Emotional Exhaustion in Healthcare Workers: Moving Beyond Coping Skills to Improve Organizational Conditions.

OBJECTIVE: Emotional exhaustion (EE)-the first stage of burnout-is related to preventable work environment exposures. We examined the understudied impact of organizational support for safety (OSS) and safety hazards (SH) on EE in a mixed licensed and unlicensed population of healthcare workers (HCWs). METHODS: A work environment exposures survey was conducted in five US public healthcare facilities in 2018-2019. A total of 1059 questionnaires were collected from a predominantly female population of mixed HCWs. RESULTS: Mean EE scores were higher among women, direct care workers, and younger subjects. In linear regression models, EE was positively associated with SH, emotional labor, psychological demands, physical demands, job strain, assault, and negative acts, while OSS was negatively associated. Safety hazard s both mediated and moderated the relationship between OSS and EE. CONCLUSIONS: When perception of SH is high, OSS has less impact on reducing EE, suggesting a need to effectively put safety policies to practice for improving EE in HCWS.

Work-Family Conflict and Depression Among Healthcare Workers: The Role of Sleep and Decision Latitude.

BACKGROUND: Healthcare workers report a higher incidence of depression than the general population. Work-family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work-family conflict into depression. METHODS: In 2018, a cross-sectional survey was collected from healthcare workers (n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants' work-family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. FINDINGS: There was a significant association between work-family conflict and depression (ß = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family-conflict and depression was stronger among workers with low decision latitude. CONCLUSIONS: Depression was prevalent among healthcare workers and was associated with work-family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association. APPLICATION TO PRACTICE: Evidence-based interventions seeking to alleviate the effect of work-family conflict and improve healthcare workers' mental health should consider promoting employee sleep quality and improving employees' decision-making on the job.

Health Care Organization Policies for Employee Safety and COVID-19 Pandemic Response: A Mixed-Methods Study.

OBJECTIVE: The coronavirus (COVID-19) pandemic impacted the well-being of health care workers. We examined the association between prepandemic perceptions of perceived organizational support for safety (using NOSACQ-50), safety hazards and the pandemic's impact on individual workers and institutions. METHODS: Questionnaires from health care staff of five public health care facilities were collected in 2018 ( n = 1059) and 2021 ( n = 1553). In 2021, 17 workers were interviewed from the same facilities. RESULTS: Interviewees reported that their organizations struggled to communicate due to changing guidelines, inadequate personal protective equipment, training, and infection control, early in the pandemic. Questionnaire reports of decreased staffing and increased workload during the pandemic were associated with lower baseline NOSACQ scores. CONCLUSION: Survey findings predicted some variation in organizational response to the pandemic. Better organizational policies for employee safety and pandemic planning could improve health care institutions' preparedness.

Emotional Labor and Depressive Symptoms Among Healthcare Workers: The Role of Sleep.

BACKGROUND: Depression is the second leading cause of disability worldwide. Health care workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied. This study examines the relationship between emotional labor and depressive symptoms and whether sleep plays a role in explaining this relationship. METHODS: In 2018, health care workers (n = 1,060) from five public sector facilities in the northeast United States participated in this cross-sectional survey. The survey included questions on participants' surface-acting emotional labor (masking one's feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. FINDINGS: There was a significant association between emotional labor and depressive symptoms (ß = 0.82, p < .001). Sleep disturbances, but not short sleep duration, partially mediated this association. Neither sleep variable moderated this association. CONCLUSIONS/APPLICATION TO PRACTICE: Depressive symptoms were prevalent among health care workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce health care workers' emotional labor to improve their mental health. Sleep promotion should also be emphasized to mitigate the negative effect of emotional labor and promote mental wellbeing.