Differences in Physicians' Ratings of Work Stressors and Resources Associated With Digital Transformation: Cross-Sectional Study.

BACKGROUND: The emergence of the COVID-19 pandemic rapidly accelerated the need and implementation of digital innovations, especially in medicine. OBJECTIVE: To gain a better understanding of the stress associated with digital transformation in physicians, this study aims to identify working conditions that are stress relevant for physicians and differ in dependence on digital transformation. In addition, we examined the potential role of individual characteristics (ie, age, gender, and actual implementation of a digital innovation within the last 3 years) in digitalization-associated differences in these working conditions. METHODS: Cross-sectional web-based questionnaire data of 268 physicians (mean age 40.9, SD 12.3 y; n=150, 56% women) in Germany were analyzed. Physicians rated their chronic stress level and 11 relevant working conditions (ie, work stressors such as time pressure and work resources such as influence on sequence) both before and after either a fictional or real implementation of a relevant digital transformation at their workplace. In addition, a subsample of individuals (60; n=33, 55% women) submitted self-collected hair samples for cortisol analysis. RESULTS: The stress relevance of the selected working conditions was confirmed by significant correlations with self-rated chronic stress and hair cortisol levels (hair F) within the sample, all of them in the expected direction (P values between .01 and <.001). Multilevel modeling revealed significant differences associated with digital transformation in the rating of 8 (73%) out of 11 working conditions. More precisely, digital transformation was associated with potentially stress-enhancing effects in 6 working conditions (ie, influence on procedures and complexity of tasks) and stress-reducing effects in 2 other working conditions (ie, perceived workload and time pressure). Younger individuals, women, and individuals whose workplaces have implemented digital innovations tended to perceive digitalization-related differences in working conditions as rather stress-reducing. CONCLUSIONS: Our study lays the foundation for future hypothesis-based longitudinal research by identifying those working conditions that are stress relevant for physicians and prone to differ as a function of digital transformation and individual characteristics.

Work stressors, work-family conflict, parents' depressive symptoms and perceived parental concern for their children's mental health during COVID-19 in Canada: a cross-sectional analysis.

BACKGROUND: Work-related stressors and work-family conflict are important social determinants of mental health. While the impact of these stressors on parents' mental health is well documented, we know comparatively less about their impact on children's mental health. Furthermore, though the COVID-19 pandemic has significantly altered these stressors, particularly with the increase in teleworking, major knowledge gaps persist regarding the association between parents' stressors and perceived parental concern for their children's mental health during the COVID-19 pandemic. Based on the stress contagion perspective, this study tests (1) the mediating role of parents' depressive symptoms with parental concern for their children's mental health, and (2) whether these associations vary depending on whether parents had the opportunity to engage in telework. METHODS: A path analysis was performed from a cross-sectional analytic sample of 780 employed parents in the province of Quebec (Canada). The same model was then stratified by teleworking opportunity. The model's indirect associations were obtained by the bootstrap bias-corrected method with 1,000 replications. RESULTS: The results show that the stressors of work-to-family conflict, increased difficulties in work-family balance since the COVID-19 pandemic, irregular schedules, low esteem derived from work, and job insecurity were all indirectly associated with an increase in parental concern for their children's mental health through increased parents' depressive symptoms. However, some associations differ depending on teleworking status. The indirect associations involving increased difficulties in work-family balance since the COVID-19 pandemic as well as irregular work schedules were observed only in the teleworking group. CONCLUSIONS: This study fills a gap in research on the association between the work-family interface and parental concern for their children's mental health during the COVID-19 pandemic. It highlights the importance of concerted and cohesive action between child health policies and those regarding work and work-family balance to prevent work-related psychosocial risks, particularly considering the post pandemic expanded and persistent reliance on teleworking.

Vocal-Stress Diary: A Longitudinal Investigation of the Association of Everyday Work Stressors and Human Voice Features.

