Is it okay to feel this way? Exploring the joint effect of emotional experiences and expectations on life satisfaction.

This research investigates the joint effect of individual emotional experiences and societal expectations on life satisfaction. Inspired by the Affect Valuation Theory and Self-Discrepancy Theory, we explored how discrepancies between actual emotional experiences and what society believes we "ought" to feel are linked with life satisfaction. A total of 301 U.S. online participants rated their emotional experiences and societal expectations for emotions, along with measures of life satisfaction. Response surface analyses were used to assess the effect of emotional experience-norm congruence on life satisfaction. Findings revealed that the highest life satisfaction reported by individuals infrequently experiencing negative emotions but perceiving high societal expectations for these emotions, while congruence effects were not supported. These findings suggest the potential benefits of a societal shift toward greater acceptance of a wider range of negative emotions. The study may potentially stimulate interventions to enhance individuals' life satisfaction by reconsidering societal beliefs about emotions.

Happiness Maximization Is a WEIRD Way of Living.

Psychological science tends to treat subjective well-being and happiness synonymously. We start from the assumption that subjective well-being is more than being happy to ask the fundamental question: What is the ideal level of happiness? From a cross-cultural perspective, we propose that the idealization of attaining maximum levels of happiness may be especially characteristic of Western, educated, industrial, rich, and democratic (WEIRD) societies but less so for others. Searching for an explanation for why "happiness maximization" might have emerged in these societies, we turn to studies linking cultures to their eco-environmental habitat. We discuss the premise that WEIRD cultures emerged in an exceptionally benign ecological habitat (i.e., faced relatively light existential pressures compared with other regions). We review the influence of the Gulf Stream on the Northwestern European climate as a source of these comparatively benign geographical conditions. We propose that the ecological conditions in which WEIRD societies emerged afforded them a basis to endorse happiness as a value and to idealize attaining its maximum level. To provide a nomological network for happiness maximization, we also studied some of its potential side effects, namely alcohol and drug consumption and abuse and the prevalence of mania. To evaluate our hypothesis, we reanalyze data from two large-scale studies on ideal levels of personal life satisfaction-the most common operationalization of happiness in psychology-involving respondents from 61 countries. We conclude that societies whose members seek to maximize happiness tend to be characterized as WEIRD, and generalizing this across societies can prove problematic if adopted at the ideological and policy level.

Crossover of the dimensions of work-family and family-work conflict in couples: Protocol for a qualitative study.

Conflict between work and non-work is a bidirectional and a multidimensional construct that has garnered much attention from researchers and practitioners alike. Previously, studies with a dyadic design demonstrated that interrole conflict can cross over between partners in romantic relationships. The aim of the present study is to explore-from an individual and dyadic perspective-how partners perceive dimensions of interrole conflict (that is: time, strain, behaviour, and possibly others) and whether crossover between partners is dimension-dependent. This protocol outlines a qualitative interview study. Participants (N = 40) will be dual-earner couples that meet two inclusion criteria: both partners need to be professionally active, and the couples need to have lived together for at least a year. Interviews will be conducted separately with each partner. To analyse the data at the individual level we will use reflexive thematic analysis. To analyse the data at the dyadic level we will apply an adapted version of the framework method. We anticipate that findings of this study will have the potential to advance theoretical models depicting crossover processes and, more generally, the interface between work and family lives. Moreover, insights into how couples experience dimension-based interrole conflict will be important for the development of targeted interventions.

Promotion and prevention regulatory focus LIWC dictionary. Polish adaptation and validation.

This article describes the adaptation and validation of a Polish version of the regulatory focus (RF) Linguistic Inquiry and Word Count (LIWC) dictionary. RF theory proposes that there are two types of self-regulation: promotion (focus on gains, growth, and ideals) and prevention (focus on losses, security, and oughts). Apart from self-report questionnaires, one method to measure RF includes a linguistic analysis. LIWC counts the frequency of words from relevant categories and presents the output as a percentage of all words used in a writing sample. RF LIWC contains two categories: promotion (e.g., achieve, ideal) and prevention (e.g., afraid, fail). To test the psychometric properties of our Polish adaptation of the RF LIWC instrument, we performed three studies. In Study 1 (N = 10), experts in RF theory rated the extent to which each dictionary entry was related to promotion and prevention foci. Results showed that words from the promotion category were rated as more promotion than prevention-related, and the pattern was reversed for words from the prevention category. In Study 2 (N = 130) we examined the divergent validity of the instrument by experimentally manipulating RF and testing the writing patterns. When a promotion focus was activated, individuals wrote more words from the promotion than prevention category, and the pattern was reversed in the prevention group. Study 3 (N = 414) investigated whether the promotion and prevention scores obtained through RF LIWC are linked with results obtained using a self-report questionnaire that measures chronic RF. Promotion scores from RF LIWC correlated positively with chronic promotion RF and prevention scores from RF LIWC correlated positively with chronic prevention RF. These preliminary findings provide initial support for the validity of the Polish adaptation of the RF LIWC.

