A Comparison of Job Stress Models: Associations With Employee Well-Being, Absenteeism, Presenteeism, and Resulting Costs

The relationship between job stress and the perception of patient safety culture among Palestinian hospital nurses

BACKGROUND

Patient safety is a global concern, with high rates of medical errors reported annually. Understanding the relationship between nurses' job stress and patient safety culture (PSC) is crucial. Despite their pivotal role in healthcare, nurses face stress due to demanding job roles and the challenging healthcare system in Palestine. This study aims to explore the relationship between nurses' job stress and PSC in Palestinian hospitals, identifying predictors that impact PSC to enhance healthcare outcomes and support healthcare professionals.

METHODS

This study employed a quantitative cross-sectional approach. Data collection took place from June to September 2023. The study utilized self-report surveys, including the Hospital Survey of Patient Safety Culture (HSOPSC) and the Nursing Stress Scale (NSS), administered to 355 nurses working in 16 North West Bank hospitals in Palestine. The data collected were analyzed via descriptive and inferential analysis.

RESULTS

Overall, 47% of the nurses reported having positive PSC. The areas with the most positive perception were "teamwork" and "organizational learning-continuous improvement", with mean percentages of positive responses of 63.1% and 55.8%, respectively. Conversely, the composites with the lowest positive response scores included "Response to Error" and "Staffing and Work Pace", with mean percentages of positive responses of 30.9% and 34.8%, respectively. Furthermore, the most common sources of job stress perceived by nurses were "workload" and "death and dying", with mean scores of 1.42 and 1.20, respectively. However, the lowest-scoring sources of stress were in the subscales "Uncertainty concerning treatment" and "Inadequate preparation", with mean scores of 1.02 and 1.06, respectively. Statistical tests revealed that six factors were significantly associated with the perception of PSC. Among these factors, income, hospital type, activities to improve PSC, patient safety ratings of work areas, and weekly night shifts emerged as predictors of PSC. Additional tests revealed nine factors significantly associated with job stress. Among these factors, gender, educational level, engagement in stress relief activities, participation in PSC improvement activities, and patient safety ratings emerged as predictors of job stress. Moreover, the study revealed negative correlations between job stress and PSC.

CONCLUSION

This study identified the need for tailored policies and interventions that address nurses' specific stressors to enhance PSC within hospital settings. Moreover, the study shed light on the unique challenges faced by nurses in Palestine, such as limited resources, unemployment concerns, staffing, and transportation issues, which further exacerbated job stress levels and potentially compromised patient safety. Understanding these contextual factors is crucial for developing targeted interventions and support systems that prioritize the holistic well-being of nurses and the quality of patient care delivery.

Job stress and patient safety culture: a qualitative study among hospital nurses in Palestine

BACKGROUND

In recent years, the healthcare industry has witnessed growing concern over patient safety culture, with a specific focus on the role of nursing professionals. This research explores the intricate dynamics between job-related stress and patient safety culture perceptions among hospital nurses in Palestine.

METHODS

This study employed a qualitative, interpretative phenomenological approach to explore the lived experiences of nurses. A purposive sampling strategy was used to select seven registered nurses from multiple hospital units across the North West Bank, Palestine. The participants were selected based on criteria including a minimum of one year of clinical experience, experience in diverse hospital units, and willingness to share their experiences. Special emphasis was placed on including nurses with a Master's degree in nursing because of their potential for advanced insights and the high percentage of nurses with this degree in Palestine. In-depth semi-structured interviews, lasting approximately 28-40 min each, were conducted in September 2023. Three interviews were conducted via Zoom, and four were conducted face-to-face. Thematic analysis was used to identify key themes and patterns. The small sample size was justified by the study's focus on in-depth exploration of individual experiences and the achievement of thematic saturation.

RESULTS

The study findings revealed six main themes: five related to patient safety culture and three related to job stress. Factors such as teamwork, workload, staffing, communication, conflict with colleagues, lack of support, and error reporting significantly influence job stress and patient safety culture. The study suggested that job stress has a negative effect on the perception of patient safety culture. Notably, support for nurses in managing job stress was primarily at the individual level, with limited hospital-based initiatives.

CONCLUSION

This study emphasized the importance of customized policies and interventions to address nurses' specific stressors and improve hospital patient safety culture. Additionally, it highlighted the distinct challenges encountered by Palestinian nurses, including resource limitations and staffing issues. These factors intensify job stress and could increase job stress and impact patient safety. Recognizing these contextual nuances is essential for designing focused interventions and support systems that prioritize nurses' overall well-being and enhance the quality of patient care. Hospital administrations should also focus on implementing coping mechanisms to help nurses manage stress and mitigate its effects on their well-being and patient outcomes.

Burnout, collective efficacy and the social network of an intensive care unit

BACKGROUND

The prevalence of burnout among critical care nurses is high. Burnout has been explored at the individual and system levels, with little research occurring at the unit level. Increased social support and self-efficacy are correlated with a decreased risk of burnout at the individual level; however, little is known in how collective efficacy and types of social support are protective against the development of burnout.

