Job burnout and organizational justice among medical interns in Shanghai, People's Republic of China

The Bridge Symptoms of Work-Family Conflict, Sleep Disorder, and Job Burnout: A Network Analysis

Background: This study aims to elucidate characteristics of the symptom network of work-family conflict (WFC) and sleep disorders among Chinese correctional personnels while accounting for job burnout as a possible confounder. Method: A total of 472 correctional personnel were included. Their WFC, sleep disorders, and job burnout were measured using a Chinese version of Work-Family Conflict Scale (WFCS), the Athens Insomnia Scale (AIS), and a revised Chinese version of Maslach Burnout Inventory-General Survey (MBI-GS), respectively. Central symptoms and bridge symptoms were respectively identified based on centrality indices and bridge centrality indices. Network stability was examined using the case-dropping procedure. Results: Daytime condition (strength = 0.01) and strain-based work interference with family (WFCs, strength = 1.45) symptoms had the highest centrality values in the WFC-sleep disorder network structure, which were also identified as two bridge symptoms. Emotional exhaustion, daytime condition, and WFCs appeared to be potential bridge symptoms in the WFC-sleep disorder-burnout network structure. Conclusions: In this study, among Chinese correctional personnel, daytime conditions, and WFCs were found to be central symptoms in the WFC-sleep disorder network structure, with emotional exhaustion as the bridge symptom in the WFC-sleep disorder-burnout network structure. We encourage relevant organizations to provide timely and effective education and guidance for regulatory personnel regarding these bridge symptoms. Subsequent research should follow up to assess the impact of relevant interventions on symptoms in the WFC-sleep disorder-burnout network, thereby advocating for the mental and physical health of correctional personnel.

Investigating the relationship between organizational health and burnout and job stress among midwives working in hospitals in 2020

BACKGROUND

Despite the prominent role of midwives in improving the health of women and families, limited studies have been conducted in the occupational and organizational field and their role on the performance of this group. The purpose of this research is to investigate the relationship between organizational health, burnout, and job stress among midwives working in hospitals affiliated to Shahrekord University of Medical Sciences.

MATERIALS AND METHODS

The present study is a cross-sectional descriptive-analytical study, which was conducted with available sampling method on 159 midwives working in hospitals affiliated to Shahrekord University of Medical Sciences in 2020. Data collection tools were: Demographic Questionnaire, Modified Hoy and Feldman Organizational Health Questionnaire, Job Stress Questionnaire, Maslach Questionnaire to measure job burnout. Finally, the obtained data were analyzed with descriptive and analytical statistical tests (Pearson).

RESULTS

The findings of the study showed that 70.4% of the participants had moderate to severe job stress and 70.4% of the participants had moderate level of organizational health and 79.9% suffered from job burnout. The results of structural equations showed that organizational health has an inverse and significant relationship with job stress (P < 0.001, β = -0.45) and job burnout (P = 0.002, β = -0.33).

CONCLUSION

Organizational health has an inverse and significant relationship with job stress and job burnout. The findings of this study can be useful in planning and organizational policies for midwifery professionals. It also conveys the importance of extensive studies and planning to reduce stress and burnout and then improve organizational health. As a result, it can improve the performance and productivity, and as a result, improve the health of midwives and patients under their care and, consequently, the health of the society.

How Does IT Influence Chinese IS/IT Users' Job Burnout?

Organizational utilization of information systems and information technology continues to grow in the 21st century, and job stress has become a worldwide problem; but the emotional expression of people differ in diverse cultural societies, and employees need to use IS/IT (IS/IT users) to do their work. Work exhaustion will also increase with the time. Mainland China (the PRC) and Taiwan share the same language and inherit Chinese culture; thus, this study based on job a burnout model and Chinese Guanxi perspective adopts a qualitative research method to collect IS/IT users' data from these two areas. This study has explored (1) permeability as a critical factor of the technology characteristics, (2) that technology characteristics and Chinese Guanxi will influence each other, and (3) that Chinese Guanxi will influence emotional job demands, social support, and personal accomplishment of Chinese IS/IT users. Finally, it has a contribution to both the academics and practice of the job burnout issue.

Independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health in medical students: A cross-sectional study

Objective

Studies on the association between sleep behavior and health often ignored the confounding effects of biorhythm-related factors. This study aims to explore the independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health (SRH) in medical students.

Methods

Cross-sectional study. Proportional stratified cluster sampling was used to randomly recruit students from various medical specialties at a medical university in eastern China. Our questionnaire mainly included information on basic demographic characteristics, SRH, sleep behavior, and biorhythm-related factors. The independent and joint effects of sleep duration and sleep quality on suboptimal SRH were assessed by logistic regression after controlling for potential confounders.