Mind the gap: analysis of two pilot projects of a home telehealth service for persons with complex conditions in a Swedish hospital.

BACKGROUND: Developing and implementing home telehealth (HTH) services for patients with chronic conditions is a challenge. HTH services provide continuous and integrated care to patients, but very often pilot projects face non-adoption and abandonment issues. Change processes in healthcare are often complex and require learning to adapt to non-linear and unpredictable events. Complexity science can thus provide a complementary view to the predominant Quality Improvement (QI) approach in healthcare. In this study of two pilot projects in a Swedish hospital, we explore how a theory-driven approach can be used (a) to support the development of a self-monitoring HTH service in hospital care and (b) to evaluate staff and patients' experiences from early adoption. METHODS: To plan and evaluate the service for the recipients (i.e., patients and healthcare providers), we used the Plan-Do-Study-Act (PDSA) tool in combination with two complexity-informed frameworks: the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework, and the joint Complexity Assessment Tool (CAT). The theory-informed development process led to two pilot projects of an HTH service for patients with heart failure and COVID-19. We collected data from multiple sources (project documents, a survey on readiness for change among staff, and semi-structured interviews with patients and staff) and analyzed the data using descriptive statistics and qualitative content analysis with a deductive approach. RESULTS: Patients and staff perceived the services as valuable as they enabled rapid feedback, and improved communication and collaboration between patients and healthcare providers. Yet, despite the extensive development efforts, there was a perceived gap between how individuals valued the service and the capacity of adopters, the organization, and the wider system to effectively integrate these services into routine care. CONCLUSIONS: The combined use of PDSA, NASSS, and CAT can support the development and evaluation of HTH services that are perceived as valuable by individual patients and staff. For successful adoption, the value for individuals must be supported by organizational efforts to learn how to integrate new routines and tasks into clinical practice and daily life, and how to coordinate multiple providers within and outside the hospital walls.

It all depends on which side of the fence you are standing: agent and recipient perspectives are differently linked with job crafting.

BACKGROUND: In social contexts, people may view themselves as agents, who are in control of the environment, or recipients, who succumb to what others have decided. Here, we investigated how these perspectives determine job crafting (JC)-self-initiated employee behaviors targeted at altering job characteristics to fit them with one's needs. METHODS: Study 1 tested the relationships between chronic agent-recipient tendencies and JC in a cross-lagged panel design. Study 2 was a randomized experiment where agent-recipient perspectives were manipulated to predict JC intentions in the week to follow. RESULTS: Supporting our predictions, while agents sought structural job resources and increased challenging demands, recipients resorted to reducing hindering demands (Study 1). Study 2 revealed that activating an agent perspective led to stronger intentions to increase structural job resources and challenging demands. CONCLUSIONS: We conclude that agent and recipient perspectives are linked with differential patterns of JC behaviors. Strengthening agency is a vital step in forming job redesign goals during JC interventions.

Job crafting interventions: what works, for whom, why, and in which contexts? Research protocol for a systematic review with coincidence analysis.

