Predictive and Associated Factors of Burnout in Nursing Faculty: An Integrative Review

BACKGROUND

Nurse educators are at high risk of experiencing burnout, resulting in high numbers of vacant faculty positions.

PURPOSE

The aims of this integrative review were to review the prevalence of measurable dimensions of professional burnout and discuss the predictive and associated factors of burnout and intent to leave nursing academia.

APPROACH

This review used the Whittemore and Knafl integrative review methodology to perform a structured search of 4 electronic databases (CINAHL, ERIC, EMBASE, and PubMed).

OUTCOMES

Nine empirical research studies measured 5 identifiable features of burnout in nursing educators: emotional exhaustion, depersonalization, lack of accomplishment, compassion satisfaction, and secondary traumatic stress. Five predictors of intent to leave nursing academia were identified: demographics, health status, salary, workload, and work-life imbalance.

CONCLUSIONS

The highest contributing factor to burnout and intent to leave nursing academia is high workload levels and lack of work-life balance. Nursing faculty report moderate to high levels of all dimensions of professional burnout.

Comparing Synchronous and Asynchronous Task Delivery in Mixed Reality Environments

Asynchronous digital communication is a widely applied and well-known form of information exchange. Most pieces of technology make use of some variation of asynchronous communication systems, be it messaging or email applications. This allows recipients to process digital messages immediately (synchronous) or whenever they have time (asynchronous), meaning that purely digital interruptions can be mitigated easily. Mixed Reality systems have the potential to not only handle digital interruptions but also interruptions in physical space, e.g., caused by co-workers in workspaces or learning environments. However, the benefits of such systems previously remained untested in the context of Mixed Reality. We conducted a user study ($\mathrm{N}=26$) to investigate the impact that the timing of task delivery has on the participants' performance, workflow, and emotional state. Participants had to perform several cognitively demanding tasks in a Mixed Reality workspace. Inside the virtual workspace, we simulated in-person task delivery either during tasks (i.e., interrupting the participant) or between tasks (i.e., delaying the interruption). Our results show that delaying interruptions has a significant impact on subjective metrics like the perceived performance and workload.

Evaluation of a motorised patient transfer device based on perceived workload, technology acceptance, and emotional states

PURPOSE

The high prevalence of musculoskeletal disorders (MSDs) among healthcare workers is partly attributed to the low adoption of patient transfer assistive devices. This study aimed to evaluate the nurses' perceived workload, technology acceptance, and emotional states during the use of the sliding board (SB) and mechanical intervention in the form of a Motorised Patient Transfer Device (MPTD).

METHODS

The SB and MPTD activities were performed by seven nurses on a simulated patient. The nurses' facial expressions were recorded during the trial. The NASA Task Load Index and technology acceptance questionnaire were also assessed.

RESULTS

The MPTD significantly reduced the mean overall NASA-TLX score by 68.7% (p = 0.004) and increased the overall acceptance score (median = 8.30) by 21.2% (p = 0.016) when compared to the SB (median = 6.85). All the subjects reported positive feelings towards MPTD. However, facial expression analysis showed that the nurses had a significantly higher peak density of fear while using MPTD (p = 0.016). Besides, there was no improvement in the negative valence and contempt emotion compared to the SB.

CONCLUSION

Overall, nurses showed positive perceptions and acceptance of MPTD even when they experienced negative emotions.IMPLICATIONS FOR REHABILITATIONThe Motorised Patient Transfer Device (MPTD) reduced the perceived workload of nurses and showed a higher acceptance level compared to the commonly used baseline device (SB).Factors that attributed to the nurses' negative emotions can be used to improve technology and patient transfer processes.More training should be given to familiarise the health practitioners with the new assistive device to reduce their fear of technology.

The Effect of Task Interruption on Working Memory Performance

OBJECTIVE

This study used electroencephalography to explore the behavioral and electrophysiological effects of task interruption on performance.

BACKGROUND

Task interruption is known to harm work performance, especially on working memory-related tasks. However, most studies pay little attention to cognitive processes by exploring brain activity and ignore the cumulative effect of sequential interruptions.

METHOD

Thirty-four healthy participants performed a spatial 2-back in three conditions: (1) interruptions with simple math questions, (2) suspensions with prolonged fixation cross, and (3) a pure 2-back. The measured outcomes comprise performance data, ERP amplitudes, EEG power, and subjective workload.

RESULTS

Work performance decreased in the resumption trials, and cumulative interruptions had a more destructive effect on performance. EEG results showed that the P2 and P3 amplitudes induced by the 2-back task significantly increased after interruptions; theta and alpha power increased after interruptions. The P3 amplitude and alpha power induced by interruptions were significantly higher than that induced by suspensions.

CONCLUSION

Behavioral data revealed the disruptive effect of interruptions on postinterruption performance and the cumulative effect of interruptions on accuracy. Changes in ERP amplitudes and EEG power indicate the mechanisms of attention reallocation and working memory during interruptions. Larger P3 amplitudes and alpha power after interruptions than after suspensions suggested the inhibition of irrelevant information. These results may support the memory for goals model and improve the understanding of the effects of interruption on working memory.

APPLICATION

Focusing upon the mechanisms at play during the interruption process can support interruption management to ensure work safety and efficiency.

An Adaptive Human-Robotic Interaction Architecture for Augmenting Surgery Performance Using Real-Time Workload Sensing-Demonstration of a Semi-autonomous Suction Tool

OBJECTIVE

This study developed and evaluated a mental workload-based adaptive automation (MWL-AA) that monitors surgeon cognitive load and assist during cognitively demanding tasks and assists surgeons in robotic-assisted surgery (RAS).

BACKGROUND

The introduction of RAS makes operators overwhelmed. The need for precise, continuous assessment of human mental workload (MWL) states is important to identify when the interventions should be delivered to moderate operators' MWL.

METHOD

The MWL-AA presented in this study was a semi-autonomous suction tool. The first experiment recruited ten participants to perform surgical tasks under different MWL levels. The physiological responses were captured and used to develop a real-time multi-sensing model for MWL detection. The second experiment evaluated the effectiveness of the MWL-AA, where nine brand-new surgical trainees performed the surgical task with and without the MWL-AA. Mixed effect models were used to compare task performance, objective- and subjective-measured MWL.

RESULTS

The proposed system predicted high MWL hemorrhage conditions with an accuracy of 77.9%. For the MWL-AA evaluation, the surgeons' gaze behaviors and brain activities suggested lower perceived MWL with MWL-AA than without. This was further supported by lower self-reported MWL and better task performance in the task condition with MWL-AA.

CONCLUSION

A MWL-AA systems can reduce surgeons' workload and improve performance in a high-stress hemorrhaging scenario. Findings highlight the potential of utilizing MWL-AA to enhance the collaboration between the autonomous system and surgeons. Developing a robust and personalized MWL-AA is the first step that can be used do develop additional use cases in future studies.

APPLICATION

The proposed framework can be expanded and applied to more complex environments to improve human-robot collaboration.

