A comparative study of organisational characteristics, work characteristics and nurses' psychological work reactions in a hospital and nursing home setting

Canine-Assisted Interventions in Hospitals: Best Practices for Maximizing Human and Canine Safety

Canine-assisted interventions (CAI) are becoming more popular in hospital settings, representing a crucial intersection between animals, veterinary medicine, and society. However, standardized policies and procedures to minimize risk and maximize benefit to vulnerable humans and protect therapy dog welfare are lacking, posing a challenge to safe practice. Few intervention programs are evaluated to document efficacy compounding the potential risk. This paper presents a rationale for CAI in hospitals and describes the evidence, issues, and challenges to establishing and maintaining safe and effective programs for humans and animals. Recommendations are made for best practices based on the existing scientific evidence and a model program in place in a major medical center for 19 years. Scientific and practical implications are considered.

Authentic leadership and job satisfaction among long-term care nurses

Purpose

The purpose of this study is to examine the effects of managers’ authentic leadership, person–job match in the six areas of worklife (AWLs) and emotional exhaustion on long-term care registered nurses’ job satisfaction.

Design/methodology/approach

A secondary analysis of baseline data from a national survey of 1,410 Canadian registered nurses from various work settings was used in this study, which yielded a subsample of 78 nurses working in direct care roles in long-term care settings. Hayes’ PROCESS macro for mediation analysis in SPSS was used to test the hypothesized model.

Findings

Findings showed that authentic leadership significantly predicted job satisfaction directly and indirectly through AWLs and emotional exhaustion.

Practical implications

Authentic leadership may provide guidance to long-term care managers about promoting nurses’ job satisfaction, which is essential to recruiting and retaining nurses to meet the care needs of an aging population.

Originality/value

As demand for care of the aged is increasing and creating challenges to ensuring a sufficient and sustainable nursing workforce, it is important to understand factors that promote long-term care nurses’ job satisfaction. Findings contribute to knowledge of long-term care nurses by suggesting that managers’ authentic leadership can positively affect nurses’ job satisfaction directly and indirectly through positive perceptions of AWLs and lower emotional exhaustion.

Determinants of hand hygiene compliance among nurses in US hospitals: A formative research study

Hand hygiene is the simplest and most effective measure for preventing healthcare-associated infections. Despite the simplicity of this procedure and advances made in infection control, hospital health care workers’ compliance to hand hygiene recommendations is generally low. Nurses have the most frequent patient care interactions, and thus more opportunities to practice hand hygiene. As such, it is important to identify and understand determinants of nurses’ reported compliance. Formative research was undertaken to assess the potential impact of several unexamined factors that could influence HH among nurses: professional role and status, social affiliation, social norms, and physical modifications to the work environment (as well as institutional factors like safety climate). A survey questionnaire was developed primarily to inform the creation of a behaviour change intervention. The survey looked at how these factors influence HH among nurses and sought to identify barriers and levers to reported hand hygiene. It was administered to a survey panel of acute care nurses, working in US hospitals, with a year or more of experience. Multivariate regression modelling suggested that reported hand hygiene compliance was most likely to be a function of a hospital management’s communication openness, perceived performance by peers, increased interactions with patients and other staff members, and the reduction in stress, busyness, and cognitive load associated with role performance. A powerful, effective intervention on HH among nurses therefore could be directed at improving communication openness, consider the impact of perceived performance by peers, increase interactions with patients and staff, and determine how to reduce the stress and cognitive load associated with role performance.

Nurse competence in the interface between primary and tertiary healthcare services

AIMS

(a) To explore nurses' self-assessed competence and perceived need for more training in primary and tertiary healthcare services; and (b) to investigate the factors associated with these issues.

DESIGN

Quantitative, cross-sectional, descriptive.

METHODS

The ProffNurseSAS, the Job Satisfaction Scale and socio-demographics were used. A convenient sampling method was used to invite registered nurses from 23 primary (N = 104) and tertiary care wards (N = 26).

RESULTS

Five significant differences in self-assessed competence were identified, with none regarding the perceived need for more training between nurses working in primary versus tertiary health care. Nurses in primary health care had longer experience, and a larger proportion had continuing education. Nevertheless, this was not associated with either self-assessed competence or the perceived need for more training. Years of experience, training or reported job satisfaction was not associated with the items on the ProffNurseSAS.

CONCLUSION

Findings indicate that nurses' competence is same in primary and tertiary healthcare settings. Moreover, the findings of this research highlight areas that need further improvement and emphasis from both leaders and educational institutions when they attempt to ensure nurses' competence.