AIM

Explore the relationships between burnout, collective efficacy and social supports in an intensive care unit.

STUDY DESIGN

Using a descriptive design, health care professionals working in an intensive care unit (n = 39) were recruited to complete surveys measuring burnout, collective efficacy and four types of social support (emotional, instrumental, informational and advice-seeking). Data were analysed using Spearman's rank correlation and sociograms.

RESULTS

The unit displayed burnout with high levels of emotional exhaustion, moderate levels of depersonalization and high levels of personal accomplishment. The unit had high levels of collective efficacy. Collective efficacy demonstrated a significant and strong negative correlation with emotional exhaustion (rs = -0.57, p < .001) and a significant strong positive correlation with personal accomplishment (rs = 0.50, p < .005). The advice-seeking network was dense (67%) and advice-seeking social support had a significant negative association with personal accomplishment (rs = -0.35, p < .01).

CONCLUSIONS

The results demonstrated that burnout develops sequentially from emotional exhaustion to depersonalization to lack of personal accomplishment. Social network analysis methods displayed a deeper understanding of community on a unit than prior quantitative research exploring burnout.

RELEVANCE TO CLINICAL PRACTICE

To decrease burnout, we recommend assessing burnout as a continuum and as a unit-level risk factor. Interventions should be identified that strengthen community on the unit as well as supporting unit leaders.

Effects of a mindfulness-based health promotion program on mindfulness, psychological capital, compassion fatigue, and affect in healthcare workers

Objective

This study aimed to examine the effects of the Mindfulness-Based Health Promotion program on mindfulness, psychological capital, compassion fatigue, and affect in a sample of healthcare workers at a hospital in Colombia.

Method

Randomized controlled study with pre-test and post-test measures, in which 33 workers participated (Mage = 35.01, SD = 10.0), assigned to the experimental group (EG, n = 16, Mage = 34.00, SD = 9.59) and the wait-list control group (CG, n = 17, Mage = 36.03, SD = 10.56). The contrast of the program effects was carried out through a mixed factorial ANOVA.

Results

We found significant effects on observing, non-reacting and mindfulness as a function of the group factor.

Conclusion

We concluded the Mindfulness-Based Health Promotion program showed positive effects on mindfulness, this was tested with a novel program designed for the Latin population. This study is pioneering in using this mindfulness program in Colombia. These findings offer valuable insights for leaders of healthcare institutions when developing intervention programs that promote the mental health in the workplace. Future studies with larger samples and mixed-methods are necessary to confirm our results and to identify factors that can predict these findings.

Violent encounters on the front line: Sequential explanatory mixed-methods investigation of physical violence factors in the prehospital setting

OBJECTIVE

Workplace violence (WPV) is an important issue in prehospital care, especially for emergency medical technicians ( EMTs) who are at increased risk of physical violence due to the nature of their work. This study aimed to shed light on the specific factors that contribute to the underlying causes of physical WPV in the prehospital context through direct experience and insight into the work of EMTs.

METHODS

Sequential explanatory mixed methods were applied in five western provinces of Iran from 2022 to 2023. In total, 358 EMTs that met the criteria for the quantitative phase were selected using a multi-stage clustering method. In the quantitative phase, the researchers used a questionnaire on workplace violence in the healthcare sector. Based on the results of the quantitative phase, 21 technicians who had experienced physical violence in the past 12 months were invited for in-depth interviews in the qualitative phase.

RESULTS

The average age of the EMTs was 33.96 ± 6.86 years, with an average work experience of 10.57 ± 6.80 years. More than half (53.6%) of the staff worked 24-hour shifts. In addition, most EMTs were located in urban bases (50.3%), and 78 (21.8%) reported having experienced physical violence. No significant correlations were found between the demographic characteristics of the technicians and the frequency of physical violence, except base location in the last 6 months. The qualitative study also created one theme (the complexity of WPV in the prehospital setting), four categories, and ten subcategories.

CONCLUSION

The study's results emphasize the need for comprehensive WPV factors in the prehospital setting. These factors can lead to identifying and improving strategies such as organizational support, improving communication and collaboration between responders, and training in de-escalation techniques. In addition, it is crucial to address the root causes of WPV such as poverty and lack of education in the community to create a safer and more supportive environment for patients and staff.

Exploring presenteeism trends: a comprehensive bibliometric and content analysis

Objective

This research will conduct a bibliometric and content analysis of presenteeism from 2000 to 2023. It aims to investigate publication trends, authorship patterns, and significant publications by using presenteeism conceptualizations, measurements, determinants, consequences, and interventions analysis. The study provides valuable insights for researchers, practitioners, and policymakers about understanding and addressing workplace presenteeism issues.

Methods

The research involved conducting a bibliometric study to analyze presenteeism publication trends, authorship patterns, and significant publications. It also explored the evolution of presenteeism research over time, identifying contributing countries, institutions, and writers. The interdisciplinary nature of presenteeism research was emphasized, covering occupational health, psychology, management, and public health. The researchers have used VOS Viewer and R Studio (biblioshiny) for this study.

