Organizational climate and employee mental health outcomes: A systematic review of studies in health care organizations

Psychosocial work characteristic profiles and health outcomes in registered nurses at different stages of their careers: a cross-sectional study

BACKGROUND

Individual psychosocial work characteristics have been associated with the health and well-being of registered nurses. However, it remains to be determined whether different types of psychosocial work characteristics form patterned profiles and whether the profiles are associated with registered nurses' health and welfare at different stages of their careers. The purpose of this study was to identify latent psychosocial work characteristic profiles and examine whether the profiles are associated with a certain career stage and health outcomes.

METHODS

This cross-sectional study was conducted with 624 early-career registered nurses and 1,016 later-career registered nurses. Data were collected using an electronic survey with internationally validated measures including the Organizational Justice Scale, the Nurse Stress Index Scale, the Job Content Questionnaire, the Team Climate Inventory, the Psychological Distress Questionnaire, the Sleep Problems Questionnaire, and the Self-Rated Health Questionnaire. Latent profile analysis was conducted to identify subgroups with similar psychosocial work characteristic profiles. Multinomial and linear regression analyses were used to examine the association between latent work characteristics profiles, stage of career, and health outcomes.

RESULTS

We identified five profiles. The profiles were named based on class descriptions. The low strain/high support profile group and the moderate strain/high support profile group had statistically better self-rated health (p = < 0.001), less psychological distress (p = < 0.001) and less sleep problems (p = < 0.001) compared to the high strain/low support profile group.

CONCLUSIONS

Low to moderate strain, high interactional and procedural justice, and participative safety in teams form patterned profiles associated with better health in registered nurses. High strain, a lack of justice and a lack of participation safety form a risk combination pattern profile that may lead to health problems in registered nurses. Promoting procedural and interactional justice, and participation safety in teams seems efficient in enhancing the health and well-being of registered nurses. The findings indicate no significant correlation between career stages and work characteristic profiles. It is crucial to identify stressors specific for career stages and develop tailored interventions.

Workload and emotional exhaustion among older assistant care workers in Japan: Buffering effect of work resources

AIM

Based on the Job Demands-Resources model, this study aimed to assess the predictive effect of workload on emotional exhaustion and test the buffering effect of three types of work resources (workplace cohesion, work control, and workplace support) on the relationship between workload and emotional exhaustion among older Japanese assistant care workers.

METHODS

We analyzed data from a national survey on the work features and work-related outcomes of 1601 older assistant care workers working in geriatric health services facilities in Japan. Demographic characteristics, workload, work resources, and emotional exhaustion were analyzed. A hierarchical multiple regression analysis and simple slope test were conducted.

RESULTS

Workload had a significant main effect in predicting emotional exhaustion (β = 0.337, P < 0.001). Workplace cohesion buffered the negative effect of workload on emotional exhaustion (interaction between workload and workplace cohesion: β = -0.097, P = 0.002). Work control (interaction between workload and work control: β = -0.015, P = 0.585) and workplace support (interaction between workload and workplace support: β = 0.025, P = 0.391) had no buffering effect on the negative impact of workload on emotional exhaustion.

CONCLUSIONS

Regulating workload and promoting workplace cohesion might be effective strategies for preventing burnout among elderly workers. Investigations into the occupational stress of elderly workers from diverse cultures and work contexts are needed. Geriatr Gerontol Int 2025; 25: 273-278.

Network of job demands-resources and depressive symptoms in critical care nurses: a nationwide cross-sectional study

BACKGROUND

Critical care nurses are vulnerable to depression, which not only lead to poor well-being and increased turnover intention, but also affect their working performances and organizational productivity as well. Work related factors are important drivers of depressive symptoms. However, the non-liner and multi-directional relationships between job demands-resources and depressive symptoms in critical care nurses has not been adequately analyzed. Understanding these relationships would be helpful for reducing depression, increasing nurses' well-being and retain healthcare forces.

METHODS

This was a cross-sectional study using baseline data from the Nurses' mental health study (NMHS), a prospective cohort study on nurses from 67 tertiary hospitals in 31 province-level administrative regions in China. Only clinical nurses working in the ICU were included (n = 13,745). Data were collected using online questionnaires, and analyzed using network analysis and structural equation model. Job demands (average working hours per week, average number of night shifts per month, paperwork burden and work-life balance), job resources (supervisor support, co-worker support, leader justice, organizational climate satisfaction, work meaning, and career prospect), personal resource (resilience) and depressive symptoms were main variables in the networks, while demographic data and social health (social-emotional support and loneliness) were covariates.

RESULTS

The prevalence of severe, moderately severe, moderate, mild, and none or minimum depressive symptoms in critical care nurses of this study were 1.21, 3.42, 9.76, 42.88, and 42.07% respectively. In the final network, 132 of 210 possible edges (62.8%) were not zero. "Fatigue" had the highest expected influence, followed by "Motor", and "Appetite". Meanwhile, in terms of job demands-resources and personal resources, the node with the highest expected influence was "Supervisor support", followed by "Work meaning" and "Co-worker support". Three bridge variables were identified: "Resilience-adaptation", "Average working hours per week", and "Co-worker support". The final structural equation model basically supported the results of network analysis with an acceptable model-fit (GFI = 0.918, AGFI = 0.896, PCFI = 0.789, PNFI = 0.788, NFI = 0.909, IFI = 0.911, CFI = 0.911, SRMR = 0.040, and RMSEA = 0.064).

CONCLUSIONS

There was a rather strong interconnectedness between depressive symptoms and job demands-resources. Fatigue, motor, and appetite were core depressive symptoms of critical care nurses. Close attention to those symptoms could help recognize depression in critical care nurses. Supervisor support, work meaning, and co-worker support played vital roles as job resources in reducing depression, while negative impact of long average working hours per week were more contagious. Resilience, as personal resources, could help mediate the associations between job demands-resources and depression. In clinical practice, it's recommended for nursing managers to (1) encourage critical care nurses to find their "meaning in work", (2) implement resilience enhancing programs for nurse, (3) build and maintain meaningful relationships with nurses and support them in daily work, and (4) create a harmonious and dedicated working environment where co-workers are willing to help and support each other. Improvements in those modifiable aspects could help reduce risk and prevent exacerbations of depressive symptoms in critical care nurses.

"Do I feel safe here?" Organisational climate and mental health peer worker experience

BACKGROUND

In Australia, lived experience peer support workforces are expanding making it one of the fastest growing emerging disciplines in transdisciplinary mental health settings. This article provides insight for organisations on the contextual realities peer workers face, increases understanding of peer support services to improve service delivery environments and contributes to mental health systems reform. This study aimed to qualitatively explore peer support workers experience integrating into and working within transdisciplinary mental health service teams.

METHOD

Semi-structured interviews were undertaken with 18 peer support workers currently working in mental health services in Australia. The research was a qualitative descriptive study design. All data collected were analysed utilising thematic analysis.

RESULTS

Peer workers found their experience in the workplace was influenced by their colleagues and the organisation's understanding of the peer role. Factors relating to organisational culture and climate were a central theme throughout discussions noting that a negative climate was perceived as harmful to peer workers. Themes established through results include (1) the role of leadership, (2) attitudes and behaviours of colleagues, (3) provision of psychologically safe environments, (4) the organisations messaging and use of language and (5) organisational structures and policy.