Individual and organizational predictors of allied healthcare providers' job satisfaction in residential long-term care

Background

Job satisfaction is a predictor of intention to stay and turnover among allied healthcare providers. However, there is limited research examining job satisfaction among allied health professionals, specifically in residential long-term care (LTC) settings. The purpose of this study was to identify factors (demographic, individual, and organizational) that predict job satisfaction among allied healthcare providers in residential LTC.

Methods

We conducted a secondary analysis of data from Phase 2 of the Translating Research in Elder Care program. A total of 334 allied healthcare providers from 77 residential LTC in three Western Canadian provinces were included in the analysis. Generalized estimating equation modeling was used to assess demographics, individual, and organizational context predictors of allied healthcare providers’ job satisfaction. We measured job satisfaction using the Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale.

Results

Both individual and organizational context variables predicted job satisfaction among allied healthcare providers employed in LTC. Demographic variables did not predict job satisfaction. At the individual level, burnout (cynicism) (β = −.113, p = .001) and the competence subscale of psychological empowerment (β = −.224, p = < .001), were predictive of lower job satisfaction levels while higher scores on the meaning (β = .232, p = .001), self-determination (β = .128, p = .005), and impact (β = .10, p = .014) subscales of psychological empowerment predicted higher job satisfaction. Organizational context variables that predicted job satisfaction included: social capital (β = .158, p = .012), organizational slack-time (β = .096, p = .029), and adequate orientation (β = .088, p = .005).

Conclusions

This study suggests that individual allied healthcare provider and organizational context features are both predictive of allied healthcare provider job satisfaction in residential LTC settings. Unlike demographics and structural characteristics of LTC facilities, all variables identified as important to allied healthcare providers’ job satisfaction in this study are potentially modifiable, and therefore amenable to intervention.

Electronic supplementary material

The online version of this article (10.1186/s12913-018-3307-3) contains supplementary material, which is available to authorized users.

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

Do positive relations with patients play a protective role for healthcare employees? Effects of patients' gratitude and support on nurses' burnout

Background: A growing number of studies reveal that there are significant associations between a patient's perception of quality of care and a health professional's perceived quality of work life. Previous studies focused on the patients or on the workers. Alternatively, they center the discussion on either the negative or the positive effects, both on patients and care workers. This research work focuses on the positive relationship with patients—a possible resource for care workers.

Method:Study 1: A CFA was conducted to test the factorial structure and the tenure of the Italian version for patients of the Customer-initiated Support scale. Study 2: Using a multi-group path analysis, the effects of work characteristics and of the relationship with patients on burnout were tested in two different contexts: emergency and oncology ward.

Results:Study 1: The one-factor instrument shows good reliability, convergent, and divergent validity. Study 2: for oncology nurses cognitive demands, job autonomy, and support from patients have direct effects on emotional exhaustion and job autonomy; interactions between cognitive demands and patients' support have an effect on depersonalization. For emergency nurses cognitive demands and interactions between job autonomy and support from patients have effects on emotional exhaustion; job autonomy, patients support and gratitude have direct effects on personal accomplishment.

Conclusions: Results confirm expectations about the role of patients' support and gratitude in reducing nurses' burnout, with differences in the two contexts: emergency nurses show higher burnout and lower perception of positive relationship with patients, but present more intense protective effects of the interaction between job autonomy and support/gratitude. Suggestions can be offered to managers in developing interventions to promote “healthy organization” culture that consider jointly employees and patients' needs.

Meanings over time of working as a nurse in elderly care

Background:

Although registered nurses (RNs) play a central role in the care of older persons, their work in elderly care has historically been described as “low status” in nursing. This is especially problematic due to the global issue of RN turnover, but there is still little evidence of how to change this trend. Better understanding is needed of the reasons why RNs work in elderly care, as well as knowledge of whether these reasons have changed over time.

Aim:

The aim was to explore the meaning of working in elderly care, over time, from the perspective of RNs.

Method:

We interviewed thirteen RNs working in nursing homes, six of them in 2000 and the remaining seven in 2012, and analysed the resulting data using Interpretive Description.

Results:

The results show similarities and differences over time in the RNs’ reasoning about the meaning of their work with older persons, from a focus on obstacles to a view of opportunities.

Conclusion:

An RN’s intention to continue working in elderly care might be based on their beliefs; their view of older people, and their experiences of being able to influence the care. Managing this knowledge could be an essential factor in reversing the historical trend of RN work in elderly care being seen as low status, and the increasing turnover in such nurses. Our results could stimulate reflection on daily care and beliefs about caring for older persons.

