Toward a Climate-Ready Health Care System: Institutional Motivators and Workforce Engagement.

Policy Points The US health care system faces mounting pressure to reduce greenhouse gas emissions and adapt to the impacts of climate change; motivated institutions and an engaged health care workforce are essential to the development, implementation, and maintenance of a climate-ready US health care system. Health care workers have numerous profession-specific and role-specific opportunities to address the causes and impacts of climate change. Policies must address institutional barriers to change and create incentives aligned with climate readiness goals. Institutions and individuals can support climate readiness by integrating content on the health care implications of climate change into educational curricula.

Oncologists' psychological flourishing: A driving force for positive attitudes at work.

OBJECTIVE: Oncologists' psychological health is a major challenge due to the consequential concerning the quality of the care they provide. However, only critical states of their health have been really examined by scientists. This study sought to plug this gap by investigating the mediating role of psychological flourishing in the relationship between the perception of the professional social context (i.e., perceived workplace isolation and organizational support) and positive attitudes at work among oncologists (i.e., work engagement, task adjustment and empathy). METHODS: The study was a cross-sectional, including 541 French oncologists. Participants completed a self-report questionnaire. Structural Equation Modeling was employed to test the hypotheses. RESULTS: The analysis revealed that workplace isolation and organizational support perceptions were related to oncologists' work engagement, task adjustment and empathy. Additionally, psychological flourishing acted as a partial mediator between these perceptions of professional social context and oncologists' work-related attitudes. CONCLUSIONS: This research underlined the potential of enhancing the psychological flourishing of oncologists by improving organizational support and mitigating their sense of isolation, and in turn, to enhance some dimensions of their positive attitudes at work.

Relationship between resilience at work, work engagement and job satisfaction among engineers: a cross-sectional study.

BACKGROUND: Workplace challenges can negatively affect employees and the organization. Resilience improves work-related outcomes like engagement, satisfaction, and performance. Gaps exist in studying resilience at work, particularly in relation to engagement and satisfaction. Therefore, this study aims to investigate relationship between Resilience at Work, Work Engagement and Job Satisfaction among engineers in an Egyptian Oil and Gas Company. METHODS: It was a cross-sectional study. The target population was the engineers who are working in Egyptian Oil and Gas Company. The study was performed on 100 engineers. Participants were enrolled by simple random sampling technique via an online questionnaire. The study was conducted from May 2023 to the end of September 2023. The data were collected in the duration of June to August 2023. Data was obtained through a structured and personally accomplished questionnaire, which was disseminated electronically via email. The questionnaire comprises of personal information, work experience, a Resilience at Work scale consisting of 20 items, the Utrecht Work Engagement Scale with nine items to evaluate work engagement, and the 20-item Short-Form Minnesota Satisfaction Questionnaire was utilized to determine employee satisfaction. The bivariate analysis employed independent samples t-test and Mann-Whitney U test. The associations between scores were measured by Spearman rho correlation. Simple linear and multiple linear regressions were used to predict work engagement and job satisfaction. RESULTS: A statistically strong positive correlation was observed among all the aspects of work engagement, including vigor, absorption, and dedication. This study demonstrated a significant correlation between resilience and work engagement (r = 0.356, p < 0.05). There was a strong correlation between resilience and job satisfaction (r = 0.608, p < 0.05). A significant moderate correlation was determined between job satisfaction and work engagement (r = 0.396, p < 0.05). Both gender with a female coefficient of -15.517, and resilience with a coefficient of 0.235 significantly predicted work engagement. Whereas, the significant predictors of job satisfaction were resilience (ß = 0.294), and work engagement (ß = 0.283). CONCLUSIONS: Resilience greatly affects work engagement and job satisfaction. Thus, organizations need to promote resilience in employees to create a positive work environment and increase productivity.

Reducing sickness absence among public-sector healthcare employees: the difference-making roles of managerial and employee participation.