CONCLUSION

This study contributes to evidence for the impact of organisational culture on integrating and supporting peer support workers in mental health service delivery. This study provides insights into peer worker experiences integrating into transdisciplinary teams, confirming findings established in previous studies, highlighting a lack of movement or change in workplace culture to support peer worker integration into mental healthcare settings.

Effects of organizational climate on employee job satisfaction and psychological well-being: the role of technological influence in Chinese higher education

BACKGROUND

In the Chinese education sector, educators' job satisfaction (JoS) is considered critical to educational quality and student outcomes. One critical area of inquiry is the organizational climate (OC) and its impact on JoS, and psychological well-being (PW), with technological influence (TI) moderating effect.

PURPOSE

The current study has tried to look at the exact relationship among OC, PW, and JoS for educators working in the Chinese higher education setting. It also discusses the moderating role of TI on OC and JoS.

DESIGN/METHODOLOGY

This study uses a quantitative cross-sectional survey design, grounded in post-positivism assumptions. Data collection involved sampling 690 respondents in the Chinese higher education setting via WeChat.

FINDINGS

The study methodology part included a pre-test, translation validation, demographic characteristics of participants, and results that showed a significant positive influence on JoS for PW and OC. The study also confirms the positive effect of PW on JoS. Moreover, the mediating role of PW within the OC-JoS link is also supported. Furthermore, TI positively moderates the OC-JoS relationship, thus it implies a supportive role of technology in enhancing the educators' satisfaction. The model indicated that OC, PW, and TI explain 72.4% of the variation in JoS.

CONCLUSION

In this respect, the findings offer some practical insights for educational institutions and policymakers to facilitate enhancement strategies for OC, thus recognizing its influence on JoS and the well-being of educators. Understanding how technology can play a moderating role presents the strategic occasion to utilize technological tools for a more satisfying work environment.

Lived experience allyship in mental health services: Recommendations for improved uptake of allyship roles in support of peer workforces

Inclusion of service users in the design and delivery of mental health services is clearly articulated throughout Australian mental health action plans and stated as an expectation within contemporary mental health policy. International and local Australian research demonstrates benefits for the inclusion of lived experience workers in service users' recovery journey; however, persistent challenges and barriers limit their effective integration into transdisciplinary mental health service teams. Non-lived experience workers who actively advocate and champion the inclusion of lived experience or peer workers, known as allies, are acknowledged and recognised as enablers for effective integration of peer workers to service teams. In this discursive paper, authors present recommendations for further development of allyship roles within leadership positions of mental health organisations in Australia. Leaders are in a position to influence the allocation of resources, redress power inequalities and facilitate opportunities for the inclusion of lived experience expertise across all levels of mental health organisations. This paper makes recommendations for areas of learning and unlearning ingrained bias and assumptions which may be detrimental to integration of lived experience workforces and hinder movement toward greater adoption of recovery-orientated service delivery.

Mitigating Job Burnout in Jordanian Public Healthcare: The Interplay between Ethical Leadership, Organizational Climate, and Role Overload

In today's dynamic organizational landscape, characterized by rapid technological advancements and evolving workplace dynamics, understanding the factors influencing employee well-being is paramount. This study investigates the interplay between ethical leadership, organizational climate, role overload, and job burnout in public healthcare organizations across northern Jordan. By focusing on ethical leadership, organizational climate, and role overload as determinants of job burnout, this research provides insights into strategies for enhancing employee well-being. Drawing on ethical leadership theory, social exchange theory, and the job demands-resources model, this study employs PLS-SEM to analyze data collected from 260 employees working in Jordanian government hospitals. The findings reveal negative associations between ethical leadership and job burnout, highlighting the importance of ethical leadership behaviors in mitigating employee burnout. Additionally, a positive organizational climate is associated with lower levels of burnout, underscoring the impact of the broader organizational context on employee well-being. The study also explores the mediating role of organizational climate and the moderating effect of role overload in the relationship between ethical leadership and job burnout, providing insights into the complex dynamics at play in healthcare organizations. These findings enrich our understanding of the factors influencing employee well-being in healthcare contexts and underscore the importance of fostering ethical leadership and supportive organizational climates to mitigate job burnout.

A healthy balance: the ratio of social support-to-demands is associated with metabolic syndrome

Metabolic syndrome is associated with increased risk for negative health events, decrements in quality of life, and greater health costs. The current study sought to identify whether the ratio of social support to social demands across multiple relationship types (spouse, friends, children, or other family members) were associated with concurrent metabolic syndrome in a nationally representative sample of US adults ages 32-40. Results indicate that the ratio of total social support to social demands was associated with a greater likelihood of meeting criteria for metabolic syndrome, even after statistically controlling for the effects of race, ethnicity, sex, age, income, and prior metabolic syndrome. When considering the relative contributions of each relationship type, greater support relative to demands from friends was the only relationship type that was significantly independently associated with lower likelihood of metabolic syndrome. Although not statistically significant, a trend-level negative association with spousal support/demands emerged, as did a trend-level positive association with support/demands from children. Taken together, the current study reaffirms the relevance of considering social support and demands with regards to metabolic syndrome and highlights the ways in which specific relationships may differentially relate to health risk.

Exploring key job demands and resources in Norwegian child mental health services: a cross-sectional study of associations with and relationship between compassion satisfaction, burnout, secondary traumatic stress and turnover intention

Background

Burnout, secondary traumatic stress, and high turnover rates among child mental health clinicians are a challenge, not only for the individual therapist and the organization but also for the successful implementation of evidence-based practices. However, little is known about which and how job-and implementation-related factors are associated with burnout, secondary traumatic stress, and turnover intention as well as compassion satisfaction among child therapists. In the present study, we aimed to explore these factors and related mechanisms by integrating the "professional quality of life" and the "job demands-resources" models of occupational health.

Methods

We measured the perceived professional quality of life and turnover intention among a national sample of 256 therapists working in Norwegian Child and Adolescence Mental Health Clinics (n = 44) that implemented Trauma-Focused Cognitive Behavior Therapy (TF-CBT). Seventeen Job-and implementation-related resources and demands were also measured using the General Nordic Questionnaire for Psychological and Social Factors at Work and the Implementation Component Questionnaire. Path analysis was used to test whether burnout and compassion satisfaction mediate the relationship between job demands and resources on one hand, and secondary traumatic stress and turnover intention on the other hand.

Results and discussion

Results revealed that two job resources, i.e., positive challenges at work and mastery of work, were significant predictors of all professional outcomes. The proposed model was only partly supported. That is, while burnout did mediate the relationship between some job demands (i.e., work-family interference and role conflict) and job resources (i.e., human resource primacy, positive challenges, and mastery of work) with secondary traumatic stress and turnover intention, compassion satisfaction did not mediate the relationship between job resources and turnover intention. Moreover, in addition to their indirect effects via burnout, role conflict and organizational climate (human resource primacy) also directly affected turnover intention. These findings propose that interventions that reduce burnout should be prioritized to improve the professional quality of life and turnover intention among child therapists. Theoretically, it seems that compassion satisfaction and work engagement act differently.