Results

The study identified several elements influencing presenteeism, such as health issues, work-related factors, organizational culture, and individual characteristics. It further examined the impact of organizational policies, leadership support, employee assistance programs, and health promotion activities in reducing absenteeism and enhancing employee well-being. These findings highlight the importance of addressing these factors to mitigate presenteeism issues and promote a healthier work environment.

Conclusion

This research identified deficiencies in presenteeism research and provided recommendations for future investigations in this field. It emphasized the need for standardized measures and methodologies, longitudinal studies to understand causality, and industry- and population-specific interventions. These insights can guide future research directions and interventions to address presenteeism issues in a rapidly changing work and research landscape.

Burnout and perceived stress among Italian physical therapists during the COVID-19 pandemic: a cross-sectional study

High levels of burnout and psychological distress have been reported for healthcare workers, with seemingly worse outcomes after the outbreak of the COVID-19 pandemic. However, to date, scarce evidence has been gathered about the condition of physical therapists. This cross-sectional study investigated the three burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment as measured by the Maslach Burnout Inventory (MBI) and assessed perceived stress with the 10-item Perceived Stress Scale (PSS) in a sample of Italian physical therapists with the aim of examining the relationships between these variables and demographic and work-related factors. An anonymous questionnaire was administered to a convenience sample of 671 professionals from the whole nation and associations between burnout, perceived stress, and work-related variables were investigated with descriptive and inferential statistical methods. Overall, 25% of the participants showed high burnout risk (40% scored high on emotional exhaustion, 36% scored high on depersonalization, and 19% scored low on personal accomplishment), whereas 50% reported high levels of perceived stress. Having been exposed to verbal or physical aggressive behaviors at work (OR = 4.06) was associated with high burnout risk, and participants at risk were significantly younger than those showing no burnout risk (d = 0.27). Having a partner (OR = 0.54) and having children (OR = 0.56) were associated on the other hand with reduced burnout risk. Regression models identified weekly working hours (β = 0.16), exposure to aggressive behaviors at work (β = 0.12), and perceived stress (β = 0.66) as significant predictors of emotional exhaustion, gender (β = 0.18), exposure to aggressive behaviors (β = 0.09), and perceived stress (β = 0.37) as predictors of depersonalization, and gender (β=-0.1) and perceived stress (β=-0.35) as predictors of personal accomplishment.In summary, this study found high rates of burnout and psychological distress among Italian physical therapists a year after the outbreak of COVID-19. Significant relations were found between burnout, psychological distress, and both socio-demographic and work-related variables.

Occupational Stress: A Concept Analysis with Implications for Immigrant Workers' Mental Health in the United States

Background

Occupational stress is a phenomenon affecting people worldwide. Investigating occupational stress among immigrant worker populations will unravel some of the intricacies of this condition and its psychological effects on this population.

Aim

This paper conceptually examined occupational stress within the context of immigrant workers' mental health and offer an operational definition to aid nurse researchers, educators, and practitioners in assessing and managing patients and developing culturally appropriate interventions for this population.

Design

Walker and Avant's eight-step concept analysis is used as an organizing framework.

Data Source

MEDLINE, CINAHL, OVID, PubMed, and APA Psych Info.

Review Methods

Keywords job stress, immigrant work stress, occupational stress scale, immigrant work-related stress, and mental health were used. The search yielded 142 articles; 17 were selected based on the effect of work stress on mental health.

Results

This analysis found that occupational stress can be attributed to communication problems, alienation, discrimination, and barriers to work-life balance can cause negative consequences among immigrants. An operational definition is also provided.

Conclusion

There is a growing need to examine closely and differentiate between occupational and acculturative stress to navigate a more profound understanding of how these conditions negatively complement each other.

Universal, selective and indicated interventions for supporting mental health at the workplace: an umbrella review of meta-analyses

The current umbrella review aimed to assess and summarise evidence on universal, selective and indicated interventions for mental health at the workplace. This umbrella review forms one of the evidence reviews which were commissioned by the WHO to develop global guidelines on mental health at work. We conducted systematic searches in five bibliographic databases (PubMed, Embase, PsycINFO, Cochrane and Global Medicus Index) and included meta-analyses of randomised trials examining psychosocial, physical activity and lifestyle interventions delivered to all general workers (universal interventions), at-risk workers (selective interventions) and workers already experiencing symptoms of mental disorders (indicated interventions). We included outcomes from seven domains: symptoms of mental health conditions, positive mental health, quality of life, work-related outcomes, substance use, suicide-related outcomes and potential adverse effects. We identified 16 meta-analyses producing 66 pooled effect sizes of the examined interventions, mostly on symptoms of mental health conditions (n=43 pooled effect sizes) (eg, burnout, insomnia, stress) and positive mental health (n=15) (eg, well-being). Most of the evidence on universal, selective and indicated interventions was focused on psychosocial interventions, showing small to moderate effects across the various outcomes. Certainty levels according to GRADE (Grading of Recommendations Assessment, Development and Evaluation) were low to very low in almost all of the examined outcomes. The results of existing meta-analyses are promising for the use of preventative and early treatment interventions in the workplace. However, the quality and certainty of the evidence were very modest, and further research on the effectiveness of these interventions is warranted.

