The dynamic interplay of physical and psychosocial safety climates in frontline healthcare

Psychosocial factors, psychological well-being and safety incidents among long-distance bus drivers in Ghana: A cross-sectional survey

BACKGROUND

Commercial bus drivers account for most road traffic crashes and related mortality. The psychosocial working conditions of these drivers have been found precarious. However, road safety initiatives in Ghana still focus on correcting risky driving behaviours, ignoring the conditions under which these drivers operate. Hence, the purpose of this study was to examine whether psychosocial work factors can predict the psychological well-being and risky driving behaviours of long-distance bus drivers in Ghana.

METHODS

This quantitative cross-sectional survey recruited 7315 long-distance bus drivers that operate from Accra to other parts of Ghana and cities in other West African countries. Hypotheses were tested using Partial Least Squares Structural Equation Modelling (PLS-SEM).

RESULTS

We found that job demands and job resources are direct and significant predictors of psychological well-being and safety incidents among these drivers. Moreover, psychological well-being of the drivers had a significant inverse relationship with their safety incidents. Psychosocial safety climate (PSC) had a negative association with safety incidents, and a positive but non-significant association with psychological well-being. PSC had a negative and significant association with job resources contrary to the notion of the PSC theory.

CONCLUSION

Psychosocial work factors are predictors of psychological well-being and safety incidents of long-distance bus drivers. Owners and managers of bus transport businesses in Ghana, driver unions and station masters need to highly prioritise psychological health and safety of this bus drivers by providing suitable job resources and adopting bottom-up communication that might help the drivers effectively cope with their job demands.

Musculoskeletal pain among medical residents: role of workplace safety climate and sexual harassment

BACKGROUND

Workplace factors are important predictors of occurrence of musculoskeletal pain among different occupational populations. In healthcare, a psychologically unsafe work environment can negatively affect the emotional, physical and psychological well-being of physicians. This study aimed to examine the relationship between workplace violence, sexual harassment and musculoskeletal pain among Egyptian physicians in their years of residency.

METHODS

We distributed an online self-administered questionnaire to 101 residents working in various healthcare sectors in Egypt. It included sections on demographic data, working conditions, widespread pain index (WPI), pain interference short-form, workplace violence and harassment questionnaire, psychosocial safety climate questionnaire (PSC) and sexual harassment climate questionnaire.

RESULTS

All residents had at least one painful site on the WPI (range 1-11). The mean WPI was 3.5 ± 2.4, and 39.6% satisfied the criteria of having widespread pain by having at least 4 pain sites. Widespread pain index showed a weak statistically significant negative correlation with workplace PSC score (rho = - 0.272, p = 0.006), and a statistically significant weak positive correlation with the calculated total abuse index (rho = 0.305, p = 0.002). Workplace violence and abuse, as measured by a calculated abuse index was the only significant predictors of widespread pain among residents.

CONCLUSION

WPV was found to be a predictor of musculoskeletal pain among medical residents. Healthcare organizations need to address WPV by employing preventive strategies to minimize its hazardous effects and ensure a safe working environment for physicians.

Psychosocial safety climate (PSC) and working conditions, predictors of mental health and antidepressant and opioid use in Australia: a study protocol for longitudinal data linkage

INTRODUCTION

Work-related stress is a social determinant of global health that represents a huge cost to workers' health and reduces work performance. In Australia, mental well-being is a pressing national issue-with one in five Australians experiencing mental disorders. Antidepressants are a first-line medication commonly used to treat mental disorders. Recently, Australia has seen a dramatic increase in the use of prescribed antidepressant medications to treat mental health related illnesses. Australia has also seen a dramatic increase in the use of prescribed opioid analgesics for non-cancer pain including opioid use for psychological distress and social stressors. It is plausible a rise in mental health problems and antidepressant and opioid medication use is partly attributable to the corporate climate for worker mental health (ie, the psychosocial safety climate, PSC). This research aims to identify how PSC and workplace conditions contribute to employee well-being and distress that culminate in antidepressant and opioid medication use.