Prediction of cognitive conflict during unexpected robot behavior under different mental workload conditions in a physical human-robot collaboration

Objective. Brain-computer interface (BCI) technology is poised to play a prominent role in modern work environments, especially a collaborative environment where humans and machines work in close proximity, often with physical contact. In a physical human robot collaboration (pHRC), the robot performs complex motion sequences. Any unexpected robot behavior or faulty interaction might raise safety concerns. Error-related potentials, naturally generated by the brain when a human partner perceives an error, have been extensively employed in BCI as implicit human feedback to adapt robot behavior to facilitate a safe and intuitive interaction. However, the integration of BCI technology with error-related potential for robot control demands failure-free integration of highly uncertain electroencephalography (EEG) signals, particularly influenced by the physical and cognitive state of the user. As a higher workload on the user compromises their access to cognitive resources needed for error awareness, it is crucial to study how mental workload variations impact the error awareness as it might raise safety concerns in pHRC. In this study, we aim to study how cognitive workload affects the error awareness of a human user engaged in a pHRC.Approach. We designed a blasting task with an abrasive industrial robot and manipulated the mental workload with a secondary arithmetic task of varying difficulty. EEG data, perceived workload, task and physical performance were recorded from 24 participants moving the robot arm. The error condition was achieved by the unexpected stopping of the robot in 33% of trials.Main results. We observed a diminished amplitude for the prediction error negativity (PEN) and error positivity (Pe), indicating reduced error awareness with increasing mental workload. We further observed an increased frontal theta power and increasing trend in the central alpha and central beta power after the unexpected robot stopping compared to when the robot stopped correctly at the target. We also demonstrate that a popular convolution neural network model, EEGNet, could predict the amplitudes of PEN and Pe from the EEG data prior to the error.Significance. This prediction model could be instrumental in developing an online prediction model that could forewarn the system and operators of the diminished error awareness of the user, alluding to a potential safety breach in error-related potential-based BCI system for pHRC. Therefore, our work paves the way for embracing BCI technology in pHRC to optimally adapt the robot behavior for personalized user experience using real-time brain activity, enriching the quality of the interaction.

[Perceived changes in the workload of home care nurses during the COVID-19 pandemic: Results of an online survey]

BACKGROUND

The COVID-19 pandemic posed major challenges to the health care system, particularly to nursing. Intensive care was often the focus of attention. However, home care nursing was also confronted with drastic changes, while it is largely unknown how the work situation changed for employees as a result of the pandemic - also depending on the sponsorship of home care nursing services.

METHODS

A nationwide online survey of home-care nurses was conducted in May and June 2022. The Intensification of Job Demands Scale (IDS) and an open question regarding changes in the work situation due to the pandemic were used among other instruments.

RESULTS

More than two-thirds of the 976 home-care nurses surveyed agreed with the respective statements regarding work intensification (e.g., taking fewer breaks, doing work activities at the same time, not having enough time). Additional factors for psychological workload during the pandemic primarily fell within the scope of work organization (e.g., staff absences due to illness and quarantine, vaccination related leaves and terminations, additional workload due to handling protective clothing). Employees of privately run care services experienced fewer COVID-19-related changes than home care nurses employed by non-profit providers.

CONCLUSION

In future crisis situations, good information management (e.g., uniform, consistent and comprehensible guidelines and recommendations for action) and ways to compensate for staff shortages should be created.

Assessing mental demand in consecutive interpreting: Insights from an fNIRS study

Consecutive interpreting involves a demanding language task where mental workload (MWL) is crucial for assessing interpreters' performance. An elevated cognitive load in interpreters may lead to the interpretation failures. The widely used NASA-TLX questionnaire effectively measures MWL. However, a global score was employed in previous interpretation studies, overlooking the distinct contributions of MWL components to the interpreters' performance. Accordingly, we recruited twenty novice interpreters who were postgraduate students specializing in interpreting to complete the consecutive interpreting task. Throughout the process, we used functional near-infrared spectroscopy (fNIRS) to monitor the hemodynamic response in participants' brains. The NASA-TLX was used to measure the MWL during interpreting with six components, including mental demand, physical demand, temporal demand, performance, effort, and frustration. Five interpretation experts were invited to assess the interpretation quality. The Bayes factor approach was employed to explore the components that contributes the most to the interpretation quality. It indicated that mental demand strongly contributed to the interpretation quality. Moreover, the mediation analysis revealed a positive correlation between mental demand and brain activation in three brain areas, which, in turn, was negatively correlated with interpretation quality, indicating the predictive role of mental demand in interpretation quality through the mediating of brain activation. The functions of the mediating brain areas, including the inferior frontal gyrus, middle temporal gyrus, and inferior temporal gyrus, aligned with the three efforts proposed by Gile's effort model, which emphasizes the significance of three fundamental efforts in achieving successful interpreting. These findings have implications for interpreter learning and training.

Evaluating Operator Training Performance Using Recurrence Quantification Analysis of Autocorrelation Transformed Eye Gaze Data

OBJECTIVE

This research aimed to investigate the relationship between gaze behaviour dynamics and operator performance.

BACKGROUND

Individuals differ in their approach when learning a new task often resulting in performance disparity. During training some individuals learn the structure and dynamics of the task and develop a systematic approach, whereas others may achieve the same result albeit with increased perceived workload, or indeed some may fail to achieve superior performance levels. Previous research has shown that comparing gaze of experts with novices can provide unique insights into cognitive functioning of superior performers.

METHODS

Twenty-five individuals participated in a computer-based simulation task. The concept of coefficient of variation (CoV) of task scores was used to compute the participants' consistency of performance. Based on CoV, the cohort was split into two performance categories. The temporal patterns in participants gaze data were transformed using autocorrelation, and recurrence quantification analysis (RQA) was employed to analyse and quantify the patterns.

RESULTS

A Mann-Whitney U analysis demonstrated significantly (p < .01) higher determinism, entropy and laminarity in the superior group compared to the moderate group. Pearson's correlation revealed a significant (p < .01) negative correlation between the consistency of task performance (CoV) and the RQA measures.

CONCLUSION

The results demonstrated that eye gaze dynamics can be used as an objective measure of performance. Participants classified as superior performers consistently demonstrated a systematic gaze activity which were in line with the task structure.

APPLICATION

The methods presented here are applicable to observe and evaluate operators' strategic distribution of gaze. Specifically, for tactical monitoring and decision making in task environments where spatial locations of elements-of-interest vary continuously.

Non-invasive stress estimation in simulative endoscopy setting: literature review

One of the most common stressors is so-called "occupational stress." It is defined as the sum of physical, mental and physiological responses to work in situations where the workload or stress associated with it intensifies for an extended period of time. It is a gradual process in which individual cognitive assessments of occupational stressors generate adverse health events and may lead to burnout. Since it has become a major problem in the medical field, studying, measuring and limiting it have been set as goals for the future.

