Factors associated with health professionals' stress reactions, job satisfaction, intention to leave and health-related outcomes in acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organisations.

The aim of this study is to identify (1) the extent of work-related stress and (2) stressors associated with cognitive and behavioral stress reactions, burnout symptoms, health status, quality of sleep, job satisfaction, and intention to leave the organization and the profession among health professionals working in acute care /rehabilitation hospitals, psychiatric hospitals, nursing homes, and home care organizations. BACKGROUND: Health professionals are faced with various stressors at work and as a consequence are leaving their profession prematurely. This study aimed to identify the extent of work-related stress and stressors associated with stress reactions, job satisfaction, and intention to leave and health-related outcomes among health professionals working in different healthcare sectors (acute care, rehabilitation and psychiatric hospitals, nursing homes and home care organizations). METHODS: This study is based on a repeated cross-sectional design, which includes three data measures between 2017 and 2020 and 19,340 participating health professionals from 26 acute care / rehabilitation hospitals, 12 psychiatric hospitals, 86 nursing homes and 41 home care organizations in Switzerland. For data analysis, hierarchical multilevel models (using AIC) were calculated separately for hospitals, nursing homes, and home care organizations, regarding health professionals' stress symptoms, job satisfaction, intention to leave the organization / profession, general health status, burnout symptoms, and quality of sleep. RESULTS: The main findings reveal that the incompatibility of health professionals' work and private life was significantly associated (p < 0.05) with their stress reactions, job satisfaction, intention to leave, and health-related outcomes in all the included work areas. The direct supervisor's good leadership qualities were also associated with health professionals' job satisfaction regarding all work areas (B ≥ 0.22, p = 0.000). In addition, a positive perceived bond with the organization (B ≥ 0.13, p < 0.01) and better development opportunities (B ≥ 0.05, p < 0.05) were associated with higher job satisfaction and a lower intention to leave the organization and profession among health professionals. Also, a younger age of health professionals was associated with a higher intention to leave the organization and the profession prematurely in all the included work areas. High physical (B ≥ 0.04, p < 0.05) and quantitative demands (B ≥ 0.05, p = 0.000) at work were also associated with negative health-related outcomes.

Extent and predictors of presenteeism among healthcare professionals working in Swiss hospitals, nursing homes and home care organizations.

Presenteeism can have negative impacts on employees' health and organizational productivity. It occurs more often among occupations with high attendance demands, such as healthcare professionals. Information is lacking regarding the extent to which presenteeism differs between disciplines and settings in the health sector and what the reasons are for presenteeism as well as influencing factors. This study used cross-sectional data on 15,185 healthcare professionals (nursing staff, midwives, physicians, medical-technical and medical-therapeutic professionals) from various settings (acute care, rehabilitation or psychiatric hospitals, nursing homes and home care organizations). Presenteeism was measured by examining how many days participants had gone to work despite feeling sick during the past 12 months. Kruskal-Wallis was used to test for significant differences between healthcare professions/settings and regression analysis to identify significant predictors of presenteeism. Nursing assistants with a formal education reported the most days of presenteeism in the past 12 months (mean = 4.3, SD = 12.0). Healthcare professionals working in nursing homes reported the most days of presenteeism in the past 12 months (mean = 4.2, SD = 8.7). The majority of healthcare professionals had been present at work while being ill due to a sense of duty (83.7%), followed by consideration for colleagues and/or managers (76.5%). In particular, the psychiatric hospitals (ß = 0.139; p < 0.001), nursing homes (ß = 0.168; p < 0.001) and home care organizations (ß = 0.092; p < 0.001), as well as the language regions of Swiss French (ß = - 0.304; p < 0.001) and Italian (ß = - 0.154; p < 0.001), were significantly associated with presenteeism. Presenteeism differs between disciplines and settings in the health sector. The reasons for presenteeism and its influencing factors in the health sector are mostly consistent with those in other sectors. Cultural differences should be afforded greater relevance in future presenteeism research.

