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van de Voort I, Grossmann I, Leistikow I, Weenink JW. What's up doc? Physicians' reflections on their sustainable employability throughout careers: a narrative inquiry. BMC Health Serv Res 2024; 24:539. [PMID: 38671449 PMCID: PMC11055295 DOI: 10.1186/s12913-024-10924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Physicians have complex and demanding jobs that may negatively affect their sustainable employability (SE) and quality of care. Despite its societal and occupational relevance, empirical research on physicians' SE is scarce. To further advance our understanding of physicians' SE, this study explores how physicians perceive their employment context to affect their SE, how physicians self-regulate with the intent to sustain their employability, and how self-regulations affect physicians' SE and their employment context. METHODS Twenty Dutch physicians from different specialisms were narratively interviewed between March and September 2021 by a researcher with a similar background (surgeon) to allow participants to speak in their own jargon. The interviews were analyzed collaboratively by the research team in accordance with theory-led thematic analysis. RESULTS According to the interviewees, group dynamics, whether positive or negative, and (mis)matches between personal professional standards and group norms on professionalism, affect their SE in the long run. Interviewees self-regulate with the intent to sustain their employability by (I) influencing work; (II) influencing themselves; and (III) influencing others. Interviewees also reflect on long-term, unintended, and dysfunctional consequences of their self-regulations. CONCLUSIONS We conclude that physicians' SE develops from the interplay between the employment context in which they function and their self-regulations intended to sustain employability. As self-regulations may unintentionally contribute to dysfunctional work practices in the employment context, there is a potential for a vicious cycle. Insights from this study can be used to understand and appraise how physicians self-regulate to face complex challenges at work and to prevent both dysfunctional work practices that incite self-regulation and dysfunctional consequences resulting from self-regulations.
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Affiliation(s)
- Iris van de Voort
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Oudlaan 50, Rotterdam, 3062 PA, The Netherlands.
| | - Irene Grossmann
- Center for Safety in Healthcare, Institute for Health Systems Science at TPM Faculty, Delft University of Technology, Delft, The Netherlands
| | - Ian Leistikow
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Oudlaan 50, Rotterdam, 3062 PA, The Netherlands
- Dutch Health & Youth Care Inspectorate, Ministry of Health, Welfare & Sport, Utrecht, the Netherlands
| | - Jan-Willem Weenink
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Oudlaan 50, Rotterdam, 3062 PA, The Netherlands
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Vermeulen RCJM, van Leeuwen EH. Capturing dynamics in nursing: a diary study of nurses' job characteristics and ability and willingness to continue working. Front Psychol 2023; 14:1112530. [PMID: 37583602 PMCID: PMC10423898 DOI: 10.3389/fpsyg.2023.1112530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
Objectives This study aimed to gain insight into (1) the dynamics of job characteristics (demands and resources) of nurses and (2) how job characteristics relate to nurses' ability and willingness to continue working (understood as employability). Job characteristics are profession-specific and vary over time, but studies often overlook these dynamics. Moreover, job characteristics relate to nurses' employability, which is under pressure due to a rapidly changing work environment. It is necessary to gain insight into the dynamic job characteristics of nurses to develop targeted workplace interventions that help nurses remain employable. Methods This study adopted a mixed methods diary approach, with a strong emphasis on qualitative analysis. 46 Nurses from two hospitals in a large Dutch city completed a structured diary at six points over 3 weeks, resulting in 225 diary entries in total. The nurses used a custom-made application on their mobile devices to describe in their own words what they experienced as demanding and resourceful throughout the shifts and how they experienced their employability. Prior to the diaries, nurses completed an intake survey. Results A within-person analysis highlighted the day-to-day dynamics in the nursing profession. The job characteristics a nurse mentioned in the first diary entry often were completely different from the job characteristics the same nurse mentioned in the other diary entries. This analysis also showed variety within nurses' employability, demonstrating that perceptions of employability vary over time. A between-person analysis highlighted links between job characteristics and nurses' employability: social interactions strengthen a nurse's employability, a strict task approach threatens it, and aspects such as a strong drive to care, professional development, and autonomy (clustered as aspects that enable to "act professionally") create opportunities to enhance employability. Conclusion Insights from this study show that job characteristics typical to the nursing profession can be linked to nurses' perceptions of employability. Also, it stems from this research that not only job characteristics but also employability are dynamic in the short run. Understanding and enhancing employability in a nursing context requires capturing these dynamics, for instance by collecting data at several points in time or by using mixed-method studies to understand employability scores within their context.