Analysis of Nursing Job Characteristics in Public Sector Hospitals

Background:

Significance of any job depends on the strong presence of job characteristics which can positively improve motivation, performance and job satisfaction.

Methodology:

A structured interview scheduled was administered among 317 nurses in five BMC hospitals. The data were analyzed with the help of SPSS by using simple statistical tools.

Results:

Overall 66 per cent of the nursing staff found that the job is meaningful to them; 64.5 per cent of the staff feels that job design supports job satisfaction significantly.

Conclusion:

Nursing job contributes to well-being of human hence, it is treated as significant however the present job design did not make any positive support to their motivation and performance. This is due to inadequate presence of job characteristics.

Job characteristics, organizational conditions, and distress/well-being among Italian and Dutch nurses: a cross-national comparison

BACKGROUND

Among health care workers, nursing has been identified as particularly stressful. Several studies have shown cross-national differences in nurses' levels of occupational stress and burnout.

OBJECTIVES

The purpose of the study was to compare job characteristics, organizational conditions, and strain reactions in Italian (N = 609) and Dutch (N = 873) nurses. It was also examined how and to what extent various job characteristics and organizational conditions explain occupational and general strain.

DESIGN

The study was a cross-sectional questionnaire survey.

METHOD

Based on the Job Demand-Control-Support Model and the Tripod accident causation model, respectively job characteristics and organizational conditions were assessed as independent variables. Strain was operationalized in terms of job satisfaction, burnout, and psychosomatic complaints.

RESULTS

Italian nurses perceived their job characteristics, organizational conditions, and well-being as more unfavourable than their Dutch colleagues. Hierarchical regression analyses showed that high job demands, low skill discretion, and low social support from supervisor were the most consistent predictors of occupational and general strain across samples. Organizational conditions added significantly to the prediction of job satisfaction and burnout. Furthermore, lack of personnel was a stronger predictor of burnout in the Italian nurses than in the Dutch nurses.

CONCLUSIONS

The study provides cross-national confirmation of the impact of job characteristics and organizational conditions on nurses' well-being. Differences in job characteristics partially explain the observed cross-national differences in distress/well-being. Furthermore, some evidence for crossnational differential effects of job characteristics and organizational conditions on well-being was found.

Incidence of burnout in Spanish nursing professionals: a longitudinal study

BACKGROUND

Burnout is a psychological response to chronic work-related stress of an interpersonal and emotional nature that appears in professionals in service organizations who work in direct contact with the clients or end-users of the organization.

OBJECTIVE

The purpose of this study was to examine the incidence of burnout in a sample of staff nurses.

DESIGN

The study was longitudinal, and not randomized. The gap between time 1 (T1) and time 2 (T2) was 1 year.

SETTINGS

The data were gathered using an anonymous and self-applied questionnaire in different units of 13 Spanish hospitals.

PARTICIPANTS

The sample consisted of 316 staff nurses, 53 males (16.8%) and 262 females (83.2%). The percentage of the response obtained was 31.37% of all the questionnaires distributed in T1, and 83.77% of all the questionnaires handed out in T2. The characteristics of the sample were stable over time.

METHODS

Burnout was evaluated by the Maslach Burnout Inventory (MBI-HSS). Descriptive statistics, percentages, and t-test analyses were conducted.

RESULTS

The prevalence of burnout was different according to the approach used: (a) following the cut-off points from the American manual, the prevalence was 2.84% in T1 and 1.89% in T2; and considering the clinically derived cut-off points obtained in Holland, the percentage was 1.26% in T1 and .94% in T2.

CONCLUSIONS

The results only confirmed the hypothesis formulated applying the American cut-off points in T1. There was a significant increase in the levels of emotional exhaustion from T1 to T2, but there were no significant changes in the levels of personal accomplishment or depersonalization from T1 to T2. When the scores on the three dimensions of the MBI were considered together, a decrease in the incidence of burnout was obtained from T1 to T2. The prevalence of burnout in staff nurses can be modified over time, depending on the criteria used to estimate the prevalence.

How Much is Geriatric Caregivers Burnout Caring-Specific? Questions from a Questionnaire Survey

Summary:

Psychosocial work load and stress in the geriatric care

BACKGROUND

Due to the decrease in informal care by family members and the demographic development, the importance of professional geriatric care will rise considerably. Aim of this study was to investigate the psychosocial workplace situation for employees in this profession.