The identification environment matters: Students' social identification, perceived physical school environment, and anxiety - A cross-level interaction model

The social identity approach to health argues that well-being depends on the psychosocial circumstances of the groups to which individuals belong. However, little is known about how the average level of identification in the group - 'the identification environment' - buffers the negative health consequences of stressors. We used multilevel modelling to investigate whether identification environment in a school modified the association between the students' perceptions of the quality of their school's physical environment and their reported levels of anxiety. In two representative samples of Finnish school students (N = 678 schools/71,392 students; N = 704 schools/85,989 students), weak identification environment was related to increased anxiety. In addition, in schools where identification environment was weaker, the student level relationship between perceived physical environment and anxiety was stronger, and students were more anxious. Our results provide evidence that identification environment needs to be considered when we analyse how group membership affects well-being.

The Mediating Role of Job Stress Between Organizational Climate and Work Alienation Among Nurses in Emergency Departments: A Cross-sectional Study

BACKGROUND

Nurses suffer a certain degree of work alienation (a psychological state in which employees feel separated from their jobs because the jobs do not meet the needs of employees or do not match their expectations). It is necessary to identify predictors of work alienation and find effective interventions.

OBJECTIVE

To explore the influence of organizational climate and job stress on work alienation among nurses in emergency departments.

METHODS

This was a cross-sectional study conducted from June to August 2022. A convenience sampling method was adopted to invite 342 nurses from emergency departments in 12 tertiary public hospitals in 4 cities in China. Data were collected using self-reported questionnaires on organizational climate, job stress, and work alienation. Path analysis implemented by IBM AMOS 21.0 was used to explore the associations among organizational climate, job stress, and work alienation.

RESULTS

Job stress can positively affect work alienation among nurses in emergency departments (β = 0.44, P < .01). Organizational climate can directly and negatively affect work alienation (β = -0.33, P < .01); it can also negatively and indirectly affect work alienation through job stress (β = -0.20, 95% confidence interval: -0.252 to -0.146).

CONCLUSIONS

Job stress partially mediated the effect of organizational climate on work alienation among nurses in emergency departments. The findings provided a valuable perspective on predictors of work alienation among emergency department nurses.

The Multilevel Reliability and Interrater Agreement of the Nurse Practitioner Primary Care Organizational Climate Questionnaire

Background and Purpose: It is critical to accurately measure and understand the nurse practitioner (NP) work environment in which individual NP information is gathered but decisions or inferences are made at an aggregated, group level. However, there is little research on preconditions of aggregating individual-level data into group level in nursing research. This study was conducted to assess the multilevel reliability and group interrater agreement (IRA) of the Nurse Practitioner Primary Care Organizational Climate Questionnaire. Methods: Secondary data analysis from a cross-sectional survey with 247 NPs in 112 practices across 6 U.S. states in 2018-2019 was used. Results: The generalizability coefficients and values of IRA were acceptable (> .70), and values of ICC(1) were significant (.18-.38). Conclusions: Aggregating individual NP data to a higher group-level work environment construct is acceptable.

The relationships among overcommitment, effort-reward imbalance, safety climate, emotional labour and quality of working life for hospital nurses: a structural equation modeling

BACKGROUND

Quality of working life (QWL) is a highly important issue for nurses. Nurses with lower QWL tend to have lower job performance and intention to stay. The aim of this study was to apply a theoretical model to examine the structural relationships among overcommitment, effort-reward imbalance (ERI), safety climate, emotional labour and QWL for hospital nurses.

METHODS

A cross-sectional study design and a simple random sampling method were used to recruit 295 nurses in a teaching hospital and used a structured questionnaire was used to collect data.

RESULTS

Overall, the nurses' QWL was moderate. Our theoretical model showed a good model fit. Overcommintment had a significant direct positive effect on ERI (β = 0.35, p < 0.001) and indirect effects on safety climate (β = -0.149, p = 0.001), emotional labour (β = 0.105, p = 0.001) and QWL (β = -0.061, p = 0.004). Additionally, ERI not only had significant direct effects on safety climate (β = -0.42, p < 0.001), emotional labour (β = 0.30, p < 0.001) and QWL (β = -0.17, p < 0.001) but also indirectly affected QWL through safety climate (β = -0.304, p = 0.001) and emotional labour (β = -0.042, p = 0.005). Both safety climate (β = 0.72, p < 0.001) and emotional labour (β = -0.14, p = 0.003) showed significant direct effects on QWL. Our final model accounted for 72% of the variance in QWL.

CONCLUSION

Our results highlight the necessity of improving the QWL of nurses. Policymakers and hospital administrators should develop policies and strategies that encourage nurses to exhibit an appropriate level of commitment, balance effort and reward, establish a climate of safety, and reduce emotional labour to improve the QWL of hospital nurses.

The Role of Wellness Climate in Small Business Health Promotion and Employee Wellbeing

Wellness involves physical, emotional, behavioral, social, and spiritual dimensions. A climate for wellness exists at both the psychological and organizational levels, consisting of individual and shared perceptions of policies, structures, and managerial behavior that support or promote employee wellbeing. This study explored the associations between psychological and organizational wellness climate and the effectiveness of a team health promotion training on employees' perceived physical and mental wellbeing and substance use. Employees from 45 small businesses completed self-report measures of wellness climate, wellbeing, positive unwinding behavior, work-family conflict, job stress, drug use, and alcohol use, assessed before, and one and six months after, attending either of two types of onsite health promotion training. Team Awareness training targeted improvements in the social climate at work. Healthy Choices training targeted individual health behavior. A control group did not receive training until after the study. Businesses were randomly assigned to conditions and data were analyzed using multi-level modeling. Models that included wellness climate as a mediator fit the data significantly better than models without climate as a mediator. Team Awareness participants showed greater improvements in wellness climate and wellbeing compared to the control group. Healthy Choices participants showed no changes in climate and no mediation effects of climate. Health promotion efforts may be enhanced by including wellness climate as a target in program design at multiple levels.

Understanding Low Utilization of Employee Assistance Programs and Time Off by US Public Health Workers During the COVID-19 Pandemic

OBJECTIVE

Despite high rates of reported mental health symptoms among public health workers (PHWs) during the COVID-19 pandemic, utilization of employer-offered resources was low. Our objective was to understand what barriers and deterrents exist for PHWs accessing employer-offered resources.

METHODS

Four national public health organizations disseminated a national online survey of public health department employees during March-April 2021; 26 174 PHWs completed the survey. We examined 5164 write-in survey responses using thematic analysis to identify key reasons why PHWs were not accessing time off and employee assistance programs (EAPs) and to understand what resources PHWs would like to see their employers offer.

RESULTS

The top reasons that PHWs reported for not taking time off during the COVID-19 pandemic were financial concerns (24.4%), fear of judgment or retaliation (20.8%), and limitations in the amount of time off offered or available (11.0%). The top reasons that PHWs reported for not using EAPs during the COVID-19 pandemic were difficulty accessing EAPs (53.1%), use of external services (21.5%), and a lack of awareness about EAPs or motivation to initiate their use (11.3%). While desired employer-offered resources varied widely, PHWs most frequently listed financial incentives, paid time off, flexible scheduling, and organizational change.

CONCLUSION

Organizations can best help their employees by organizing the workforce in a way that allows PHWs to take time off, creating a positive and supportive organizational climate, regularly assessing the needs of PHWs, clearly communicating the availability of employer-offered benefits, and emphasizing the acceptability of using those benefits.

A bidirectional examination of mental health symptoms and perceptions of leader support: Which comes first?