EEG Dataset Collection for Mental Workload Predictions in Flight-Deck Environment

High mental workload reduces human performance and the ability to correctly carry out complex tasks. In particular, aircraft pilots enduring high mental workloads are at high risk of failure, even with catastrophic outcomes. Despite progress, there is still a lack of knowledge about the interrelationship between mental workload and brain functionality, and there is still limited data on flight-deck scenarios. Although recent emerging deep-learning (DL) methods using physiological data have presented new ways to find new physiological markers to detect and assess cognitive states, they demand large amounts of properly annotated datasets to achieve good performance. We present a new dataset of electroencephalogram (EEG) recordings specifically collected for the recognition of different levels of mental workload. The data were recorded from three experiments, where participants were induced to different levels of workload through tasks of increasing cognition demand. The first involved playing the N-back test, which combines memory recall with arithmetical skills. The second was playing Heat-the-Chair, a serious game specifically designed to emphasize and monitor subjects under controlled concurrent tasks. The third was flying in an Airbus320 simulator and solving several critical situations. The design of the dataset has been validated on three different levels: (1) correlation of the theoretical difficulty of each scenario to the self-perceived difficulty and performance of subjects; (2) significant difference in EEG temporal patterns across the theoretical difficulties and (3) usefulness for the training and evaluation of AI models.

The effects of increased mental workload of air traffic controllers on time perception: Behavioral and physiological evidence

Research has shown that timing is modulated by mental workload, making duration judgments a measure of cognitive demand, alongside subjective assessments, and physiological measurements. Yet, it is unclear whether such findings can be extended in less controlled setups. By employing air traffic controllers in a real aviation environment, we tested whether tasks with different levels of cognitive load can affect their timing behavior. Participants completed temporal production, verbal estimation, and passage of time judgments, while actively engaging in real flight control sessions. Subjective assessments of task demands, as well as physiological responses (cardiac and electrodermal activity) were also measured. Accuracy of the produced intervals was measured at two distinct phases of the flight (during low-load cruising vs. high-load landing) and under two different task load manipulations (controlling one vs. two helicopters and speaking in native vs. non-native language). Analysis of interval production accuracy showed that during the high-load landing phase significant overproductions were made, compared to the low-load cruising phase, and landing two helicopters led to greater overproductions compared to landing only one. The duration of the two-helicopter sessions was significantly overestimated compared to the single-helicopter ones, and the passage of time was felt significantly faster. Subjective assessments of workload were positively correlated with the temporal estimations and passage of time judgments, and skin responses were positively correlated with the produced intervals. Overall, our results are consistent with past research, suggesting that mental workload modulates time perception in complex, real-world environments, thus making timing behavior a reliable index of the workload changes.

The dynamic interplay of job characteristics and psychological capital with employee health: A longitudinal analysis of reciprocal effects

The dynamic development of employee health is increasingly addressed by occupational health scholarships. Based on the job demands-resources theory, this study examines reciprocal relationships among job resources, job demands, psychological capital (PsyCap), work engagement, and burnout over time. We hypothesize that PsyCap, job resources, and work engagement are part of a reciprocal gain cycle that is based on static levels and changes in these variables. Further, we assume that PsyCap has multiplicative buffering and boosting relationships with job demands and burnout. We test our hypotheses using latent change score modeling with data from 661 employees surveyed over 3 consecutive months. The results reveal a complex reciprocal cycle between PsyCap, work engagement, and job resources. However, PsyCap does not interact with the reciprocal relationship between job demands and burnout, as it is directly reciprocally related to burnout and certain types of job demands. Against the background of these results, our study contributes to research and practice on the role of personal resources, specifically PsyCap, by identifying individual differences in change patterns and highlighting the importance of considering individual differences and temporal aspects in the context of occupational health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

GP perspectives on a psychiatry phone line in Western Australia's Great Southern region: implications for addressing rural GP workload

BACKGROUND

Mental illness is a public health challenge disproportionately affecting rural Australians. GPs provide most of the mental health care, and they report increasing levels of burnout and unsustainable workload in the context of increased patient complexity. This may be more salient in rural settings characterised by resource constraints. In this paper, we use evaluation data from a GP psychiatry phone line established in Western Australia's Great Southern region in 2021 to describe GPs' perspectives on the service and reflect on how it may help alleviate rural GP workload.

METHODS

The sample was recruited among GPs practicing in the region. Data were collected through an online survey and semistructured interviews. Descriptive statistics were used to analyse the survey data. Interview data were subjected to thematic analysis; qualitative survey data were used for triangulation.

RESULTS

A total of 45GPs completed the survey and 14 were interviewed. Interview data yielded three themes: the criticality of timeliness; the building blocks of confidence; and trust. GPs were highly satisfied with the service, and timeliness and trust were the characteristics underpinning its effectiveness. The service built GPs' confidence in managing mental health and alcohol and other drug use issues through strengthening knowledge and providing reassurance.

CONCLUSIONS

Our results suggest that a telephone line operated by trusted, local psychiatrists with knowledge of the local mental health ecosystem of support can reduce rural GP workload through building confidence and strengthening personal agency, helping GPs navigate the ethical and clinical labyrinth of managing patient complexity in rural settings.

A Review of Cognitive Support Systems in the Operating Room

BACKGROUND

In recent years, numerous innovative yet challenging surgeries, such as minimally invasive procedures, have introduced an overwhelming amount of new technologies, increasing the cognitive load for surgeons and potentially diluting their attention. Cognitive support technologies (CSTs) have been in development to reduce surgeons' cognitive load and minimize errors. Despite its huge demands, it still lacks a systematic review.

METHODS

Literature was searched up until May 21st, 2021. Pubmed, Web of Science, and IEEExplore. Studies that aimed at reducing the cognitive load of surgeons were included. Additionally, studies that contained an experimental trial with real patients and real surgeons were prioritized, although phantom and animal studies were also included. Major outcomes that were assessed included surgical error, anatomical localization accuracy, total procedural time, and patient outcome.

RESULTS

A total of 37 studies were included. Overall, the implementation of CSTs had better surgical performance than the traditional methods. Most studies reported decreased error rate and increased efficiency. In terms of accuracy, most CSTs had over 90% accuracy in identifying anatomical markers with an error margin below 5 mm. Most studies reported a decrease in surgical time, although some were statistically insignificant.

DISCUSSION

CSTs have been shown to reduce the mental workload of surgeons. However, the limited ergonomic design of current CSTs has hindered their widespread use in the clinical setting. Overall, more clinical data on actual patients is needed to provide concrete evidence before the ubiquitous implementation of CSTs.

Cognitive Job Demands and Sports Participation among Young Workers: What Moderates the Relationship?

