Stress: Psychosoziale Arbeitsbelastung und Risiken für kardiovaskuläre Erkrankungen sowie Depression

Managers' Action-Guiding Mental Models towards Mental Health-Related Organizational Interventions-A Systematic Review of Qualitative Studies

Research indicates that managers' active support is essential for the successful implementation of mental health-related organizational interventions. However, there is currently little insight into what subjective beliefs and perceptions (=mental models) make leaders support such interventions. To our knowledge, this is the first qualitative systematic review of this specific topic, and it considers 17 qualitative studies of managers' perspective. Based on the theory of planned behavior, this review provides an overview of three action-guiding factors (attitudes, organizational norms and behavioral control) that can serve as starting points for engaging managers in the implementation of mental health-related measures and ensuring their success. Our results provide evidence that supportive organizational norms may particularly help to create a common sense of responsibility among managers and foster their perceived controllability with respect to changing working conditions. Our study thus contributes to a more differentiated understanding of managers' mental models of health-related organizational interventions.

Kriteriumsbezogene Cut-Off-Werte für Tätigkeitsspielraum und Arbeitsintensität

Zusammenfassung. Cut-Off-Werte ermöglichen eine ökonomische, binäre Beurteilung von Summenscores. Für Beanspruchungsfragebögen, die personenbezogene Merkmale erfragen, sind Cut-Off-Werte häufig vorhanden und in der klinischen Diagnostik unerlässlich. Für die Bewertung von Arbeitsmerkmalen sind Cut-Off-Werte ebenfalls wünschenswert. Bislang fehlen sie jedoch für die Beurteilung von Arbeitsmerkmalen wie Arbeitsintensität und Tätigkeitsspielraum. Zwischen 2006 und 2016 wurden daher in verschiedenen Branchen 801 objektive Arbeitsplatzanalysen durchgeführt, welche eine Unterteilung in gut und schlecht gestalteten Tätigkeitsspielraum sowie gut und schlecht gestaltete Arbeitsintensität nach DIN EN ISO 6385 (2016) ermöglichen. Anhand dieser Unterteilung wurden mit der Receiver-Operating-Characteristics-Analyse Cut-Off-Werte für den subjektiv-bedingungsbezogen Fragebogen zum Erleben von Arbeitsintensität und Tätigkeitsspielraum (FIT; Richter et al., 2000 ) ermittelt. Für den Tätigkeitsspielraum weisen Summenscores ≤ 22 und für die Arbeitsintensität Summenscores ≥ 15 auf eine schlechte Gestaltung des jeweiligen Arbeitsmerkmals hin. Anhand einer weiteren Stichprobe von 1 076 Arbeitenden konnte gezeigt werden, dass Arbeitende mit schlecht gestaltetem Tätigkeitspielraum vital erschöpfter sowie weniger engagiert sind und Arbeitende mit schlecht gestalteter Arbeitsintensität eine höhere Erholungsunfähigkeit sowie vitale Erschöpfung aufweisen.

[Psychological stressors, resources and well-being of surgeons in Germany : A cross-sectional study]

BACKGROUND

Psychological stress at work is associated with detrimental and health-impairing consequences for employees.

OBJECTIVE

In this study major stress factors and the resource job control at the workplace of surgeons and facets of mental health were examined and compared to benchmark results of a large reference sample.

METHOD

Data were collected by a representative online survey among surgeons throughout Germany who were contacted via the Professional Association of German Surgeons. In total 643 surgeons from different organizations and different disciplines completed the questionnaire that was developed using well-validated instruments.

RESULTS

Time pressure was the most meaningful stress factor for surgeons. Moreover, the results for medical assistants showed adverse stress combinations of high goal uncertainty and low job control as well as high emotional exhaustion and low job satisfaction. In addition, the results indicated that surgeons in single and group practices as well as in outpatient healthcare centers have less stressors and more job resources.

CONCLUSION

The survey results suggest high levels of burnout risk for German surgeons, especially among medical assistants and medical specialists from large hospitals. In order to maintain a high quality in the surgical disciplines, a concerted effort by all players in the healthcare system is necessary.

A call for Applied Knowledge and Lived Interdisciplinarity in the medical care of depressed employees: a cross-sectional survey with German occupational physicians and psychotherapists

OBJECTIVES

To identify approaches for an effective patient-centred care of depressed employees, we investigated occupational physicians' (OPs) and psychotherapists' (PTs) knowledge about job stressors on the development of depression, application of this knowledge, interdisciplinary cooperation and perceived barriers.

STUDY DESIGN

A cross-sectional online survey.

PARTICIPANTS

OPs (163; 48.5% male) and PTs (69; 43.5% male) providing complete data on the survey out of 257 OPs and 112 PTs who started the survey. There have been 458 (OPs) and 821 (PTs) initial clicks.

METHODS

Main outcome measures were the importance ratings of specific job stressors, the frequency of asking patients about those stressors, the need for interdisciplinary cooperation, as well as perceived barriers for cooperation. We performed multivariate analysis of variance, intraclass correlation coefficients (ICCs) and Spearman's rank-order correlations.

RESULTS

The achieved response rate for OPs was 56.1% and for PTs 13.6%. Both disciplines agreed on the importance of job stressors regarding depression (ICC=0.90; 95% CI: 0.54 to 0.98), but both ranked these factors differently from the current state of research. As to knowledge application, OPs showed positive associations between the importance of job stressors and the frequency of asking employees about them (eg, job insecurity (r_s=0.20, p=0.005)) and PTs for social stressors (eg, interpersonal conflicts (r_s=0.38, p=0.001)). OPs (mean=3.41) reported a higher necessity of interdisciplinary cooperation than PTs (mean=3.17; F(1,230)=7.02, p=0.009). Furthermore, cooperation was reported as difficult to implement. PTs perceived barriers (eg, time restriction) as more hindering (mean=3.2) than OPs (mean=2.8; F(1,171)=8.16, p=0.005).

CONCLUSIONS

Both disciplines are aware of the relevance of job stressors as risk factors for depression, but should be encouraged to ask employees more frequently about them. The need for interdisciplinary cooperation and possible barriers are discussed. It is crucial to emphasise the meaning of sufficient cooperation, since closing this gap for improving patient-centred care especially for employees suffering from depression is necessary.