Leader support for psychological health (LSPH) has been identified as an important factor in the prediction of mental health symptoms among warfighters. Although research has examined the relationship between LSPH and mental health symptoms, the extent to which this relationship is bidirectional has been underexplored. Consequently, the present study examined the longitudinal relationships between perceived LSPH and mental health symptoms (depression and PTSD) among military personnel over a 5-month period. We found that perceived LSPH at Time 1 (T1) was associated with fewer mental health symptoms at Time 2 (T2); however, mental health symptoms at T1 were also associated with lower perceptions of LSPH at T2. The results differed slightly based on the type of symptoms experienced, but the relationships between perceived LSPH and symptoms did not vary based on whether soldiers had been exposed to combat. However, it is important to note that the overall sample had low combat experience. Despite this, these findings may suggest that the assumption that leader support can enhance soldier mental health may fail to consider that the symptoms themselves may also affect how leaders are perceived. Therefore, organizations such as the military should consider both directions to optimally understand the relationship between leaders and subordinate mental health.

Psychosocial safety behavior: A scoping review of behavior-based approaches to workplace psychosocial safety

INTRODUCTION

In an era of workplace safety where psychosocial risks are widely recognized as occupational hazards, emerging research has sought to clarify the impact of these risks and the requisite interventions for improving psychosocial safety climate and reducing psychological injury risk.

METHOD

The construct of psychosocial safety behavior (PSB) provides a novel framework for emerging research that seeks to apply a behavior-based safety approach to workplace psychosocial risks across several high-risk industries. This scoping review aims to provide a synthesis of existing literature on PSB, including its development as a construct and application in workplace safety interventions to date.

RESULTS

Although a limited number of studies of PSB were identified, the findings of this review provide evidence for growing cross-sector applications of behaviorally-focused approaches to improving workplace psychosocial safety. In addition, the identification of a broad spectrum of terminology surrounding the construct of PSB provides evidence of key theoretical and empirical gaps, with implications for future intervention-based research to address emerging areas of focus.

The ECO VI Organizational Climate Scale: An Invariance Study in Four Latin American Countries

Introduction

Cross-cultural research is fundamental for the development and validation of work and organizational theories and to guide evidence-based practices around the globe. Although organizational climate is one of the most investigated higher-level constructs in organizational psychology, there is a lack of research analysing the invariance of measurements across national cultures in Latin America. This prevents scientists and practitioners from having a deeper understanding of this variable across the different countries and cultures composing this continent.

Objectives

This study aims at examining the measurement invariance of the Encuesta de Clima Organizacional scale in its VI version (ECO VI) in Colombia, Costa Rica, Panama, and Dominican Republic.

Method

Data were gathered from 38 companies operating in the manufacturing sector based in the four abovementioned countries and the sample sizes were as follows: Colombia was represented by 1007 employees, Costa Rica by 1090 employees, Panama by 372 employees, and Dominican Republic by 213. Measurement invariance was examined by testing the configural, metric, scalar, and structural models of invariance.

Results

The results supported with empirical evidence that the ECO VI scale is characterized by measurement invariance. More precisely, 6 of its 8 dimensions are unbiasedly interpreted and can be considered for making meaningful comparisons across the considered national cultures, while the outputs deriving from the dimensions of "resources availability" and "interpersonal relationships" should be treated with more caution. Indeed, for such dimensions support for only configural and metric invariance was found.

Conclusions

The main contribution of the present study was to provide evidence about the measurement invariance of the ECO VI scale. Thus, providing the community of scientists and practitioners operating in different Latin American countries with a molar organizational climate scale that can be used for conducting cross-cultural research. Hence, it is now possible to have a deeper understanding of how theories and practices involving the organizational climate for well-being can be better applied across the countries and cultures composing this continent.

Mental health services need action on organisational culture and justice

OBJECTIVE

A commentary on the usefulness of the concepts of organisational culture, organisational climate and justice on the quality and safety of mental health services and how conditions may be improved.

CONCLUSIONS

Organisational culture, organisational climate and justice impact upon the quality and safety of care, as well as well-being of staff, in mental health services. Psychiatrists and trainees, should consider, act and advocate for improved organisational culture, climate and justice. Improvement in these organisational domains can be achieved, through a coordinated framework that acts across all levels of administration, mid-level management and frontline clinical staff.

Predictors of Satisfaction With Work Environment in the Context of a Mismatch in Working Hours: A Nationwide, Large-Scale, Cross-Sectional Study

This nationwide, large-scale, cross-sectional study has hypothesized that there might be differences in workers' satisfaction with work environment depending on demographic, socio-economic, and work characteristics in the context of a mismatch between actual and preferred working hours. The current study is a secondary data analysis of the Fifth Korean Working Conditions Survey. A total of 29 694 subjects (n = 29 694) were finally included in the current study. Female gender (β = -.372, OR 0.689 [95% CI 0.646-0.736]), age of ≥60 years old (β = .226, OR 1.253 [95% CI 1.089-1.441]), graduation from middle school (β = -.320, OR 0.726 [95% CI 0.616-0.856]), college (β = .492, OR 1.636 [95% CI 1.371-1.952]), or university (β = .826, OR 2.283 [95% CI 1.918-2.718]), fixed period of work (β = -.105, OR 0.901 [95% CI 0.823-0.986]), full-time employment (β = -.105, OR 0.900 [95% CI 0.813-0.996]), the engagement in public sector (β = .544, OR 1.722 [95% CI 1.532-1.935]), private-public partnership organization (β = .605, OR 1.832 [95% CI 1.342-2.500]) or NPO or NGO (β = .780, OR 2.182 [95% CI 1.522-3.127]), regular side job (β = -.929, OR 0.395 [95% CI 0.289-0.539]), or temporary side job (β = -.330, OR 0.719 [95% CI 0.533-0.970]), membership of multiple teams (β = -.501, OR 0.606 [95% CI 0.552-0.666]), labor union (β = .143, OR 1.154 [95% CI 1.047-1.273]), and better health status (β = .977, OR 2.657 [95% CI 1.175-6.007]) were predictors of satisfaction with work environment in the context of a mismatch between actual and desired working hours. Based on the current results, it can be concluded that female gender, age of ≥60 years old, graduation from middle school, college, or university, fixed period of work, full-time employment, the engagement in public sector, private-public partnership organization or NPO or NGO, regular side job or temporary side job, membership of multiple teams, labor union, and better health status were predictors of satisfaction with work environment.

Differences in employment, job characteristics, and work-related perceptions by sociodemographic factors among registered nurses of diverse race/ethnicity

BACKGROUND

Available research on registered nurses (RNs) indicates that RNs with diverse race/ethnicity are more likely to work in disadvantaged workplaces.

PURPOSE

To examine differences in employment, job characteristics and perceptions about work among RNs by sociodemographic characteristics.

METHODS

We analyzed data from statewide random samples of California RNs (N=895).

FINDINGS

Increased age was associated with increased likelihoods of working part-time, day-shift, and in non-hospital settings and having managerial positions. Asian and Black nurses were more likely to work in urban areas than White nurses. The levels of job demand, job control, job satisfaction, perceived organizational culture, and safety climate were significantly different by sociodemographic characteristics. Greater intention to leave the job was associated with younger age and working in non-hospital settings.

DISCUSSION

The findings suggest that differences exist in nurses' employment, job characteristics, and perceptions about their work and work environment by sociodemographic characteristics among RNs of diverse race/ethnicity.