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Affiliation(s)
| | - Evelien Hanna van Leeuwen
- Utrecht University School of Governance, Utrecht University, Utrecht, Netherlands
- University Medical Center Utrecht, Utrecht, Netherlands
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Tamminga SJ, Emal LM, Boschman JS, Levasseur A, Thota A, Ruotsalainen JH, Schelvis RM, Nieuwenhuijsen K, van der Molen HF. Individual-level interventions for reducing occupational stress in healthcare workers. Cochrane Database Syst Rev 2023; 5:CD002892. [PMID: 37169364 PMCID: PMC10175042 DOI: 10.1002/14651858.cd002892.pub6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Healthcare workers can suffer from work-related stress as a result of an imbalance of demands, skills and social support at work. This may lead to stress, burnout and psychosomatic problems, and deterioration of service provision. This is an update of a Cochrane Review that was last updated in 2015, which has been split into this review and a review on organisational-level interventions. OBJECTIVES: To evaluate the effectiveness of stress-reduction interventions targeting individual healthcare workers compared to no intervention, wait list, placebo, no stress-reduction intervention or another type of stress-reduction intervention in reducing stress symptoms. SEARCH METHODS: We used the previous version of the review as one source of studies (search date: November 2013). We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PsycINFO, CINAHL, Web of Science and a trials register from 2013 up to February 2022. SELECTION CRITERIA We included randomised controlled trials (RCT) evaluating the effectiveness of stress interventions directed at healthcare workers. We included only interventions targeted at individual healthcare workers aimed at reducing stress symptoms. DATA COLLECTION AND ANALYSIS: Review authors independently selected trials for inclusion, assessed risk of bias and extracted data. We used standard methodological procedures expected by Cochrane. We categorised interventions into ones that: 1. focus one's attention on the (modification of the) experience of stress (thoughts, feelings, behaviour); 2. focus one's attention away from the experience of stress by various means of psychological disengagement (e.g. relaxing, exercise); 3. alter work-related risk factors on an individual level; and ones that 4. combine two or more of the above. The crucial outcome measure was stress symptoms measured with various self-reported questionnaires such as the Maslach Burnout Inventory (MBI), measured at short term (up to and including three months after the intervention ended), medium term (> 3 to 12 months after the intervention ended), and long term follow-up (> 12 months after the intervention ended). MAIN RESULTS: This is the second update of the original Cochrane Review published in 2006, Issue 4. This review update includes 89 new studies, bringing the total number of studies in the current review to 117 with a total of 11,119 participants randomised. The number of participants per study arm was ≥ 50 in 32 studies. The most important risk of bias was the lack of blinding of participants. Focus on the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Fifty-two studies studied an intervention in which one's focus is on the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.52 to -0.23; 41 RCTs; 3645 participants; low-certainty evidence) and medium term (SMD -0.43, 95% CI -0.71 to -0.14; 19 RCTs; 1851 participants; low-certainty evidence). The SMD of the short-term result translates back to 4.6 points fewer on the MBI-emotional exhaustion scale (MBI-EE, a scale from 0 to 54). The evidence is very uncertain (one RCT; 68 participants, very low-certainty evidence) about the long-term effect on stress symptoms of focusing one's attention on the experience of stress. Focus away from the experience of stress versus no intervention/wait list/placebo/no stress-reduction intervention Forty-two studies studied an intervention in which one's focus is away from the experience of stress. Overall, such interventions may result in a reduction in stress symptoms in the short term (SMD -0.55, 95 CI -0.70 to -0.40; 35 RCTs; 2366 participants; low-certainty evidence) and medium term (SMD -0.41 95% CI -0.79 to -0.03; 6 RCTs; 427 participants; low-certainty evidence). The SMD on the short term translates back to 6.8 fewer points on the MBI-EE. No studies reported the long-term effect. Focus on work-related, individual-level factors versus no intervention/no stress-reduction intervention Seven studies studied an intervention in which the focus is on altering work-related factors. The evidence is very uncertain about the short-term effects (no pooled effect estimate; three RCTs; 87 participants; very low-certainty evidence) and medium-term effects and long-term effects (no pooled effect estimate; two RCTs; 152 participants, and one RCT; 161 participants, very low-certainty evidence) of this type of stress management intervention. A combination of individual-level interventions versus no intervention/wait list/no stress-reduction intervention Seventeen studies studied a combination of interventions. In the short-term, this type of intervention may result in a reduction in stress symptoms (SMD -0.67 95%, CI -0.95 to -0.39; 15 RCTs; 1003 participants; low-certainty evidence). The SMD translates back to 8.2 fewer points on the MBI-EE. On the medium term, a combination of individual-level interventions may result in a reduction in stress symptoms, but the evidence does not exclude no effect (SMD -0.48, 95% CI -0.95 to 0.00; 6 RCTs; 574 participants; low-certainty evidence). The evidence is very uncertain about the long term effects of a combination of interventions on stress symptoms (one RCT, 88 participants; very low-certainty evidence). Focus on stress versus other intervention type Three studies compared focusing on stress versus focusing away from stress and one study a combination of interventions versus focusing on stress. The evidence is very uncertain about which type of intervention is better or if their effect is similar. AUTHORS' CONCLUSIONS Our review shows that there may be an effect on stress reduction in healthcare workers from individual-level stress interventions, whether they focus one's attention on or away from the experience of stress. This effect may last up to a year after the end of the intervention. A combination of interventions may be beneficial as well, at least in the short term. Long-term effects of individual-level stress management interventions remain unknown. The same applies for interventions on (individual-level) work-related risk factors. The bias assessment of the studies in this review showed the need for methodologically better-designed and executed studies, as nearly all studies suffered from poor reporting of the randomisation procedures, lack of blinding of participants and lack of trial registration. Better-designed trials with larger sample sizes are required to increase the certainty of the evidence. Last, there is a need for more studies on interventions which focus on work-related risk factors.
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Affiliation(s)
- Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Lima M Emal
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Julitta S Boschman
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Alice Levasseur
- Faculté des sciences de l'éducation, Université Laval, Québec, Canada
| | | | - Jani H Ruotsalainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Roosmarijn Mc Schelvis
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Body@Work, Research Center on Work, Health and Technology, TNO/VUmc, Amsterdam, Netherlands
| | - Karen Nieuwenhuijsen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Henk F van der Molen
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Societal Participation & Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Chifor RI, Oprea B. Romanian Version of the Career Crafting Assessment: Psychometric Properties. JOURNAL OF CAREER ASSESSMENT 2023. [DOI: 10.1177/10690727231163322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The notion of career is no longer understood as a progressive advancement within the same organization, but rather as a lifelong dynamic transition between multiple jobs. Lee et al. (2021) developed Career Crafting Assessment as a means of identifying the proactive behaviors that people engage in when developing their career paths. The aim of this study was to test the psychometric properties of the Romanian version of the scale. In Study 1 ( N = 938), Confirmatory Factor Analysis supported the four-factor model of the scale. The results supported the measurement invariance for gender, but not for age. The internal consistency of the scale was adequate. In Study 2 ( N = 344), we found significant positive correlations between career crafting and two similar constructs, namely job crafting and organizational career management, supporting the convergent validity of the scale. In Study 3 ( N = 213), the criterion validity of the scale was supported by significant positive correlations between career crafting and four of its possible outcomes, namely performance, work engagement, perceived meaningfulness of work, and person-job fit. Our results are in line with the findings of Lee et al. (2021) and suggest that the Romanian version of the instrument is valid.