METHODS/ANALYSIS

Data will be collected through creative data linkage from the Australian Workplace Barometer (AWB), to medication data (via the Pharmaceutical Benefits Scheme, PBS). The participant sample will include 1372 working Australians from the AWB project from 2009 to 2021. Four waves of longitudinal data from 2009 to 2021 will be used to investigate the plausible link between Australia's high levels of antidepressant and opioid use and distress at work. The project advances theory by probing the role corporate climate plays in work design, distress, mental health problems and antidepressant and opioid use. It will determine if antidepressant and opioid use has led to an underestimation of work stress effects. Proposed theoretical models will be analysed through linked data, using continuous time structural equation modelling, hierarchical linear modelling, logistic regression and cost estimation.

ETHICS AND DISSEMINATION

The study has been approved by the Human Research Ethics Committee of the University of South Australia (Ethics Protocol: 203003). Further, approval from the Australian Institute of Health and Welfare Ethics Committee was also granted for linkage of AWB data and PBS data (EthOS Application EO2022/1/1190).Results of the study will be disseminated through worldwide keynotes, key international settings, high-impact peer-reviewed journals, industry conference presentations and media outlets to reach managers, workers, and industry partners. Further, UniSA requires publications from public projects to be held in an institutional repository which fulfils the Australian Research Council's Open Access Policy.

Influence of psychosocial safety climate on occupational health and safety: a scoping review

BACKGROUND

Creating a healthy, decent and safe workplace and designing quality jobs are ways to eliminate precarious work in organisations and industries. This review aimed at mapping evidence on how psychosocial safety climate (PSC) influence health, safety and performance of workers.

METHODS

A literature search was conducted in four main databases (PubMed, Scopus, Central and Web of Science) and other online sources like Google Scholar. A reference list of eligible studies was also checked for additional papers. Only full-text peer-reviewed papers published in English were eligible for this review.

RESULTS

A search in the databases produced 13,711 records, and through a rigorous screening process, 93 papers were included in this review. PSC is found to directly affect job demands, job insecurity, effort-reward imbalance, work-family conflict, job resources, job control and quality leadership. Moreover, PSC directly affects social relations at work, including workplace abuse, violence, discrimination and harassment. Again, PSC has a direct effect on health, safety and performance outcomes because it moderates the impact of excessive job demands on workers' health and safety. Finally, PSC boosts job resources' effect on improving workers' well-being, safety and performance.

CONCLUSION

Managers' efforts directed towards designing quality jobs, prioritising the well-being of workers, and fostering a bottom-up communication through robust organisational policies, practices, and procedures may help create a high organisational PSC that, in turn, promotes a healthy and decent work environment.

Developing a model for predicting safety performance of nurses based on psychosocial safety climate and role of job demands and resources, job satisfaction, and emotional exhaustion as mediators

BACKGROUND

The present study aimed to develop a model for predicting the safety performance of nurses based on psychosocial safety climate (PSC) and the role of job demands and resources, job satisfaction, and emotional exhaustion as mediators.

METHODS

A cross-sectional study using structural equation modeling (SEM) was carried out among nurses in Iran. Data were collected using the Psychosocial Safety Climate questionnaire, Neal and Griffin's Safety Performance Scale, the Management Standards Indicator Tool, the Effort-Reward Imbalance questionnaire, the Michigan Organizational Assessment Job Satisfaction subscale and the Maslach Burnout Inventory.

RESULTS

Surveys were distributed to 340 nurses provided informed consent. After removing incplete surveys, data from 280 partipants were analysed. The completion rate was 82.35%. The SEM results indicated that PSC can directly and indirectly predict nurses' safety performance. The final model showed an acceptable goodness of fit (p = 0.023). It indicated that PSC, job demands, and job satisfaction were directly related to safety performance, and also that PSC, emotional exhaustion, job resources, and job demands were all indirectly related to safety performance. Also, PSC had a significant relationship with all mediator variables, and job demands had direct effect on emotional exhaustion.