Enhancing the well-being of front-line healthcare professionals in high pressure clinical environments: A mixed-methods evaluative research project

BACKGROUND

The last few years have witnessed a growing concern with the well-being of healthcare professionals internationally because of increasing recognition of its impact on patient outcomes and staff retention. The COVID-19 pandemic, which has placed additional and substantial pressure on frontline healthcare professionals, gives added urgency to the topic. While numerous, and successful, interventions have been developed to address compromised well-being among healthcare professionals, they have not always been able to support the needs of frontline staff, specifically those working in high-pressure environments.

OBJECTIVE

This paper presents findings of an evaluative research study of an intervention, named the Resilience and Well-being Training Programme, developed and implemented within an Acute Assessment Unit in a hospital in the UK. The 8 week-long programme followed a combined approach (both person-directed and work-directed), with mindfulness training as well as lectures and discussions to deepen participants' understanding of organisational life. The training, delivered from January to July 2018, involved a total of 72 healthcare professionals from a wide range of levels (UK bands 2-8), trained in three cohorts.

DESIGN

The research followed a pre-post design to explore participants' experiences of working on the Unit, the programme and its impact on themselves and their working life.

SETTING

The study was conducted in a large NHS district general hospital in South London, UK.

PARTICIPANTS

Participants included healthcare assistants and nurses who had completed their preceptorship, worked in the hospital's acute assessment unit, and had undertaken the resilience and well-being training programme.

METHODS

The study employed mixed methods (online questionnaire, face-to-face focus groups/interviews) to collect data.

RESULTS

Findings showed participants' positive experience with the programme, however it had limited positive impacts on aspects of compromised well-being at the personal level and a statistically significant enhancement of the quality of relationships and communication on the Unit, with medium effect size (Cohen's D). The programme had a positive impact on the culture of the Unit.

CONCLUSIONS

Results highlight the demand for and value of programmes designed in ways that enable this group of professionals to take part, because these professionals are often not able to participate in such programmes. A strong commitment from the leadership to enable staff attendance in time-protected programmes is one approach that works well in the short-term. However, this may be challenging to accomplish and raises issues of sustainability.

Interventions to reduce the risk of mental health problems in health and social care workplaces: A scoping review

Work in the health and social care sector is stressful, and work-related stress increases the risk of depression, anxiety, burnout, and sleep disorders. Although interventions to reduce stress and burnout at workplaces have been developed and studied, most studies have lacked the effectiveness to improve the situation. Thus, more knowledge on interventions and analysis of their mechanisms is needed to reduce the risk of more adverse mental health problems (MHP). We conducted a scoping review to identify the relevant literature on individual and organizational interventions to improve mental health in health and social care workplaces. Data were gathered on target groups, intervention types and their effectiveness, and the outcomes of the interventions. We summarized this data thematically. The final review consisted of 76 studies. Mental health interventions primarily focused on health care workers rather than social care professionals. The interventions were mostly directed at individual workers, ignoring organizational-level interventions. They used a great variety of outcomes and questionnaires, and the questionnaires that measured the outcomes were used ambiguously. In most cases, the reported effectiveness of the studied interventions was incoherent, and many of the interventions had both statistically significant and non-significant effects. Evidence that interventions reduce the risk of work-related MHP is scarce. High-quality randomized controlled trials of interventions to promote mental health with more coherently formed outcomes are needed, especially on the organizational level. More interventions to improve social care professionals' mental health are also needed.

Mental health and psychological wellbeing of maritime personnel: a systematic review

Background

Seafaring has frequently been reported to be a ‘risky occupation’ in terms of both physical and mental health. Individuals working in seafaring professions are exposed to various stressors in the workplace, including social isolation, exposure to poor physical conditions and long work hours. This systematic review aimed to update previous reviews by collating recent literature (published between 2012 and 2021) on the factors associated with mental health and wellbeing in seafaring personnel.

Methods

Four electronic databases were searched in April 2021 for primary peer-reviewed studies on factors associated with the mental health and psychological wellbeing of seafarers or interventions to improve the wellbeing of seafarers, published in English in or after the year 2012. Thematic analysis was used to synthesise the data and standardised measures of quality appraisal were used to assess risk of bias.

Results

Sixty-three studies were reviewed. Risk factors for poor mental health among seafarers appear to be younger age; being single; poor physical health; exposure to noise/vibration; feeling unsafe; high job demands; long working hours; night/irregular shifts; poor sleep; poor team cohesion; poor perception of management; poor social support; lack of autonomy; scheduling uncertainties; long duration at sea; and over-commitment.

Conclusions

There are numerous steps that maritime managers could take to improve the wellbeing of their personnel, including increased monitoring of the potential for poor mental health in their staff, increasing crew numbers and provision of education and support.

Co-Design, Delivery, and Evaluation of Wellbeing Initiatives for NHS Staff: The HOW (Healthier Outcomes at Work) NHS Project

Stress and mental health are leading causes of sickness absence in the UK, responsible for over 50% of sickness absence across the country. Healthcare sector workers play a vital role in the life of everyone across the country but have among the highest levels of sickness absence of any sector. The aim of this project, therefore, was to work with UK healthcare workers to co-develop, implement, and evaluate a series of mental health and wellbeing interventions delivered via a smartphone app and associated toolkit. A participatory action research methodology, consisting of individual interviews, focus group discussions, and oversight by an expert action learning group, was used to develop primary (i.e., those associated with the workplace) and secondary (improving individual resilience and coping) stress management interventions. Pre-post-intervention analysis demonstrated improvements in work engagement and working conditions, although significant improvements were only found in mean scoring on demands, control, managerial support, and peer support working condition measures. The project therefore demonstrates that co-produced initiatives which focus on improving either the organisation or resilience of the workforce may be useful in supporting employee health and wellbeing. Future studies should build upon these findings through a full RCT to determine utility of the interventions.

The Antecedents and Consequences of Workaholism: Findings From the Modern Japanese Labor Market

The present study examined the direct and indirect (via workaholism) relationships between competitive work environments and subjective unhealthiness. It also examined the effects of adjusting for cognitive distortions in the relationship between a competitive work environment and subjective unhealthiness and between a competitive work environment and workaholism. Data were collected from 9,716 workers in various industries, occupations, and positions. The results show that competitive work environments were positively related to subjective unhealthiness, both directly and through workaholism. Furthermore, cognitive distortions moderated the positive effect between a competitive work environment and workaholism, and the positive relationship was stronger when cognitive distortions were high (as compared to low). This study has important and practical implications for companies that are increasingly concerned about the health of their employees.