The Benefits of an Employee-Friendly Company on Job Attitudes and Health of Employees: Findings from Matched Employer-Employee Data

Background: This study explored the association of an employee-friendly work environment with employees’ job attitudes (engagement, commitment, turnover intentions, and job satisfaction), and health (mental and general health), applying matched employer–employee data. Methods: The German Linked Personnel Panel (LPP; n = 14,182) survey simultaneously captures the data of employees and the human resources (HR) management of companies. A two-step cluster analysis of 16 items of the HR valuation identified relatively more- and less-employee-friendly companies (EFCs). Logistic regressions tested differences between these companies in the assessment of job attitudes and health of their employees. Results: Compared to less-EFCS, more-EFCS had a reduced risk of poorer job attitudes and substandard health of their employees. For example, the risk for higher turnover intentions was reduced by 33% in more-EFCS (OR = 0.683, 95% C.I. = 0.626–0.723), and more-EFCS had an 18% reduced chance of poor mental health reporting of their employees (OR = 0.822, 95% C.I. = 0.758–0.892). Conclusions: More-EFCS have more motivated and healthier employees. The most distinct factors for more-EFCS were: the existence of development plans for employees, opportunities for advancement and development, and personnel development measures.

A Technology-Assisted Telephone Intervention for Work-Related Stress Management: Pilot Randomized Controlled Trial

Background

Stress management interventions combining technology with human involvement have the potential to improve the cost-effectiveness of solely human-delivered interventions, but few randomized controlled trials exist for assessing the cost-effectiveness of technology-assisted human interventions.

Objective

The aim of this study was to investigate whether a technology-assisted telephone intervention for stress management is feasible for increasing mental well-being or decreasing the time use of coaches (as an approximation of intervention cost) while maintaining participants’ adherence and satisfaction compared with traditional telephone coaching.

Methods

A 2-arm, pilot randomized controlled trial of 9 months for stress management (4-month intensive and 5-month maintenance phases) was conducted. Participants were recruited on the web through a regional occupational health care provider and randomized equally to a research (technology-assisted telephone intervention) and a control (traditional telephone intervention) group. The coaching methodology was based on habit formation, motivational interviewing, and the transtheoretical model. For the research group, technology supported both coaches and participants in identifying behavior change targets, setting the initial coaching plan, monitoring progress, and communication. The pilot outcome was intervention feasibility, measured primarily by self-assessed mental well-being (WorkOptimum index) and self-reported time use of coaches and secondarily by participants’ adherence and satisfaction.

Results

A total of 49 eligible participants were randomized to the research (n=24) and control (n=25) groups. Most participants were middle-aged (mean 46.26, SD 9.74 years) and female (47/49, 96%). Mental well-being improved significantly in both groups (WorkOptimum from “at risk” to “good” Â>0.85; P<.001), and no between-group differences were observed in the end (Â=0.56, 95% CI 0.37-0.74; P=.56). The total time use of coaches did not differ significantly between the groups (366.0 vs 343.0 minutes, Â=0.60, 95% CI 0.33-0.85; P=.48). Regarding adherence, the dropout rate was 13% (3/24) and 24% (6/25), and the mean adherence rate to coaching calls was 92% and 86% for the research and control groups, respectively; the frequency of performing coaching tasks was similar for both groups after both phases; and the diligence in performing the tasks during the intensive phase was better for the research group (5.0 vs 4.0, Â=0.58, 95% CI 0.51-0.65; P=.03), but no difference was observed during the maintenance phase. Satisfaction was higher in the research group during the intensive phase (5.0 vs 4.0, Â=0.66, 95% CI 0.58-0.73; P<.001) but not during the maintenance phase.

Conclusions

The technology-assisted telephone intervention is feasible with some modifications, as it had similar preliminary effectiveness as the traditional telephone intervention, and the participants had better satisfaction with and similar or better adherence to the intervention, but it did not reduce the time use of coaches. The technology should be improved to provide more digested information for action planning and templates for messaging.

Trial Registration

ClinicalTrials.gov NCT02445950; https://www.clinicaltrials.gov/ct2/show/study/NCT02445950

Organizational Justice and Health: Reviewing Two Decades of Studies

Organizational justice refers to employees’ perceptions of the fairness of decision-making rules and policies in the workplace. Lack of justice is suggested to be a significant psychosocial risk factor that affects employees’ attitudes and health. The aim of this narrative review was to compile the evidence available about the effects of organizational justice on health. To this end, a literature search was carried out using the Web of Science, PubMed, and PsycINFO databases. The final sample consisted of 103 articles that studied the effects of justice on mental health (40 results), job stress (26), sickness absence (15), physical health (14), absenteeism/presenteeism (3), safety at work (3), and health of third parties (2). The results show that perceptions of workplace justice predict employees’ mental health, stress-related health problems, and lower levels of sickness absence were relatively compelling. Future studies should focus on less-researched outcomes and on how these associations are modified by other variables for a better understanding of how justice affects health, with a view to being able to carry out preventive measures more efficiently.