The human voice conveys plenty of information about the speaker. A prevalent assumption is that stress-related changes in the human body affect speech production, thus affecting voice features. This suggests that voice data may be an easy-to-capture measure of everyday stress levels and can thus serve as a warning signal of stress-related health consequences. However, previous research is limited (i.e., has induced stress only through artificial tasks or has investigated only short-term or extreme stressors), leaving it open whether everyday work stressors are associated with voice features. Thus, our participants (111 adult working individuals) took part in a 1-week diary study (Sunday until Sunday), in which they provided voice messages and self-report data on daily work stressors. Results showed that work stressors were associated with voice features such as increased speech rate and voice intensity. We discuss theoretical, practical, and ethical implications regarding the voice as an indicator of psychological states.

Investigation of psychosocial factors on upper limb musculoskeletal disorders and the prevalence of its musculoskeletal disorders among nurses: a systematic review and meta-analysis.

OBJECTIVE: Musculoskeletal disorders are one of the most important occupational problems especially among nurses. The aim of this study was to investigate the prevalence of musculoskeletal disorders in upper limbs and its associated psychosocial factors in the workplace. METHODS: A systematic review was conducted by searching the Medline/PubMed, EMBASE, Scopus, ISI/web of knowledge and Google Scholar databases. The authors classified studies into categories of psychological work stressors and musculoskeletal problems. The statistical analysis was performed using Stata software. RESULTS: We found 1742 articles in our initial search. After reviewing the titles, abstracts and full texts, 66 articles were finally analyzed. Psychosocial factors affecting the prevalence of upper limb musculoskeletal disorders among nurses were identified which included boring work, inadequate staffing, job demands, insufficient support, time pressure, decision latitude, job dissatisfaction, and job stress. There was a significant relationship between these factors and prevalence of musculoskeletal disorders in the wrists, shoulders, neck and shoulders, and wrists and hands. CONCLUSION: Collectively, the results of this study provide strong evidence of some psychosocial factors affecting the prevalence of upper limb musculoskeletal disorders among nurses. Thus, organizational interventions to minimize these stressors may be promising in reducing one risk factor for the development of nurses' musculoskeletal disorders. These interventions should not only consider the factors of physical ergonomics but also seek to improve the organizational aspects of the workplace.

Work stress on rise? Comparative analysis of trends in work stressors using the European working conditions survey.

OBJECTIVE: The rapid transformation of labor markets has been accompanied by the belief of rising stress at work. However, empirical evidence on such trends based on reliable survey data is scarce. This study analyzes long-term trends in well-established measures of work stressors across Europe, as well as potential occupational differences. METHODS: We use repeated cross-sectional data of 15 European countries from waves 1995, 2000, 2005, 2010, and 2015 of the European Working Conditions Surveys. We apply three-way multilevel regressions (with employees nested in country-years, which are in turn nested in countries) to analyze trends in work stressors measured according to the demand-control and effort-reward imbalance models. Trends by occupational groups are also assessed. RESULTS: Our findings suggest that work stress generally increased from 1995 to 2015, and that the increase was mostly driven by psychological demands. People working in lower-skilled occupations had generally higher levels of job strain and effort-reward imbalance, as well as they tend to have a steeper increase in job strain than people working in higher-skilled occupations. Most of the change occurred from 1995 to 2005. CONCLUSION: Our results indicate that work stress has been on rise since 1995, specifically for people working in disadvantageous occupations. This directs the attention to the vulnerable position of the least skilled and also to the use of preventive measures to counteract some of the disadvantages experienced by this occupational group.

Associations between change in labour market policies and work stressors: a comparative longitudinal survey data analysis from 27 European countries.