BACKGROUND: Recent challenges in the working world that resulted from the pandemic and technological advances have underlined the importance of flexibility in how jobs are designed. Job crafting (JC) refers to self-initiated changes that employees introduce to their jobs to optimize their job design and increase the fit between the job and their needs and preferences. These behaviors can be stimulated by job crafting training interventions, which aim to change how individual employees design, organize, or manage their work. However, since the interventions are implemented in various ways, we do not know which context and intervention factors are necessary or sufficient to achieve desired outcomes. Without this knowledge, benefitting from the potential of job crafting interventions is limited. The overall aim of this project will be to investigate what combinations of context, intervention, and mechanism factors are linked with effective JC interventions. Specifically, we will detect what factors are minimally sufficient and/or necessary to produce a successful JC intervention, how they combine, as well as what are the multiple alternative paths to their success. METHODS: We will perform a systematic review of the JC interventions literature combined with coincidence analysis (CNA). We will search electronic databases of journals and utilize Rayyan software to make decisions regarding inclusion. Data regarding context (e.g., fit), intervention (e.g., types of activities), mechanisms (e.g., intention implementation), and outcomes (e.g., employee well-being, job performance) will be extracted using a pre-piloted form and coded into a crisp-set (factor present vs. absent). Analyses will be carried out using the CNA package in R. DISCUSSION: This review will address gaps in knowledge about the context, intervention, and mechanism-related factors that may impact the effects of JC interventions. Consequently, this review will help develop a program theory for JC interventions that explains what works, how and under which circumstances. Applying CNA to synthesize these complex solutions across multiple studies provides an innovative method that may be used in future review attempts evaluating the implementation of interventions. Finally, our synthesis will provide knowledge relevant to organizational practitioners and scholars who want to implement JC interventions. TRIAL REGISTRATION: https://osf.io/2g6yx.

How Should Job Crafting Interventions Be Implemented to Make Their Effects Last? Protocol for a Group Concept Mapping Study.

BACKGROUND: By means of job crafting (JC) employees shape and customize their job design to align it with their preferences. Research has so far shown that such bottom-up proactivity can be stimulated via JC interventions. While the overall effectiveness behind these interventions has been supported, it is unclear how to implement these interventions to make their effects lasting. METHODS: The overall aim of this project will be to investigate how to implement JC interventions with lasting effects. We will apply a group concept mapping (GCM) methodology, which is a mixed methods approach of exploratory nature for engaging stakeholder groups in a structured conceptualization process. As part of concept mapping procedures, brainstorming sessions will be conducted with experts in job crafting to identify factors expected to make job crafting intervention effects lasting. These factors will be sorted by similarity and rated by each participant in regard to their perceived importance and feasibility to ensure lasting, sustainable effects. The data will be analyzed using multidimensional scaling (MDS), hierarchical cluster analysis, and descriptive and inferential statistics, resulting in a visual representation of conceptually distinguished clusters representing the factors influencing the sustainability of JC interventions. In the final step, a workshop will be conducted with the participants to facilitate the interpretation of the results. RESULTS AND CONCLUSION: This study will provide knowledge relevant to organizational practitioners and scholars who want to implement JC interventions with lasting effects. Although data collected following the group concept mapping procedure is self-reported and at risk of being simplified, the method allows for a structured conceptualization process integrating different perspectives and uncovering implicit knowledge making it suitable for studying complex phenomena. The results will not only enrich the current literature concerning the effectiveness of JC interventions but also be used to develop a practitioner-oriented toolkit outlining evidence-based recommendations concerning designing and implementing, as well as evaluating JC interventions.

Better self-care through co-care? A latent profile analysis of primary care patients' experiences of e-health-supported chronic care management.

Background: Efficient self-care of chronic conditions requires that an individual's resources be optimally combined with healthcare's resources, sometimes supported by e-health services (i.e., co-care). This calls for a system perspective of self-care to determine to what extent it involves demanding or unnecessary tasks and whether role clarity, needs support, and goal orientation are sufficient. This study aims to explore typical configurations of how the co-care system is experienced by individuals with chronic conditions who used an e-health service supporting self-monitoring and digital communication with primary care. Method: We performed a latent profile analysis using questionnaire data from two waves (7 months apart) involving 180 of 308 eligible patients who pilot-tested an e-health service for co-care at a Swedish primary care center. The five subscales of the Distribution of Co-Care Activities (DoCCA) scale were used to create profiles at Time 1 (T1) and Time 2 (T2). Profiles were described based on sociodemographic variables (age, gender, education level, and health condition) and compared based on exogenous variables (self-rated health, satisfaction with healthcare, self-efficacy in self-care, and perceptions of the e-health service). Results: We identified four typical configurations of co-care experiences at T1: strained, neutral, supportive, and optimal. Patients with optimal and supportive profiles had higher self-rated health, self-efficacy in self-care, and satisfaction with healthcare than patients with strained and neutral profiles. Slightly more than half transitioned to a similar or more positive profile at T2, for which we identified five profiles: unsupportive, strained, neutral, supportive, and optimal. Patients with optimal and supportive profiles at T2 had higher self-efficacy in self-care and satisfaction with healthcare than the other profiles. The optimal profiles also had higher self-rated health than all other profiles. Members of the optimal and supportive profiles perceived the effectiveness of the e-health service as more positive than the unsupportive and strained profile members. Discussion: Primary care patients' co-care profiles were primarily distinguished by their experiences of needs support, goal orientation, and role clarity. Patients with more positive co-care experiences also reported higher self-rated health, self-efficacy in self-care, and satisfaction with healthcare, as well as more positive experiences of the e-health service.