PURPOSE: Evaluations of organizational-level interventions to prevent work-related illness have identified enabling factors, but knowledge of necessary and sufficient conditions for intervention success is needed. The aim was to identify difference-making factors that distinguish intervention groups with and without a positive intervention effect on sickness absence. METHODS: An organizational-level intervention designed to decrease sickness absence by providing support from process facilitators was implemented at eight healthcare workplaces in Sweden between 2017 and 2018. We applied coincidence analysis (CNA) to analyze 34 factors and determine which factors were necessary and sufficient for a successful implementation of tailored interventional measures on an organizational level (dichotomous) and reduced sickness absence (trichotomous). RESULTS: Two factors perfectly explained both the presence and absence of a successful implementation: "a high sense of urgency" and "good anchoring and participation from the strategic management". The presence of either of these factors alone was sufficient for successful implementation, whereas the joint absence of both conditions was necessary and sufficient for the absence of successful implementation and an intervention effect. In addition, high employee participation was both necessary and sufficient for a high intervention effect. For organizations without high employee participation, successful implementation led to a medium-effect size. CONCLUSIONS: This study identified participation as a difference-maker in the implementation process. Participation from different stakeholders turned out to be important in different phases. When implementing organizational-level interventions, high participation from both strategic management and employees appears to be crucial in terms of the intervention's effect on sickness absence.

Maintaining the working state of firefighters by utilizing self-concept clarity as a resource.

The working state of firefighters is important for their own safety as well as that of the general public. The purpose of this study is to investigate the correlations between self-concept clarity, resilience, work engagement, and job burnout among firefighters, as well as the impacts of self-concept clarity and resilience as resources that can maintain their working state. Based on data from 2,156 firefighters, analysis showed that self-concept clarity was negatively associated with job burnout and positively associated with work engagement. The results also showed that self-concept clarity had a direct effect on job burnout and work engagement, and an indirect effect by improving the firefighters' resilience. Maintaining and improving their self-concept clarity and resilience promises to be an effective strategy for guaranteeing the working state of firefighters.

A new perspective on balancing life domains: work-nonwork balance crafting.

BACKGROUND: Self-initiated and proactive changes in working conditions through crafting are essential for shaping work and improving work-related well-being. Recently, the research stream of job crafting has been extended to other life domains. The present paper aims to study a novel crafting concept-work-nonwork balance crafting-investigating the role of its antecedents and identifying relevant outcomes. Work-nonwork balance crafting is defined as individuals' unofficial techniques and activities to shape their work-nonwork balance, here considering their life domain boundary preferences. METHODS: In the study, 1,060 employees in three European countries (Austria, Germany and Switzerland) were surveyed in a longitudinal three-wave study with three-month intervals. We explored the influences of job/home demands and resources as antecedents of work-nonwork balance crafting. Important constructs for employee health and well-being (i.e., work engagement, work-related burnout, mental well-being and detachment from work) were investigated as outcomes. RESULTS: The findings suggest that resources and demands in the context of work or home are key antecedents of work-nonwork balance crafting. Work-nonwork balance crafting was also predictive for important employee health and well-being outcomes over three months, mainly in a positive and health-promoting way. CONCLUSION: This study provides insights into the antecedents of proactive efforts to balance the complex interplay of life domains. By studying work-nonwork balance crafting, we provide a new perspective on crafting beyond job crafting, which may help maintain or improve employees' mental health and well-being.

Exploring the relationship between psychosocial factors, work engagement, and mental health: a structural equation modeling analysis among faculty in Saudi Arabia.

BACKGROUND: Psychosocial hazards in the workplace were identified as a considerable risk to employee mental health as well as their general well-being. Few studies were found to examine its relationship with work engagement and mental health. Thus, this study examines the relationships between psychosocial factors, work engagement, and mental health within the faculty in Saudi Arabia using structural equation modeling. METHODS: The cross-sectional study was conducted with a sample size of 375 faculty. Data collection was done using a self-administered online survey that included instruments such as the Copenhagen Psychosocial Questionnaire (COPSOQ), Utrecht Work Engagement Scale (UWES), and General Health Questionnaire (GHQ-12). SmartPLS 3 software facilitated data analysis and included the assessment of factors. Structural equation modelling was used to examine the interplay between psychosocial factors, work engagement, and mental health. RESULTS: The robust measurement model was characterized by high loadings (0.719 to 0.970), Cronbach's alpha (0.595 to 0.933), and composite reliability (0.807 to 0.968). Convergent and discriminant validity were confirmed using AVE and various criteria. The fit of the saturated model was superior. Burnout explained significant variance (0.585) with predictive relevance for all constructs. Notably, the impact of burnout on family conflict and the influence of stress on burnout were found to have significant effect sizes. CONCLUSION: The study uses structural equation modeling to examine the relationships between psychosocial factors, work engagement, and mental health among faculty in Saudi Arabia. The robust measurement model demonstrated high reliability and validity, while the saturated model demonstrated excellent fit. These findings contribute to our understanding of psychosocial dynamics, work engagement, and overall health among faculty in Saudi Arabia.

