burnout is a stress-related, psychological syndrome due to high levels of job stressors. It has been found to be related to impairments of well-being, health, and job outcomes. Alterations of glucocorticoid secretion might be a mechanism explaining the linkage between burnout and reduced psychophysical functioning. Regarding hair cortisol as indicator this assumption, so far, has been only examined in cross-sectional studies. Therefore, we aimed to compare cross-sectional and prospective associations between different burnout symptoms and hair cortisol, additionally investigating potential nonlinear associations. METHODS: The prospective study sample comprises 194 employees (95% nurses) from German geriatric care. We assessed burnout symptoms at baseline (t1) and 6 months later (t2) and collected hair samples for cortisol analyses at t2. RESULTS: We found significant cross-sectional and prospective nonlinear (i.e., exponential) but not linear relationships between an aggregated measure of the burnout subscales emotional exhaustion, cynicism, and reduced efficacy and hair cortisol, even after adjusting for BMI and depressive mood. None of the single subscales of burnout was related to hair cortisol after adjusting for confounders. CONCLUSIONS: Our findings further support the assumption that accumulated burnout symptoms and hypercorticolism are positively related.
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Agotamiento Profesional , Cabello/química , Hidrocortisona/análisis , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de TiempoRESUMEN
BACKGROUND: The aim of this review was to synthesize the evidence on the potential relationship between psychosocial work factors from the Areas of Worklife (AW) model (workload, job control, social support, reward, fairness, and values) and chronic low back pain (CLBP; unspecific pain in the lumbar region lasting 3 months or longer). METHODS: We conducted a systematic literature search of studies in Medline, PsycINFO, Web of Science, and CINAHL (1987 to 2018). Three authors independently assessed eligibility and quality of studies. In this meta-analysis, we pooled studies' effect sizes using a random-effects model approach and report sample size weighted mean Odds Ratios (ORs). RESULTS: Data from 18 studies (N = 19,572) was included in the analyses. We found no studies investigating associations between fairness or values and CLBP. CLBP was significantly positively related to workload (OR = 1.32) and significantly negatively related to overall job control (OR = 0.81), decision authority (OR = 0.72), and two measures of social support (ORs = 0.75 to 0.78), even in prospective studies. Skill discretion and reward did not significantly relate to CLBP. Moderation analyses revealed several variables (e.g., exposure time, mean age and sex) affecting these relationships. CONCLUSIONS: Our results support employees' workload, job control, and social support as predictors of CLBP. In this line, these work factors should be considered when developing programs to prevent chronic low back pain. Future studies should apply measures of CLBP that are more precise, and investigate the full areas of work life (AW) factors in combination.
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Dolor Crónico/psicología , Dolor de la Región Lumbar/psicología , Estrés Laboral/psicología , Apoyo Social , Carga de Trabajo/psicología , Dolor Crónico/epidemiología , Dolor Crónico/prevención & control , Carga Global de Enfermedades , Humanos , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/prevención & control , PrevalenciaRESUMEN
Work breaks are known to have positive effects on employees' health, performance and safety. Using a sample of twelve employees working in a stressful and cognitively demanding working environment, this experimental field study examined how different types of work breaks (boxing, deep relaxation and usual breaks) affect participants' mood, cognitive performance and neurophysiological state compared to a control condition without any break. In a repeated measures experimental design, cognitive performance was assessed using an auditory oddball test and a Movement Detection Test. Brain cortical activity was recorded using electroencephalography. Individual's mood was analysed using a profile of mood state. Although neurophysiological data showed improved relaxation of cortical state after boxing (vs. 'no break' and 'deep relaxation'), neither performance nor mood assessment showed similar results. It remains questionable whether there is a universal work break type that has beneficial effects for all individuals. Practitioner Summary: Research on work breaks and their positive effects on employees' health and performance often disregards break activities. This experimental field study in a stressful working environment investigated the effect of different work break activities. A universal work break type that is beneficial for this workplace could not be identified.