BACKGROUND: Many studies have shown that work stressors have a negative impact on health. It is therefore important to gain an understanding of how work stressors can be reduced. Recent studies have shown that employees in countries with high investments into labour market policies less often report exposure to work stressors. Although these studies are indicative of an influence of the political level on work stressors, they are based on cross-sectional cross-country analyses where causal assumptions are problematic. The aim of this study is to extend the existing evidence by longitudinally testing whether changes in labour market policies are related to changes in work stressors. METHODS: We used comparative longitudinal survey data from the European Working Conditions Survey (27 countries; for the years 2005, 2010, 2015). The measurement of work stressors is based on two established work stress models: effort-reward imbalance (ERI) and job demand-control (job strain). To measure labour market policies, we used information on active (ALMP) and passive labour market policies (PLMP). After excluding persons with missing data, 64,659 participants were eligible for the ERI and 67,114 for job strain analyses. Estimation results are provided by three-way multilevel models (individuals, country-years, country), which allow us to estimate longitudinal and cross-country macro-effects. RESULTS: An increase in ALMP leads to a decrease of ERI. The analyses for the subcomponents 'effort' and 'reward' showed that mainly the 'reward' component is positively associated with ALMP. The association between ALMP and 'reward' shows that an increase in ALMP investments is related to an increase in rewards. Yet, no significant longitudinal associations between ALMP and job strain, and between PLMP and the work stressors, were observed. CONCLUSIONS: The study extends the current knowledge with longitudinal information by showing that an increase in ALMP is associated with an increase in rewards and a decrease of ERI. These longitudinal analyses may support a causal interpretation. The findings of this study have important policy implications. Our main result suggests that investments into ALMP can lead to better working conditions.

Hair cortisol in relation to job stress and depressive symptoms.

BACKGROUND: Measurement of hair cortisol concentration (HCC) may be used as a biomarker for chronic stress. However, the association between stress and HCC has rarely been investigated in a working population. AIMS: To explore associations between (i) HCC and various stress measures and (ii) HCC and symptoms of depression in Belgian workers. METHODS: Hair samples were collected from workers in two production companies and cortisol content was determined by liquid chromatography tandem mass spectrometry. Participants completed a questionnaire including socio-demographics, health behaviours and standardized measures for assessing stress. RESULTS: After excluding those workers suffering from a psychiatric or neuroendocrine disease and those treated with glucocorticoids, there were a total of 102 workers with both questionnaire, cortisol results and anthropometric measures. Median HCC was 5.73 pg/mg hair (interquartile range = 4.52-9.06). No significant associations were found between cortisol and the standardized measures related to several work psychosocial risk factors. A significantly lower mean HCC was found in shift workers compared with dayworkers, adjusted for age. Additionally, a significant higher mean HCC was found in workers with symptoms of depression compared with those without symptoms of depression, after adjustment for age. CONCLUSIONS: HCC showed a limited applicability as a biomarker for job stress in this sample, although the results suggest this method may be a suitable marker for detecting early symptoms of depression. Further research is needed to investigate the applicability of HCC in the working environment and within job stress research.

Level of economic development of the country of origin and work-to-family conflict after migration to Canada.

Using a sample of employed adults living in Canada, this article examines patterns and antecedents of work-to-family conflict (WFC) among immigrants, relative to the native-born. We test whether the origin-country- or intermediary country of residence- country-level economic development, and length of residence in Canada interact to affect WFC differentially for immigrants. We hypothesize that origin-country economic development impacts the value and transferability of immigrants' capital in the host country. Discrepancies between the two results in underemployment, stressful work experiences, and thus greater WFC for immigrants, relative to the native-born. Results indicate greater WFC among recent and established immigrants from less developed countries and among established immigrants from developed countries. This finding, however, is conditioned by gender and particularly strong among established immigrant men from less developed countries, compared to their female counterparts.

Does office space occupation matter? The role of the number of persons per enclosed office space, psychosocial work characteristics, and environmental satisfaction in the physical and mental health of employees.

The study examined the effects of office space occupation, psychosocial work characteristics, and environmental satisfaction on physical and mental health of office workers in small-sized and open-plan offices as well as possible underlying mechanisms. Office space occupation was characterized as number of persons per one enclosed office space. A total of 207 office employees with similar jobs in offices with different space occupation were surveyed regarding their work situation (psychosocial work characteristics, satisfaction with privacy, acoustics, and control) and health (psychosomatic complaints, irritation, mental well-being, and work ability). Binary logistic and linear regression analyses as well as bootstrapped mediation analyses were used to determine associations and underlying mechanisms. Employee health was significantly associated with all work characteristics. Psychosocial work stressors had the strongest relation to physical and mental health (OR range: 1.66-3.72). The effect of office space occupation on employee health was mediated by stressors and environmental satisfaction, but not by psychosocial work resources. As assumed by sociotechnical approaches, a higher number of persons per enclosed office space was associated with adverse health effects. However, the strongest associations were found with psychosocial work stressors. When revising office design, a holistic approach to work (re)design is needed.