Cognitive job demands are theoretically and empirically associated with sports participation in various ways. Workers may be overwhelmed by stress and fatigue from their workload and therefore refrain from sports activities, but they can also feel the need to use sports as a way to recover and detach from work. The strategy to which workers adhere can depend on workers' resources that moderate the cognitive job demands and sports participation relationship, such as educational attainment, being a parent, or having worktime and work location control. To test our expectations, we used recent information on sports participation by young working adults from the Netherlands (N = 2032). Using multinomial logistic regression modelling, we found that workers in mentally demanding jobs were more likely to participate in sports more than three times a week. In particular, workers without children reported a higher likelihood of participating in sports more than three times a week when they experienced high cognitive job demands. Among the higher-educated, workers with high cognitive job demands were less likely to participate in sports one to three times a week. We reflect on the academic and policy-related implications of our findings.

Cusp Catastrophe Models for Cognitive Workload and Fatigue for Teams Making Dynamic Decisions

This study evaluated cusp models of workload and fatigue experienced by teams on a dynamic decision making task. Cognitive workload is the amount of information that a person is required to process in a given way in a fixed amount of time. Fatigue, which is captured by a work curve or a cubic polynomial function, is the loss of work capacity that is produced by an extended amount of time spent on a particular cognitive or physical task. In this experiment, 32 groups of three, four or five members (136 individuals) played two matches of a first-person shooter computer game, and completed subjective measures of workload and cognitive measures of elasticity versus rigidity. For the workload cusp models with elasticity-rigidity components, the bifurcation in performance levels occurred when teams expressed greater emotional intelligence, anxiety, levels of fluid intelligence, coping flexibility, cognitive flexibility, and were more decisive (R2=.54-.56, linear alternative, .09-.23). For workload cusp models assessing subjective ratings of workload, bifurcation occurred with groups who reported greater levels of performance demand and effort required (R2=.51, linear alternative, .20). For fatigue cusp models, bifurcation occurred for groups that played fewer rounds of the game before winning or losing the match, or came from the smaller-sized groups, which were supplemented by computer-generated agents (R2=.66-.67, linear alternative, .21-.68). Results supported the general-ization of the cusp models for workload and fatigue to situations requiring teamwork in dynamic decision making environments. The study also raised new questions about the role of autonomic synchrony in the workload or fatigue processes and similarity of the dynamics of human-autonomy teams compared to all-human teams.

Gender differences in self-assessed performance and stress level during training of basic interventional radiology maneuvers

OBJECTIVES

Gender differences have been reported to influence medical training. We investigated gender differences encountered during training in interventional radiology maneuvers.

METHODS

Catheter handling was analyzed under standardized conditions in 64 participants naïve to endovascular procedures (26 women, 38 men). Objective (e.g., catheter pathway, catheter movements, required time) and subjective parameters (stress level) were recorded. The NASA-Task Load Index (NASA-TLX; 1-20 points) was used to assess participants' stress levels and perceived workload.

RESULTS

In the easier tasks, no significant differences between male and female participants regarding catheter handling were observed. In the most complex task, female participants took themselves more time (688 ± 363 vs. 501 ± 230 s; p = 0.02), asked for help more frequently (n = 19 vs. n = 8) and earlier than men (203 ± 94 vs. 305 ± 142 s; p = 0.049), whereas men stood out by more agitated catheter handling (6.0 ± 1.8 vs. 4.8 ± 1.6 movements/s; p = 0.005). Overall, female participants perceived tasks to be more difficult (11.5 ± 4.2 vs. 9.6 ± 3.3; p = 0.016), perceived higher stress levels (8.9 ± 4.9 vs. 6.3 ± 4.4; p = 0.037), and rated their own performance lower (9.12 ± 3.3 vs. 11.3 ± 3.3; p = 0.009). However, female participants were able to correlate self-assessed with objective parameters correctly (r between -0.555 and -0.469; p = 0.004-0.018), whereas male participants failed to correctly rate their performance (p between 0.34 and 0.73). Stress levels correlated with objective parameters in males (r between 0.4 and 0.587; p < 0.005), but not in female participants.

CONCLUSION

Perceived stress levels, self-evaluation skills, and catheter handling differ greatly between untrained male and female participants trying to solve interventional radiological tasks. These gender-specific differences should be considered in interventional radiology training.

CLINICAL RELEVANCE STATEMENT

As psychological aspects may influence individual working strategies gender-specific differences in self-perception while learning interventional radiology maneuvers could be essential regarding success in teaching and treatment outcomes.

KEY POINTS

• After performing standardized training, 38 male and 26 female volunteers showed significant differences regarding objective and self-assessed performance, as well as in perceived workload while performing simulated endovascular catheter maneuvers. • After solving simulated endovascular radiological tasks, female participants were able to self-assess their objective performance much more accurately than male participants. • Women took more time to solve simulated endovascular tasks and asked earlier and more frequently for help than men.

The impact of co-pilot displays use on driver workload and driving performance exploring the impact of co-pilot display on drivers' workload and driving performance

New production vehicles equipped with multiple screens have various functions and technologies at the user's fingertips that create informative and immersive cockpits not only for the driver but also for the passenger. Despite the growing popularity of the co-pilot display, surprisingly little is known about the impact of its engagement on drivers. Engagement, in the context of this paper, is defined as visual, auditory, and mental involvement but no manual involvement. The present study sought to investigate the effects of co-pilot display engagement on drivers' visual workload, cognitive workload, and driving performance and offered a deeper insight into the design factors and task involvement of the co-pilot display. The study involved a driving simulator testing of 25 participants in five automobiles with a co-pilot display. Our analysis found increased driver visual workload and cognitive workload in the conditions of co-pilot display engagement. Participants exhibited more erratic driving behavior (standard deviation of speed and standard deviation of lane position) while the front passenger was watching a video. Furthermore, five linear mixed models were built to further analyze the effects of task type, screen size, screen layout, and task involvement on dependent measures. Potential applications of this research include refinements to the co-pilot display and workload estimation of co-pilot display engagement.

Extended-Duration Work Shifts in Surgical Specialties: A Systematic Review

INTRODUCTION

There has been widespread international implementation of duration-hour restrictions to prevent surgical resident burnout and promote patient safety and wellbeing of doctors. A variety of Extended-Duration Work Shifts (EDWS) have been implemented, with a variety of studies examining the effect of shift systems on both surgical performance and the stress response unestablished in the literature.

METHODS

This was a systematic review evaluating the impact of extended working hours on surgical performance, cognitive impairment, and physiological stress responses. The review used PubMed, Ovid Medline, Embase, and Google Scholar search engines between September and October 2021 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Filters including studies carried out after 2002 and published in the English language were applied.

RESULTS

In total, 30 studies were included for analysis. General surgery was the most commonly studied rotation, with Neurosurgical, Orthopedic, and ear, nose and throat specialties also included. The majority of studies found no difference or a significant improvement in post-EDWS on simulated performance. EDWS appeared to have the greatest impact on physiological stress markers in junior surgical trainees.

CONCLUSIONS

Experience appears to confer a protective element in the postcall period, with preservation of skill demonstrated. More experienced clinicians yielded lower levels of physiological markers of stress, although variability in hierarchical workload should be considered. Heterogeneity of findings across physiological, cognitive, and psychomotor assessments highlights the need for robust research on the optimum shift pattern prevents worker burnout and promotes patient safety. Future research to evaluate correlation between stress, on-call workload, and performance in the postcall period is warranted.