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Boxeo , Relajación , Descanso , Estrés Psicológico/fisiopatología , Estrés Psicológico/psicología , Carga de Trabajo , Adulto , Afecto , Boxeo/fisiología , Boxeo/psicología , Cognición , Electroencefalografía , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Relajación/fisiología , Relajación/psicología , Descanso/fisiología , Descanso/psicología , Carga de Trabajo/psicologíaRESUMEN
We investigated how two types of care setting (home care and nursing home) and type of ownership (for-profit vs. public/non-profit) of geriatric care services interacted in influencing registered nurses' intention to give up their profession. In prior research, employment in for-profit-organizations, high job demands, and low job control were important antecedents of nurses' intent to leave. However, the impact of care setting on these associations was inconclusive. Therefore, we tested a mediated moderation model predicting that adverse work characteristics would drive professional leaving intentions, particularly in for-profit services and in nursing homes. A representative German sample of 304 registered nurses working in 78 different teams participated in our cross-sectional study. As predicted, lower job control and higher job demands were associated with higher professional leaving intentions, and nurses reported higher job demands in public/non-profit care than in for-profit care, and in nursing homes compared to home care. Overall, RNs in nursing homes and home care reported similar intent to leave, but in for-profit settings only, nurses working in nursing homes reported higher professional leaving intentions than did nurses in home care, which was linked to lower job control in the for-profit nursing home setting, supporting mediated moderation. Taken together, our results indicate that the interplay of care setting and type of ownership is important when explaining nurses' intentions to give up their profession. © 2016 Wiley Periodicals, Inc.
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Intención , Control Interno-Externo , Satisfacción en el Trabajo , Enfermeras y Enfermeros , Reorganización del Personal/estadística & datos numéricos , Adulto , Actitud del Personal de Salud , Estudios Transversales , Femenino , Alemania , Servicios de Atención de Salud a Domicilio/estadística & datos numéricos , Humanos , Masculino , Enfermeras y Enfermeros/estadística & datos numéricos , Casas de Salud/estadística & datos numéricos , PropiedadRESUMEN
Instrumental help and support in the workplace are mostly associated with outcomes that are considered desirable for organisations and their employees. In this study, we seek to shed light on a specific type of help at work that may entail negative consequences: being offered help that is not wanted by the recipient. Drawing on basic psychological needs theory and on theory of ruminative thoughts, we propose that offering unwanted help frustrates the recipient's psychological needs for autonomy and competence, which in turn affects after-work recovery processes in the form of increased rumination and decreased psychological detachment. Supporting our hypotheses, a cross-sectional survey study (Study 1, N = 279) revealed that employees who were offered unwanted help from coworkers or supervisors experienced higher frustration in need for competence and autonomy, which in turn was associated with higher rumination after work and less psychological detachment from work. Results from a time-lagged survey with two measurement points 2 weeks apart (Study 2, N = 165) showed that being offered unwanted help was concurrently related to increased competence and autonomy frustration, of which only autonomy frustration later translated into higher after-work rumination and ultimately lower psychological detachment from work. Our findings suggest that needs frustration provides a promising approach to investigate and explain potentially detrimental effects of unwanted help at work on after-work recovery processes.
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In this document we provide a correction to mistakes in [...].
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This study aimed to investigate the prevalence of three characteristics of work break organization, namely skipping work breaks, interruptions of work breaks, and meal break duration, and their relationships with physical and mental health. We used data from the BAuA-Working Time Survey 2017, a representative workforce survey in Germany, and restricted the sample to 5979 full-time employees. Logistic regression analyses were conducted with in total five health complaints as dependent variables: back pain and low back pain, pain in the neck and shoulder region, general tiredness, faintness, or fatigue, physical exhaustion, and emotional exhaustion. Many employees often skipped their work breaks (29%) and experienced break interruptions (16%). Frequent skipping of work breaks was significantly positively, that is detrimentally, related to all five health complaints and frequent interruptions of work breaks also, except for neck and shoulder pain. Meal break duration was significantly negatively, that is beneficially, related to physical exhaustion.