Satisfaction with clinical pathway implementation versus job performance of clinicians: empirical evidence on the mediating role of work engagement from public hospitals in Sichuan, China.

BACKGROUND: The job performance of clinicians is a clear indicator of both hospital capacity and the level of hospital service. It plays a crucial role in maintaining the effectiveness and quality of medical care. Clinical pathways are a systematic method of quality improvement successfully recommended by broader healthcare systems. Since clinicians play a key role in implementing clinical pathways in public hospitals, this study aims to investigate the effect of the satisfaction of clinicians in public hospitals with clinical pathway implementation on their job performance. METHODS: A cross-sectional study design was used. Questionnaires were administered online. A total of 794 clinicians completed the questionnaires in seven tertiary public hospitals in Sichuan Province, China, of which 723 were valid for analysis. Questionnaires contained questions on social demographic characteristics, satisfaction with clinical pathway implementation, work engagement, and job performance. Structural Equation Model (SEM) was used to test the hypotheses. RESULTS: The satisfaction of clinicians in public hospitals with clinical pathway implementation was significantly positively correlated with work engagement (r = 0.570, P < 0.01) and job performance (r = 0.522, P < 0.01). A strong indirect effect of clinicians' satisfaction with clinical pathway implementation on job performance mediated by work engagement was observed, and the value of this effect was 0.383 (boot 95%CI [0.323, 0.448]). CONCLUSION: The satisfaction of clinicians in public hospitals with clinical pathway implementation not only directly influences their job performance, but also indirectly affects it through the mediating variable of work engagement. Therefore, managers of public hospitals need to pay close attention to clinicians' evaluation and perception of the clinical pathway implementation. This entails taking adequate measures, such as providing strong organizational support and creating a favorable environment for the clinical pathway implementation. Additionally, focusing on teamwork to increase clinicians' satisfaction can further enhance job performance. Furthermore, managers should give higher priority to increasing employees' work engagement to improve clinicians' job performance.

Antecedents and outcomes of work engagement among nursing staff in long-term care facilities-A systematic review.

AIM: To determine antecedents and outcomes of work engagement (WE) among nursing staff in long-term care (LTC) using the Job Demand-Resources model. DESIGN: A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and Synthesis Without Meta-analysis in systematic reviews guideline. A study protocol was registered in PROSPERO (registration number CRD42022336736). DATA SOURCES: The initial searches were performed in PsycInfo, Medline, Academic Search Premier, CINAHL and Scopus and yielded 3050 unique publications. Updated searches identified another 335 publications. Sixteen studies published from 2010 to 2022 were included. REVIEW METHODS: The screening of titles and abstracts, and subsequently full-text publications, was performed blinded by two author teams using the inclusion/exclusion criteria. When needed, a mutual consensus was obtained through discussion within and across the teams. A descriptive and narrative synthesis without a meta-analysis of the included studies was performed. RESULTS: The extent of research on WE in LTC facilities is limited and the factors examined are heterogeneous. Of forty-two unique antecedents and outcomes, only three factors were assessed in three or more studies. Antecedents-in particular job resources-are more commonly examined than outcomes. CONCLUSION: Existing literature offers scant evidence on antecedents and outcomes of WE among nursing staff in LTC facilities. Social support, learning and development opportunities and person-centred processes are the most examined factors, yet with ambiguous results. IMPACT: Antecedents and outcomes of engagement among nursing staff in LTC facilities have not previously been reviewed systematically. Engagement has been correlated with both more efficient and higher-quality service delivery. Our findings suggest opportunities to improve health and care services by enhancing engagement, whilst at the same time better caring for employees. This study lays the groundwork for more detailed research into the contributing factors and potential results of increasing caregivers' engagement. No patient or public contribution.