Investigation of the neural correlation with task performance and its effect on cognitive load level classification

Electroencephalogram (EEG)-based cognitive load assessment is now an important assignment in psychological research. This type of research work is conducted by providing some mental task to the participants and their responses are counted through their EEG signal. In general assumption, it is considered that during different tasks, the cognitive workload is increased. This paper has investigated this specific idea and showed that the conventional hypothesis is not correct always. This paper showed that cognitive load can be varied according to the performance of the participants. In this paper, EEG data of 36 participants are taken against their resting and task (mental arithmetic) conditions. The features of the signal were extracted using the empirical mode decomposition (EMD) method and classified using the support vector machine (SVM) model. Based on the classification accuracy, some hypotheses are built upon the impact of subjects' performance on cognitive load. Based on some statistical consideration and graphical justification, it has been shown how the hypotheses are valid. This result will help to construct the machine learning-based model in predicting the cognitive load assessment more appropriately in a subject-independent approach.

Work for the Prison Service: selected health consequences - investigating the role of personal resources, job demands, work stress, and burnout

OBJECTIVES

The specific job demands of the Prison Service (PS) may affect the health of officers. The job demands-resources model (JD-R) model was used to design a survey of the consequences of working subject to particular job demands. The aim was to gain an insight into the relationship between job demands, personal resources, occupational stress and burnout and selected health consequence indicators (such as behaviors associated with the consumption of alcohol, stress symptoms).

MATERIAL AND METHODS

A total of 1732 PS officers in Poland were surveyed. The following tools were used as part of the survey: the Copenhagen Psychosocial Questionnaire (COPSOQ II), the Multidimensional Inventory for Assessing Coping Responses (COPE), the Alcohol Use Disorders Identification Test (AUDIT) and a form with a respondent's particulars. Path analysis using partial least squares structural equation modelling (PLS-SEM) was performed.

RESULTS

The assumed hypotheses were partially confirmed by the results. Out of 4 job demands categories only work pace turned out not to be a significant predictor of burnout and stress. For alcohol related behaviors, stress level was the only significant predictor, both as a direct and indirect effect taking into account job demands. It transpired that support from superiors rather than support from colleagues or self-efficacy was a significant moderator in the emotional demands - stress relationship. Limitations of the study and perspectives for its continuation are also presented herein.

CONCLUSIONS

Based on the obtained results it may be concluded that job demands and support from superiors do have an impact on stress in the PS group. This is also consistent with available reports in literature. At the same time stress is a significant predictor of alcohol related behaviors. Coping through the use of psychoactive substances was not a significant factor in statistical analyses and it has still not been subject to sufficient scientific analysis. Int J Occup Med Environ Health. 2023;36(6):744-60.

Factors influencing the mental health status of support nurses and their workload during the COVID-19 epidemic

OBJECTIVES

The authors used the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and general health questionnaire to analyze the factors influencing the mental health status and the workload of support nurses during the COVID-19 epidemic.

MATERIAL AND METHODS

The authors conducted a cross-sectional survey of 349 support nurses in April-October 2022. Using QuestionStar, a powerful online survey tool, the authors administered surveys to the participants, collected data on the mental health status and workload of support nurses, and analyzed the influencing factors based on the collected data.

RESULTS

A total of 316 questionnaires were successfully collected, with an effective rate of 98.75%. The proportion of support nurses with mental health problems was 25% and the value of the NASA-TLX questionnaire was: M±SD 68.91±7.28 pts. Multi-factor analysis revealed that the number of children, family support, and nursing support location were the influencing factors of mental health status, while the multivariate analysis revealed that the presence of symptoms, nursing support location, support work type, and total 12-item General Health Questionnaire (GHQ-12) score were the influencing factors of the workload of support nurses.

CONCLUSIONS

Compared to their counterparts in the plains, nurses working in isolated plateau regions who were caring for children and lacked family support, were more likely to have mental health issues. There was a positive correlation between the changes in GHQ-12 and NASA-TLX scores of the study participants. Compared to their counterparts in the plains and the tropical regions, nurses working in plateau regions had a heavier workload. As part of the follow-up measures to prevent and treat patients impacted by the COVID-19 epidemic, it is important to improve the mental health evaluation, consultation, and treatment of the support nurses to guarantee the high quality of the first-line support work. Int J Occup Med Environ Health. 2023;36(6)761-72.

Development and validation of a task load index for process control room operators (PCRO-TLX)

Process control room operators (PCRO) perform a range of complex cognitive safety-critical tasks. The aim of this exploratory sequential mixed methods study was to develop an occupation specific tool to measure the task load of PCRO using NASA Task Load Index (TLX) methodology. Participants were 30 human factors experts and 146 PCRO at two refinery complexes in Iran. Dimensions were developed via a cognitive task analysis, a research review, and three expert panels. Six dimensions were identified: perceptual demand, performance, mental demand, time pressure, effort, and stress. Data from 120 PCRO confirmed that the developed PCRO-TLX has acceptable psychometric properties, and a comparison with the NASA-TLX confirmed that perceptual, not physical, demand was relevant for measuring workload in PCRO. There was a positive convergence of scores of the Subjective Workload Assessment Technique and the PCRO-TLX. This reliable tool (α = 0.83) is recommended for risk assessing the task load of PCRO.Practitioner summary: There are benefits of having a specific tool to measure task load in safety critical roles. Thus, we developed and validated an easy-to-use targeted tool, the PCRO-TLX, for process control room operatives. Timely use and response will assure optimal production alongside health and safety in an organisation.Abbreviations: PCRO: process control room operator; TLX: task load index; PCRO-TLX: process control room operator task load index; NASA-TLX: National Aeronautics and Space Administration task load index; SWAT: subjective workload assessment technique; DALI: driving activity load index; SURG-TLX: surgery task load index; SIM-TLX: virtual reality simulation task load index; VACP: visual, auditory, cognitive and psychomotor; CVI: content validity index; CVR: content validity ratio; RMSEA: root mean square of error approximation; GFI: goodness of fit index; AGFI: adjusted goodness of fit index; CFI: comparative fit index; ANOVA: analysis of variance; CI: confidence interval.

What makes nurses flourish at work? How the perceived clinical work environment relates to nurse motivation and well-being: A cross-sectional study

BACKGROUND

Literature shows that the work environment is a main determinant of nurses' well-being and psychological strain; yet, the (psychological) mechanisms underlying this relationship remain understudied.

OBJECTIVE

This study explored the underlying (psychological) mechanisms (why) and boundary conditions (when) by which characteristics present in the clinical work environment influence nurses' well-being. We investigated the mediating role of intrinsic motivation in the relationship of job demands and job resources with burnout vs. work engagement. In addition, we examined if job resources strengthen the relationship of job demands with intrinsic motivation and burnout.

DESIGN

A cross-sectional survey study.

SETTING(S)

General acute care hospitals in Belgium (n = 14).