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Dolor de la Región Lumbar , Salud Mental , Humanos , Encuestas y Cuestionarios , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/etiología , Cuello , FatigaRESUMEN
Work-related thoughts during off-job time have been studied extensively in occupational health psychology and related fields. We provide a focused review of the research on overcommitment-a component within the effort-reward imbalance model-and aim to connect this line of research to the most commonly studied aspects of work-related rumination. Drawing on this integrative review, we analyze survey data on ten facets of work-related rumination, namely (1) overcommitment, (2) psychological detachment, (3) affective rumination, (4) problem-solving pondering, (5) positive work reflection, (6) negative work reflection, (7) distraction, (8) cognitive irritation, (9) emotional irritation, and (10) inability to recover. First, we apply exploratory factor analysis to self-reported survey data from 357 employees to calibrate overcommitment items and to position overcommitment within the nomological net of work-related rumination constructs. Second, we apply confirmatory factor analysis to self-reported survey data from 388 employees to provide a more specific test of uniqueness vs. overlap among these constructs. Third, we apply relative weight analysis to assess the unique criterion-related validity of each work-related rumination facet regarding (1) physical fatigue, (2) cognitive fatigue, (3) emotional fatigue, (4) burnout, (5) psychosomatic complaints, and (6) satisfaction with life. Our results suggest that several measures of work-related rumination (e.g., overcommitment and cognitive irritation) can be used interchangeably. Emotional irritation and affective rumination emerge as the strongest unique predictors of fatigue, burnout, psychosomatic complaints, and satisfaction with life. Our study is intended to assist researchers in making informed decisions on selecting scales for their research and paves the way for integrating research on the effort-reward imbalance and work-related rumination.
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Agotamiento Profesional , Humanos , Agotamiento Profesional/psicología , Recompensa , Encuestas y Cuestionarios , Emociones , Solución de Problemas , Estrés Psicológico/psicología , Satisfacción en el TrabajoRESUMEN
Psychological detachment from work during off-job time is crucial to sustaining employee health and well-being. However, this can be difficult to achieve, particularly when job stress is high and recovery is most needed. Boosting detachment from work is therefore of interest to many employees and organizations, and over the last decade numerous interventions have been developed and evaluated. The aim of this meta-analysis was to review and statistically synthesize the state of research on interventions designed to improve detachment both at work and outside of it. After a systematic search (covering the period 1998-2020) of the published and unpublished literature, 30 studies with 34 interventions (N = 3,725) were included. Data were analyzed using a random-effects model. Interventions showed a significant positive effect on detachment from work (d = 0.36) on average. Moderator analyses revealed that it did not matter how the different studies conceptualized detachment but that the context in which detachment was measured (outside or at work) significantly influenced intervention effectiveness. Furthermore, using the stressor-detachment model as the organizing framework, we found that while interventions addressing job stressors or altering primary and secondary appraisal were all effective, only the interventions that addressed primary appraisal were more effective than those that did not. Additionally, while the delivery format did not moderate intervention effectiveness, interventions with longer durations and higher dosages were more effective than shorter and lower dosage interventions. Finally, interventions were more effective among older participants and participants with initial health or recovery-related impairments. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Estrés Laboral/prevención & control , Equilibrio entre Vida Personal y Laboral , Adaptación Psicológica , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Servicios de Salud del Trabajador , Estrés Laboral/psicología , Trabajo/psicologíaRESUMEN
AIMS: Work breaks improve well-being, productivity, and health. The aim of this study was to investigate the individual determinants of rest-break behavior during work using the theory of planned behavior (TPB). METHODS: The association between attitude, control, and subjective norm and rest-break intention (i.e., taking rest breaks regularly), and rest-break behavior (average number of rest breaks/workhour) was analyzed with stepwise linear regression in a cross-sectional design. The study participants included 109 clerical employees, and 215 nurses. RESULTS: Attitude and control were positively associated with rest-break intention. Intention and control were positively associated with rest-break behavior. The effect of intention was moderated by occupation, with intention being more weakly associated with rest-break behavior in nurses who had less behavioral control. CONCLUSIONS: Job control is the major predictor of rest-break behavior, with attitudes playing a minor role, and social norm playing no role. To increase rest-break behavior, a greater extent of job control is necessary.