The Effect of Innovative Organizational Climate on Employee Job Satisfaction

Innovation has critical importance in making a difference in the competitive environment of organizations and countries. Organizations that produce similar products or services in the same market need to be innovative to make a difference to their competitors. For increasing innovation in organizations, first of all, the management approach should be in a way that supports innovation. Organizations that determine their organizational policies by considering the demands of the employees within an organizational structure suitable for the modern age and employee expectations are more advantageous in this regard. It is not easy to achieve sustainable success in organizations where employees' ideas are not given importance, and only certain people make decisions and implement them. In this respect, the suggestions put forward by all employees should be considered in solving problems and improving product and service quality. Organizations also need to allocate supporting resources so that employees can improve existing processes or introduce new initiatives. In organizations with an innovative climate, employees are involved in critical processes. Their ideas are considered essential, and financial support is provided for their suggestions and ideas in product development and problem-solving. Although some research on the effects of an innovative climate on organizational performance has been carried out, few studies examined the effects of the innovative climate on employees' attitudes towards work. In this regard, this study it is aimed to examine the impact of innovative climate perception of white-collar employees working at middle and upper levels on job satisfaction. Quantitative research was designed to achieve this aim. A total of 222 employees from the food, textile, and automotive sectors participated in the research. A questionnaire form including scales whose psychometric properties were tested previously and a personal information form was created. The questionnaire form was delivered to the participants online. Within the scope of the research, frequency, internal consistency, factor, independent samples T-test, and correlation analysis were applied. The findings showed a positive and strong correlation between the innovative organizational climate perception of the employees (including the sub-dimensions) and their job satisfaction. The innovative climate perception of the employees did not differ according to the variables such as the position in the organization (middle and lower level) and whether they have a managerial role. The obtained results were discussed, and some research suggestions were made.

The effect of emotional leadership and job security on employees' mental health

We examined the impact of emotional leadership on employees' mental health by establishing a cross-level theoretical model to test this relationship as a function of employees' sense of job security, selfdirected learning, and organizational identification. The research sample consisted of 304 employees of 10 high-technology companies in China. Results show that emotional leadership was positively associated with employees' mental health, and that job security mediated this relationship. Organizational identification and selfdirected learning positively moderated the relationship between job security and employees' mental health, resulting in a moderated mediation effect on the model. The conclusions of this study have implications for improving employees' mental health via interactions with emotional leaders.

Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis

IMPORTANCE

Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic.

OBJECTIVE

To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic.

DESIGN, SETTING, AND PARTICIPANTS

In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada's largest health care institutions. Questions could be submitted online anonymously in advance of the virtual forums on COVID-19 by any of the University Health Network's 21 555 employees, and staff members were able to anonymously endorse questions by upvoting, indicating that an already posed question was of interest.

MAIN OUTCOMES AND MEASURES

Themes, text structure, and rhetorical devices used within the questions were analyzed, taking into consideration their larger institutional and societal context.

RESULTS

Unique individual views of the forums ranged from 2062 to 7213 during the study period. Major individual-level concerns related to risks of contamination and challenges coping with increased workloads as a result of the pandemic intersected with institutional-level challenges, such as feeling or being valued within the health care setting and long-standing stratifications between types of HCWs. Concerns were frequently reported in terms of calls for clarity or demands for transparency from the institutional leadership.

CONCLUSIONS AND RELEVANCE

The findings of this qualitative study suggest that larger institutional-level and structural concerns need to be addressed if HCWs are to be engaged in support and coping programs. Potential service users may be dissuaded from seeing their needs as being met by workplace mental health interventions that solely relate to individual-level concerns.

Influence of Organizational Climate and Clinician Morale on Seclusion and Physical Restraint Use in Inpatient Psychiatric Units

OBJECTIVES

Reducing seclusion and restraint use is a prominent focus of efforts to improve patient safety in inpatient psychiatry. This study examined the poorly understood relationship between seclusion and restraint rates and organizational climate and clinician morale in inpatient psychiatric units.

METHODS

Facility-level data on hours of seclusion and physical restraint use in 111 U.S. Department of Veterans Affairs (VA) hospitals in 2014 to 2016 were obtained from the Centers for Medicare & Medicaid Services. Responses to an annual census survey were identified for 6646 VA inpatient psychiatry clinicians for the same period. We examined bivariate correlations and used a Poisson model to regress hours of seclusion and restraint use on morale and climate measures and calculated incident rate ratios (IRRs).

RESULTS

The average physical restraint hours per 1000 patient hours was 0.33 (SD, 1.27; median, 0.05). The average seclusion hours was 0.31 (SD, 0.84; median, 0.00). Physical restraint use was positively associated with burnout (IRR, 1.76; P = 0.04) and negatively associated with engagement (IRR, 0.22; P = 0.01), psychological safety (IRR, 0.48; P < 0.01), and relational climate (IRR, 0.69; P = 0.04). Seclusion was positively associated with relational climate (IRR, 1.69; P = 0.03) and psychological safety (IRR, 2.12; P = 0.03). Seclusion use was also nonsignificantly associated with lower burnout and higher engagement.

CONCLUSIONS

We found significant associations between organizational climate, clinician morale, and use of physical restraints and seclusion in VA inpatient psychiatric units. Health care organization leadership may want to consider implementing a broader range of initiatives that focus on improving organizational climate and clinician morale as one way to improve patient safety.

Nurses' Qualitative Descriptions of the Organizational Climate of Hospitals

PURPOSE

To explore nurses' perceptions of the organizational climate in general hospitals in Myanmar.

DESIGN AND METHODS

Using a qualitative descriptive design, data were purposively collected from all levels of registered nurses in eight general hospitals across Myanmar during August to October 2019. Seventeen individual in-depth interviews and eight focus group discussions with 65 nurses were undertaken and analyzed using Graneheim and Lundman's qualitative content analysis.

FINDINGS

Four categories of organizational climate from a Myanmar nursing context emerged: organizational uniqueness, organizational alignment, sense of empowerment, and the reinforcing organization. Organizational uniqueness included the subcategories of perception of features and orientation of the organization, whilst organizational alignment comprised the three subcategories of the values inherent in the management process, the criteria of success, and strategic emphasis. The sense of empowerment category embraced the subcategories of the perceptions of the decision making and roles of leaders or managers; the last category, the reinforcing organization, incorporated the subcategories of bonding and recognition of the organization.

CONCLUSIONS

This was the first qualitative nursing study on nurses' perceptions of organizational climate in Myanmar hospitals. Participants revealed a rich source of information that needs to be considered by hospital administrators and other policymakers to enhance quality clinical care by nurses, and their overall well-being and working conditions. The emphasis on the holistic nature of this concept points to further investigations of working conditions, the lives of nurses, and management of nurses within the hospital environments in Myanmar hospitals, and can inform other countries.

CLINICAL RELEVANCE

Nurses revealed a rich understanding of what an organizational climate represents or should represent, and they need to work with hospital administrators and managers to contribute to the development of positive organizational climate, which in turn should increase nurse retention and the efficacy of health care provided in hospitals.

Measures of Organizational Culture and Climate in Primary Care: a Systematic Review

BACKGROUND

Primary care is increasingly contributing to improving the quality of patient care. This has imposed significant demands on clinicians with rising needs and limited resources. Organizational culture and climate have been found to be crucial in improving workforce well-being and hence quality of care. The objectives of this study are to identify organizational culture and climate measures used in primary care from 2008 to 2019 and evaluate their psychometric properties.

METHODS

Data sources include PubMed, PsycINFO, HAPI, CINAHL, and Mental Measurements Yearbook. Bibliographies of relevant articles were reviewed and a cited reference search in Scopus was performed. Eligibility criteria include primary health care professionals, primary care settings, and use of measures representing the general concept of organizational culture and climate. Consensus-Based Standards for the selection of health Measurement Instruments (COSMIN) guidelines were followed to evaluate individual studies for methodological quality, rate results of measurement properties, qualitatively pool studies by measure, and grade evidence.