Associations between Coping Profile and Work Performance in a Cohort of Japanese Employees

This study aimed to investigate the effects of coping profiles on work performance. Data were collected during a 2-year prospective cohort study of 1359 employees in Japan. Participants completed a self-administered questionnaire in 2018 (T1; baseline) and again in 2020 (T2; followup; followup rate: 69.8%) to enable the assessment of work performance, perceived stress, and stress coping profiles at T1 and T2. Multivariate logistic regression models and causal mediation analysis were performed to identify the effects of coping profiles on work performance. Covariates included age, sex, company, job type, employment status, working hours, holidays, and lifestyle behaviors (e.g., smoking, sleep duration). A dysfunctional coping profile (β = −1.17 [95% CI, −2.28 to −0.06], p = 0.039) was negatively associated with work performance. Coping profiles of planning (β = 0.86 [95% CI, 0.07−1.66]) and self-blame (β = −1.33 [95% CI, −1.96 to −0.70], p < 0.001) were significantly associated with work performance. Dysfunctional coping, specifically, self-blame (β = −1.22 [95% CI, −1.83 to −0.61]), mediated the association between stress and work performance. Thus, some coping profiles may lead to an increase or decrease in work performance. The possible impact of coping strategies on workers’ productivity requires further exploration. Furthermore, information on effective coping profiles should be incorporated into occupational health examinations.

Mindfulness practice improves managers’ job demands-resources, psychological detachment, work-nonwork boundary control, and work-life balance – a randomized controlled trial

Purpose

Contemporary workplaces undergo frequent reorganizations in order to stay competitive in a working life characterized by globalization, digitalization, economic uncertainty, and ever-increased complexity. Managers are in the frontline of these challenges, leading themselves, organizations and their employees in high stress environments. This raises questions on how to support managers’ work-life sustainability, which is crucial for organizational sustainability. Mindfulness has been related to enhanced capacities to cope with challenges that are associated with organizational change. The authors evaluated short- and long-term effects of an eight-week mindfulness-based intervention in a company setting, which was going through reorganization.

Design/methodology/approach

Forty managers (42.5% males), mean age 54.53 (SD 5.13), were randomized to the mindfulness intervention or a non-active wait-list control. Self-report data were provided on individual sustainability factors in a work context: job demands and resources, psychological detachment, i.e. possibilities for letting go of work-related thoughts during leisure, control over work-nonwork boundaries, work-life balance, and mindfulness at baseline, postintervention, and at 6-month follow-up.

Findings

Linear mixed models (LMMs) analysis (all ps < 0.005 to 0.05) showed that the intervention group had a larger decrease in job demands and a smaller decrease in job resources, a larger increase in psychological detachment, work-nonwork boundary control, work-life balance, and mindfulness from baseline to postintervention when compared with the reference group. These initial effects were sustained at 6-month follow-up.

Originality/value

The study provides evidence that mindfulness practice can enhance managers’ long-term capacity to cope with challenging working conditions, and increase their work-life sustainability in times of organizational change and disruption.

Presenteeism and absenteeism in the manufacturing sector: A multilevel approach identifying underlying factors and relations to health

Presenteeism is problematic since it relates to lower health and productivity. Prior research examined many work and attitudinal variables relating to presenteeism at the individual level. Here, we conceptualize presenteeism as multilevel phenomenon also shaped by the overall attendance behavior (absenteeism and presenteeism) at the work unit. We surveyed employees at a manufacturing plant on presenteeism, health-related lost productive time (HLPT) and absenteeism (N = 911, 22 units) and collected preceding (past 12-7 and 6 months) objective absence data aggregating it at unit level. Considering the individual-level antecedents only higher physical demands predicted higher absence duration. Presenteeism related positively to physical demands, a burdensome social environment, and organizational identification and negatively to ease of replacement, and core self-evaluations. These relationships were similar for HLPT as outcome. Regarding unit-level factors, preceding unit-level absence frequency (but not duration) negatively related to presenteeism. The negative relationship between core self-evaluations and individual presenteeism decreased under a stronger presenteeism context supporting the hypothesized cross-level effect of unit-level presenteeism context strength. Moreover, individual and unit-level presenteeism correlated, as expected, more strongly with health complaints than absenteeism. Our study demonstrates the value of a contextual, multilevel approach for understanding antecedents and consequences of attendance behavior.

Reducing Psychosocial Risk Factors and Improving Employee Well-Being in Emergency Departments: A Realist Evaluation

This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach "PRIMA" which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, the study aims to assess potential moderators including the level of intervening (organization-directed or multilevel), process variables (the number and fit of actions to risk factors, communication and employee participation) and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity (based on the number of actions implemented) and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions (including professional support for employees with stress-related complaints) seem essential to also improve well-being.

Moderating Effect of Psychological Well-Being on the Effect of Workplace Safety Climate on Job Stress

AIM

The main purpose of this study is to reveal the moderating effect of psychological well-being on the effect of workplace safety climate on job stress.

