Work Intensification and Its Effects on Mental Health: The Role of Workplace Curiosity.

Work intensification is a psychosocial risk that has been increasing in recent decades and may have been accentuated after the COVID-19 pandemic. Its effects on health are negative, but they can be moderated by contextual and personal factors. The aim of this study was twofold: to analyze the effect of work intensification on workers' stress, anxiety, and depression and to explore the role of workplace curiosity in these relationships. The study design was cross-sectional, and a total of 766 Spanish workers (58.9% female) with different occupations completed the survey. The results showed that work intensification was associated with the symptomatology of stress, anxiety, and depression, with a medium effect size. Women workers showed higher work intensification, but its association with mental health was equally strong for both genders. Workers with higher levels of the workplace curiosity dimension "stress tolerance" showed less impaired mental health in the presence of work intensification. However, workers with higher levels of the workplace curiosity dimension "deprivation sensitivity" showed more symptoms of stress, anxiety, and depression when faced with high work intensification. The results were discussed in terms of their contributions to the field of study of work intensification, the future research they could inspire, and the prevention and intervention measures they could motivate.

Composing a Life that Works with a Life that Counts for Nurses.

The life of a nurse since the Covid-19 pandemic is characterized by high rates of anxiety, depression, and burnout, leading national organizations to declare the nursing shortage a national emergency. Solutions cite work-life balance, but this term has no clear guiding definition. Experts in the organizational psychology and personal development literature suggest other ways to reconsider this dilemma, that of integration. In this paper the concept of integration is proposed to focus on relationships with family and friends, work, and oneself. The American Association of Critical-Care Nurses 'standards for a healthy work environment are used to frame the benefits of an integrated life. Strategies to achieve an integrated life, one with meaning and purpose, are described to create more happiness and joy and to begin to mitigate the nursing shortage.

The impact of negative and positive affectivity on the relationship between work-related psychological factors and work engagement in Japanese workers: a comparison of psychological distress.

BACKGROUND: A previous study has shown that Japanese individuals generally exhibit behavior that suppresses the expression of positive emotions, which are strongly affected by affectivity traits. In the present study, to clarify the relationship between affectivity traits and work engagement (WE) or work-related psychosocial factors among Japanese workers, we compared it to the association between psychological distress and these same factors. METHODS: A total of 1,000 full-time Japanese regular workers responded to an online survey that measured demographic variables, negative and positive affectivity, job demands and resources, WE, and psychological distress. A hierarchical multiple regression analysis was conducted separately, which used WE and psychological distress as dependent variables. RESULTS: The proportion of variance explained by negative and positive affectivity was lower for WE than for psychological distress. However, the proportion of variance defined by job demands and resources was higher for WE than for psychological distress. The proportion of variance explained by all variables for negative and positive affectivity and job demands and resources, and their interactions was approximately equal for WE and psychological distress. CONCLUSION: These results emphasize when researchers aim to evaluate the change of psychosocial factors in the workplace, such as improving the workplace environment among Japanese workers, it might be beneficial to measure positive indicators in addition to negative indicators. Furthermore, enriching job resources would be effective in improving WE and alleviating psychological distress.

A Social Cognitive Assessment of Workplace Sedentary Behavior among a Sample of University Employees.

Sedentary behavior (SB) is an important public health concern. Adults working in desk-based occupations spend a considerable proportion of the workday sitting. More information is needed regarding the factors that contribute to occupational SB. The aim of this study was to assess the utility of social cognitive theory (SCT) to explain work-related SB using a quantitative, cross-sectional design by administering an online questionnaire. Participants included 381 full-time employees at a large, public university in the south-central United States. Hierarchical multiple linear regression was used to determine the relationship between SCT constructs and SB. Mean work-related SB was 5.95 (SD = 1.30) h/8 h workday. In model 1, 9.6% of the total variance in SB was accounted for by standing desk ownership and physical activity level (p = 0.001; R2 = 0.096). In model 2, SCT constructs led to a statistically significant R2 increase of 4.9% (p < 0.001), where standing desk ownership, physical activity, and self-efficacy explained 13.3% of the variance in work-related SB. Findings from this study suggest that self-efficacy may be an important factor in explaining variation in occupational SB. Public health researchers and practitioners should consider strategies to address self-efficacy when developing workplace interventions to target occupational SB.

[Work Environment-Mediated Job Burnout and Intention-to-Stay in Registered Nurses].