PARTICIPANTS

Direct care nurses (n = 1729).

METHODS

Data were collected by means of online questionnaires between October 2020 and July 2021. Study variables included burnout, work engagement, intrinsic motivation and a set of different job demands (workload, role conflicts, emotional demands, red tape) and job resources (performance feedback, autonomy, skill use, opportunity for growth, and value congruence). All variables were obtained using self-report measures. The central hypotheses were tested using structural equation modeling.

RESULTS

Job resources appeared to be a crucial factor for nurses' health showing positive associations with work motivation (β = 0.513) and work engagement (β = 0.462) and negative associations with burnout (β = -0.216). Job demands remained an essential factor that harms psychological health and is associated with increased burnout (β = 0.489). Our results confirmed that intrinsic motivation mediated the relationship of job resources with work engagement (β = 0.170) and burnout (β = -0.135). In addition, job resources moderated the relationship of job demands with burnout (β = -0.039). Against our expectations, we found no associations between job demands and intrinsic motivation or a moderation effect of job resources on the respective relationship.

CONCLUSIONS

A highly demanding work environment can be a source of significant stress which may put nurses' health at severe risk. Nurses who perceive sufficient job resources such as feedback, autonomy and opportunities for growth and development, are likely to feel intrinsically motivated at work. In addition, it will foster their work engagement and prevent them from burning out, particularly when job demands are high.

REGISTRATION

The study described herein is funded under the European Union's Horizon 2020 Research and Innovation program from 2020 to 2023 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).

TWEETABLE ABSTRACT

Providing nurses with sufficient resources will not only increase their motivation and engagement at work but also reduce their feelings of burnout.

Uncovering the main and interacting impact of workaholism on momentary hedonic tone at work: An experience sampling approach

Workaholism is a current issue in modern organizations with well-characterized implications for individual health and well-being. Yet, the affective experience of workaholics at work and their emotional reactivity to job stressors have been poorly investigated, with the few available studies being cross-sectional or based on retrospective reports obtained outside the working time. Here, we conducted an experience sampling study to characterize workaholics' affective experience during work and their emotional reactivity to workday accumulation and momentary workload. A total of 139 full-time back-office workers participated in a 3-day protocol by reporting on their hedonic tone and momentary workload up to six times per workday. Multilevel modeling was used to investigate the relationship between trait workaholism and job-related hedonic tone as well as the cross-level interactions between workaholism and both workday accumulation and momentary workload. As expected, our results showed lower job-related hedonic tone for individuals with higher workaholic tendencies, with workaholism interacting with the two investigated job stressors. However, contrary to our hypotheses, we found that workaholism weakened, rather than strengthening, the negative trend of hedonic tone over the levels of both predictors, a result possibly explained by a blunted reactivity condition due to chronic job strain. Moreover, we corroborated previous findings suggesting worse outcomes in workaholic women compared to workaholic men. Organizations should consider taking action to monitor and manage the workaholism levels in the workforce and to create a psychosocial work environment that discourages the enactment of workaholic tendencies. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Affective work rumination as a mediator of the reciprocal relationships between job demands and exhaustion

High levels of job demands are considered as the main predictor for teachers' exhaustion, but longitudinal studies of the causal effects are few. Recently it has been suggested that research should further explore possible reciprocal relationships between stressors and strain and investigate if work rumination contributes to explain these relationships. In a sample of teachers (n = 1067) using a three-wave design, we hypothesized positive causal effects of job demands (work pace and role conflict) on affective work rumination, and of affective work rumination on exhaustion. We also hypothesized a positive reversed causal effect of exhaustion on affective work rumination, and of affective work rumination on job demands. Furthermore, affective work rumination was expected to mediate the positive causal and reversed causal effects between job demands and exhaustion. The results partly confirmed the expected causal and reversed causal effects. However, affective work rumination was only found to mediate the reversed causal effect of exhaustion and role conflict. Furthermore, a reciprocal relationship was only found between role conflict and exhaustion. The empirical, theoretical, and practical implications of the study are discussed.

The Impact of Information Integration in a Simulation of Future Submarine Command and Control

OBJECTIVE

Examine the extent to which increasing information integration across displays in a simulated submarine command and control room can reduce operator workload, improve operator situation awareness, and improve team performance.

BACKGROUND

In control rooms, the volume and number of sources of information are increasing, with the potential to overwhelm operator cognitive capacity. It is proposed that by distributing information to maximize relevance to each operator role (increasing information integration), it is possible to not only reduce operator workload but also improve situation awareness and team performance.

METHOD

Sixteen teams of six novice participants were trained to work together to combine data from multiple sensor displays to build a tactical picture of surrounding contacts at sea. The extent that data from one display were available to operators at other displays was manipulated (information integration) between teams. Team performance was assessed as the accuracy of the generated tactical picture.

RESULTS

Teams built a more accurate tactical picture, and individual team members had better situation awareness and lower workload, when provided with high compared with low information integration.

CONCLUSION

A human-centered design approach to integrating information in command and control settings can result in lower workload, and enhanced situation awareness and team performance.

APPLICATION

The design of modern command and control rooms, in which operators must fuse increasing volumes of complex data from displays, may benefit from higher information integration based on a human-centered design philosophy, and a fundamental understanding of the cognitive work that is carried out by operators.

Simulated skill complexity and perceived cognitive load during preclinical dental training

INTRODUCTION

Cognitive Load theory (CLT) focuses on the information processing aspect of learning and how the working memory handles the mental effort associated with new task. The aim of this study is to investigate the association between the perceived cognitive load and performance amongst dental students during preclinical simulation training at various levels of procedural task complexity. Additionally, some cognitive load-modifying factors were examined.

MATERIALS AND METHODS

This cross-sectional study evaluated the perceived cognitive load amongst second-year dental students (n = 34), using the validated National Aeronautics and Space Administration's Task Load Index (NASA TLX index) after training on four dental tasks at two levels of complexity, in addition to structured online anonymous questionnaire about demographics, feedback and performance. The NASA TLX raw scores and the weighted global score were calculated for each exercise. Descriptive statistics and Pearson's correlations between performance and the corresponding NASA TLX-weighted score were calculated. Mean differences in the perceived cognitive load across the exercise levels were assessed using RM-ANOVA with Bonferroni corrections at p < .05.

RESULTS

Reduced performance was significantly associated with higher cognitive load particularly in high complexity dental task (class II-mirror vision). Simulated exercise complexity significantly influenced the students' perceived mental demand, physical demand and temporal demand; all were significantly higher for class II- mirror vision task than for direct vision tasks. The majority of participants (82.1%) preferred detailed feedback from instructors, and more than half of the participants (60.7%) preferred continuous feedback throughout the training session.

CONCLUSION

Complex dental tasks are associated with higher cognitive load in novice dental students during preclinical training. The NASA TLX index is a useful instrument to explore the level of perceived cognitive load associated with performance of simulated complex dental skills. Cognitive load theory is relevant to simulation-based dental education to improve the preclinical instructional efficiency and to enhance students learning.