METHODS

: The cross-sectional study was designed inclusive of the use of the survey method. 291 healthcare professionals returned the survey forms, among those, 75.9% of the participants were women, and the mean age of the sample was 32.83±6.03. Most of the participants (66.6%) had a Bachelor's degree or higher. We analyzed the data using, a structural equation modeling framework used to test both direct and mediating effects. Hayes' (2013) Model 4 was used to identify the mediating role of psychological well-being on the effect of workplace safety climate on job stress.

RESULTS

:According to the analysis results, the created model is significant, and psychological well-being plays a mediating role on the effect of workplace safety climate on job stress, reinforcing the negative effect of workplace safety climate on job stress.

CONCLUSION

Our results revealed that first the safety environment perceived by the employees reduces their stress. Second, psychological well-being plays a mediating role in relation to the effect of safety climate on job stress. This role contributes to the reduction of stress through the improvement of the safety climate.

Predicting Work-Life Conflict: Types and Levels of Enacted and Preferred Work-Nonwork Boundary (In)Congruence and Perceived Boundary Control

In 2020, everyday life changed dramatically for employees worldwide as a result of the outbreak of the Covid-19 pandemic, where an estimated 558 million employees started working from home. The pandemic, therefore, marks a fundamental shift of individuals’ work-nonwork boundaries, which can impact work-life conflict. In particular, the interplay between individuals’ enacted boundaries (degree to which they separate/segment or blend/integrate work-nonwork), preferred boundaries (degree of preferred segmentation or integration of work-nonwork), and perceived control over work-nonwork boundaries, may relate to work-life conflict. This study, the first to the best of our knowledge, examines whether different types and levels of work-nonwork boundary (in)congruence matter for work-life conflict, and whether perceived boundary control moderates these relationships. Boundary (in)congruence represents the degree of (mis)fit between enacted and preferred segmentation or integration. Several types of (in)congruence are distinguished: “segmentation congruence” (enacting and preferring segmentation); “integration congruence” (enacting and preferring integration); “intrusion” (enacting integration but preferring segmentation) and “distance” (enacting segmentation but preferring integration). Data from 1,229 managers working in public and private organizations in Sweden was analyzed using polynomial regression analysis with response surface modeling and moderation analysis in SPSS Process. Findings showed that “integration congruence” was related with higher work-life conflict than “segmentation congruence.” Moreover, a U-shaped relationship between incongruence and work-life conflict was found: the more incongruence, the more work-life conflict. Specifically, “intrusion” was related to higher work-life conflict than “distance.” Finally, boundary control mitigated the effect of incongruence (especially “intrusion”) on work-life conflict. From our findings, we may conclude that work-life conflict is impacted differently depending on the type and level of boundary (in)congruence. Particularly enacted and/or preferred integration may be problematic when it comes to work-life conflict, rather than just (in)congruence per se. Moreover, boundary control can be viewed as a key factor in combating work-life conflict, especially among individuals who enact integration, but prefer segmentation. Taken together, our study contributes new and substantial knowledge by showing the importance for research and HRM-policies that take into account different types and levels of boundary (in)congruence, as these are associated with different levels of work-life conflict, which, in turn, are moderated by boundary control.

The Effect of Emotional Labor on Presenteeism of Chinese Nurses in Tertiary-Level Hospitals: The Mediating Role of Job Burnout

Background: Employees who are physically present but work insufficiently because of illness are deemed as having presenteeism. In the health care setting, the issue has taken on greater importance because of the impairment of the physical and mental health of nurses and the nursing safety of the patients. According to the Job Demand-Resource Model, burnout may link emotional labor with presenteeism. Thus, this study analyzed the role of burnout as a mediating factor between the three types of emotional labor strategies and presenteeism among nurses in tertiary-level hospitals. Methods: A cross-sectional study of 1,038 nurses from six Chinese hospitals was conducted. The questionnaires, including the 14-item emotional labor strategies scale, 22-item Maslach Burnout Inventory scale, 6-item Stanford Presenteeism Scale, and items about demographic characteristics and work-related factors, were used to collect data. A multivariable linear regression was used to predict work-related factors and investigate the correlation of emotional labor, burnout, and presenteeism. The structural equation model was implemented to test the mediating effects of job burnout. Results: The results of the study showed that the average presenteeism score of the participants was 14.18 (4.33), which is higher than in Spanish, Portuguese, and Brazilian nurses. Presenteeism was explained by 22.8% of the variance in the final model in multivariable linear regression (P < 0.01). Presenteeism was found to be positively correlated with surface acting, emotionally expressed demands, deep acting, emotional exhaustion, depersonalization, and low personal accomplishment (P < 0.01). Notably, presenteeism was negatively correlated with deep acting (P < 0.01). In addition, burnout partially mediated the correlation between emotionally expressed demands, deep acting, and presenteeism with a mediatory effect of 24 and 63.31% of the total effect. Burnout completely mediated the association between surface acting and presenteeism, a mediating effect of 86.44% of the total effect. Conclusions: The results of this study suggested that different emotional labor strategies affect presenteeism, either directly or indirectly. Nursing managers should intervene to reduce presenteeism by improving the ability of the nurses to manage emotions, thereby alleviating burnout.