Preparing students to deal with the consequences of the workforce shortage among health professionals: a qualitative approach.

BACKGROUND: Healthcare is facing a shortage of qualified healthcare professionals. The pandemic has brought to light the fragile balance that affects all healthcare systems. Governments have realized that these systems and the professionals working in them need support at different levels to strengthen the retention of the workforce. Health professionals' education can play an important role in ensuring that new generations of workers have sound personal and professional competencies to successfully face the challenges of professional practice. These challenges are described in the literature, but the extent to which they are considered in health professionals' education is less clear. METHODS: This qualitative study compares the professional challenges and educational needs described in the literature with the current curricula for health professionals offered in Switzerland. Data were collected nationally through focus group interviews with 65% of Switzerland's directors of bachelor's and master's programs of health professions (nursing, physiotherapy, occupational therapy, midwifery, nutrition and dietetics, osteopathy, radiologic medical imaging technology, health promotion and prevention, and health sciences). The data attained were analyzed using knowledge mapping. RESULTS: The results reveal a gap among education programs with regard to occupational health promotion and cultural diversity. Both topics are taught with a sole focus on patients, and students are expected to adopt similar strategies for their health promotion and stress management. Physicians are insufficiently involved in interprofessional education. The programs fail to enhance health professionals' political, economic and digital competencies. CONCLUSION: The results of this study offer clear guidance about what topics need to be integrated into curricula to improve health professionals' well-being at work and their preparedness to face daily professional challenges.

Cultural Adaptation and Validation of the Health and Work Performance Questionnaire in German.

BACKGROUND: Research interest in presenteeism as a productivity loss has grown given its estimated costs for organizations. To enable researchers in German-speaking countries to compare their findings internationally, a validated German Health and Work Performance Questionnaire (HPQ) version is needed. METHODS: First, the HPQ was translated from English into German, culturally adapted, and tested using cognitive debriefing in interviews. Second, the structural validity of the item measuring presenteeism as productivity loss was tested. RESULTS: Overall, 14 problems with items were identified in the cognitive debriefing. Of these, 57% were comprehension problems. Two of three alternative hypotheses for discriminative validity were accepted. No discrimination was possible for individuals with or without chronic disease. CONCLUSIONS: The German HPQ has satisfactory cross-cultural validity and can be used to measure overall performance, as well as presenteeism in a specified sample with health problems.

Assessing the psychosocial work environment in the health care setting: translation and psychometric testing of the French and Italian Copenhagen Psychosocial Questionnaires (COPSOQ) in a large sample of health professionals in Switzerland.

BACKGROUND: Measuring work-related stress in a reliable way is important in the development of appropriate prevention and intervention strategies. Especially in multilingual studies the use of comparable and reliable instruments is crucial. Therefore, the aim of this study was to translate selected scales and single items from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ) into French and Italian and psychometrically test them in a sample of health professionals. METHODS: This study used cross-sectional data from health professionals at 163 randomised selected health organisations in Switzerland. Selected COPSOQ items/scales were backwards- and forwards- translated and cross-culturally adapted from German to French and Italian. Reliability was assessed with Cronbach alpha and intraclass correlation coefficients, construct validity with confirmatory factor analysis (CFA) and structural equation modelling as well as comparative fit index. RESULTS: Responses from 12,754 health professionals were included in the analysis. Of the overall 24 scales, 20 in the German version, 19 in the French version and 17 in the Italian version attained sufficient internal consistency with a threshold of 0.7 for Cronbach's alpha. Predominantly high factor loadings on scale level are reported (> 0.35), as well as good and satisfactory fit values with RMSEA below 0.1, SRMR below 0.08 and CFI above 0.95. For 10 out of 15 scales, the test for factor invariance revealed a significant difference regarding the psychological constructs of the scales across the language versions. CONCLUSIONS: The psychometric properties verify the underlying theoretical model of the COPSOQ questionnaire, which is to some extent comparable across the three language versions. Of the 10 scales with significant factor variance, four showed large differences, implying that revision is needed for better comparability. Potential cultural issues as well as regional differences may have led to the factor variance and the different reliability scores per scale across language versions. One known influencing factor for regional differences is culture, which should be considered in scale development. Moreover, emerging topics such as digitization should be considered in further development of the questionnaire.