METHODS

The German version of the COPSOQ (Copenhagen Psychosocial Questionnaire) was used for the assessment of psychosocial factors at work. The instrument includes 22 scales and 3 single items concerning demands, control, stress, support, and strain.Results between two study groups of geriatric care were compared to each other as well as to employees in general hospital care and a general population mean (COPSOQ database).Statistical analysis included t-tests, ANOVA and multiple comparisons of means. Statistical significance (p < 0.01, two-tailed) and a difference of at least 5 points in mean values were defined as the relevant threshold.

RESULTS

In total 889 respondents from 36 institutions took part in the study. 412 worked in Home Care (HC), 313 in Geriatric Nursing Homes (GNH), 164 in other professions (e.g. administration).Comparison between HC and GNH showed more favourable values for the first group for the most scales, e.g. lower quantitative and emotional demands and less work-privacy conflict, better possibilities for development etc. Compared to external values from the German COPSOQ database for general hospital care (N = 1.195) and the total mean across all professions, COPSOQ-total (N = 11.168), the results are again positive for HC workers on most of the scales concerning demands and social support. The only negative finding is the very low amount of social relations at work due to the obligation to work alone most of the time. Employees in GNH rate predictability, quality of leadership and feedback higher when compared to general hospital care and show some further favourable mean values compared to the COPSOQ mean value for all professions. A disadvantage for GNH is the high rating for job insecurity.A supplementary subgroup analysis showed that the degree of negative evaluation of psychosocial factors concerning demands was related to the amount of working hours per week and the number of on-call duties.

CONCLUSIONS

Compared to employees in general hospital care and the COPSOQ overall mean value across all professions, geriatric care employees and especially home care workers evaluate their psychosocial working situation more positive for most aspects. However, this seems partly due to the very high proportion of part-time workers. Critical results for the two study groups are the relatively high job insecurity in nursing homes and the lack of social relations for the HCrs.

Can individual health differences be explained by workplace characteristics?--A multilevel analysis

Research on work-related health has mainly focused on individual factors. The present study expands the focus by exploring the role of organizational characteristics of workplaces for different individual health outcomes. The aim of the study was to look at differences in relative effect of workplace variations on five health outcomes, and to explain those differences in health outcomes by organizational characteristics. The sample encompassed 90 workplaces in Sweden and about 4300 individuals employed within these workplaces. Measurement of the workplace characteristics was carried out independently of the measurement of the individual's working conditions and health. Organizational data were collected by interviews with local managers at participating workplaces, and individual data were obtained by means of a survey of the employees. The results showed that a significant proportion of the variance in sickness absence, work ability, general health, and musculoskeletal disorders was attributed to the workplace. Of eight tested organizational characteristics, customer adaptation, lean production, and performance control could explain some of this workplace variance. The results also showed that only one organizational effect remained significant when controlled for the individual confounder of age and gender. High customer adaptation is associated with higher sickness absence. This association is not mediated via differences in mental and physical job strain.

Nursing staff competence, work strain, stress and satisfaction in elderly care: a comparison of home-based care and nursing homes

AIMS

The aims of this study were to: (1) compare older people care nursing staff's perceptions of their competence, work strain and work satisfaction in nursing homes and home-based care; and (2) to examine determinants of work satisfaction in both care settings.

BACKGROUND

The shift in older people care from hospitals to community-based facilities and home care has had implications for nursing practice. Lack of competence development, high levels of work strain and low levels of work satisfaction among nursing staff in both care settings have been associated with high turnover. Few studies have compared staff perceptions of their competence and work in nursing homes as opposed to home-based care.

DESIGN

A cross-sectional questionnaire survey.

METHODS

Nursing staff perceptions of their competence, work strain, stress and satisfaction were measured by questionnaire in 2003 in two older people care organizations in Sweden. Comparisons of all outcome variables were made between care settings both within and between the two organizations. Multiple regression analysis was used to determine predictors of work satisfaction in home care and nursing homes respectively.

RESULTS

In general, staff in home-based care reported significantly less sufficient knowledge compared with staff in nursing homes. However, home care staff experienced significantly less physical and emotional strain compared with staff in nursing homes. Ratings of work-related exhaustion, mental energy and overall work satisfaction did not differ significantly between care settings. In both care settings, work-related exhaustion was the strongest (inverse) predictor of work satisfaction.

CONCLUSIONS

Future interventions should focus on counteracting work-related exhaustion and improving competence development to improve work satisfaction among older people care nursing staff in both care settings. Relevance to clinical practice. Work-related exhaustion and lack of competence development may have significant negative implications for work satisfaction among older people care nursing staff in both home care and nursing homes.