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Affiliation(s)
| | - Bogdan Oprea
- Department of Psychology and Cognitive Sciences, University of Bucharest, Romania
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A New Construct in Career Research: Career Crafting. Behav Sci (Basel) 2023; 13:bs13010049. [PMID: 36661621 PMCID: PMC9854777 DOI: 10.3390/bs13010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 12/31/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
Career crafting is a new concept in the field of career research in recent years. However, the research on career crafting is still in its infancy, and there are few systematic and integrated studies. In this study, we have collected the existing research and extracted the 12 most related articles from 10 databases (Web of Science, Google Scholar, ProQuest, and EBSCO Host, etc.) by the end of 2022 to discuss the concepts of discrimination, theoretical basis, research methods, and measurement tools and variables of career crafting. As a reference for the follow-up in-depth study, future research should progress forward, such as by deepening and expanding the theoretical basis, testing and developing mature scales, building multilevel influencing factors and testing their interaction, and furthering the research on the mechanism of multi-field effects.
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Zhou AY, Hann M, Panagioti M, Patel M, Agius R, Van Tongeren M, Esmail A, Bower P. Exploring Associations between Stressors and Burnout in Trainee Doctors During the COVID-19 Pandemic in the UK. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:723-728. [PMID: 35661339 PMCID: PMC9165924 DOI: 10.1007/s40596-022-01660-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/12/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The authors examined associations between stressors and burnout in trainee doctors during the COVID-19 pandemic. METHODS An anonymous online questionnaire including 42 questions on general and pandemic-specific stressors, and the Maslach Burnout Inventory-Health Services Survey (MBI-HSS), was sent to 1000 randomly selected trainee doctors in North-West England. Main outcomes were burnout scores that were stratified into Emotional Exhaustion (EE), Depersonalisation (DP), and reduced Personal Accomplishment (PA) and associations between stressors and burnout using stepwise regression analysis. RESULTS A total of 362 complete responses were received giving a response rate of 37%. Mean scores for EE, DP, and PA derived from the MBI-HSS were 27.7, 9.8, and 34.3 respectively. Twenty-three stressors were found to be associated with burnout dimensions. "Increase in workload and hours due to COVID-19," "Poor leadership and management in the National Health Service," and "Not feeling valued" were found to have strong associations with burnout dimensions. Only "Not confident in own abilities" was found to be associated with all burnout dimensions. CONCLUSIONS Associations with burnout were found to be identified in a range of work, pandemic, and non-work-related stressors, supporting the need for multi-level interventions to mitigate burnout.
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Affiliation(s)
| | - Mark Hann
- University of Manchester, Manchester, UK
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Tsai MC, Wang SF, Gray NJ, Jourdan D. Occupational Health of Education Personnel-The Role of Job Crafting and Other Control Strategies on Healthy Ageing at Work. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15970. [PMID: 36498038 PMCID: PMC9740758 DOI: 10.3390/ijerph192315970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
This article looks at the strategies that influence healthy ageing at work from the motivational theory of life span development (MTD). It aims to better understand the influence of job crafting as a selective primary control, help-seeking as a compensatory primary control, positive reappraisal as a selective secondary control, and downward social comparison and downgrading expectation as a compensatory secondary control on healthy ageing at work (work engagement, health, and motivation to continue working after retirement). A total of 386 educational personnel participated in the study. This study used hierarchical regression analysis to test incremental validity, supplemented with confirmatory factor analysis and structural equation modelling as a solution to solve the potential error problems caused. The results show that job crafting is positively correlated with healthy ageing at work. Positive reappraisal and downward social comparison showed incremental validity in predicting healthy ageing at work beyond job crafting among the middle-aged group (45-65-years-old); in particular, positive reappraisal was the determinant of healthy ageing at work among the middle-aged group. However, both help-seeking and downgrading expectation did not show incremental validity. This study can contribute to the evolution of career development interventions and human resource management focused on supporting older people at work.