Maximizing economic prosperity, strengthening military, or developing social bonds? Study protocol for research on the relationship between regulatory focus and preferences for the direction of societal development.

Recent research has pointed to cross-cultural differences with regard to preferences for the directions that societies should take in their development. From an individual's perspective, these directions might be understood as 'goals', i.e., internal representations of desired end states. To date, research on individual differences that determine preferences for such directions is scarce. However, people's motivational concerns, i.e., what they fundamentally value, may shape their views about the desired paths for their country's future. The role of such motivational concerns has been described by regulatory focus theory, which distinguishes between promotion concerns related to advancement needs and prevention concerns linked with security needs. The overall aim of this project is to map the different pathways of societal development with regulatory focus concerns. This will be achieved in two studies. In Study 1, a group concept mapping method will be employed, and leading psychologists will assess the extent to which various societal development goals represent promotion and prevention goals. Based on these ratings, a two-dimensional map of the goals will be created and presented to the same experts, who will be asked to create goal clusters based on their proximity with regard to promotion and prevention ratings. This study will reveal which societal development directions have promotion concerns that outweigh prevention concerns (and vice versa) and which are both high (or low) on these dimensions. This initial mapping will be corroborated in correlational Study 2 with representative samples from two countries differing in dominating regulatory orientations (Poland vs. USA). Here, the roles of individual promotion and prevention orientations in preferences for specific societal development directions will be evaluated. This project will provide new insights into the roles of individual motivational systems in preferences for goals that might be pursued in country development.

National governance of de-implementation of low-value care: a qualitative study in Sweden.

BACKGROUND: The de-implementation of low-value care (LVC) is important to improving patient and population health, minimizing patient harm and reducing resource waste. However, there is limited knowledge about how the de-implementation of LVC is governed and what challenges might be involved. In this study, we aimed to (1) identify key stakeholders' activities in relation to de-implementing LVC in Sweden at the national governance level and (2) identify challenges involved in the national governance of the de-implementation of LVC. METHODS: We used a purposeful sampling strategy to identify stakeholders in Sweden having a potential role in governing the de-implementation of LVC at a national level. Twelve informants from nine stakeholder agencies/organizations were recruited using snowball sampling. Semi-structured interviews were conducted, transcribed and analysed using inductive thematic analysis. RESULTS: Four potential activities for governing the de-implementation of LVC at a national level were identified: recommendations, health technology assessment, control over pharmaceutical products and a national system for knowledge management. Challenges involved included various vested interests that result in the maintenance of LVC and a low overall priority of working with the de-implementation of LVC compared with the implementation of new evidence. Ambiguous evidence made it difficult to clearly determine whether a practice was LVC. Unclear roles, where none of the stakeholders perceived that they had a formal mandate to govern the de-implementation of LVC, further contributed to the challenges involved in governing that de-implementation. CONCLUSIONS: Various activities were performed to govern the de-implementation of LVC at a national level in Sweden; however, these were limited and had a lower priority relative to the implementation of new methods. Challenges involved relate to unfavourable change incentives, ambiguous evidence, and unclear roles to govern the de-implementation of LVC. Addressing these challenges could make the national-level governance of de-implementation more systematic and thereby help create favourable conditions for reducing LVC in healthcare.

Beyond the individual: A systematic review of the effects of unit-level demands and resources on employee productivity, health, and well-being.