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The number of studies on work breaks and the importance of this subject is growing rapidly, with research showing that work breaks increase employees' wellbeing and performance and workplace safety. However, comparing the results of work break research is difficult since the study designs and methods are heterogeneous and there is no standard theoretical model for work breaks. Based on a systematic literature search, this scoping review included a total of 93 studies on experimental work break research conducted over the last 30 years. This scoping review provides a first structured evaluation regarding the underlying theoretical framework, the variables investigated, and the measurement methods applied. Studies using a combination of measurement methods from the categories "self-report measures," "performance measures," and "physiological measures" are most common and to be preferred in work break research. This overview supplies important information for ergonomics researchers allowing them to design work break studies with a more structured and stronger theory-based approach. A standard theoretical model for work breaks is needed in order to further increase the comparability of studies in the field of experimental work break research in the future.
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Relajación , Lugar de Trabajo , Humanos , Salud Laboral , Lugar de Trabajo/psicologíaRESUMEN
OBJECTIVES: To prevent an accumulation of strain during work and to reduce error risk, many countries have made rest breaks mandatory. In the nursing literature, insufficient rest break organization is often reported. However, the outcomes of nurses' rest break organization and its anteceding factors are less clear. DATA SOURCES: We searched for academic literature on nurses' rest break organization in electronic databases (PubMed, Medline, PsycArticles, PsycINFO, CINAHL). REVIEW METHODS: Our search yielded 93 potentially relevant articles published between 01/1990 and 04/2016. The final sample in our scoping review consisted of 36 publications and included data from 35 independent and international study samples and two reviews. RESULTS: Several studies reported a high prevalence of missed, interrupted, or delayed rest breaks in nursing. Nurses' rest breaks often related to better physical and mental well-being but did not affect motivational outcomes and performance systematically. Results on the effects of napping breaks were inconsistent. Rest break activities and high quality rest break areas are further factors that relieve nurses from job demands and can be helpful in coping with them. Several study results indicated that temporal and quantitative work demands, job resources, and individual characteristics influence rest break organization. However, most of these findings stem from studies that do not allow causal conclusions to be drawn. CONCLUSIONS: Well-designed rest breaks influence nurses' occupational well-being and behavior positively. However, the mechanisms and moderating break-, work-, and person-related factors involved in producing these effects are not well understood today. Thus, further theory building and stronger empirical data are needed.
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Personal de Enfermería , Descanso , Humanos , Errores Médicos/prevención & control , Estrés Laboral/prevención & controlRESUMEN
Detachment from work has been proposed as an important non-work experience helping employees to recover from work demands. This meta-analysis (86 publications, k = 91 independent study samples, N = 38,124 employees) examined core antecedents and outcomes of detachment in employee samples. With regard to outcomes, results indicated average positive correlations between detachment and self-reported mental (i.e., less exhaustion, higher life satisfaction, more well-being, better sleep) and physical (i.e., lower physical discomfort) health, state well-being (i.e., less fatigue, higher positive affect, more intensive state of recovery), and task performance (small to medium sized effects). However, average relationships between detachment and physiological stress indicators and work motivation were not significant while associations with contextual performance and creativity were significant, but negative. Concerning work characteristics, as expected, job demands were negatively related and job resources were positively related to detachment (small sized effects). Further, analyses revealed that person characteristics such as negative affectivity/neuroticism (small sized effect) and heavy work investment (medium sized effect) were negatively related to detachment whereas detachment and demographic variables (i.e., age and gender) were not related. Moreover, we found a medium sized average negative relationship between engagement in work-related activities during non-work time and detachment. For most of the examined relationships heterogeneity of effect sizes was moderate to high. We identified study design, samples' gender distribution, and affective valence of work-related thoughts as moderators for some of these aforementioned relationships. The results of this meta-analysis point to detachment as a non-work (recovery) experience that is influenced by work-related and personal characteristics which in turn is relevant for a range of employee outcomes.