CONCLUSIONS

The current study presented a new model for predicting safety performance in nurses in which PSC, both directly and indirectly, plays an important role. In addition to paying attention to the physical aspects of the workplace, healthcare organizations should also take into account PSC to improve safety. Next steps in reducing safety issues in nursing is to develop intervention studies using this new evidence-based model as a framework.

The association between patient safety culture and adverse events - a scoping review

BACKGROUND

Adverse events (AEs) affect 10% of in-hospital patients, causing increased costs, injuries, disability and mortality. Patient safety culture (PSC) is an indicator of quality in healthcare services and is thus perceived as a proxy for the quality of care. Previous studies show variation in the association between PSC scores and AE rates. The main objective of this scoping review is to summarise the evidence on the association between PSC scores and AE rates in healthcare services. In addition, map the characteristics and the applied research methodology in the included studies, and study the strengths and limitations of the evidence.

METHODS

We applied a scoping review methodology to answer the broad research questions of this study, following the PRISMA-ScR checklist. A systematic search in seven databases was conducted in January 2022. The records were screened independently against eligibility criteria using Rayyan software, and the extracted data were collated in a charting form. Descriptive representations and tables display the systematic mapping of the literature.

RESULTS

We included 34 out of 1,743 screened articles. The mapping demonstrated a statistical association in 76% of the studies, where increased PSC scores were associated with reduced AE rates. Most of the studies had a multicentre design and were conducted in-hospital in high-income countries. The methodological approaches to measuring the association varied, including missing reports on the tools` validation and participants, different medical specialties, and work unit level of measurements. In addition, the review identified a lack of eligible studies for meta-analysis and synthesis and demonstrated a need for an in-depth understanding of the association, including context complexity.

CONCLUSIONS

We found that the vast majority of studies report reduced AE rates when PSC scores increase. This review demonstrates a lack of studies from primary care and low- and- middle-income countries. There is a discrepancy in utilised concepts and methodology, hence there is a need for a broader understanding of the concepts and the contextual factors, and more uniform methodology. Longitudinal prospective studies with higher quality can enhance efforts to improve patient safety.

Psychosocial safety climate (PSC) at middle management level in the healthcare sector: A contribution to the Italian validation of psychosocial safety climate-4

Introduction

Psychosocial safety climate (PSC) refers to workers' shared perceptions of organizational policies, practices and procedures for the protection of psychological health and safety. PSC offers a multilevel organizational approach that expands traditional models of workplace stress, giving a more comprehensive understanding of occupational health and safety issues. Although considerable research on psychosocial risks in the healthcare sector has been conducted, few studies have explored the role of PSC among healthcare workers at middle management level. Additionally, no validated version of PSC is available in Italian language. The aim of this study is to contribute to the validation of the Italian 4-item version of the PSC and to explore this theory within the Job Demands-Resources model (JD-R) among a sample of Italian healthcare workers by testing PSC at the middle management level.

Methods

We used cross-sectional data from 276 employees working in 17 different wards in a large Italian hospital. Intra-class coefficient (ICC) coefficient and agreement index were used to test PSC as a climate construct (data nested to hospital ward level). We performed hierarchical linear models to test mediation and moderation effects.

Results

The Italian version of PSC-4 proved to have good psychometric properties and confirmed its role as a group-level construct (α = 0.84; ICC = 0.16). Multilevel random coefficient models showed PSC was associated with Job demands (Effort: B = -0.36, SE = 0.07; Emotional demands: B = -0.03, SE = 0.01) and Job resources (Reward: B = 1.16, SE = 0.01; Physical work environment: B = 0.06, SE = 0.01). Results confirmed the indirect effect of PSC on Psychological (Burnout) and Occupational health (Job satisfaction) outcomes supporting the role of Job resources and Job demands as mediators. The multilevel analysis did not find a significant interaction terms between PSC and Job demands on Burnout therefore the moderation hypothesis was not supported.