Development of an Interrelated Definition of Psychosocial Health for the Health Sciences Using Concept Analysis.

The term psychosocial health encompasses a variety of definitions and references among different disciplines, and it is widely used in various settings within the health professions and health sciences; however, the term is difficult to conceptualize, which has led to its random and unspecified usage. To bring clarity to use of this term, a concept analysis was conducted. After a careful selection process, 15 articles, including those with their primary published definition, were analyzed and synthesized. The central attributes of the concept of psychosocial health were identified, and an overarching definition addressing its various aspects was proposed. The resulting definition is comprehensive and applicable to a variety of disciplines within the health professions. The definition provides a new understanding and increased clarity for this complex term. Importantly, it will also assist in promoting the psychosocial health of patients as well as health professionals. [Journal of Psychosocial Nursing and Mental Health Services, 60(6), 19-26.].

Technostress and Digital Competence Among Health Professionals in Swiss Psychiatric Hospitals: Cross-sectional Study.

BACKGROUND: Psychiatric hospitals are becoming increasingly digitized because of the disruptive rise in technical possibilities. This digitization leads to new tasks and demands for health professionals, which can have an impact on technostress. It is unclear whether digital competence reduces technostress and how technostress affects health professionals' mental and physical health. OBJECTIVE: This study aims to assess the association between digital competence and technostress, considering individual characteristics and the association between technostress and long-term consequences for health professionals. METHODS: Cross-sectional data from 3 Swiss psychiatric hospitals were analyzed using multiple linear regression. The dependent variables for the models were digital competence, technostress, and long-term consequences (intention to leave the organization or the profession, burnout symptoms, job satisfaction, general health status, quality of sleep, headaches, and work ability). One model was calculated for each long-term consequence. The mean scores for technostress and digital competence could range between 0 (fully disagree) and 4 (fully agree), where a high value for technostress indicated high technostress and a high value for digital competence indicated high digital competence. RESULTS: The sample comprised 493 health professionals in psychiatric hospitals. They rated their technostress as moderate (mean 1.30, SD 0.55) and their digital competence as high (mean 2.89, SD 0.73). Digital competence was found to be significantly associated with technostress (ß=-.20; P<.001). Among the individual characteristics, age (ß=.004; P=.03) and profession were significantly associated with both digital competence and technostress. Technostress is a relevant predictor of burnout symptoms (ß=10.32; P<.001), job satisfaction (ß=-6.08; P<.001), intention to leave the profession (ß=4.53; P=.002), organization (ß=7.68; P<.001), general health status (ß=-4.47; P<.001), quality of sleep (ß=-5.87; P<.001), headaches (ß=6.58; P<.001), and work ability (ß=-1.40; P<.001). CONCLUSIONS: Physicians and nurses who have more interaction with digital technologies rate their technostress higher and their digital competence lower than those in other professions. Health professionals with low interaction with digital technologies appear to overestimate their digital competence. With increasing digitization in psychiatric hospitals, an increase in the relevance of this topic is expected. Educational organizations and psychiatric hospitals should proactively promote the digital competence of health professionals to manage expected disruptive changes.

Work-related stress and intention to leave among midwives working in Swiss maternity hospitals - a cross-sectional study.