The connection between illness representations of Alzheimer's disease and burnout among social workers and nurses in nursing homes and hospitals: a mixed-methods investigation.

OBJECTIVE: To examine the relationship between Alzheimer's disease (AD) illness representations and burnout among social workers and nurses, based on the self-regulatory model. METHOD: A mixed-methods study was conducted. First, 327 social workers and nurses completed measures of cognitive and emotional representations, burnout (emotional exhaustion, depersonalization, lack of personal accomplishment), role variables, knowledge about AD, emotion-focused coping, problem-focused coping, and demographic and occupational characteristics. Second, interviews were conducted with eight social workers and nurses to uncover their perceptions about AD and their burnout experience. RESULTS: Using structural equation modeling and controlling background variables, findings indicated that emotional representations were associated with burnout while only some of the cognitive illness representations were associated with burnout. While cognitive illness representations were associated directly to burnout, the association between emotional representations and burnout was mediated by emotion-focused coping. The trimmed model showed a good fit of the data and explained 32.2% of the variance in emotion-focused coping, 51% of the variance in emotional exhaustion, 37.7% of the variance in depersonalization, and 22.6% of the variance in lack of personal accomplishment. Interviews demonstrated that AD characteristics were perceived as affecting participants on both personal and professional levels; the participants expressed negative feelings towards AD and stated that these perceptions and feelings had led them to burnout. CONCLUSIONS: AD illness representations may be a risk factor for developing burnout. New directions for intervention programs, aiming to reduce burnout, should be examined.

Mindfulness-based stress reduction for managers: a randomized controlled study.

BACKGROUND: Mindfulness-based stress reduction (MBSR), which was initially used in clinical settings, has also proved to be an effective tool for managing work-related stress in occupational groups inherently exposed to certain psychosocial risks. AIMS: To examine the potential for work-related stress management using MBSR for middle-level managers who are considered to be particularly affected by the negative effects of stress related to organizational restructuring. METHODS: Middle-level managers participated in a randomized controlled study which implemented a 2 (experimental versus control group) × 2 (baseline, post-treatment) study design, yielding a between-group comparison. The participants were randomly assigned to an 8-week intervention group or to a wait-list control group. RESULTS: The results showed that, relative to the control group, the MBSR intervention had significant effects on several outcomes in the 144 subjects, including: decreases in perceived work-related stress (F(1,140) = 20.4, P < 0.001, ddiff = 0.72), negative affect (F(1,140) = 45.3, P < 0.001, ddiff = 0.93), intensity of somatic complaints (F(1,140) = 20.7, P < 0.001, ddiff = 0.69), and sickness absence (F(1,140) = 67.3, P < 0.001, ddiff = 0.69), and increase in self-esteem (F(1,140) = 44.1, P < 0.001, ddiff = 1.25), and positive affect (F(1,140) = 6.73, P < 0.01, ddiff = 0.43). No effects were found on frequency of somatic complaints. CONCLUSIONS: These results suggest that MBSR is an effective method for managing work-related stress and bolstering psychological resilience in the workplace, particularly in the face of psychosocial risks of a global, economic nature.

Depressive symptoms and psychosocial aspects of work in bank employees.