Subjective cognitive impairment and presenteeism mediate the associations of rumination with subjective well-being and ill-being in Japanese adult workers from the community

Background

In recent years, the roles of rumination, subjective cognitive impairment (SCI), and presenteeism have been emphasized in occupational mental health. However, associations between rumination, SCI, presenteeism, and psychological well-being are not fully understood. We hypothesized that SCI and presenteeism mediate the associations between rumination and subjective well-being (SWB) and subjective ill-being (SIB). Hence, we investigated the mediating roles of SCI and presenteeism in this study.

Methods

A total of 458 adult workers (mean age, 40.8±11.9 years; 44.1% male), who were recruited in Tokyo using convenience sampling, were analyzed in this study. The Ruminative Responses Scale, Cognitive Complaints in Bipolar Disorder Rating Assessment, Work Limitations Questionnaire 8, and Subjective Well-being Inventory were used to evaluate rumination, SCI, presenteeism, and psychological well-being (SWB and SIB), respectively. Path analyses were performed to evaluate the relations between these parameters.

Results

The path analysis indicated that rumination, SCI, and presenteeism were directly and negatively associated with SWB and SIB. Regarding indirect effects, rumination was negatively associated with SWB and SIB via SCI, presenteeism, and both SCI and presenteeism. Furthermore, SCI was negatively associated with SWB and SIB via presenteeism.

Conclusions

The results suggest that SCI and presenteeism mediate the associations of rumination with SWB and SIB in Japanese adult workers. To address the psychological well-being associated with rumination, evaluating SCI and presenteeism simultaneously may be useful in occupational mental health. This study provides key insights into the development of comprehensive intervention strategy based on the biopsychosocial perspective for worker’s psychological well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13030-021-00218-x.

Work-Related Factors Affecting the Occurrence of Presenteeism － Recent Research Trends and Future Directions

Productivity loss due to presenteeism accounts for a large proportion of economic losses caused by workers' health problems. To reduce presenteeism, it is necessary to identify its causes, but, in contrast to the large amount of research on the effects of diseases and lifestyles, there is not enough research on the effects of work-related factors on presenteeism. In this study, those factors include the work environment and the work-related psychological status of workers. The purpose of this review was to identify research trends in presenteeism, defined as work-related productivity loss, and to examine future directions for presenteeism research. We conducted a search with only the keyword "presenteeism" using MEDLINE/PubMed for the last 5 years and extracted 30 relevant articles, most of which were cross-sectional studies. The articles were categorized into the following themes: 1) studies on the associations of various stress models and factors with presenteeism; 2) studies on the mediators and the pathways of association between stress factors and presenteeism; 3) studies on the relationships between organizational factors and presenteeism; and 4) studies on the link between workers' positive and negative psychological status and presenteeism. Our findings showed that, over the last 5 years, the relationship between psychological stress and presenteeism has been extended to include a variety of stress models and stressors. In addition, by putting many models and factors into a single statistical model and adjusting for their interrelationships, important factors have been examined by ensuring that a significant relationship with presenteeism remains. As there is still a lack of longitudinal studies necessary to discuss causality, more research of higher quality is needed.

Proposal of layered mental healthcare for mental well-being

A new concept, 'Layered mental healthcare' for keeping employees mental well-being in the workplace to avoid losses caused by both absenteeism and presenteeism is proposed. A key factor forming the basis of the concept is the biometric measurements over three layers, i.e., behaviour, physiology, and brain layers, for monitoring mental/distress conditions of employees. Here, the necessity of measurements in three layers was validated by the data-driven approach using the preliminary dataset measured in the office environment. Biometric measurements were supported by an activity tracker, a PC logger, and the optical topography; mental/distress conditions were quantified by the brief job stress questionnaire. The biometric features obtained 1 week before the measurement of mental/distress scores were selected for the best regression model. The feature importance of each layer was obtained in the learning process of the best model using the light graded boosting machine and was compared between layers. The ratio of feature importance of behaviour:physiology:brain layers was found to be 4:3:3. The study results suggest the contribution and necessity of the three-layer features in predicting mental/distress scores.

Are Demanding Job Situations Associated with Alcohol-Related Presenteeism? The WIRUS-Screening Study

Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance for safety at work.

Effectiveness and cost effectiveness of a stress management training for leaders of small and medium sized enterprises - study protocol for a randomized controlled-trial

BACKGROUND

Leaders in small and medium-sized enterprises (SMEs) are exposed to increased stress as a result of a range of challenges. Moreover, they rarely have the opportunity to participate in stress management trainings. Therefore, KMU-GO (ger: Kleine und mittlere Unternehmen - Gesundheitsoffensive; en: small and medium-sized enterprises - health campaign) aims at conducting and evaluating such a stress management training. The focus of evaluation does not only lie on the effects on leaders participating but also on their employees.