Creating sustainable employment-that is, a condition in which employees remain productive but also enjoy good health and well-being-is a challenge for many organizations. Work environment factors are major contributors to these employee outcomes. The job demands-resources model categorizes work environment factors into demands versus resources, which are, respectively, detrimental versus beneficial to employee outcomes. Although conceptualized as workplace factors, these job characteristics have been studied mostly at an individual level. Therefore, their roles at the supraindividual level (i.e., any work-unit level above an individual, such as group or organization) for employee productivity, health, and well-being remains unclear. The aim of this systematic review is to synthesize evidence concerning job resources and job demands at the supraindividual level and their relationships to productivity, health, and work-related well-being. The review covers articles published through December 2018. In total, 202 papers met the inclusion criteria. We found stronger support for the beneficial roles of supraindividual job resources than for the detrimental roles of job demands for productivity and work-related well-being. Regarding health, most of the relationships were found to be nonsignificant. To conclude, this review demonstrates that, at the supraindividual level, the motivational path has received more support than the health impairment path. Based on these findings, we provide recommendations for further research and practice. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Are we seeing "eye to eye" on qualitative job insecurity in healthcare? Employee-teammates perceptual (in)congruence and individual well-being.

Background: In healthcare, employees are exposed to continuous change when new methods are implemented to optimize care. Such changes may result in qualitative job insecurity (QJI), i.e., a fear concerning the potential loss of important job features. QJI is an individual experience; however, it may be shared within a team to a varying extent. This study examines how QJI perceptual (in)congruence between individuals and their teammates relates to individuals' well-being.Method: Healthcare employees (N = 305) from 30 healthcare units completed questionnaires measuring QJI, work engagement, and recovery.Results: Multi-level polynomial regression analyses showed that QJI congruence had a curvilinear relationship with well-being: employees reported higher work engagement when QJI perceptions were in agreement, both when QJI was low and high. We observed a negative relationship between QJI congruence and recovery. Recovery was lower when perceptions of QJI were in agreement and were high (vs. low). Finally, we found support for the effects of perceptual incongruence: when employees reported higher QJI than their teammates, they experienced lower recovery and engagement.Conclusions: To understand how employees' QJI relates to their well-being, it is essential to consider their teammates' perceptions. The social context can augment or reduce individuals' stress reactions to job insecurity.

Reducing Hindering Job Demands: The Role of Belief in Life as a Zero-Sum Game and Workload.

When individuals engage in job crafting by decreasing their job demands, the workload of their teammates rises. Pursuing self-interest at the expense of others requires holding a belief about the antagonistic nature of human relations. The present research demonstrates how belief in life as a zero-sum game (BZSG) shapes workplace behaviors. Our two studies-one cross-sectional and one time-lagged-support our predictions that a strong BZSG weakens proactivity and increases the tendency to decrease one's job demands at the expense of others. We also observed a suppression effect: workload triggers a reduction in job demands indirectly by activating BZSG, while the direct link between workload and reducing hindering job demands is negative. The results are important for both theory and practice because they delineate the conditions that prompt the avoidance of job demands by the employees.

The Cross-Level Moderation Effect of Resource-Providing Leadership on the Demands-Work Ability Relationship.

Employees in female-dominated sectors are exposed to high workloads, emotional job demands, and role ambiguity, and often have insufficient resources to deal with these demands. This imbalance causes strain, threatening employees' work ability. The aim of this study was to examine whether resource-providing leadership at the workplace level buffers against the negative repercussions of these job demands on work ability. Employees (N = 2383) from 290 work groups across three countries (Germany, Finland, and Sweden) in female-dominated sectors were asked to complete questionnaires in this study. Employees rated their immediate supervisor's resource-providing leadership and also self-reported their work ability, role ambiguity, workload, and emotional demands. Multilevel modeling was performed to predict individual work ability with job demands as employee-level predictors, and leadership as a group-level predictor. Work ability was poor when employees reported high workloads, high role ambiguity, and high emotional demands. Resource-providing leadership at the group level had a positive impact on employees' work ability. We observed a cross-level interaction between emotional demands and resource-providing leadership. We conclude that resource-providing leadership buffers against the repercussions of emotional demands for the work ability of employees in female-dominated sectors; however, it is not influential in dealing with workload or role ambiguity.

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on 12 May 2020. The protocol, as accepted by the journal, can be found at https://doi.org/10.6084/m9.figshare.c.4878591.v1.

Contact, moral foundations or knowledge? What predicts attitudes towards women who undergo IVF.