BACKGROUND: The financial sector has seen an increase in the number of cases of violence and stress, which can result in adverse health outcomes, including depressive symptoms, but studies related to stress at work and depression for these workers are scarce. AIMS: To investigate the association between exposure to psychosocial work stressors and depressive symptoms in bank employees. METHODS: A self-administered questionnaire was completed by a sample of bank employees in Pará and Amapá, Brazil. The survey assessed sociodemographic characteristics, mental health (Patient Health Questionnaire-9), Demand-Control-Support and Effort-Reward Imbalance (ERI). Outcomes included two levels of depressive symptoms: major depressive symptoms (MDS) and other forms of depressive symptoms (ODS). Logistic regression models were used to estimate associations between depressive symptoms, the two job stress models and relevant covariates. RESULTS: Of 2806 eligible subjects, there were 1445 respondents (52% response rate) and the final analyses included 1046 participants. The overall prevalence of depressive symptoms was 32% (MDS = 18%; ODS = 14%), with no statistically significant difference between men and women. High demands, low levels of control and low social support were associated with MDS and/or ODS, adjusted for gender, age and other work-related conditions. High effort/low reward, over-commitment and ERI were also associated with MDS and ODS. CONCLUSIONS: Psychosocial conditions in banking activity involving high strain, low social support at work, high effort with low reward and over-commitment may represent possible risk factors for depressive symptoms in bank employees.

Examining the sources of occupational stress in an emergency department.

BACKGROUND: Previous work has established that health care staff, in particular emergency department (ED) personnel, experience significant occupational stress but the underlying stressors have not been well quantified. Such data inform interventions that can reduce cases of occupational mental illness, burnout, staff turnover and early retirement associated with cumulative stress. AIMS: To develop, implement and evaluate a questionnaire examining the origins of occupational stress in the ED. METHODS: A questionnaire co-designed by an occupational health practitioner and ED management administered to nursing, medical and support staff in the ED of a large English teaching hospital in 2015. The questionnaire assessed participants' demographic characteristics and perceptions of stress across three dimensions (demand-control-support, effort-reward and organizational justice). Work-related stressors in ED staff were compared with those of an unmatched control group from the acute ear, nose and throat (ENT) and neurology directorate. RESULTS: A total of 104 (59%) ED staff returned questionnaires compared to 72 staff (67%) from the acute ENT/neurology directorate. The ED respondents indicated lower levels of job autonomy, management support and involvement in organizational change, but not work demand. High levels of effort-reward imbalance and organizational injustice were reported by both groups. CONCLUSIONS: Our findings suggest that internal ED interventions to improve workers' job control, increase support from management and involvement in organizational change may reduce work stress. The high levels of effort-reward imbalance and organizational injustice reported by both groups may indicate that wider interventions beyond the ED are also needed to address these issues.

Coping patterns in special school staff: demographic and organizational factors.

BACKGROUND: Teachers' mental health is commonly discussed in organizational health studies, but studies in special schools are rare. Work-related coping and experience patterns (WCEPs) have been shown to be associated with mental health and intentions to leave. The influence of organizational factors on coping patterns has not been examined. AIMS: To assess the distribution of WCEPs in special school staff and to identify potential influencing factors. METHODS: We surveyed a sample of teachers and educational staff in 13 German special schools using the WCEP questionnaire and COPSOQ (Copenhagen Psychosocial Questionnaire). RESULTS: Of 245 teachers and 417 educational staff contacted, 114 teachers (47%) and 252 educational staff (60%) responded, an overall response rate of 55% (366/662). Coping patterns of special school staff were classified as unambitious (30%), excessively ambitious (7%), resigned (17%), healthy-ambitious (12%) or unclassifiable (34%). Furthermore we found several significant relations with demographic and organizational factors. For example, the resigned pattern is associated with age [Exp(B) 1.12; 95% CI 1.05-1.19], emotional demands [Exp(B) 1.07; 95% CI 1.01-1.12], work-family conflict [Exp(B) 1.07; 95% CI 1.03-1.10] and bullying [Exp(B) 1.04; 95% CI 1.00-1.08]. CONCLUSIONS: Since emotional and social factors are associated with risky (excessively ambitious or resigned) and unambitious coping patterns in special school teachers and educational staff, interventions should focus on them. Further research could explore causal relations and observe the development of coping styles over time.

Emergency medicine resident well-being: stress and satisfaction.