Discussion

The Italian version of PSC-4 is a valid tool to evaluate PSC. These findings sustain the multilevel framework of PSC and the significant role played by mid-leaders in both the health impairment and motivational path. Further studies should explore the buffering effect of PSC at higher baseline levels as well as the adoption of PSC as a target for occupational health intervention the Italian context.

The Effect of Psychosocial Safety Climate on Engagement and Psychological Distress: A Multilevel Study on the Healthcare Sector

All work sectors have been affected by the impact of the COVID-19 pandemic. The perception of risk combined with the lack of safety and fear for their own safety have caused severe psychological discomfort in workers. Of all the work sectors, the most affected was certainly the healthcare sector. In hospitals, medical staff were at the forefront of the battle against COVID-19, providing care in close physical proximity to patients and had a direct risk of being exposed to the virus. The main objective of the study was to investigate the perception of a psychosocial safety climate and the effect on engagement and psychological stress in a sample of 606 healthcare workers (physicians 39.6%, nurses 41.3%, healthcare assistant 19.1%), belonging to six organisations and organised into 11 working groups. Furthermore, we wanted to investigate the mediating effect of workaholism at both individual and group level. The results partially confirmed our hypotheses and the mediating effect at the individual level of working compulsively. A psychosocial safety climate in healthcare workers led to a decrease in engagement through the mediation of working compulsively. The mediating effect of working compulsively might be due to a climate that did not guarantee or preserve the psychological health and safety of healthcare workers. In this research, the most important limit concerns the number of organisations and the number of groups.

Bringing risk back in: managers' prioritization of the work environment during the pandemic

Purpose

The purpose of the paper is to investigate managers' experiences of managing work environment and risks during the Covid-19 pandemic and to explore how managers might use these experiences to develop future risk management.

Design/methodology/approach

Semi-structured interviews were carried out with 18 Swedish managers at different hierarchical levels working in 11 different organizations. A directed content analysis was carried out, informed by theory on risk management.

Findings

The results point to the pandemic as a societal crisis which workplaces needed to manage through large means of improvisation. Regular work environment routines were put to the test, and several deficiencies in the work environment and risk management were identified. Organizations that handle occupational safety and risks on a daily basis through established routines were less affected and could easier adjust work environment and risk management, compared to organizations prioritizing the social and organizational work environment, which had to re-prioritize and start paying more attention to the physical work environment and to bring risk management into their daily routines.

Originality/value

The study offers an account of how managers in different labor market sectors in Sweden have acted in the midst of the pandemic by handling real-time crises, how these experiences can be used for engaging in retrospective learning and how this may imply changes to their prospective risk management.

Work Engagement and Patient Quality of Care: A Meta-Analysis and Systematic Review

Past research has demonstrated that work engagement among health care professionals influences patient quality of care. There is, however, no estimate of the strength of this relationship, and existing reviews have not always explained conflicting findings. We conduct a meta-analysis and review of 25 articles, and find a small to medium mean effect size (r = .26, p < .01) for the positive association between engagement and quality of care. Moderator analyses on five factors (type, data source, level of analysis of the quality of care measure, profession, and work engagement measure) indicate that only data source is significant, providing preliminary evidence that the relationship is stronger if quality of care is measured via self-assessments. Although a more consistent conceptualization of quality of care is needed to better determine its association with work engagement, our findings suggest that work engagement is as important as burnout in predicting quality of care.

Does context count? The association between quality of care and job characteristics in residential aged care and hospital settings: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Within residential aged care settings, reduced quality of care (QOC), abuse, and neglect have been global phenomena which require urgent intervention. As the reported rate of these problems is much higher in aged care compared to hospital settings, we investigated whether differing job design characteristics between the two settings might explain the difference.

RESEARCH DESIGN AND METHODS

We used a meta-analysis to compare differences in the relationships between high job demands, low job resources, and job strain with QOC and counter-productive work behaviors (CWBs) across aged care and hospital settings.