RESULTS

Of 1745 initial studies, 42 studies met key study inclusion criteria, with 27 measures available for review (16 for organizational culture, 11 for organizational climate). There was considerable variability in measures, both conceptually and in psychometric quality. Many reported limited or no psychometric information.

DISCUSSION

Notable measures selected for frequent use and strength and applicability of measurement properties include the Culture Questionnaire adapted for health care settings, Practice Culture Assessment, and Medical Group Practice Culture Assessment for organizational culture. Notable climate measures include the Nurse Practitioner Primary Care Organizational Climate Questionnaire, Practice Climate Survey, and Task and Relational Climate Scale. This synthesis and appraisal of organizational culture and climate measures can help investigators make informed decisions in choosing a measure or deciding to develop a new one. In terms of limitations, ratings should be considered conservative due to adaptations of the COSMIN protocol for clinician populations.

PROSPERO REGISTRATION NUMBER

CRD 42019133117.

Organizational Climate and Support Among Peer Specialists Working in Peer-Run, Hybrid and Conventional Mental Health Settings

As the peer specialist workforce continues to expand, it is critical to better understand peer providers' working conditions and workplace experiences. The current study utilized a targeted non-probability sample of 801 peer specialists to explore whether key organizational climate and support variables would yield distinct multivariate groups, and to investigate the correlates of these groups. Analyses yielded a seven-group solution, with peer run organizations comprising a substantially greater proportion of the groups with high organizational climate and support scores. In direct comparisons, peer-run programs outranked all other groups in the areas of perceived organizational climate, supports for career development and perceived service quality.

Association between Work Environments and Stigma towards People with Schizophrenia among Mental Health Professionals in Japan

This study aimed to examine the association between control over practice in work environments and stigma toward people with schizophrenia among mental health professionals. We conducted secondary analyses on data from a self-administered questionnaire survey. The sample in the initial study included mental health professionals from two psychiatric hospitals, 56 psychiatric clinics, and community service agencies in Japan. The Ethics Committee of the University of Tokyo, approved this study. Data from 279 participants were used for secondary analyses (valid response rate = 58.7%). The hierarchical multiple regression analysis was used to determine the association between control over practice and stigma. We performed subgroup analyses among nurses (n = 121) and psychiatric social workers (n = 92). Control over practice was negatively associated with stigma among mental health professionals (β = −0.162, p < 0.01). The subgroup analyses among nurses indicated that control over practice, educational history and recovery knowledge were associated with stigma. However, these variables were not associated with stigma among psychiatric social workers. Control over practice might help to reduce stigma among mental health professionals. Factors related to stigma might differ by occupation. Therefore, further comprehensive studies among various professionals would further our understanding of these factors.

Psychological Distress Among HIV Healthcare Providers During the COVID-19 Pandemic in China: Mediating Roles of Institutional Support and Resilience

Psychological distress among healthcare providers is concerning during COVID-19 pandemic due to extreme stress at healthcare facilities, including HIV clinics in China. The socioecological model suggests that psychological distress could be influenced by multi-level factors. However, limited COVID-19 research examined the mechanisms of psychological distress among HIV healthcare providers. This study examined organizational and intrapersonal factors contributing to psychological health during COVID-19 pandemic. Data were collected via online anonymous surveys from 1029 HIV healthcare providers in Guangxi, China during April–May 2020. Path analysis was utilized to test a mediation model among COVID-19 stressors, institutional support, resilience, and psychological distress (PHQ-4). Thirty-eight percent of the providers experienced psychological distress (PHQ-4 score > 3). Institutional support and resilience mediated the relationship between COVID-19 stressors and psychological distress. Psychological distress was common among Chinese HIV healthcare providers during COVID-19 pandemic. Psychological health intervention should attend to institutional support and resilience.

A contemporary understanding of organizational climate in healthcare setting: A concept analysis

AIM

The overarching objective of this report is to provide an updated definition of the concept of organizational climate and to strengthen its operational application.

BACKGROUND

Organizational climate is one of the major contributing factors to the exodus of the nursing workforce from the profession. Extensive research has addressed the impact of "organizational climate" on the nursing workforce; yet variations in the interpretation of the concept calls for an updated definition.

DESIGN

Walker and Avant's strategy was implemented.

DATA SOURCE

Data were compiled from Medline and CINAHL, Google search engine, and book chapters.

REVIEW METHOD

A comprehensive and detailed review of the literature was performed. Nineteen historic publications (1939-2012) and 39 healthcare-related publications (2013-2018) were included in the final review.

RESULTS

The climate of an organization reflects a set of core values and behaviors that can be used to implement evidence-based leadership and management within the context of the 21st century. We have revised the definition of organizational climate to capture this context.

CONCLUSION

The perception of a supportive and constructive climate in an organization propels the workforce, independent of ethnic or personal background, to a higher level of productivity and encourages loyalty and workforce stability.

Empirical Research in Colombian Services Sector: Relation between Transformational Leadership, Climate and Commitment

The objective of this study is to analyze the relationship between the variables of transformational leadership, climate and commitment in a sample of 319 workers of a multinational organization in the Colombian Services Sector. For data collection, we used the Multifactor Leadership Questionnaire (MLQ), the climate/culture questionnaire FOCUS-93 and the Intellectual, Social and Affective Commitment Scale (ISA). Data were processed with SPSS 23 and AMOS 22 for modeling with structural equations. In the path diagram, calculated according to the indicators of structural adjustments, variances were obtained for the dimensions of organizational commitment. The resulting model presented favorable adjustment indicators as evidenced in the results, and the relationship between commitment and climate was significant (β = 4.61; p = 0.001), as well as between climate and commitment (β = 0.018; p = 0.001). However, the relationship between transformational leadership and commitment was not direct but mediated through organizational climate.

Workplace resources, mentorship, and burnout in early career physician-scientists: a cross sectional study in Japan

BACKGROUND

Physician-scientists are a vital segment of the healthcare workforce, but they may face significant challenges balancing and integrating clinical responsibilities, scientific research, and domestic responsibilities. This study investigates factors associated with burnout among highly successful early career physician-researchers in Japan.

METHOD

Among 1790 physician awardees of Grant-in-Aid for Young Scientists by the Japanese Ministry in 2014-2015, 490 participated in this cross-sectional survey in 2016 (usable response rate 23.8%). The primary outcome was psychological burnout, measured by the Copenhagen Burnout Inventory (i.e., personal burnout, work-related burnout, and patient-related burnout). "Workplace resources" in our study refers to the presence of career education in the workplace, promotion of gender equity, well-being consultation services on "career and work," "research," "harassment," and/or "mental health," as well as the presence of a role model in the workplace who has perceived good work-life balance.

RESULTS

Among 408 physician-researchers (75% male, mean age 37 yrs), personal burnout scores were slightly higher in women than in men (mean score, 41.9 points vs. 36.7 points, difference, 5.2, 95% confidence interval, 0.5-9.9, p = 0.029), but work-related and patient-related burnout scores did not differ significantly between genders. Over half of women (64%) and men (58%) had a mentor (p = 0.374). In multivariable general linear regression models, personal burnout scores were higher for women (β = 4.98, p = 0.045), and lower among those who had a mentor (β = - 5.82, p = 0.010) and whose workplaces had well-being consultation services (β = - 0.79, p = 0.022). Work-related burnout scores were lower among those with larger amounts of grant funding (β = - 4.70, p = 0.013), a mentor (β = - 6.12, p = 0.002), well-being consultation services (β = - 0.78, p = 0.008) and a role model with a perceived good work-life balance (β = - 4.00, p = 0.038). Patient-related burnout scores were higher among physician-scientists aged older than 37 years (β = 6.25, p = 0.002) and those who had board certification (β = 9.01, p = 0.017), while these scores were lower among those had larger amounts of funding (β = - 5.01, p = 0.006) or a mentor (β = - 5.35, p = 0.006).