BACKGROUND: The willingness to try in vitro fertilization (IVF) as an infertility treatment, as well as its psychosocial consequences for couples, may be influenced by how they perceive the attitudes of general public towards this procedure. The focus of the current study was to identify predictors of attitudes towards mothers who underwent IVF to conceive a child. Three predictors were derived from attitude components: contact with someone who had undergone IVF (behavior), moral foundations (emotions), and the level of knowledge (cognition) about IVF. METHOD: In total, 817 participants (118 male and 692 female, 7 unreported) from Poland took part in the study. Participants were asked whether they knew a person who underwent IVF, completed a Moral Foundation Questionnaire, and answered a pre-piloted IVF knowledge test. Attitudes towards women who utilised IVF were measured with a modified Bogardus Social Distance Scale. Data were analysed using hierarchical and logistic regression analyses. RESULTS: The results showed that there was a weak link between previous contact with a person who underwent IVF and a positive attitude toward a woman who underwent IVF. The attitudes was also predicted by moral foundations: positively by care/harm and fairness/cheating foundations, and negatively by sanctity/degradation. Importantly, more knowledge about IVF was linked with a more positive attitude towards IVF, and this effect explained additional variance over and above moral foundations. CONCLUSIONS: Our study implies the need of psychoeducation to prevent stigmatization of individuals who try IVF due to infertility.

Burnout and self-regulation failure: A diary study of self-undermining and job crafting among nurses.

AIM: The objective was to test how nurse burnout impairs day-to-day adaptive self-regulation strategies that link levels of regulatory resources with employee job performance. BACKGROUND: Regulatory resources help employees manage their thoughts, feelings, and behaviours on a daily basis. On days when these resources are low, employees may engage in maladaptive self-regulation: more self-undermining (i.e. creating additional obstacles) and less job crafting (i.e. optimizing job demands and resources), which debilitates their work performance. We expected that self-regulation is impaired especially when individuals exhibit low motivation and low ability to regulate their behaviour, that is, when they experience elevated burnout. DESIGN: This research used a daily diary design. Nurses responded to a general survey and then completed daily diary surveys in three different moments: before, during and after work for 10 consecutive workdays (total reports N = 732). METHOD: A sample of 81 nurses from Polish hospitals and primary healthcare centres completed self-reported questionnaires between January and March 2018. Hypotheses were tested using multilevel modelling in Mplus. RESULTS: Momentary self-regulatory capacity before work was negatively related to self-undermining and positively related to job crafting, and it indirectly predicted daily job performance. As hypothesized, these indirect relationships were moderated by general, chronic burnout. We found that only for employees with low levels of burnout, daily self-regulation was linked with better functioning via increased job crafting and decreased self-undermining. CONCLUSION: Chronic burnout disturbs day-to-day behaviour regulation. Individuals with elevated burnout symptoms have difficulty to translate momentary boosts in regulatory resources into adaptive strategies that are linked with higher performance. IMPACT: Our findings call for better recovery programmes, strategic Human Resource Management practices aimed at reducing factors that deplete daily self-regulatory resources, and finally top-down interventions preventing burnout among employees in the healthcare system.

How do healthcare professionals make decisions concerning low-value care practices? Study protocol of a factorial survey experiment on de-implementation.

BACKGROUND: A large number of practices used in health care lack evidence of effectiveness and may be unnecessary or even cause harm. As such, they should be de-implemented. While there are multiple actors involved in de-implementation of such low-value care (LVC) practices, ultimately, the decision to abandon a practice is often made by each health care professional. A recent scoping review identified 6 types of factors affecting the utilization vs. abandonment of LVC practices. These factors concern health care professionals, patients, outer context, inner context, processes, and the characteristics of LVC practice itself. However, it is unclear how professionals weigh these different factors in and how these determinants influence their decisions about abandoning LVC practices. This project aims to investigate how health care professionals account for various factors as they make decisions regarding de-implementation of LVC practices. METHODS: This project will be carried out in two main steps. First, a factorial survey experiment (a vignette study) will be applied to empirically test the relevance of factors previously identified in the literature for health care professionals' decision-making about de-implementation. Second, interactive workshops with relevant stakeholders will be carried out to develop a framework for professionals' decision-making and to offer suggestions for interventions to support de-implementation of LVC practices. DISCUSSION: The project has the potential to contribute to improved understanding of the decision-making involved in de-implementation of LVC practices. We will identify which factors are more important when they make judgments about utilizing versus abandoning LVC practices. The results will provide the basis for recommendations concerning appropriate interventions to support de-implementation decision-making processes.