RESULTS

Data was extracted from 42 studies (n=55 effects). QOC was negatively correlated with high job demands (ρ̅ =-.22, 95% CI: -.29:-.15, k=7), low job resources (ρ̅ = -.40, 95% CI:-.47:-.32, k=15), and job strain (ρ̅ =-.32, 95% CI: -.38:.-.25, k=22), CWBs had a positive relationship with job demands (ρ̅ =.35, 95%CI: .10:.59, k=3) and job strain (ρ̅ =.34, 95% CI: .13:.56, k=6). The association between poor QOC and low job resources was stronger in aged care (r=-.46, 95% CI:-.55:-36, k=8) than in hospital settings (r= -.30, 95% CI:-.41:-.18, k=7).

DISCUSSION AND IMPLICATIONS

Our findings suggest that relationships between low job resources and poor quality of care are exacerbated in residential aged care contexts. To improve care outcomes, stakeholders should improve job resources such as skill discretion, supervisory supports, and increased training and staffing levels in residential aged care.

Quantifying the Employer Burden of Persistent Musculoskeletal Pain at a Large Employer in the United Kingdom: A Non-interventional, Retrospective Study of Rolls-Royce Employee Data

OBJECTIVE

To quantify the burden of work-relevant persistent musculoskeletal (MSK) pain to a large UK employer.

METHODS

A retrospective, longitudinal, analytical cohort study using linked Rolls-Royce data systems. Cases were employees with a MSK-related referral to occupational health; controls were age-, sex-, and job role-matched employees without such a referral. Outcomes were compared during 12 months' follow-up.

RESULTS

Overall, 2382 matched case-control pairs were identified (mean age: 46 y; 82% male). Cases took 39,200 MSK-related sickness absence days in total (equating to £50 million in sickness absence costs). Cases took significantly more all-cause sickness absence days than controls (82,341 [£106 million] versus 19,628 [£26 million]; P < 0.0001).

CONCLUSIONS

Despite access to extensive occupational health services, the burden of work-relevant persistent MSK pain remains high in Rolls-Royce. There is a clear need to better understand how to effectively reduce this burden.

Determinants of Occupational Safety Culture in Hospitals and other Workplaces-Results from an Integrative Literature Review

Background: The aim of the present study was to obtain an overview of occupational safety culture by assessing and mapping determinants in different workplaces (hospital workplaces and workplaces in construction, manufacturing, and other industry sectors) using an already established theoretical framework with seven clusters developed by Cornelissen and colleagues. We further derived implications for further research on determinants of occupational safety culture for the hospital workplace by comparing the hospital workplace with other workplaces. Methods: We conducted an integrative literature review and searched systematically for studies in four research databases (PubMed, Web of Science, CINAHL, and PsycINFO). The search was undertaken in 2019, and updated in April 2020. Results of the included studies were analyzed and mapped to the seven clusters proposed by Cornelissen and colleagues. Results: After screening 5566 hits, 44 studies were included. Among these, 17 studies were conducted in hospital workplaces and 27 were performed in other workplaces. We identified various determinants of an occupational safety culture. Most studies in hospital and other workplaces included determinants referring to management and colleagues, to workplace characteristics and circumstances, and to employee characteristics. Only few determinants in the studies referred to other factors such as socio-economic factors or to content relating to climate and culture. Conclusions: The theoretical framework used was helpful in classifying various determinants from studies at different workplaces. By comparing and contrasting results of studies investigating determinants at the hospital workplace with those addressing other workplaces, it was possible to derive implications for further research, especially for the hospital sector. To date, many determinants for occupational safety culture known from workplaces outside of the healthcare system have not been addressed in studies covering hospital workplaces. For further studies in the hospital workplace, it may be promising to address determinants that have been less studied so far to gain a more comprehensive picture of important determinants of an occupational safety culture in the hospital sector.