BACKGROUND: Nurse engagement and retention are critical issues affecting the quality of healthcare. Although the work environment is known to affect nursing performance and patient outcomes, little is known regarding the impact of this environment on nurse burnout and future work intention, especially in non-Western settings. PURPOSE: This study explored the extent to which Taiwanese nurses' perceptions of their practice environment mediates burnout levels and intention-to-stay. METHODS: This descriptive, correlational study, conducted between September and December 2020, recruited nurses employed at a regional teaching hospital located in a relatively rural region in Taiwan. The participants completed standardized questionnaires, including a demographic information form, the 31-item Practice Environment Scale of the Nursing Work Index (PES-NWI), the 22-item Maslach Burnout Inventory (MBI-HSS), and the 6-item Intention-to-stay (ITS) scale. The mediating effect among the variables related to intention-to-stay was examined using Model 4 of the PROCESS macro and tested using the bootstrapping method (repeated 5,000 times) with a p value < .05. RESULTS: The mean age of the 376 participants was 34.3 years (SD = 8.1). Nearly one-third (30.3%) scored > 27 on the emotional exhaustion subscale of the MBI-HSS, indicating they were "highly burned-out". Also, nearly one-third (30.6%) were uncertain about their intention to stay with their current employer. Burnout was associated with intention-to-stay (ß = -.088, p < .001), and holding a positive perception toward their practice environment was shown to mediate the relationship between burnout and intention-to-stay (ß = -.015; p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Targeted interventions and technical support that promote a collaborative climate and psychological empowerment in clinical practice may alleviate burnout and intention-to-leave in nurses and improve workplace quality.

The effectiveness of implementing the Guideline for the Prevention of Mental Ill-health Problems at the Workplace on health-outcomes, organizational and social risk factors: a cluster-randomized controlled trial in Swedish schools.

OBJECTIVES: This study aimed to compare the effectiveness of the multifaceted implementation strategy (multifaceted group) versus a discrete implementation strategy (discrete group) for implementing the Swedish Guideline for the Prevention of Mental Ill-health Problems at the Workplace on the primary intervention outcome - exhaustion - and secondary outcomes of stress, health, recovery, psychosocial safety climate, and social and organizational risk factors. Another aim was to examine whether the primary and secondary outcomes differed on the basis of guideline adherence levels, irrespective of the group. METHODS: A cluster-randomized waiting-list controlled trial with 6- and 12-months follow-up was conducted among 19 Swedish public schools. Primary and secondary outcomes as well as guideline adherence were assessed by self-reported questionnaire. Linear mixed modeling was used to compare differences in outcomes between the groups from baseline to 6 and 12 months, and in relation to different adherence levels. RESULTS: The trial comprised 698 employees (83.1%) participated. There were no differences between groups in the primary and secondary outcomes at 6 months, while at 12 months differences were observed for some outcomes to the advantage of the discrete group. Better guideline adherence was associated with improvements in exhaustion at 12 months and the secondary outcomes of psychosocial safety climate, work organization and job content, interpersonal relations and leadership, and recovery over 6 and 12 months. CONCLUSION: The multifaceted implementation strategy was no more effective than the discrete strategy in improving health outcomes or organizational and social work environment. However, higher adherence to the guideline was associated with larger improvements in health outcomes and organizational and social work environment, irrespective of the implementation strategy used.

Workplace violence and its associated factors among health care workers of a tertiary hospital in Kathmandu, Nepal.

Workplace violence (WPV) is a globally prevailing public health concerns among healthcare workers. Workplace violence includes occupational abuse (physical, sexual, verbal and psychological), threats or harm among health workers, and workplace harassment. It is important to identify the prevalence of workplace violence at the workplace. Therefore, this study aimed to assess workplace violence and its associated factors among healthcare workers at a tertiary hospital in Kathmandu, Nepal. A descriptive cross-sectional study was carried out among 369 health care workers in a tertiary hospital in Kathmandu. A semi-structured questionnaire was used for data collection. Data was entered and analyzed using SPSS v20. Descriptive statistics were used to assess workplace violence and other independent variables. Bivariate and multivariate logistic regression model was used to examine the factors associated with workplace violence. The prevalence of verbal violence was highest among doctors (34.3%) and nurses (52.8%) followed by bullied/mobbed among doctors (11.9%) and nurses (17%) any time in the past. Experience of any type of workplace violence in the past among doctor was 45.5% and among nurses was 54% while 35.8% doctors and 46.8% nurses had experienced it in the past 12 months. Patients and relatives of patient were major perpetrator for physical and verbal violence while management and staff members were major perpetrators for bullying/mobbing. Participants marital status, work experience, posted department, nature of work shift, frequency of night shift and working hours per week showed statistically significant association with the experience of workplace violence within past 12 months (p<0.05) in binary logistic regression analysis. There is a crucial need to establish evidence-based actions to prevent violence in the workplace and promote a healthy workplace setting. Placing adequate staffs at emergency and medical departments and providing training to cope with the stressful emergency situations would help in minimizing workplace violence among health workers.