CONCLUSIONS

Workplace resources and mentorship appear to be associated with lower levels of psychological burnout for both men and women early career physician-scientists.

A Systematic Review on the Research Progress and Evolving Trends of Occupational Health and Safety Management: A Bibliometric Analysis of Mapping Knowledge Domains

Background: Effective occupational health and safety management (OHSM) is important to employee health, enterprise sustainability, and social stability. However, scientific research into OHSM lags behind practice, and contextualizing OHSM research from the perspective of its historical evolution is urgently required.

Methods: The mapping of knowledge domains, based on bibliometric analysis, was adopted to classify 4,852 journal articles related to OHSM listed in the core database of Web of Science and published between 1900 and 2018.

Results and Conclusions: Risk assessment/management at the organizational level were found to have always been research hotspots, and the relationship between safety culture/atmosphere, sickness absence, and safety performance, among other factors, have become core research topics in the field in recent years. Research at the individual level has gradually evolved from an early focus on physiological problems such as work-related musculoskeletal disorders and low back pain, further toward issues such as occupational stress, mental health, and quality of life. In addition, the results of clustering analysis based on high-frequency keywords indicated six aspects of OHSM: OHSM mode and method; OHSM systems and standards; OHS risk assessment and management; OHSM and safety culture; mental health and quality of life; and specific disease management. Future development trends in OHSM research are described providing theoretical and practical reference for further study.

A Brief Measure of Organizational Wellness Climate: Initial Validation and Focus on Small Businesses and Substance Misuse

OBJECTIVE

Organizations with fewer than 100 employees comprise most businesses in the United States. Since small businesses lack comparable resources, they may benefit from a simple valid tool for broadly assessing positive wellness climate, especially because climate contributes to employee wellbeing.

METHODS

Using an ethnically and occupationally diverse sample of 45 businesses (n = 1512), the current study developed and tested a brief self-report measure of organizational wellness climate.

RESULTS

Confirmatory factor analysis shows that a 9-item measure has good model fit (RMSEA = 0.06, CFI = 0.91), inter-item consistency of 0.74, and mean Rwg(j) of 0.87. The new measure is significantly positively correlated with physical health and wellbeing, and negatively correlated with substance use behavior.

CONCLUSIONS

Findings indicate that a 9-item measure has good reliability, construct, and criterion validity. Implications for practical use of the measure are discussed.

Working conditions and compensated sickness absence among nurses and care assistants in Sweden during two decades: a cross-sectional biennial survey study

OBJECTIVES

The aims of the study were to trace the patterns of work environment factors and compensated sickness absence (SA) among nurses and care assistants compared with other occupations and to compare SA among exposed and non-exposed nurses and care assistants.

DESIGN

A cross-sectional survey on work environment factors based on the biennial Swedish Work Environment Surveys 1991-2013, linked to longitudinal register data on SA 1993-2014.

PARTICIPANTS

The study included 98 249 individuals, stratified into nurses and care assistants (n=16 179) and a reference population including all other occupations (n=82 070).

OUTCOME MEASURE

Annual days of compensated SA (>14 days) 3 years after exposure years.

RESULTS

Nurses and care assistants had higher SA in 1993-2014 compared with all other occupations, and differences in background factors only partly explained this relationship. For both groups, exposure to physical work factors remained steady, but the number of exposed were 10%-30% higher among nurses and care assistants. Those exposed to heavy physical work and strenuous working postures had in most years significantly higher SA when compared with non-exposed (rate ratio range: 1.4-1.9). Exposure to high job demands increased 10%-25% in 1991-1999 among nurses and care assistants but became more stable in 2001-2013 and high proportions of high job demands coincided with the increase in SA in 1995-1999. Nurses and care assistants exposed to high job demands had for most years significantly higher SA than non-exposed (rate ratio range: 1.5-2.1). Low job control and low support from supervisors elevated SA significantly only for a few years.

CONCLUSIONS

Exposure to negative work factors among nurses and care assistants was weakly associated with variations in SA, but may be related to their higher level of SA when compared with other occupations. Improved physical and psychosocial working conditions may reduce the elevated SA level in these occupations.

Developing the Australian Midwifery Workplace Culture instrument

AIM

To develop and psychometrically test the Australian Midwifery Workplace Culture instrument.

BACKGROUND

Workplace culture is critical within midwifery settings. Culture determines not only the well-being and continued retention of maternity staff and managers but it also affects the quality and ultimate safety of the care they provide to women, infants and families. Several studies have identified cultural problems within maternity services. Relatively few instruments take account of the unique aspects of these workplaces and the relationship between midwives and women.

DESIGN

Three-stage instrument development involved item generation (based on the Culture of Care Barometer), expert content validation and a pilot test.

METHODS

During 2016, 38 midwifery experts reviewed the initial items, and 322 midwives then pilot-tested the draft instrument. We used exploratory factor analysis to identify key domains and to refine the instrument.

RESULTS

The refined instrument contained 22 items in three distinct domains: relationship with managers, empowerment and collegiality.

CONCLUSION

The instrument can contribute to understanding important dimensions of the culture in maternity workplaces and thus to examining problematic attitudes and practices. The instrument requires further development and testing with larger and more diverse samples of midwives and validation in specific midwifery settings and models of care.

Epidemic characteristics and related risk factors of occupational exposure for pediatric health care workers in Chinese public hospitals: a cross-sectional study

Background

Health care workers have a high risk of occupational exposure. However, the risk of occupational exposure for pediatric health care workers has not been acknowledged in previous studies. The purpose of this study was to investigate the occupational exposure rate of pediatric health care workers in Chinese public hospitals, to explore risk factors for occupational exposure, and to put forward corresponding countermeasures to reduce occupational exposure of pediatric health care workers and protect their physical and mental health.

Methods

A cross-sectional study was conducted with pediatric health care workers in 43 hospitals in 15 provinces in eastern, central, and western China between July and October 2018. With this sample, we computed the descriptive statistics of the demographic characteristics, calculated the frequency of various types of occupational exposure, and tested risk factors for occupational exposure using a chi-squared test and binary logistic regression analysis.

Results

Most respondents were nursing staff (61.1%) and workers with a low-ranking professional title (50.5%). The most common style of occupational exposure in our sample was a hazard in the work environment (62.6%). Notably, physicians were less likely to experience occupational exposure than nurses (OR = 0.320, 95% CI = 0.241, 0.426). Meanwhile, pediatric health care workers who interpreted the doctor-patient relationship as harmonious (OR = 0.304, 95% CI = 0.152, 0.607) were less likely to suffer occupational exposure.

Conclusion

Pediatric health care workers in Chinese public hospitals have a high occupational exposure risk and the risk factors are complex and diverse. The state, society, hospitals should acknowledge this issue and develop strategies to protect the physical and mental health of pediatric health care workers.