BACKGROUND: Emergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress. AIMS: To evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms. METHODS: An online survey instrument was developed to gauge resident stress, satisfaction with current lifestyle, stress coping mechanisms and demographics. A stratified random sample of EM residents from three postgraduate years (PGY-I, PGY-II and PGY-III) was obtained. Descriptive statistics and one-way analysis of variance were used to compare residents across PGY level. RESULTS: There were 120 potential participants in each of the three PGYs. The overall response rate was 30% (109) with mean age of 30 and 61% were male. On a 0-4 scale (0 = completely dissatisfied), respondents in PGY-I reported significantly less satisfaction with lifestyle than those in PGY-II and III (mean rating: 1.29, 1.66 and 1.70, respectively; P < 0.001). There were no significant differences in mean ratings between PGYs on each of the other stress categories: work relationships (1.37), work environment (1.10) and response to patients (1.08). Residents reported exercise (94%), hobbies (89%) and use of alcohol (71%) as coping methods. CONCLUSIONS: Residents reported low satisfaction with current lifestyle. This dissatisfaction was unrelated to perceived work-related stress. Some undesirable coping methods were prevalent, suggesting that training programs could focus on promotion of healthy group activities.

Persistent low job control and subsequent major depression: A prospective cohort study of Australian working males.

Workers' perception of control over work is a key construct in the relationship between the psychosocial work environment and health. While exposure to low job control has been prospectively linked to poor mental health including depression and anxiety, there is less research examining the impact of prolonged exposure to low job control on mental health. Data from 5054 employed men from 2013 to 2021 in the Australian Longitudinal Study on Male Health was used to examine persistent and intermittent low job control and subsequent major depression symptoms. Persistent low job control was based on consecutive self-reports of low job control over waves 1 and 2. Combinations of low and high job control were classified as intermittent exposure and continuous high job control exposure over both waves was classified as persistent high job control. Major depression symptoms, derived from the Patient Health Questionnaire-9, was measured in wave 3. Generalised linear models and augmented inverse probability weighting were undertaken. There was a strong stepwise relationship between low job control and major depression. Compared to persistent high job control, intermittent low job control was associated with an increased risk of subsequent major depression symptoms by 32% (RR 1.32, 95% CI 0.82, 2.15); and persistent low job control by 103% (RR 2.03, 95% CI 1.21, 3.41). Compared to men exposed to persistent high job control, the average treatment effect for persistent low job control was 0.036 (95%CI 0.014, 0.058) and intermittent low job control 0.019 (95%CI 0.006, 0.032) equating to a risk ratio of 2.46 (95%CI 1.43, 3.50) and 1.79 (95% CI 1.14, 2.45) respectively. This study's findings have implications for public health and occupational policies, as they underscore the importance of reducing prolonged exposure to low job control to protect against the risk of major depression in the working population.

Psychosocial working conditions and cognitive and physical impairment in older age.

BACKGROUND: Psychosocial working conditions are associated with cognitive and physical impairments. The aim of this study was to investigate the associations between mid-late life psychosocial working conditions and the combination of physical and cognitive impairment among older adults, and the potential sex differences in these associations. METHODS: Data were derived from two Swedish nationally representative surveys (n = 839; follow-up: 20-24 years). Multinomial and binary logistic regressions assessed the associations between work stressors (job demand-control model), and a combination of cognitive and physical impairment. RESULTS: Low control jobs were significantly associated with higher odds of cognitive (OR: 1.41, CI: 1.15-1.72) and physical impairment (OR: 1.23, CI: 1.02-1.47), and cognitive and physical impairment combined (OR: 1.50, CI: 1.19-1.89). Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment (OR: 1.57, CI: 1.12-2.20), and combined cognitive and physical impairment (OR: 1.59, CI: 1.07-2.36). Active jobs (high control, high demand) were associated with lower odds of cognitive impairment (OR: 0.48, CI: 0.29-0.80). Sex-stratified analyses showed stronger associations among men; passive jobs were associated with both cognitive (OR: 2.18, CI: 1.31-3.63) and physical impairment (OR: 1.78, CI: 1.13-2.81), while low strain jobs were associated with less physical impairment (OR: 0.55, CI: 0.33-0.89). No significant associations between work stressors and impairment were found for women. CONCLUSIONS: These results highlight the importance of psychosocial working conditions for late-life physical and cognitive impairment, especially among men. Jobs characterised by low control and low demands are associated with higher risk for impairments.