Motivations, activities, timing, and employee engagement: three approaches to business involvement in disasters.

The alarming rise in occurrences of disasters, along with the positive development of corporate social responsibility (CSR), has led to the growing need for and involvement of businesses in disaster relief. However, this involvement differs greatly across organisations, and the fragmented research that exists has not offered an understanding of these differences and how they affect disaster relief. This study provides a comprehensive model of companies' involvement in disaster relief by integrating two disaster relief frameworks (activities and timing) into two CSR frameworks (motivation and employee engagement). The result is the MATE Model of four inextricably linked dimensions (motivation, activities, timing, and employee engagement), examined in a qualitative study with 57 interviewees across 34 organisations in Australia. The resulting Corporate Involvement in Disasters Model details the four MATE dimensions and categorises three approaches to corporate involvement in disaster relief: reactive, relational, and comprehensive. This model details a roadmap for effective business involvement in disaster relief.

Psychometric properties of the Persian version of the Engaged teachers Scale (ETS).

BACKGROUND & AIM: Teacher engagement can be defined as the teachers' effort and attention to teaching professional tasks, adequate emotions and commitment to relationships with students and colleagues in classroom and school. The Engaged Teacher Scale (ETS) is the frequently used scale, measuring teacher engagement developed by Klassen et al., 2013 in the UK, and consists of four dimensions: cognitive engagement (CE), emotional engagement (EE), social engagement with students (SES), and social engagement with colleagues (SEC). Therefore, the aim of this study was to measure the psychometric properties of the Persian version of the Engaged Teachers Scale (ETS). MATERIALS & METHODS: A total of 123 teachers who worked at Shahid Beheshti University of Medical Sciences, Tehran, Iran, were included in this study. The study participants were selected using the convenience sampling. The Persian version of a 16-item scale developed by Klassen et al. was validated by this study. Face and Content validity index and reliability were assessed after translation and cultural adaptation, and also construct validity was calculated by confirmatory factor analysis using the PLS22. RESULTS: Of the 123 study participants, 74 (60.01%) were females and 49 (39.9%) were males. The mean age of the subjects was about 30-40 years. The majority of the study participants were general practitioners (n = 75; 60.9%) and others were from different specialists. Content validity among 15 experts was 0.88. Confirmatory factor analysis for all 16 items loaded across four factors, and this four-factor scale showed a good fit in the Iranian community. Reliability using Cronbach's alpha was 0.79. The value of root mean square error of approximation (RMSEA) was 0.0094 with the 99% confidence interval, and also the goodness of fit index GFI value was 0.98. CONCLUSION: The Persian version of ETS had good validity and reliability in Iran and could be a useful tool for measuring the teacher engagement factors of faculty members that can be used by teachers and educational administrators.

Let's talk about work: pilot study of an education program on discussing work participation with cancer patients for general practitioners in training.

BACKGROUND: Cancer patients report that they lack support from healthcare providers when it comes to returning to or maintaining employment. In the education of general practitioners (GPs) in the Netherlands, there is little attention given to discussing work participation with patients. The aim of this pilot study was to evaluate a newly developed education program for GPs in training that focuses on discussing work participation with cancer patients. METHODS: Two groups of in total twenty-one GPs in training participated in the education program. GPs were educated about the importance of discussing work participation with patients, work-related problems cancer patients can experience, and advice they can give to support cancer patients regarding work issues. In this pilot study using a mixed-method design, participants evaluated the program in two self-developed questionnaires and in a focus group discussion. RESULTS: Seventeen participating GPs (81%) indicated that the education program was suitable for implementation in the education curriculum. Eleven participants (52%) reported that they had never discussed work participation with cancer patients before. Directly after the education program, eighteen participants (86%) reported that they planned to discuss work participation more often with their patients. Four months after the program, 67% indicated they had applied their new knowledge and skills in practice by discussing work participation and by referring cancer patients to occupational health professionals or online resources. According to the GPs in training, integrating the topic of work participation into other education for GPs in training and focusing on a broader group of patients could improve the impact of the education program. CONCLUSIONS: According to the results of this pilot study, the newly developed education program increased the awareness of GPs in training on the importance of discussing work participation with cancer patients. Future studies should focus on whether cancer patients experience more support from their GPs for maintaining and returning to employment after their GP has participated in the training program.