The challenges of managing patients with cancer in the workplace: Needs, opportunities and perspectives of occupational physicians.

Cancer is a global major public health problem since it is a leading cause of death, accounting for nearly 10 million deaths in 2020 worldwide and the most recent epidemiological data suggested that its global impact is growing significantly. In this context, cancer survivors have to live for a long time often in a condition of disability due to the long-term consequences, both physical and psychological. These difficulties can seriously impair their working ability, limiting the employability. In this context, the occupational physician plays a key role in the implementation and enforcement of measures to support the workers affected by cancer, to address issues such as the information on health promotion, the analysis of work capacity and the management of disability at work and also promoting a timely and effective return to work and preserving their employability. Therefore, the aim of this study was to gather useful information to support the occupational physicians in the management of workers affected by cancer, through a survey on 157 Italian occupational physicians. Based on the interviewees' opinions, the most useful occupational safety and health professionals in terms of job retention and preservation of workers affected by cancer are the employers and the occupational physicians themselves, whose role is crucial in identifying and applying the most effective reasonable accommodations that should be provided to the workers affected by cancer. The provision of these accommodations take place on the occasion of mandatory health surveillance medical examination to which the worker affected by cancer is subjected when he returns to work. Results on training and information needs showed that the management of the workers affected by cancer is essentially centered on an appropriate fitness for work judgment and on the correct performance of health surveillance. However, an effective and successful management model should be based on a multidisciplinary and integrated approach that, from the earliest stages of the disease, involves the occupational physicians and employers.

The Mediating Role of General and Cognitive Stress on the Effect of an App-Based Intervention on Productivity Measures in Workers: Randomized Controlled Trial.

BACKGROUND: Loss of productivity is a result of absence from work (absenteeism) or of working with limitations due to illness (presenteeism). Recently, occupational mental health interventions have increasingly been delivered in digital format, as this is thought to be more convenient, flexible, easily accessible, and anonymous. However, the effectiveness of electronic mental health (e-mental health) interventions in the workplace to improve presenteeism and absenteeism remains unknown, and could be potentially mediated by psychological variables such as stress levels. OBJECTIVE: The aim of this study was to determine the effectiveness of an e-mental health intervention to reduce absenteeism and presenteeism in employees, as well as to investigate the mediating role of stress in this effect. METHODS: Employees of six companies in two countries participated in a randomized controlled trial (n=210 in the intervention group and n=322 in the waitlist control group). Participants in the intervention group could use the Kelaa Mental Resilience app for 4 weeks. All participants were asked to complete assessments at baseline, during the intervention, postintervention, and at a 2-week follow-up. Absenteeism and presenteeism were assessed by means of the Work Productivity and Activity Impairment Questionnaire: General Health, while general and cognitive stress were assessed through the Copenhagen Psychosocial Questionnaire-Revised Version. Regression and mediation analyses were performed to evaluate the effect of the Kelaa Mental Resilience app on presenteeism and absenteeism. RESULTS: The intervention did not have a direct effect on presenteeism or absenteeism, neither at postintervention nor at follow-up. Nevertheless, general stress significantly mediated the intervention effect on presenteeism (P=.005) but not on absenteeism (P=.92), and cognitive stress mediated the effect of the intervention on both presenteeism (P<.001) and absenteeism (P=.02) right after the intervention. At the 2-week follow-up, the mediating effect of cognitive stress on presenteeism was significant (P=.04), although this was not the case for its mediating effect on absenteeism (P=.36). Additionally, at the 2-week follow-up, general stress did not mediate the intervention effect on presenteeism (P=.25) or on absenteeism (P=.72). CONCLUSIONS: While no direct effect of the e-mental health intervention on productivity was found in this study, our findings suggest that stress reduction could mediate the effect of the intervention on presenteeism and absenteeism. As such, e-mental health interventions that address stress in employees might also indirectly reduce presenteeism and absenteeism in these employees. However, due to study limitations such as an overrepresentation of female participants in the sample and a high proportion of attrition, these results should be interpreted with caution. Future research is needed to better understand the mechanisms of interventions on productivity in the workplace. TRIAL REGISTRATION: ClinicalTrials.gov NCT05924542; https://clinicaltrials.gov/study/NCT05924542.