Results

Of 1,524 medical students (mean age = 19.9 years, SD = 1.2 years; 59.1% female), 652 (42.8%) had suboptimal SRH. Most medical students (51.5%) slept for 7 h/night, followed by ≥8 (29.1%) and ≤ 6 h (19.4%). After adjusting for basic demographic characteristics and biorhythm-related factors, compared with students who slept for ≥8 h/night, the adjusted ORs (95%CI) for those who slept 7 and ≤ 6 h/night were 1.36 (1.03, 1.81) and 2.28 (1.60, 3.26), respectively (P < 0.001 for trend); compared with those who had good sleep quality, the adjusted ORs (95%CI) for those who had fair and poor sleep quality were 4.12 (3.11, 5.45) and 11.60 (6.57, 20.46), respectively (P < 0.001 for trend). Further, compared with those who slept for ≥8 h/night and good sleep quality, those who slept ≤ 6 h and poor sleep quality had the highest odds of suboptimal SRH (OR 24.25, 95%CI 8.73, 67.34).

Conclusions

Short sleep and poor sleep quality were independently and jointly associated with higher odds of suboptimal SRH among medical students.

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.

Tiredness, depression, and sleep disorders in frontline healthcare workers during COVID-19 pandemic in Vietnam: A field hospital study

BACKGROUND

The COVID-19 outbreak witnessed in the autumn of 2021 led to unprecedented changes in healthcare systems in some emerging countries. Many field-hospitals, temporary sites of care for COVID-19 patients, were built around the country and followed by the healthcare workers who were mobilized. This study aimed to measure sleep disorders, depression, and fatigue in volunteers working at field hospitals during the COVID-19 outbreak.

METHODS

This was a cross-sectional study. The self-report questionnaire was used for each study subject. Sleep characters, including STOP's elements were questioned. Healthcare workers' burnout was detected by using Pichot's questionnaire.

RESULTS

One hundred front-line healthcare workers (FHWs), predominantly last year and graduated medical students, were included in the study (86% female subjects). The mean sleep-time of FHWs before, while working, and during the isolation period after working at COVID-19 field hospitals were: 7.78 ± 1.48, 5.71 ± 1.40, and 8.78 ± 2.31 h per day, respectively. Burnout was not a crucial issue for these volunteer subjects. The mean scores of Pichot's Fatigue Scale and Pichot's Depression Scale, measured after 4 weeks working at field hospitals, were 4.18 ± 5.42 and 2.54 ± 3.36, respectively. Thirteen participants were suspected of depression. The fatigue scores decreased significantly in the group who claimed short sleep latency. The factor that increased the depression score was "anxious feeling" (p = 0.001). Other significant factors were "short sleep latency," "observed sleep apnea," "tiredness, daily sleepiness" and "snoring."

CONCLUSION

Appropriate work schedule, better sleep conditions, and mental health support could be helpful for FHWs. The mandatory 2 weeks of isolation after working in field hospitals provided opportunity for FHWs' recovery.

The Impact of Psychological Interventions with Elements of Mindfulness (PIM) on Empathy, Well-Being, and Reduction of Burnout in Physicians: A Systematic Review

Introduction: Physician’s burnout has been recognized as an increasing and significant work-related syndrome, described by the combination of emotional exhaustion (EE) and depersonalization (D), together with low personal accomplishment (PA). It has many negative consequences on personal, organizational, and patient care levels. This systematic review aimed to analyze research articles where psychological interventions with elements of mindfulness (PIMs) were used to support physicians in order to reduce burnout and foster empathy and well-being. Methods: Systematic searches were conducted in May 2019, within six electronic databases PubMed, EBSCOhost MEDLINE, PsycArticles, Cochrane Library, JSTOR, and Slovenian national library information system. Different combinations of boolean operators were used—mindfulness, empathy, medicine/family medicine/general practice/primary care, burnout, doctors/physicians, intervention, and support group. Additional articles were manually searched from the reference list of the included articles. Studies with other healthcare professionals (not physicians and residents) and/or medical students, and those where PIMs were applied for educational or patient’s treatment purposes were excluded. Results: Of 1194 studies identified, 786 screened and 139 assessed for eligibility, there were 18 studies included in this review. Regardless of a specific type of PIMs applied, results, in general, demonstrate a positive impact on empathy, well-being, and reduction in burnout in participating physicians. Compared with other recent systematic reviews, this is unique due to a broader selection of psychological interventions and emphasis on a sustained effect measurement. Conclusions: Given the pandemic of COVID-19, it is of utmost importance that this review includes also interventions based on modern information technologies (mobile apps) and can be used as an awareness-raising material for physicians providing information about feasible and easily accessible interventions for effective burnout prevention and/or reduction. Future research should upgrade self-reported data with objective psychological measures and address the question of which intervention offers more benefits to physicians.

