Evaluation of the Quebec Healthy Enterprise Standard: Effect on Adverse Psychosocial Work Factors and Psychological Distress

THE RELATIONSHIP BETWEEN PSYCHOSOCIAL WORK ENVIRONMENT AND NURSES' PERFORMANCE, ON STUDIES THAT USED THE VALIDATED INSTRUMENT COPENHAGEN PSYCHOSOCIAL QUESTIONNAIRE (COPSOQ): AN EMPTY SCOPING REVIEW

OBJECTIVE

Aim: This study was to map the relationship between psychosocial work environment and nurses' performance, on studies that used the Copenhagen Psychosocial Questionnaire (COPSOQ).

PATIENTS AND METHODS

Materials and Methods: The review intended to answer following questions: 'Can COPSOQ screen completely psychosocial risks of nurses' work environment?' 'Which of these dimensions affect more nurses psychosocial world? A scoping review was developed guided by the JBI methodology and using PRISMA-ScR.

CONCLUSION

Conclusions: Hospital workers, and in particular nurses, are exposed to different risk factors with the most important being psychosocial risks. These arise from problematic work planning, organization and management, as well as from an unhealthy social context of work and may lead to negative psychological, physical and social outcomes. The review highlighted the need for further research using the entire COPSOQ questionnaire in order to fully study the psychosocial risks that nurses face in their work environment.

Psychological distress in the workplace: The indirect contribution of work organization conditions to work performance

BACKGROUND: Psychological distress affects between 5 and 27% of the general population [1]. Workers facing stressful work conditions are especially at high risk for experiencing psychological distress [1]. OBJECTIVES: To evaluate the association between work organization conditions and work performance via psychological distress. While the individual contribution of work organization conditions to psychological distress and work performance has been examined in the scientific literature, their combined influence on work performance remains relatively unknown. METHODS: To adjust for design effects, we relied on cluster sampling (employees working in organizations). MPlus was used to conduct path analyses [2]. RESULTS: While psychological demands, number of hours worked, and job insecurity were positively associated with psychological distress, job recognition was negatively associated with it. In the same vein, irregular work schedules and job insecurity seem to be negatively associated with work performance. On the one hand, skill utilization, decision latitude, recognition, and job promotion, all seemed to be positively associated with employee’s work performance. On the other hand, psychological demands, number of hours worked, and job insecurity were negatively and indirectly associated with work performance. CONCLUSIONS: Understanding the indirect association between work variables and workers’ psychological distress could promote their work performance. Understanding this association could help shed light on the difficulties employees with psychological distress face while meeting their job requirements. The results of this study should serve as a reminder to intervene on work organization conditions.

A multilevel analysis of the role personality play between work organization conditions and psychological distress

BACKGROUND

Psychological distress in the workplace is usually attributed to work-related variables as well as non-work-related variables. Individuals working in the same organization can differ in terms of their appraisal of work-related stressors and coping strategies used to face them. The present study aims to evaluate the moderating role personality plays between work organizations conditions and psychological distress in a large sample of Canadian participants working in various occupations and workplaces.

METHODS

Multilevel regression analyses were conducted on a sample that followed a hierarchical structure with workers (N1 = 1958) nested in workplaces (N2 = 63). The direct contribution of workplace and personality was tested in a variance component model as a first step. Following this initial step, we introduced interaction variables by blocks of 11. Those interaction variables refer to each interaction combined with a specific personality variable.

RESULTS

Psychological demands, number of hours worked, job insecurity, neuroticism, and agreeableness were associated with higher levels of psychological distress. Inversely, decision authority, job recognition, self-esteem, locus of control were associated with lower levels of psychological distress. Lastly, agreeableness played a moderating role between low social support garnered from one's supervisor and psychological distress.

CONCLUSIONS

To intervene on work-related variables, organizations could reduce psychological demands, minimize the number of hours worked through job redesign, allow teleworking and encourage work schedule flexibility. To reduce job insecurity, organizations could explicitly communicate future organizational plans. In the same vein, decision authority could be targeted by reducing hierarchical steps and increasing autonomy. Lastly, the results pertaining to agreeableness stand in contrast with those of previous studies. We assumed that workers scoring high on agreeableness tend to put themselves last and please others first. These tendencies could make them more susceptible to health issues. With that said, work environments still need workers who are agreeable and nice to be around. To prevent high levels of agreeableness leading to psychological distress, training and information workshops are recommended. Those include stress management interventions and workshops pertaining to time management and relaxation techniques.

The Group Nurturance Inventory - initial psychometric evaluation using Rasch and factor analysis

BACKGROUND

This paper describes the development and psychometric evaluation of a behavioral assessment instrument primarily intended for use with workgroups in any type of organization. The instrument was developed based on the Nurturing Environments framework which describes four domains important for health, well-being, and productivity; minimizing toxic social interactions, teaching and reinforcing prosocial behaviors, limiting opportunities for problem behaviors, and promoting psychological flexibility. The instrument is freely available to use and adapt under a CC-BY license and intended as a tool that is easy for any group to use and interpret to identify key behaviors to improve their psychosocial work environment.