Associations of clinical context-specific ambiguity tolerance with burnout and work engagement among Japanese physicians: a nationwide cross-sectional study.

PURPOSE: Ambiguity tolerance specific to the clinical context - in contrast to ambiguity tolerance as a personality trait - may vary with experience and has received considerable attention. Although this tolerance appears to be related to burnout and work engagement, few studies have examined this association among physicians. Thus, we aimed to examine the relationships between clinical context-specific ambiguity tolerance, burnout, and work engagement among physicians in Japan. METHODS: We conducted a nationwide cross-sectional study in Japan. We invited family physicians from 14 family medicine residency programs and physicians with specialties other than family medicine from monitors of an Internet survey company to participate in the study. We measured ambiguity tolerance in the clinical context using the Japanese version of the Tolerance of Ambiguity in Medical Students and Doctors (J-TAMSAD) scale, burnout using the Japanese version of the Burnout Assessment Scale (BAT-J), and work engagement using the Utrecht Work Engagement Scale (UWES). We performed a multivariable linear regression analysis to determine whether the J-TAMSAD scale score was associated with the BAT-J and UWES scores. RESULTS: 383 respondents were included in the analysis. After adjustment for possible confounders, clinical context-specific ambiguity tolerance showed a dose-dependent negative association with burnout (adjusted mean difference -0.39, 95% confidence interval (CI) -0.56 to -0.22 for the highest J-TAMSAD score quartile compared with the lowest). Ambiguity tolerance in the clinical context also showed a dose-dependent positive association with work engagement (adjusted mean difference 0.83, 95% CI 0.49 to 1.16 for the highest J-TAMSAD score quartile compared with the lowest). CONCLUSIONS: Our study showed that tolerance for ambiguity in the clinical context was negatively associated with burnout, and positively associated with work engagement. These findings will be useful in developing interventions aimed at preventing burnout and promoting work engagement among physicians.

Digital stressors and resources perceived by emergency physicians and associations to their digital stress perception, mental health, job satisfaction and work engagement.

BACKGROUND: Digital technologies are increasingly being integrated into healthcare settings, including emergency departments, with the potential to improve efficiency and patient care. Although digitalisation promises many benefits, the use of digital technologies can also introduce new stressors and challenges among medical staff, which may result in the development of various negative work and health outcomes. Therefore, this study aims to identify existing digital stressors and resources among emergency physicians, examine associations with various work- and health-related parameters, and finally identify the potential need for preventive measures. METHODS: In this quantitative cross-sectional study, an online questionnaire was used to examine the relationship between digital stressors (technostress creators), digital resources (technostress inhibitors), technostress perception as well as mental health, job satisfaction and work engagement among 204 physicians working in German emergency medicine departments. Data collection lasted from December 2022 to April 2023. Validated scales were used for the questionnaire (e.g. "Technostress"-scale and the Copenhagen Psychosocial Questionnaire (COPSOQ). Descriptive and multiple regression analyses were run to test explorative assumptions. RESULTS: The study found medium levels of technostress perception among the participating emergency physicians as well as low levels of persisting technostress inhibitors. The queried physicians on average reported medium levels of exhaustion symptoms, high levels of work engagement and job satisfaction. Significant associations between digital stressors and work- as well as health-related outcomes were analyzed. CONCLUSION: This study provides a preliminary assessment of the persistence of digital stressors, digital resources and technostress levels, and their potential impact on relevant health and work-related outcomes, among physicians working in German emergency departments. Understanding and mitigating these stressors is essential to promote the well-being of physicians and ensure optimal patient care. As digitisation processes will continue to increase, the need for preventive support measures in dealing with technology stressors is obvious and should be expanded accordingly in the clinics. By integrating such support into everyday hospital life, medical staff in emergency departments can better focus on patient care and mitigate potential stress factors associated with digital technologies.

