The association of perceived leadership style and subjective well-being of employees in a tertiary hospital in Germany

"Direct Me or Leave Me": The Effect of Leadership Style on Stress and Self-Efficacy of Healthcare Professionals

This study aims to investigate the influence of leadership on the self-efficacy of healthcare professionals. Additionally, it seeks to explore whether stress mediates the relationship between leadership and self-efficacy. Specifically, our study is focused on both transactional leadership and laissez-faire leadership, which are commonly practiced by healthcare professionals due to the settings of healthcare environments. This study utilized a structured questionnaire for measuring the leadership, stress, and self-efficacy of healthcare professionals. Data collection involved respondents rating these statements on a Likert scale. The sample consisted of 395 participants employed in healthcare organizations in Serbia. The analysis employed partial least squares structural equation modeling (PLS-SEM). The research findings indicate that laissez-faire leadership is positively associated with stress, while no significant negative impact on self-efficacy was observed. Transactional leadership did not demonstrate a significant relationship with reduced stress but was found to positively influence self-efficacy. Moreover, stress was identified as negatively impacting self-efficacy and mediated the association between laissez-faire leadership and self-efficacy, although no mediating effect was found for transactional leadership. This study underscores the critical role of leadership style in shaping the well-being and self-efficacy of healthcare professionals. By understanding how different leadership approaches impact employee stress and job satisfaction, healthcare organizations can tailor their management practices to foster a supportive work environment and enhance overall performance. The results emphasize the need for leaders to balance organizational objectives with employee needs, demonstrating effective communication and adaptability to promote a positive workplace culture.

Personality functioning and mental distress in leaders of small- and medium sized enterprises

OBJECTIVE

For leaders of small and medium-sized enterprises (SMEs) grappling with diverse tasks and stressors, personality functioning can play a key role on stress perception and building and managing professional relationships. We investigated the relationship between SME leaders' personality functioning on the dimensions of self-perception and self-regulation on perceived stress reactivity (PSR), and symptoms of anxiety and depression.

METHODS

A cross-sectional sub analysis of a multi-centre RCT project was performed. A sample of N = 174 SME leaders from various sectors in southern Germany were examined on their self-rated levels of personality functioning (OPD-SQ), involving self-perception (facets: self-reflection, affect differentiation, sense of identity) and self-reflection (facets: impulse control, affect tolerance, regulation of self-esteem), with higher scores indicating lower levels of personality functioning. The outcome variables were perceived stress reactivity (PSRS) and symptoms of depression and anxiety (HADS).

RESULTS

The mean score for symptoms of anxiety was M = 6.13 (SD = 3.34), depression M = 4.40 (SD = 3.35), and for PSRS M = 21.39 (SD = 8.04). The mean sum score for self-perception was M = 7.71 (SD = 7.19) and for self-regulation M = 10.50 (SD = 7.09). The results of three regression models showed that higher scores for affect differentiation (rsp = .13), impulse control (rsp = .14) and regulation of self-esteem (rsp = .29) were associated with higher scores for PSR. Higher scores for affect differentiation (rsp = .17) and affect tolerance (rsp = .20) were significantly associated with higher scores for anxiety. A higher score for regulation of self-esteem (rsp = .17) was associated with higher depression scores.

CONCLUSION

This study highlights the association between core dimensions of SME leaders' personality functioning and mental distress. The findings can be applied on interventions and health promotion and the establishment of high-quality professional relationships and leadership skills.

Unveiling social relationships: exploring the importance of relationships as a moderator of the link between effort-reward imbalance and leader-member exchange among healthcare professionals

OBJECTIVE

Healthcare professionals are at increased risk of experiencing occupational stress and its detrimental stress-sequalae. Relevant theories that contribute to the subjective experience of occupational stress have been identified, such as the model of effort-reward imbalance (ERI) and the concept of leader-member exchange (LMX). The aim of this study was to examine how the perceived importance of social relationships at work moderates the relationship between LMX and imbalance ERI.

METHODS

A survey was conducted among N = 1,137 healthcare professionals from diverse occupational categories in a tertiary hospital in Germany. ERI was gauged using the German version of the Effort-Reward Imbalance Questionnaire (ERI-S 10). The quality of leader-employee dyadic relationships was assessed using the German version of the Leader-Member Exchange (LMX-7). The importance of social relationships was assessed on the basis of a previously validated polarity profile.

RESULTS

More than 75% of healthcare professionals reported high levels of ERI, with those involved in direct patient care particularly affected. On average, leaders rated relationship quality higher than their respective followers. Subjectively higher LMX was associated with lower ERI. This association was moderated by the perceived importance of social relationships at work. Higher subjective ratings of their importance led to a stronger association.

CONCLUSION

The study highlights the particular challenges faced in the healthcare sector. The results emphasize that the perceived importance of social relationships at work can play a key role in healthcare professionals' job stress and underline the need for stress prevention programs that engage both leaders and followers.

Insights into discrepancies in professional identities and role models in undergraduate medical education in the context of affective burden

Introduction

International evidence strongly suggests that medical students are at high risk of mental health problems. This distress, which can be mediated by a variety of individual, interpersonal and contextual factors within the curriculum, can be mitigated by effective coping strategies and interventions. Central to this discourse is the recognition that the challenges of professional identity formation can contribute significantly to medical students' distress. The focus of our study is therefore to examine discrepancies in professional identities and role models in undergraduate medical education in relation to affective burden.