METHODS

Questionnaire data of perceived frequency of behaviors relevant to nurturance were collected from nine different organizations in Sweden. Data were analyzed using confirmatory factor analysis, Rasch analysis, and correlations to investigate relationships with relevant workplace measures.

RESULTS

The results indicate that the 23-item instrument is usefully divided in two factors, which can be described as risk and protective factors. Toxic social behaviors make up the risk factor, while the protective factor includes prosocial behavior, behaviors that limit problems, and psychological flexibility. Rasch analysis showed that the response categories work as intended for all items, item fit is satisfactory, and there was no significant differential item functioning across age or gender. Targeting indicates that measurement precision is skewed towards lower levels of both factors, while item thresholds are distributed over the range of participant abilities, particularly for the protective factor. A Rasch score table is available for ordinal to interval data transformation.

CONCLUSIONS

This initial analysis shows promising results, while more data is needed to investigate group-level measurement properties and validation against concrete longitudinal outcomes. We provide recommendations for how to work in practice with a group based on their assessment data, and how to optimize the measurement precision further. By using a two-dimensional assessment with ratings of both frequency and perceived importance of behaviors the instrument can help facilitate a participatory group development process. The Group Nurturance Inventory is freely available to use and adapt for both commercial and non-commercial use and could help promote transparent assessment practices in organizational and group development.

Anatomy of an effective workplace health intervention: a comprehensive new model

Purpose

This study proposes a new model, called the Integrated Human Health Model (IHHM), to improve the design and effectiveness of Workplace Health Promotion (WHP) interventions.

Design/methodology/approach

Eighteen participants were purposefully selected from 44 participants in a 2.5-day WHP intervention targeting multiple health behaviours (MHB). The intervention has shown to improve quality of life and health-related behaviours in rigorous studies. Qualitative data collection methods were observations, repeat semi-structured interviews and weekly e-journals collected over three months. Template analysis was used to develop the IHHM describing participants' experiences.

Findings

The IHHM describes the health behaviour change process using eight themes: facilitation, assessment, desired life, barriers, knowledge and skills, insights, action planning, and monitor and support.

Practical implications

With the paucity of evidence informing WHP intervention effectiveness, this study provides a preliminary model serving practitioners to design more effective interventions and scholars to improve evidence.

Originality/value

This study proposes a practical comprehensive model for practitioners and leaders to more effectively design and evaluate successful MHB WHP interventions compared to existing models.

Can psychosocial work factors influence psychologists' positive mental health?

BACKGROUND

Working in healthcare can entail intense emotional demands that increases susceptibility to occupational risk factors. Psychosocial risk assessment can contribute to promoting awareness of the effects of work on positive mental health.

AIMS

To explore and analyse the influence of psychosocial work factors on positive mental health among psychologists.

METHODS

A cross-sectional study of 339 psychologists was conducted. Two instruments were used for data collection: the Mental Health Continuum-Short Form (MHC-SF) to assess well-being and the Health and Work Survey (INSAT) to assess psychosocial work factors.

RESULTS

This study identified psychosocial work factors that affect psychologists' positive mental health, namely, emotional well-being was affected by 'Need help from colleagues' (β = -1.091), 'Have no one I can trust' (β = -1.253) and 'Complex work' (β = 0.751); psychological well-being was affected by 'Intense work pace' (β = 1.151), 'Not able to participate in decisions' (β = -3.695) and 'Complex work' (β = 1.520); and social well-being was affected by 'Always changing roles and tasks' (β = -1.810) and 'Not able to participate in decisions' (β = -2.470).

CONCLUSIONS

Psychosocial work factors such as work organization, work relationships and emotional demands influence psychologists' positive mental health. Social support at the workplace and having challenging and autonomous work can promote mental health. It is important to develop better organizational practices to promote mental health and well-being among these professionals.

Effort-Reward Imbalance, Over-Commitment and Depressive Episodes at Work: Evidence from the ELSA-Brasil Cohort Study

A growing burden of mental illness, and in particular depression, among workers is a concern of occupational public health. Scientific evidence has revealed consistent associations of work-related stress, as measured by theoretical models, with depression, but mostly so in developed countries. This contribution explores these associations in a developing Latin American country, Brazil, by applying an internationally established work stress model, the effort-reward imbalance (ERI). This model focuses on the work contract where unjust exchange between high efforts spent and low rewards received in turn contributes to stress-related disorders. The model’s extrinsic (‘effort’, ‘reward’) and intrinsic components (‘over-commitment’), as well as their combination, are hypothesized to be related to a higher risk of depressive episodes (DE). Using cross-sectional data from the ELSA-Brasil study, including 10,034 workers from the public sector, we observed increased prevalence ratio (PR) of DE according to ERI scales. The quartiles of highest ‘effort’ (PR = 1.85; 1.44–2.37), highest ‘over-commitment’ (PR = 3.62; 2.80–4.70) and lowest ‘reward’ (PR = 3.44; 2.55–4.64) were associated with DE, on adjusted models, as well was the E–R ratio (PR = 2.47; 1.92–3.17). An additive interaction was identified between the E–R ratio and ‘over-commitment’. The results support the use of ERI as a screening tool for work stress in the Brazilian context and will offer guidance for worksite health promotion programs.