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Affiliation(s)
- Min-Chien Tsai
- Department of Psychology, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Sy-Feng Wang
- Department of Psychology, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Nicola J. Gray
- School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - Didier Jourdan
- ACTé EA 4281 Research Group, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France
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van Leeuwen EH, Kuyvenhoven JP, Taris TW, Verhagen MAMT. Burn-out and employability rates are impacted by the level of job autonomy and workload among Dutch gastroenterologists. United European Gastroenterol J 2022; 10:296-307. [PMID: 35229985 PMCID: PMC9004237 DOI: 10.1002/ueg2.12211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/01/2022] [Indexed: 12/03/2022] Open
Abstract
Background Increasing burn‐out rates among gastroenterologists make it necessary to find ways to prevent burn‐out and to stimulate their ability and willingness to continue working (i.e., their employability). Understanding their antecedents might help organizations to prevent burn‐out and to enhance employability among this occupational group. Objective The purpose of this study is to provide insight in the relationship between job characteristics and job crafting behavior on the one hand and job outcomes (burn‐out symptoms and employability) on the other hand. Methods Data from two surveys in 2020 and 2021 were collected in a longitudinal study among 238 Dutch gastroenterologists. The data were analyzed with multiple linear regression analyses and paired‐samples t‐tests. Results Job characteristics, specifically job aspects that require sustained physical and/or psychological effort or skills (i.e., job demands), are important predictors of burn‐out symptoms among gastroenterologists. Specifically, high quantitative and emotional workload are significantly related to more burn‐out symptoms. No strong relationship was found between job crafting and burn‐out symptoms. Furthermore, job aspects that reduce the negative impact of these demanding aspects and that help to achieve work goals (i.e., job resources), and job demands to some extent, significantly predict employability. In particular, high job autonomy is related to higher employability, and high quantitative workload is associated with lower employability. Job crafting does not significantly affect employability. Furthermore, levels of burn‐out symptoms and employability differed only little across time. Conclusion In gastroenterologists, a high quantitative workload and emotional workload are associated with a higher burn‐out risk, while low job autonomy and high quantitative workload are associated with more negative perceptions of employability. To prevent burn‐out and to create positive perceptions of employability, it is important to take these aspects into account.
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Affiliation(s)
- Evelien H van Leeuwen
- University Medical Center Utrecht, Utrecht, The Netherlands.,Utrecht University School of Governance, Utrecht, The Netherlands
| | | | - Toon W Taris
- Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, The Netherlands
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Tims M, Twemlow M, Fong CYM. A state-of-the-art overview of job-crafting research: current trends and future research directions. CAREER DEVELOPMENT INTERNATIONAL 2021. [DOI: 10.1108/cdi-08-2021-0216] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIn celebration of the 25th anniversary of the founding of Career Development International, a state-of-the-art overview of recent trends in job-crafting research was conducted. Since job crafting was introduced twenty years ago as a type of proactive work behavior that employees engage in to adjust their jobs to their needs, skills, and preferences, research has evolved tremendously.Design/methodology/approachTo take stock of recent developments and to unravel the latest trends in the field, this overview encompasses job-crafting research published in the years 2016–2021. The overview portrays that recent contributions have matured the theoretical and empirical advancement of job-crafting research from three perspectives (i.e. individual, team and social).FindingsWhen looking at the job-crafting literature through these three perspectives, a total of six trends were uncovered that show that job-crafting research has moved to a more in-depth theory-testing approach; broadened its scope; examined team-level job crafting and social relationships; and focused on the impact of job crafting on others in the work environment and their evaluations and reactions to it.Originality/valueThe overview of recent trends within the job-crafting literature ends with a set of recommendations for how future research on job crafting could progress and create scientific impact for the coming years.
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