Methods

Medical students at different stages of university education and high school graduates intending to study medicine were surveyed in a cross-sectional study. The study employed Osgood and Hofstätter's polarity profile to evaluate the self-image of participants, the image of an ideal and real physician, and their correlation with depression (PHQ-9) and anxiety (GAD-7).

Results

Out of the 1535 students recruited, 1169 (76.2%) participated in the study. Students rated their self-image as somewhere between a more critical real image of physicians and a more positive ideal image. Medical students at all training levels consistently rated the ideal image as remaining constant. Significant correlations were found between the professional role models of medical students and affective symptoms, particularly for the discrepancy between the ideal image of a physician and their self-image. Furthermore, 17% and nearly 15% reported significant symptoms of depression and anxiety, respectively.

Discussion

Our study adds to the growing body of knowledge on professional identity formation in medicine and socialisation in the medical environment. The study highlights the importance of discrepancies between self-image and ideal image in the experience of depressive and anxiety symptoms. Primary prevention-oriented approaches should incorporate these findings to promote reflective competence in relation to professional role models and strengthen the resilience of upcoming physicians in medical training.

Improving Well-Being and Fostering Health-Oriented Leadership among Leaders in Small and Medium-Sized Enterprises (SMEs): A Systematic Review

Leaders of small and medium-sized enterprises (SMEs) are often confronted with specific burdens, which frequently result in increased levels of stress. Leadership behaviour, in turn, has a significant impact on employees' health and performance. Using the Population, Intervention, Comparison, Outcome (PICO) method, we conducted a systematic literature search covering publications from 2002 to 2023 using PubMed, PsycInfo and Business Source Premier on stress-reducing and well-being-improving interventions for SME leaders. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool was used to assess the methodological quality and risk of bias of the included studies regarding selection bias, study design, confounders, blinding, data collection, withdrawal and drop-out. Of the 3150 identified publications, 6 were included after screening. The studies varied in content (cognitive behavioural therapy [CBT]-based, psychoeducation, and mixed interventions) and approach (individual- and organisation-centred). Not all of the examined interventions provided significant outcomes. However, CBT-based and individualised approaches showed a positive trend in reducing SME leaders' psychosocial stress and improving their well-being. Despite the limited data, it can be concluded that such interventions are beneficial for leaders and their specific needs. Future research should focus on tailored approaches, derived from well-founded theories and integrative interventions addressing SME leaders.

What helps hospital staff in times of crisis: qualitative results of a survey on psychosocial resources and stressors in German hospitals during the COVID-19 pandemic

Background

Even before the COVID-19 pandemic, hospital workers faced a tremendous workload. The pandemic led to different and additional strain that negatively affected the well-being of employees. This study aims to explore psychosocial resources and strategies that were used by hospital staff.

Methods

In the context of an intervention study, employees of three German hospitals were questioned in writing in summer and fall 2020. Five open-ended questions about the pandemic were asked to capture corresponding effects on daily work routine. Answers of 303 participants were evaluated using structuring qualitative content analysis.

Results

Significant stressors and resources were identified in the areas of work content and task, social relations at work, organization of work, work environment and individual aspects. Stressors included, for example, emotional demands, conflicts, an increased workload, time and performance pressure. Important resources mentioned were, among others, the exchange with colleagues and mutual support. Sound information exchange, clear processes and guidelines and a positive work atmosphere were also important. In addition, the private environment and a positive mindset were perceived as helpful.

Conclusion

This study contributes to a differentiated understanding of existing psychosocial resources of hospital staff in times of crisis. Identifying and strengthening these resources could reduce stress and improve well-being, making hospital staff better prepared for both normal operations and further crisis situations.

Managers perception of hospital employees' effort-reward imbalance

OBJECTIVE

Hospitals are frequently associated with poor working conditions that can lead to work stress and increase the risk for reduced employee well-being. Managers can shape and improve working conditions and thereby, the health of their teams. Thus, as a prerequisite, managers need to be aware of their employees' stress levels. This study had two objectives: At first, it aimed to test the criterion validity of the Effort-Reward Imbalance (ERI) questionnaire measuring psychosocial workload in hospital employees. Secondly, mean scales of the ERI questionnaire filled in by employees were compared with mean scales of an adapted ERI questionnaire, in which managers assessed working conditions of their employees.

METHODS

Managers (n = 141) from three hospitals located in Germany assessed working conditions of their employees with an adapted external, other-oriented questionnaire. Employees (n = 197) of the mentioned hospitals completed the short version of the ERI questionnaire to assess their working conditions. Confirmatory factor analyses (CFA) were applied to test factorial validity, using the ERI scales for the two study groups. Criterion validity was assessed with multiple linear regression analysis of associations between ERI scales and well-being among employees.

RESULTS

The questionnaires demonstrated acceptable psychometric properties in terms of internal consistency of scales, although some indices of model fit resulting from CFA were of borderline significance. Concerning the first objective, effort, reward, and the ratio of effort-reward imbalance were significantly associated with well-being of employees. With regard to the second objective, first tentative findings showed that managers' ratings of their employees' effort at work was quite accurate, whereas their reward was overestimated.

CONCLUSIONS

With its documented criterion validity the ERI questionnaire can be used as a screening tool of workload among hospital employees. Moreover, in the context of work-related health promotion, managers' perceptions of their employees' workload deserve increased attention as first findings point to some discrepancies between their perceptions and those provided by employees.