BACKGROUND: Health systems around the globe are struggling to recruit qualified health professionals. Work-related stress plays an important role in why health professionals leave their profession prematurely. However, little is known about midwives' working conditions and intentions to leave their profession, although this knowledge is key to work force retention. Therefore, we aimed to investigate work-related stress among midwives working in Swiss maternity hospitals, as well as differences between midwives and other health professionals and the stressors associated with midwives' intention to leave the profession. METHODS: We conducted a data analysis of two cross-sectional studies encompassing midwives working in labour, postpartum and/or gynaecology wards of 12 public Swiss maternity hospitals. Data was collected by self-report questionnaire assessing potential stressors and long-term consequences of stress at work. Data were analysed using descriptive statistics, Kruskal Wallis tests and logistic regression modelling. RESULTS: A total of 98 midwives took part in the study and one in three midwives reported doing overtime sometimes-always. Also, the score for work-private life conflicts was significantly higher among midwives than among other health professionals, with the exception of physicians (M = 37.0 versus 50.2, p < .001). Midwives' meaning of work score (M = 89.4) was significantly higher than that of other health professionals (e.g. nurses (M = 83.0, p < .001) or physicians (M = 82.5, p < .01)). Generation Y midwives showed a significantly higher intention to leave their organisation than did the baby boomers (Mean scores 29.3 versus 10.0, p < .01). Results of the regression model revealed that if midwives could compensate for their overtime in the same month, their intention to leave the profession was lower (OR = 0.23, p < .05). Additionally, the more midwives were affected by work-private life conflicts (OR = 3.01, p < .05) and thoughts about leaving their organisation (OR = 6.81, p < .05), the higher was their intention to leave their profession prematurely. CONCLUSIONS: The comparison with other health professions and the higher intention to leave the profession of younger midwife generations are important findings for heads of institutions as well as policy makers, and should stimulate them to develop strategies for keeping midwives on their staff. More extensive studies should implement and test interventions for reducing work-related stress and increasing the job and occupational satisfaction of midwives.

Adaptation and validation of the evidence-based practice beliefs and implementation scales into German.

Aims: To culturally adapt and translate the Evidence-Based Practice Belief Scale (EBP-B) and the Evidence-Based Practice Implementation Scale (EBP-I), explore the psychometric properties of their validated German versions and compare results with those of the original scales. Design: Cross-sectional descriptive study. Method: The study was conducted on a sample of 131 Registered Nurses in a Swiss German hospital. Internal consistency was rated using Cronbach's alpha. Principal component analysis using varimax rotation was used to determine construct validity. The study was undertaken in accordance with the STROBE-checklist in Appendix S1. Results: German versions of the EBP-B and EBP-I showed good reliability. Their Cronbach alphas showed lower values than those of the original scales. Principal component analysis showed medium-to-high factor loading. Principal component analyses using varimax rotations of the EBP-B's 16 items and the EBP-I's 17 items resulted in four-factor and five-factor solutions, respectively.

Work-related stress among health professionals in Swiss acute care and rehabilitation hospitals-A cross-sectional study.

AIMS AND OBJECTIVES: This study aimed to identify significant work stressors associated with stress symptoms, job satisfaction, intention to leave and health-related outcomes among health professionals. BACKGROUND: The workforce shortage of health professionals is a current concern, and a reduction of work-related stress is thus essential for retaining health professionals. Studies on the extent of work-related stress in different health professions are limited. METHODS: The research was conducted with a cross-sectional study encompassing 26 randomly selected acute care and rehabilitation hospitals. The sample consisted of 3,398 health professionals. The study was undertaken in accordance with the STROBE checklist for observational studies. RESULTS: Work-private life conflicts were significantly associated with health professionals' stress symptoms, job satisfaction, intention to leave the organisation and profession, their general health status, burnout symptoms and quality of sleep. Also, opportunities for development and the behaviour of the direct line manager (e.g. quality of leadership, unfair behaviour, rewards given) along with various profession-specific stressors were the important predictors revealed. CONCLUSIONS: This study shows the high relevance of preventing and reducing work-private life conflicts, enhancing leadership qualities as well as opportunities for development among health professionals working in acute care and rehabilitation hospitals. Also, differences between health professions should be taken into consideration in developing strategies for reducing stress at work. RELEVANCE TO CLINICAL PRACTICE: The results of this study are particularly relevant for health professional leaders and reveal the urgent need in hospital practice for effective strategies to improve health professionals' work-private life balance, opportunities for development and quality of leadership.