METHODS

The study is planned as a 2 × 3 mixed design with two groups (intervention and waiting control group) as a between factor and point in time (at baseline, 6 and 12 months later) as a within factor. We aim at collecting data from N = 200 leaders. Based on the results of a preceding assessment, an already successfully implemented stress management training was adapted to SME needs and now serves as the framework of this intervention. The stress management training comprises one and a half days and is followed by two booster sessions (each 180 min) about 3 and 6 months after the training. The main focus of this intervention lies on specifying leaders stress reactivity while at the same time investigating its effects on employees' mental health. Further dependent variables are leaders´ depression and anxiety scores, effort-reward imbalance, sick days and psychophysiological measures of heart rate variability, hair cortisol, and salivary alpha-amylase. Cost-effectiveness analyses will be conducted from a societal and employers' point of view.

DISCUSSION

Stress management is a highly relevant issue for leaders in SMEs. By providing an adequate occupational stress management training, we expect to improve leaders´ and also employees` mental health, thereby preventing economic losses for SMEs and the national economy. However, collecting data from employees about the success of a stress management training of their leader is a highly sensitive topic. It requires a carefully planned proceeding ensuring for example a high degree of transparency, anonymity, and providing team incentives.

TRIAL REGISTRATION

The KMU-GO trial is registered at the German Clinical Trial Register (DRKS): DRKS00023457 (05.11.2020).

Workplace Situation and Well-Being of Ecuadorian Self-Employed

Due to novel coronavirus 2019 (COVID-19), the labor market is going to undergo a profound restructuring. The creation of a new labor paradigm by all stakeholders is essential. This document contributes to the current political and social debates about self-employment, the need for economic growth, and how these labor measures, which are deeply institutionalized, need a change of attitude for an adequate job reconstruction in terms of welfare and sustainability. Currently, policy makers are proposing actions and policies because the new labor paradigm is being designed in the countries of Latin America. This research aims to analyze the JDCS model (Job Demand-Control-Support) and well-being in the self-employed in Ecuador. Unlike previous studies, this research takes a comprehensive approach by considering this theoretical model and the figure of the self-employed in terms of well-being. The logistic model, using cases of more than one thousand workers, generated estimated results that indicate the existence of a significant effect of physical and psychological demands at work on the balance between well-being and the management of angry clients; the speed of execution; and the complexity of the tasks. Regarding labor control, the ability to solve problems and make decisions for the company are detected as influencing factors; finally, social support is another factor influencing global well-being for the self-employed. These results show that with an effective management of the self-employed labor environment, it is possible to achieve an adequate level of workplace satisfaction.

Nurses' Job Insecurity and Emotional Exhaustion: The Mediating Effect of Presenteeism and the Moderating Effect of Supervisor Support

Presenteeism refers to attending work when one is ill, which not only leads to a decline in the physical and mental health of employees but also negatively impacts organizational productivity and increases an organization's extra costs. Therefore, to explore the antecedents and outcomes of nurses' presenteeism behavior and the acting mechanism among the variables, a sample of 330 nurses from China were investigated with the Sickness Presenteeism Questionnaire, Job Insecurity Scale, Perceived Supervisor Support Scale, and Emotional Exhaustion Scale. The results indicated that (1) job insecurity had a significantly predictive effect on nurses' presenteeism behavior; (2) nurses' presenteeism partially mediated the relationship between job insecurity and emotional exhaustion; and (3) supervisor support moderated the relationship between nurses' presenteeism behavior and emotional exhaustion; i.e., the higher the level of supervisor support, the weaker the positive relationship between nurses' presenteeism behavior and emotional exhaustion. The findings provide theoretical guidance and an empirical basis for prevention and intervention strategies concerning nurses' presenteeism behavior.

Associations Between Workplace Exercise Interventions and Job Stress Reduction: A Systematic Review

Background: High job stress is positively associated with reduced quality of life in workers, detrimental effects on worker health, and increased worker absenteeism and lower productivity. Exercise is a proven approach for coping with psychological stress in general. However, relatively few research studies have examined the effects of workplace exercise interventions on job stress reduction. The purpose of this systematic review was to identify associations between workplace exercise interventions and job stress reduction among employees. Methods: A literature search was performed using five databases (i.e., CINAHL, Medline via PubMed, Scopus, PsycINFO, and Embase), and eligible studies were written in English, and were published between January 1990 and October 2018. Studies were included if worker participants were subjected to a workplace exercise intervention, and their job stress was measured before and after the intervention. To assess the quality of these studies, van Tulder's risk of bias assessment tool was applied. Findings: Eight studies were identified, and six of those (75%) were found to be of relatively good quality. In only two of the studies (25%) was the workplace exercise program associated with a statistically significant reduction in job stress. The study findings suggest that relationships between workplace exercise interventions and job stress reduction have not been sufficiently evaluated in the literature. Conclusion and Application to Practice: Based on the limited data available, future intervention research should focus on randomized controlled trials of interventions incorporating both exercise and multidimensional strategies to reduce job stress.