Associations of COVID-19 Related Work Stressors with Psychological Distress: Racial and Ethnic Disparities in Californian Workers.

The COVID-19 pandemic continues to exert immense societal impacts, with recent data showing inequitable distribution of consequences among racial and ethnic groups. The objective of this study was to assess associations between COVID-related work stressors and psychological distress, with special emphasis on differences by race and ethnicity. Data were from the population-based California Health Interview Survey (CHIS) 2020. Associations of individual and cumulative work stressors, including job loss, reduced work hours, and working from home, with psychological distress in 12,113 workers were examined via multivariable linear regression, and stratified analyses were conducted for racial and ethnic subgroups. After adjustment for covariates, compared to workers with no work stressors, those who experienced either one or two/more work stressors had higher psychological distress (ßs and 95% CIs were 0.80 [0.51, 1.09] and 1.98 [1.41, 2.56], respectively). Notably, experiencing cumulative (two/more) work stressors had much stronger effects on psychological distress among participants who were Black (ß and 95% CI were 3.51 [1.09, 5.93]) or racial minorities (ß and 95% CI were 3.57 [1.10, 6.05]). Occupational consequences of the COVID-19 pandemic were associated with increased psychological distress in Californian workers and inequitably distributed, with racial and ethnic minorities suffering the greatest burden.

Life insurance salespeople linking work stressors to proactive behaviors by passion: Servant leadership as a moderator.

As the main sales force of life insurance companies, salespeople have accounted for more than 50% of life insurance sales channels over the years, playing a pivotal role in the development of the industry. Since the adoption of the model of employment at an agency, the commission income of life insurance salespeople has largely relied on their sales volume, which requires employee proactivity under a great number of stressors. However, because previous studies have analyzed stressors in a single dimension, our understanding of the relationship between work stressors and proactive behaviors remains limited. Applying self-determination theory, we investigated differential relationships between challenge/hindrance stressors and proactive behaviors, which were expected to be mediated by passion and moderated by servant leadership. In the sample of 332 insurance salespeople, there was a positive (negative) relationship between challenge (hindrance) stressors and proactive behaviors. In addition, passion mediated the relationship between stressors and proactive behaviors, and servant leadership moderated the relationship between stressors and passion. Theoretical and practical implications are discussed.

A study on the correlation between work stressors and the coping styles of outpatients and emergency nurses in 29 pediatric specialty hospitals across China.

Objective: This study aimed to better understand the current situation involving work stressors and the coping styles of outpatient and emergency nurses in 29 pediatric specialty hospitals across China. The study analyzed this correlation to provide a reference for the occupational stress management of pediatric nurses. Methods: From June to September 2020, 1,457 outpatient and emergency nurses in 29 pediatric specialty hospitals across China were selected as study participants, and a questionnaire survey was conducted using the Basic Information Questionnaire, the Chinese version of the Work Stressor Scale for Nurses, and the Simple Coping Style Scale. Results: The assessed stress level of outpatient and emergency nurses in 29 tertiary pediatric specialty hospitals nationwide is lower than the results of the survey of the 2007 domestic norm, p < 0.05. The stressors related to nurses' expectations, family conflicts, the nature of nursing work, patient factors, and workload were lower compared with the national norm (p < 0.05). The positive coping style score on the Simple Coping Style Scale for pediatric outpatient nurses was (36.66 ± 6.16), and work stressors were positively associated with negative coping styles (p < 0.01). Multiple regression analysis showed that the influencing factors of work stressors among pediatric outpatient and emergency nurses correlated with the authorized size, age, working years of nurses, work department, and negative coping styles. Conclusion: Negative coping styles were present among pediatric outpatient and emergency nurses and were associated with work stressors. The influencing factors of stressors mainly correlated with the clinical establishment, age, years of employment as a nurse, work department, and negative coping styles.