Social Workers' Experiences of Support in the Workplace during the COVID-19 Pandemic.

This qualitative study included in-depth semistructured interviews with 17 social workers from across the state of Texas that took place during the summer of 2021. The purpose of this study was to describe social workers' experiences of workplace support during the COVID-19 pandemic and provide implications for how to improve support in the workplace. The interviews were analyzed using a phenomenological approach to describe the main themes of the participants' experiences. The findings combined with current literature suggest that following the pandemic and in the case of similar prolonged disasters organizational leaders should consider supporting their social work staff by clearly communicating protocol changes, providing more autonomy and flexible work arrangements, increasing time off and financial support, and providing tangible assistance such as technological support. Leaders should also consider their social work staff's emotional well-being following the pandemic by providing therapeutic resources and bonding opportunities for staff to promote a more resilient team-like culture in the workplace.

Bullied: Exploring the concepts of territorialism and groupthink involvement in workplace bullying.

AIMS: To educate nurse managers on territorialism and groupthink as being factors within workplace bullying among nurses within the clinical and academic settings that can psychologically and physically harm affected persons. DESIGN: Territorialism and groupthink are explored as being factors within workplace bullying used by a bully or bullies to target others for personal gain and power. Workplace bullying has become habitual practice in nursing and nursing academia. Workplace bullying is identified not only as unethical behaviour but also as a dangerous practice that can lead to depression, anxiety, stress, and posttraumatic distress syndrome. Persons affected are subjected to emotional abuse that can lead to isolation, low self-esteem, and self-doubt. METHODS: Methods by which persons in the workplace can identify bullying that involves territorialism and groupthink are examined. Nurse managers are identified as being instrumental in the identification of workplace bullying involving territorialism and groupthink, and in working with the affected person(s) and bully or bullies to seek mediation through a human resource representative. For nursing managers, it is imperative that workplace bullying is immediately addressed. Workplace bullying creates a hostile and intimidating working environment that affects the physical and mental health of affected persons. RESULTS: Early identification and resolution of workplace bullying could alleviate the development of physiological and psychological health problems by affected persons. After workplace bullying has been reported, the affected persons should focus on the healing of mind, spirit, and body. New circumstances (e.g., a new place of employment or a promotion) may trigger feelings of anger, intimidation or fear; therefore, it' is important for persons who have experienced bullying in the workplace to understand the abusive environment itself was not directly associated with any wrongdoing by them. NO PATIENT OR PUBLIC CONTRIBUTION: Workplace bullying is disruptive to the workplace and affects productivity, absenteeism from work and turnover intentions. Persons impacted by territorialism and groupthink within the context of workplace bullying can develop psychological and physiological health problems.

Outcome assessment of a complex mental health intervention in the workplace. Results from the MENTUPP pilot study.

OBJECTIVE: Multicomponent interventions are recommendable to achieve the greatest mental health benefits, but are difficult to evaluate due to their complexity. Defining long-term outcomes, arising from a Theory of Change (ToC) and testing them in a pilot phase, is a useful approach to plan a comprehensive and meaningful evaluation later on. This article reports on the pilot results of an outcome evaluation of a complex mental health intervention and examines whether appropriate evaluation measures and indicators have been selected ahead of a clustered randomised control trial (cRCT). METHODS: The MENTUPP pilot is an evidence-based intervention for Small and Medium Enterprises (SMEs) active in three work sectors and nine countries. Based on our ToC, we selected the MENTUPP long-term outcomes, which are reported in this article, are measured with seven validated scales assessing mental wellbeing, burnout, depression, anxiety, stigma towards depression and anxiety, absenteeism and presenteeism. The pilot MENTUPP intervention assessment took place at baseline and at 6 months follow-up. RESULTS: In total, 25 SMEs were recruited in the MENTUPP pilot and 346 participants completed the validated scales at baseline and 96 at follow-up. Three long-term outcomes significantly improved at follow-up (p < 0.05): mental wellbeing, symptoms of anxiety, and personal stigmatising attitudes towards depression and anxiety. CONCLUSIONS: The results of this outcome evaluation suggest that MENTUPP has the potential to strengthen employees' wellbeing and decrease anxiety symptoms and stigmatising attitudes. Additionally, this study demonstrates the utility of conducting pilot workplace interventions to assess whether appropriate measures and indicators have been selected. Based on the results, the intervention and the evaluation strategy have been optimised.