Facilitating the Work of Unmanned Aerial Vehicle Operators Using Artificial Intelligence: An Intelligent Filter for Command-and-Control Maps to Reduce Cognitive Workload

OBJECTIVE

Evaluating the ability of a Gibsonian-inspired artificial intelligence (AI) algorithm to reduce the cognitive workloads of military Unmanned Aerial Vehicle (UAV) operators.

BACKGROUND

Military UAV operators use the command-and-control (C2) map for developing mission-relevant situation awareness (SA). Yet C2 maps are overloaded with information, mostly irrelevant to the mission, causing operators to neglect the map altogether. To reduce irrelevant information, an intelligent filtering algorithm was developed. Here we evaluate its effectiveness in reducing operators' cognitive workloads.

METHOD

Two-stage operational scenarios were conducted with professional ex-military UAV operators, using two filter protocols and a no-filter control. High-end real-time techniques were used to continuously assess workload from muscle behavior and machine learning models.

RESULTS

Lower cognitive workload was found when applying the algorithm's protocols, especially when fatigue started to accumulate (Stage II). However, concerns about the quality of SA arose.

CONCLUSION

The algorithm was positively evaluated for its ability to reduce operators' cognitive workloads. More evaluations of operators' SA are required.

APPLICATION

The algorithm demonstrates the possibility of integrating AI to improve human performance in complex systems, and can be applied to other domains where spatial-temporal information needs to be contextually filtered in real time.

Profiling cognitive workload in an unmanned vehicle control task with cognitive models and physiological metrics

In the present study, we use Cognitive Metrics Profiling (CMP) to capture variance in cognitive load within a complex unmanned vehicle control task. We aim to demonstrate convergent validity with existing workload measurement methods, and to decompose workload into constituent cognitive resources to aid in diagnosing causes of workload. A cognitive model of the task was developed and examined to determine the extent to which it could predict behavioral performance, subjective workload, and validated physiological workload metrics. We also examined model activity to draw insights regarding loaded cognitive capacities. We found that composite workload from the model predicted physiological metrics, performance, and subjective workload. Moreover, the model indicates that differences in workload were driven largely by procedural, declarative, and temporal memory demands. We have found preliminary evidence of correspondence between workload predictions of a CMP model and physiological measures of workload. This suggests our approach captures interesting aspects of workload in a complex task environment and may provide a theoretical link between behavioral, physiological, and subjective metrics. This approach may provide a means to design effective workload mitigation interventions and improve decision-making about personnel tasking and automation.

The occupational burnout among medical staff with high workloads after the COVID-19 and its association with anxiety and depression

Objective

After the end of COVID-19, medical staff were immediately faced with a high workload, leading to widespread occupational burnout. This study aims to explore the level and influencing factors of burnout among medical staff during this period, as well as its relationship with anxiety and depression.

Methods

The participants' levels of burnout were assessed using Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the reliability and validity of the questionnaire were evaluated through Cronbach's α and Confirmatory Factor Analysis (CFA). Independent sample t-test, chi-square test, and Pearson analysis were employed to determine the correlation between two sets of variables. Univariate and multivariate logistic regression analyses were conducted to identify significant factors influencing burnout. Finally, nomograms were used to predict the probability of burnout occurrence.

Results

This study collected a total of 1,550 questionnaires, and after excluding 45 questionnaires that were duplicates or incomplete, a sample of 1,505 (97.1%) participants were included in the final statistical analysis. Both Cronbach's α and the fit indices of CFA demonstrated excellent adaptability of the Chinese version of MBI-HSS in this study. The overall prevalence rates for emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA) were 52.4, 55.3, and 30.6%, respectively. Obtaining psychological support, health condition, relationship with family members, and insufficient sleep were identified as common contributing factors to burnout among medical staff. Additionally, age and promotion pressure were also associated with burnout among doctors, and exceeding legal working hours was an important factor for nurse burnout. The C-index for the nomograms predicting burnout among doctors and nurses was 0.832 and 0.843, respectively. Furthermore, burnout exhibited a significant linear correlation with anxiety and depression.

Conclusion

After the end of COVID-19, medical staff in high workload environments were facing severe burnout, which might lead to anxiety and depression. The occupational burnout of medical staff needed to be taken seriously and actively intervened.

Association between overtime and depressive symptoms among Chinese employees

Objectives

This study examines the correlation between overtime and depressive symptoms, and analyzed the moderating effect of age, education level, and income level on their correlation by using a nationally representative sample from the Chinese Family Panel Studies (CFPS) in 2018.

Methods

Participants are divided into three groups: 30-44 h/week, 44.1-61.9 h/week (defined as overtime group), and ≥ 62 h/week (heavy overtime group). The multiple ordered logistic regression models are conducted to estimate the association between overtime and depressive symptoms. The interaction term of overtime and moderators including age, education level, and income level are introduced into the models to test the moderating effect.

Results

The overtime group have an increased probability of depressive symptoms (OR = 1.11, 95% CI 1.04-1.20) compared with those who reported working hours 30-44 h/week, after controlling for important confounders. What's more, the worsening of depressive symptoms is more pronounced in the heavy overtime group (OR = 1.32, 95% CI 1.22-1.44). The moderating effect results show that younger employees, employees with high education levels, and those with high income level are more likely to be affected by the negative effects of overtime.

Conclusion

Working overtime increased the likelihood of depressive symptoms. Younger employees, high-educated employees and employees with high income level are more vulnerable to the negative effects of overtime on mental health.

Associations of effort-reward imbalance at work and quality of life among workers after stroke: a one-year longitudinal study in Thailand

Stroke incidence is increasing among working-age population, but the role of psychosocial stress in the workplace in predicting quality of life (QoL) after stroke onset is understudied. This longitudinal study aimed to investigate the relationship between work stress, measured by the effort-reward imbalance (ERI) model, and QoL over one-year period among 103 Thai workers who had experienced a stroke. The study evaluated the effort (E)-reward (R) ratio and over-commitment, the extrinsic and intrinsic components of the ERI model, before discharge; QoL was repeatedly measured at baseline, six months, and 12 months after discharge, respectively, using the Short Form Version 2 (SF-12v2) indicators of physical and mental health composite scores. Generalized estimating equations were used to examine longitudinal relationships between work stress at baseline and QoL over one year by testing the hypotheses that E-R ratio and over-commitment would have direct effects on QoL, and potential moderating effects of over-commitment on E-R ratio and QoL. The results supported the ERI model partially, as over-commitment was significantly associated with poor mental health (coefficient - 8.50; 95% CI: -13.79, -3.20) after adjusting baseline sociodemographic, behavioral, and clinical characteristics, while the E-R ratio was not significantly associated with physical or mental health; the interaction between the E-R ratio and over-commitment was also not significant. These findings suggest that more attention should be paid to workers' personal coping skills and ability to handle work-related problems and prioritize interventions that address over-commitment to promote long-term mental health among workers with stroke.