Evaluation of the Quebec Healthy Enterprise Standard: Effect on Adverse Physical and Psychosocial Work Factors and Work-Related Musculoskeletal Problems

OBJECTIVE

The aim of this study was to evaluate the effect of the Quebec Healthy Enterprise Standard (QHES) on adverse physical and psychosocial work factors and work-related musculoskeletal problems (WMSP).

METHODS

Workers of 10 organizations completed questionnaires before (n = 2849) and 2 to 3 years following (n = 2560) QHES implementation. Outcomes were assessed using validated instruments.

RESULTS

Workers exposed to adverse physical and psychosocial work factors had a higher prevalence of WMSP. After interventions, the prevalences of one adverse physical and three adverse psychosocial work factors were lower among workers exposed to interventions. Among men exposed to physical and psychosocial interventions, the lower prevalence of neck WMSP is compatible with a beneficial intervention effect. Other results generally showed few effects on WMSP.

CONCLUSION

Results suggest that QHES implementation lead to a decrease in some adverse physical and psychosocial work factors. Few effects were observed on WMSP.

Do as you say

Purpose

The purpose of this paper is to uncover the effect of psychosocial safety climate (PSC – a climate for psychological health) on managerial quality and the mediating processes explaining that association. It is posited that the alignment between what is said (espoused PSC) and what is done (enacted PSC via managerial quality) is important for successful organizational interventions. Managers’ own psychosocial work factors act as resources to facilitate the enactment of managerial quality.

Design/methodology/approach

Two waves of survey were administered over a three-month period (n at Time 1=144, n at Time 2=166, overall n=115) in a study of four organizations involved in implementing the Quebec Healthy Enterprise Standard (QHES). A cross-lagged panel analysis was used to determine the temporal direction of the PSC–managerial quality relationship. A longitudinal mediation model of PSC as a determinant of managerial quality was tested using job demands, job control, social support and quality of relationships with subordinates as mediators.

Findings

The cross-lagged panel analysis showed that PSC is temporally prior to managerial quality in that the relationship between PSC at T1 and managerial quality at T2 was stronger than the relationship between managerial quality at T1 and PSC at T2. A two-wave mediation analysis showed that PSC was positively associated with managerial quality, and that job control partially mediated this relationship. Contrary to expectations, managers’ workload, their social support and the quality of their relationships with subordinates did not mediate the PSC–managerial quality relationship.

Research limitations/implications

Despite the small sample size and short timeframe of this study, it contributes to knowledge on the resources facilitating managerial quality, which is important for employees’ psychological health. Little is known regarding the mediating processes that explain how managers’ own context and psychosocial work factors affect their management practices during organizational health interventions.

Practical implications

From a practical view point, this study contributes to the literature showing that managers need to be supported during the implementation of health interventions, and need the leeway to pursue the organization’s prevention objectives.

Originality/value

Whereas previous studies have focused on describing the impact of leadership behaviors on employee health outcomes, the study offers insights into the resources that help managers translate PSC into action in the implementation of a national standard, the QHES.

Healthcare Workers: Occupational Health Promotion and Patient Safety

The purpose of the present study was to explore the relation of work-related risk factors and well-being among healthcare workers and the impact on patient safety, using the Health and Work Survey (INSAT) and Mental Health Continuum - Short Form (MHC-SF). A sample of 361 Portuguese healthcare workers participated in this study. The results indicate some significant work-related risk factors: for emotional well-being, Impossible to express myself (β = -0.977), Not having recognition by superiors (β = -1.028) and Have to simulate good mood and/or empathy (β = -1.007); for social well-being, Exposed to the risk of sexual discrimination (β = -2.088), Career progress is almost impossible (β = -1.518), and Have to hide my emotions (β = -2.307); finally for psychological well-being Exposed to the risk of sexual discrimination (β = -2.153), Career progress is almost impossible (β = -1.377), and Have to simulate good mood and/or empathy (β = -3.201). The results showed high levels of well-being despite the exposure of several risk factors at workplace. Regarding the work-related risk factors, the study showed that most of the participants are exposed to several risk factors at workplace (ranging from environmental risk factors, biological to physical), although psychosocial risk factors (work relations with superiors and colleagues, employment relations, and emotional demands) are the ones that most impact on well-being.