Burnout Syndrome and Sleep Quality in Basic Education Teachers in Mexico.

Burnout syndrome (BS) is the result of chronic stress in the workplace. Moreover, chronic stress can affect sleep. A unidirectional relationship has been established between burnout and sleep, and it is known that white-collar workers with burnout syndrome have sleep fragmentation and marked daytime sleepiness. OBJECTIVE: The aim of this study was to assess the relationships between burnout and sleep quality in elementary school teachers in Mexico. METHODS: We collected data from more than 400 teachers who completed tests. Correlation analyses controlled for anxiety and depression, and Poisson logistic regression analyses were performed to examine the relationships of burnout with sleep quality, depression, and anxiety. RESULTS: There was a significant correlation between burnout syndrome (mainly in the dimension of emotional exhaustion) and sleep disturbances; significant correlations were also observed with other burnout, depression, and anxiety dimensions. The strength of the correlations decreased after controlling for depression and anxiety. CONCLUSIONS: The symptoms of burnout syndrome in teachers can overlap with sleep disorders, so it is necessary to make a differential diagnosis to differentiate burnout syndrome from depression and anxiety, among others.

Remote, Disconnected, or Detached? Examining the Effects of Psychological Disconnectedness and Cynicism on Employee Performance, Wellbeing, and Work-Family Interface.

Owing to the COVID-19 pandemic, organizations worldwide have implemented remote working arrangements that have blurred the work-family boundaries and brought to the forefront employees' sense of disconnectedness from their workplace (i.e., organizational disconnectedness) as a concern for multiple organizational outcomes. Cynicism, a job burnout subdimension, refers to a negative and excessively detached response to relational overload at work. While both workplace disconnectedness and cynicism involve a toxic sense of detachment, they refer to different psychological mechanisms. The present study aims to examine how employee workplace disconnectedness differs from their cynicism, and how both constructs differentially exert their detrimental effects on employee performance, work-family interface, and wellbeing. Using anonymous survey data collected online in 2021 and 2022 from a sample of in-person and flexible workers nested within organizations, conceptual distinctiveness between workplace disconnectedness and cynicism was supported. Measurement invariance across the two groups was supported, and subsequent structural invariance analyses suggested a similar pattern of results for flexible and in-person workers. Specifically, compared to disconnectedness, cynicism exerted higher negative effects on mental health and higher positive effects on cognitive failures and family-to-work conflict. Conversely, compared to cynicism, disconnectedness exerted higher negative effects on performance and work-to-family conflict. That is, feeling indifferent toward others particularly affects mental health and errors, while feeling excluded especially hampers productivity and family life. Theoretical and practical (e.g., inclusive leadership, support groups) implications of these results are discussed in light of the globally rising rates of hybrid work arrangements and related costs for employee wellbeing and productivity.

Psychosocial and organisational work factors as predictors of sickness absence among professionally active adults with common mental disorders.

BACKGROUND: The incidence of sickness absence (SA) due to common mental disorders (CMDs) has increased in recent decades. It is hence important to elucidate how individuals with CMDs can maintain work. The aim was to analyse the relationship between psychosocial and organisational workplace factors and a spell of > 14 days of SA among persons with CMDs. METHODS: Included were respondents of the Swedish Work Environment Survey (SWES) 1993-2013, diagnosed with a CMD up to five years before the interview in the SWES (n = 3,795). Relative Risk (RR) regression models with 95% Confidence Intervals (CIs) analysed associations between psychosocial-, and organisational workplace factors and a subsequent spell of SA > 14 days. RESULTS: Low control over work (RR:1.16; CI:1.01-1.35), job strain (RR:1.25; CI:1.04-1.49), no flexible working hours (RR:1.25; CI:1.08-1.45) or no possibility to work from home (RR:1.37; CI:1.13-1.66) were significantly related to an increased risk of SA. Persons diagnosed with depression experiencing job strain had the highest increased risk of SA (RR:1.55; CI: 1.07-2.25). CONCLUSIONS: A sustainable work-life among working individuals with CMDs can be provided by reducing job strain, and if possible, by increasing flexibility regarding workplace and working hours. This may prevent spells of SA, and hereby increase productivity.

Effects of chronic workplace harassment on mental health and alcohol misuse: a long-term follow-up.