Predictors of Burnout Among Physicians: Evidence From a National Study in Portugal

The aims of this research on burnout among physicians were threefold, (1) to characterize the burnout symptoms’ prevalence among Portuguese physicians, (2) to test the hypothesis that organizational demands and resources add, on top of other factors, to the explanatory level of burnout; and (3) to explore the predictors of organizational demands and resources. Data collection was conducted online at the national level in Portugal, with 9,176 complete replies and a response rate of 21%. Predictors stemming from theoretical models of an intra-individual, occupational, organizational, and socio-psychological nature were measured using an online/paper survey. Results were analyzed through a significantly modified version of the Maslach Burnout Inventory (MBI) after transformations to address the fit of this measure in this sample. Results show that 66% of physicians have high levels of emotional exhaustion, 33% high levels of depersonalization, and 39% high levels of decrease of personal accomplishment. Moreover, a first set of hierarchical multiple regression models with burnout symptoms reveals that organizational resources, demands of the relationship with the patients and of work schedule are consistently important predictors of emotional exhaustion and depersonalization on top of other theoretically relevant predictors. A second set of regression models with the organizational-level variables shows that, aside from organizational variables, other context variables, like procedural justice and teamwork, have the most substantial predictive value. These results highlight the importance of recognizing physicians’ burnout as a phenomenon that is predicted by a wide variety of factors, but also the importance of attending to the particular role of circumstancial factors that may be addressed in future interventions.

The Effects of Asymmetrical Guanxi Perception on Job Burnout: Task Conflict, Relationship Conflict, and Process Conflict as Mediators

In Chinese organizations, individuals benefit in many ways from having good guanxi. For employees, however, guanxi also comes with well-documented negative effects. Until recently, the guanxi investigated in these studies was always of a substantial nature. The negative effects of non-substantial guanxi (in effect, the absence of real guanxi), such as the guanxi of misunderstandings for those who lack good guanxi, have not been examined. This study investigates how the existence of asymmetrical guanxi perception for an employee (i.e., when other people believe that good guanxi exists between a manager and an employee, but the employee disagrees with the belief that he/she has good guanxi with his/her supervisors) contributes to job burnout for that employee due to task conflict, relationship conflict, and process conflict. A cross-sectional data sample was collected from 363 employees of 10 hotels in Taiwan. Structural equation modeling results suggest that relationship conflict is the most powerful mediator affecting the relationship between asymmetrical guanxi perception and job burnout. The results provide insights for researchers interested in the mechanism of how asymmetrical guanxi perception induces employee job burnout while generating useful implications for managers charged with reducing such burnout.

Mental distress in a clinical nurse due to a false-positive COVID-19 antibody test result during the COVID-19 epidemic in Japan: A case report

This study suggests the importance of instituting accompanying measures to prevent potential negative mental and social impacts on people receiving false-positive results.

The Moderating Role of Regulatory Institutional Environment in the Relationship Between Emotional Job Demands and Employee Absenteeism Likelihood of Healthcare Workers. Evidence From the Low-Income Country Context

Previous research has not clearly studied how the effects of emotional job demands on absenteeism likelihood are moderated by the contingent absenteeism-related regulatory institutional environments of low-income countries. In this regard, we surveyed 487 healthcare workers in a low-income country in order to test for the effect of emotional job demands on healthcare workers’ absenteeism likelihood. We also explored the mediating role of work engagement and the contingent role of context-specific regulatory institutional environments on the link between emotional job demands and absenteeism likelihood. The main findings of this study are as follows: (1) emotional job demands have a direct positive effect on healthcare workers’ absenteeism likelihood, (2) work engagement plays a mediating role on the link between emotional job demands and healthcare workers’ absenteeism likelihood, and (3) the regulatory institutional environment related to absenteeism moderates the negative link between work engagement and absenteeism likelihood. Results in this study demonstrate the crucial role that the context-specific regulatory institutional environment related to absenteeism plays in suppressing the effect of emotional job demands on absenteeism likelihood when considered through the work-engagement pathway. The study’s findings clarify the mechanism through which emotional job demands affect absenteeism likelihood in a low-income country context. The study thus offers a new refined theoretical perspective on how emotional job demands, work engagement, and context-specific regulatory institutional environments interact in ways that predict absenteeism likelihood.