Do income-welfare satisfaction and competency enhance work engagement among Chinese nursing home caregivers? --A moderated mediating effect based on professional identity.

Due to China's aging population, there is a high demand for elderly care that is further exacerbated by the shortage of well-trained caregivers and high turnover rates in nursing homes, urgently requiring enhanced work engagement of caregivers. This study used structural equation modeling based on the survey data of Chinese caregivers in nursing homes to explore the association among income-welfare satisfaction, competency, professional identity, family support and work engagement. Findings indicated that (1) income-welfare satisfaction, competency, and professional identity all enhanced caregivers' work engagement, with professional identity being stronger. (2) Professional identity partially mediated the effects of income-welfare satisfaction and competency on work engagement, with higher values and shares of competency. (3) When family support was high, the positive effect of income-welfare satisfaction on professional identity was significant, and the mediating role of professional identity between income-welfare satisfaction and work engagement was moderated by family support.

Self-appropriation in nurse engagement: Facilitating the development of expert nurses using Benner and Lonergan.

Expert nurses, as described by the work of Patricia Benner, are at the peak of clinical nursing practice and vitally important in ensuring the best possible patient care and clinical outcomes. The development of Benner's theory and its relationship with the Dreyfus model of skill acquisition provides context for understanding the progression necessary for expert development. Contemporary healthcare challenges present implications to the development of advancing levels of nursing practice. Engagement has been identified as critical to achieving expert practice. I propose the incorporation of the philosophical framework of self-appropriation from Benard Lonergan as a strategy to develop internal engagement in nurses to facilitate expert practice. I outline the synergy between Benner's theory and the work of Lonergan, which provide overlap and opportunity to overcome barriers to developing expert nursing practice. In the challenging climate of healthcare, there is an obligation to promote engagement and facilitate expert nurse development, necessary for patient outcomes as well as clinical role models, preceptors, and leaders to guide future nurses.

Profiles of burnout and work engagement in a public service organization: Nature, drivers, and outcomes.

Background: The Canadian Federal Public Service Workplace Mental Health Strategy (the Strategy) seeks to measure, report, and improve employee psychological health, recognizing the National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard) as a starting point. The present research introduced a new survey battery for the assessment of employee psychological health as profiles of burnout and work engagement. It also considered a wide range of predictors aligned with the Standard and several outcomes in accordance with the Job Demands-Resources (JD-R) Model to support the Strategy. Data and methods: A total of 4,781 Statistics Canada employees completed an Employee Wellness Survey in late 2021, during the COVID-19 pandemic, for a response rate of 58%. Additional sociodemographic variables were linked from human resource databases. Survey weights were applied to adjust for non-response. Results: Latent profile analysis uncovered four employee psychological health profiles, ranging from employees who were thriving (15%) to those who were doing well (34%), moving along (38%), or struggling (13%). Job autonomy, role clarity, person-job fit, work-life interference, and workplace incivility -- all workplace psychosocial factors aligned with the Standard -- were consistently associated with profile membership, as expected, and outcome levels were systematically less favourable from the thriving profile to the struggling profile. Interpretation: The results support the validity of the employee psychological health profiles and predictors of profile membership, meeting expectations based on the JD-R literature. Key predictors can serve as metrics to monitor and as targets for workplace interventions designed to improve employee psychological health in support of the Strategy.

Factors in the Perioperative Nurses' Work Environment That Predict Work Engagement.

Perioperative nurse engagement and certification are associated with a culture of safety, which is crucial in perioperative environments. Therefore, examining relationships between engagement, the practice environment, and certification is warranted. The purposes of this study were to examine the relationships between the perioperative practice environment and reported nurse engagement, determine differences in engagement based on certification, and identify facilitators and barriers to attaining and sustaining certification. In this multiphase mixed-methods study, we used a convenience sample of perioperative nurses (N = 379) to examine relationships between engagement, the practice environment, and certification. Qualitative interviews were conducted (n = 15) to supplement the quantitative findings. Leadership support (ß = 0.23, P = .001) and nursing foundations for quality care (ß = 0.21, P = .01) were significant predictors of engagement. Certified nurses did not have significantly higher mean engagement scores when compared with noncertified peers. Qualitative interviews corroborated the findings.