BACKGROUND: Research on the impacts of exposure to workplace harassment (WH) is largely cross-sectional, and existing prospective studies generally are between two and five years of follow-up, with the longest US study being 10 years. However, the effects of exposure to WH may persist longer, particularly if exposure has been chronic. This study fills this gap by examining effects of prior exposure to chronic sexual and generalized WH on psychological distress and alcohol misuse over an approximately 25 year study period. METHODS: Individuals originally recruited from a university-employed sample in the United States were surveyed at 8 time points from 1996-2007 and again in 2020-2021. A series of hybrid path analyses were tested on a sample of 2352 individuals, regressing recent outcomes on latent classes of harassment derived from earlier survey waves, controlling baseline outcomes and demographics. Model fit was assessed using a variety of fit statistics, and standardized regression coefficients were used to assess significance of individual pathways. RESULTS: Prior exposure to chronic sexual harassment had significant direct associations with psychological distress, alcohol misuse, and recent stressors at follow-up. Prior exposure to chronic generalized harassment had significant direct associations with lower income and alcohol misuse. Both forms of WH were significantly indirectly associated with psychological distress through recent stressors at follow-up. CONCLUSIONS: Exposure to chronic WH is associated with long-term effects on psychological distress and alcohol misuse in a sample representing a wide variety of job types and racial/ethnic identities. Enforcement of anti-sexual harassment law and policies and enactment of policies and laws to prevent generalized harassment/workplace bullying are imperative for the protection of worker health.

Incivility and interpersonal harm in organizational context: A qualitative exploration of values in STEM training programs.

This study investigates science, technology, engineering, and math (STEM) PhD students' perceptions of organizational values and incivility. Interviews with 26 STEM PhD students elicited examples of and perceptions surrounding incivility and related harms. Productivity, prestige, expertise, objectivity, self-sufficiency, and collaboration values were identified. Each included aspects deemed useful (e.g., productivity fueling discovery; expertise facilitating learning) as well as potentially contributing to harm when weaponized (e.g., productivity appeared in incivility stories when one "looked down" on those who did not work long days; expertise appeared when people gossiped about intelligence). Some aspects of collaboration (e.g., long-lasting working relationships fueling scientific discovery) may be protective. Organizational values such as productivity appeared to supersede considerations such as well-being. Current framing of these values may bolster refusal to engage in or support social justice and mental health efforts, which some participants identified as needed. Implications across settings are discussed.

Implementation of a workplace protection system and its correlation with experiences of workplace violence: a cross-sectional study.

BACKGROUND: While customer interactions are inherent and essential aspects of the service industry, instances of violence against service workers have brought social attention to the need for a system to ensure their protection. In South Korea, a protection system for the health of service workers has been implemented to prevent this type of violence and its negative consequences. This study conducted a comparative analysis to clarify the impacts of this protection system across a sample of service workers. We collected data on their general characteristics, occupational characteristics, and experiences with the service protection system to determine how those factors were related to workplace violence, with a focus on whether the system has reduced such occurrences. METHODS: We collected self-reported survey data over 28 days (March 2 to March 30, 2020), resulting in 1,349 (99.3%) responses for our final analysis. We conducted a chi-square test and logistic regression analysis to investigate the general and occupational characteristics, experiences of violence, and experiences with the worker protection system. RESULTS: We found workplace violence is more observed among males, older workers, electronic equipment repairers, irregular workers, and those who worked for extended periods. On the other hand, we found a reduction in the occurrence of workplace violence in businesses that provided service workers with regular counseling from professional counselors, had designated persons responsible for grievance procedures, and/or had grievance procedure committees. We found the lowest likelihood of workplace violence in businesses that operated stress relaxation programs (all p < 0.01). CONCLUSIONS: This study identified a correlation between the adoption of the protection system for service workers and the prevalence of workplace violence. We also clarified the effects of the service protection system and developed a plan for its expansion. KEY POINTS: This study clarified the correlation between the adoption of the protection system for service workers and the occurrence of workplace violence. Along with our investigation of the protection system's effects, these findings provide a basis for expanding Korea's existing worker protection system.

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender). Objective: To evaluate academic medical culture, faculty mental health, and their relationship. Design, Setting, and Participants: A total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health. Exposures: Minoritized identity based on gender, race and ethnicity, and LGBTQ+ status. Main Outcomes and Measures: Three aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health. Results: Of the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis. Conclusions and Relevance: High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.