Job Burnout Among Primary Healthcare Workers in Rural China: A Multilevel Analysis

The health workers in rural primary care systems are at the increasing risk of job burnout. To explore the prevalence and associated factors of the job burnout among the primary healthcare worker in rural China, a cross-sectional survey was conducted among 15,627 participants in 459 township hospitals from six provinces. A combination of stratified multi-stage sampling and cluster sampling method, and a self-administrated questionnaire with the Chinese version of the Maslach Burnout Inventory-General Scale (MBI-GS) were used in the investigation. Multilevel regression analyses were used to examine the potential associated factors on both individual and organisational levels. 47.6% of respondents were experiencing moderate burnout, and 3.3% were in severe burnout. Professionals working for over 40 h per week, at young age, with a college degree, and with professional titles at medium or high rank reported a higher degree of job burnout. At the institutional level, the high ratio of performance-based salary was associated with a higher level of depersonalization. Burnout has become prevalent among the primary healthcare workers in rural China, and multiple strategies are needed to reduce the work stress and some high-risk groups’ vulnerability to job burnout.

A systematic review of burnout among doctors in China: a cultural perspective

BACKGROUND

Numerous studies around the world has already suggested that burnout among doctors is a global phenomenon. However, studies for burnout in doctors are relatively limited in Chinese communities when compared to the West. As risk factors, barriers to intervention and strategies combatting burnout in different parts of the world can vary a lot due to different social culture and healthcare system, study with a focus at doctors in China from a cultural perspective is a worthful endeavor.

METHODS

Systematic searches of databases were conducted for papers published in peer-reviewed journals from 2006 to 2016. Selection criteria included practicing doctors in Mainland China and publications written in English or Chinese. Keywords searched including "burnout", "doctors" and "China" in 3 electronic databases has been undergone. Traditional understanding of "work attitude" and "doctors' humanity" from ancient Chinese literature has also been retrieved.

RESULTS

Eleven full papers, including 9302 participants, were included in this review. The overall prevalence of burnout symptoms among doctors in China ranged from 66.5 to 87.8%. The review suggested that negative impact of burnout include association with anxiety symptoms and low job satisfaction at the individual doctors' level, and prone to committing medical mistakes affecting patient safety and higher turnover intention at the society/organizational level. Burnout was higher among doctors who worked over 40 h/week, working in tertiary hospitals, on younger age group within the profession (at age 30-40), and with negative individual perception to work and life.

CONCLUSIONS AND IMPLICATIONS

The overall prevalence and adverse impact of burnout among doctors in China echo with the findings from Western studies. Young doctors and doctors working in tertiary hospitals are more at risk of burnout, probably related to shift of social culture related to the loss of medical humanities and a weak primary healthcare system. Potential strategies of managing burnout in Chinese doctors should therefore take consideration from the Chinese cultural perspective, with renaissance of medical humanities and strengthening the primary healthcare system in China.

The Relationship between Job Demands and Employees' Counterproductive Work Behaviors: The Mediating Effect of Psychological Detachment and Job Anxiety

This study aims to explore the relation between job demands and counterproductive work behaviors (CWBs). A cross-sectional sample of 439 coal miners completed a self-report questionnaire that assessed their job demands, psychological detachment, job anxiety, and CWBs in a Chinese context. The conceptual model, based on the stressor-detachment model, was examined using structural equation modeling. The results suggest that psychological detachment mediates not only the relation between job demands and job anxiety but also that between job demands and CWBs. Furthermore, the relation between job demands and CWBs is sequentially mediated by psychological detachment and job anxiety. Our findings validate the effectiveness of the stressor-detachment model. Moreover, we demonstrate that the underlying mechanism of the relation between job demands and CWBs can be explained by psychological detachment and job anxiety.

Effect of Positive Psychological Intervention on Posttraumatic Growth among Primary Healthcare Workers in China: A Preliminary Prospective Study

Posttraumatic growth (PTG) is defined as positive psychological change in the wake of highly challenging circumstances. Healthcare workers in particular are more vulnerable to stressors and trauma than the general population. The current study examined the use and effectiveness of a novel positive psychological intervention based on Chinese traditional culture to improve PTG in hospital healthcare workers. The intervention was provided to 579 healthcare workers at hospitals in Guilin, Shenzhen and Xiangtan. Scores on the Posttraumatic Growth Inventory (PTGI) and its subscales were significantly higher after intervention than before (p < 0.001). Of the five aspects of PTG, the aspect of "new possibilities" benefited the most from intervention (Cohen's d = 0.45). PTG in women, nurses and college graduates increased to a greater extent than other participants after intervention. It was concluded that our novel intervention is effective at improving PTG in medical staff.