[The Relationship of Work Stress and Somatic Symptoms Among Early Childhood Professionals During the COVID-19 Pandemic]

The COVID-19 pandemic has changed the world of work. Due to additional occupational health and safety measures early childhood professionals were faced with an increased workload, which may lead to an increased risk for their individual health. The aim of this cross-sectional study was to obtain updated prevalences of psychosocial work stress (effort-reward imbalance, ERI), overcommitment as well as somatic symptoms and their association during the COVID-19 pandemic. Early childhood professionals from a large city in North Rhine-Westphalia (N=1009) participated in the survey between June 2020 and May 2021. The Effort-Reward Imbalance at work questionnaire (16 items version) was used to assess work stress, and the Patient Health Questionnaire (PHQ-15) was used to assess somatic symptoms. A multiple logistic regression tested the association between work stress and somatic health. In total, 72.3% of the sample showed an effort-reward imbalance, 25.0% showed a high overcommitment. The overall prevalence of somatization at a moderate to high level was 45.2%. Effort-reward imbalance and high overcommitment increased the odds of severe symptom presence by a factor of 4.12 and 5.20, respectively. This study shows the high number of effort-reward imbalances, the high overcommitment and the above-average prevalence of somatic complaints among early childhood professionals during the COVID-19 pandemic. In view of these high prevalences and their relationships, there is still a strong need for action and research to reduce work-related stress in this occupational group as well as to investigate the persistence of and the management of somatic symptoms in order to develop long-term preventive measures.

Excessive workload and insufficient night-shift remuneration are key elements of dissatisfaction at work for French neonatologists

AIM

Neonatologists are exposed to ethical issues and unplanned emergencies that require 24-h in-house coverage. These elements may affect quality of life at work, which we surveyed.

METHODS

This was a self-administered, voluntary and anonymous cross-sectional survey of French neonatologists. An online questionnaire was sent to members of the French Society of Neonatology from June to October 2022.

RESULTS

Of approximately 1500 possible responses, 721 were analysed, with a response rate of 48%. Respondents were mostly women (77%), aged 35-50 years (50%), and hospital practitioners (63%). Reported weekly working time was over 50 h for 80%. Among the 650 neonatologists with on-call duty, 47% worked ≥5 shifts per month. For 80% of practitioners, on-call duty was perceived to have a negative impact on personal life; 49% indicated having sleep disorders. The mean satisfaction score at work was 5.7 ± 1.7 on a scale of 0-10. The main reasons for dissatisfaction were excessive working hours and insufficient remuneration for on-call duty.

CONCLUSION

This first evaluation of the quality of life at work of French neonatologists showed high workload. The working conditions and specificities of NICU activity may have significant consequences for their mental health.

Well-being and Burnout Amongst Interventional Radiologists in the United Kingdom

PURPOSE

To assess the prevalence of burnout amongst Interventional Radiologists (IRs) in the United Kingdom and identify demographic and practice-related stressors that may adversely affect well-being.

MATERIALS AND METHODS

A survey of 36 questions was divided into two sections. Section A consisted of 14 questions that assessed demographics and work characteristics; Section B assessed burnout, utilizing the 22-item Maslach burnout inventory. Four additional open-ended questions were included to allow participants to voice opinions on the biggest contributors to workplace burnout and plans that could be implemented to alleviate this. The questionnaire was distributed to the British Society of interventional (BSIR) members. The study was conducted between August and September 2022.

RESULTS

Moderate to severe scores in emotional exhaustion (EE) were recorded in 65% of participants (moderate 26%; severe 39%) of participants r. Moderate to severe depersonalization (DP) scores were recorded in 46% of participants (moderate 23%; severe 23%). Low-moderate levels of personal accomplishment (PA) scores were recorded in 77% of respondents (low 50%; moderate 27%). Weekly hours and out-of-hour IR cover were statistically significant in predicting emotional exhaustion. Age, sex (male), time available for teaching, and weekly hours were statistically significant in predicting the depersonalisation score. Age was a predictive factor for personal accomplishment. The most recurring themes in open response to major contributors of burnout were shortage of IR clinicians and supporting staff as well as the increasing IR workload.

CONCLUSIONS

This survey has demonstrated high prevalence of burnout amongst Interventional Radiologists in UK. Urgent measures are required to tackle the workforce shortage, recognition of IR workload and control IR resources.

Subjective mental workload in Spanish emergency nurses. A study on predictive factors

INTRODUCTION

Mental workload refers to the cognitive or intellectual requirements that a worker is subjected to in a workday. The objective of the present work was to discover the subjective mental workload of nursing staff at Hospital Emergency Units, and its relationship with sociodemographic, work, environmental factors at the workplace, and personality variables.

METHOD

A quantitative, descriptive, observational, and crosssectional study was conducted with 201 emergency nurses from 13 different provinces in Spain. Each participant completed 5 questionnaires (sociodemographic, work conditions, environmental conditions, personality, and subjective mental workload). Descriptive statistics were obtained, and Pearson's correlations and multivariate models (multiple linear regression) were performed.

RESULTS

The nurses had medium to high levels of mental workload. The environmental conditions had a direct relationship with the mental workload, especially with respect to noise and lighting. The participants obtained high scores in kindness, responsibility, openness/intellect, and extraversion. Positive and statistically significant relations were found between neuroticism and mental workload. Being female, older, and having stable employment or a permanent contract were associated with a greater mental workload of emergency nurses.

CONCLUSION

The domain of neuroticism personality, and the hygienic conditions in the workplace were the predictors with the most weight in the model. This study could be useful for defining aspects that need to be considered for the well-being of emergency nurses, such as lighting conditions or environmental noise in the workplace. It also invites reflection on the influence of personal factors (age, gender, personality) and work factors (type of contract, professional experience) on the mental workload of emergency nurses.

Social enrichment on the job: Complex work with people improves episodic memory, promotes brain reserve, and reduces the risk of dementia

Individuals with more complex jobs experience better cognitive function in old age and a lower risk of dementia, yet complexity has multiple dimensions. Drawing on the Social Networks in Alzheimer Disease study, we examine the association between occupational complexity and cognition in a sample of older adults (N = 355). A standard deviation (SD) increase in complex work with people is associated with a 9% to 12% reduction in the probability of mild cognitive impairment or dementia, a 0.14-0.19 SD increase in episodic memory, and a 0.18-0.25 SD increase in brain reserve, defined as the gap (residual) between global cognitive function and magnetic resonance imaging (MRI) indicators of brain atrophy. In contrast, complexity with data or things is rarely associated with cognitive outcomes. We discuss the clinical and methodological implications of these findings, including the need to complement data-centered activities (e.g., Sudoku puzzles) with person-centered interventions that increase social complexity.

Quantitative and qualitative workload assessment in steep terrain forest operations: fostering a safer work environment through yarder automation

Many forestry roles have changed from being manual tasks with a high physical workload to being a machine operator task with a high mental workload. Automation can support a decrease in mental fatigue by removing tasks that are repetitive and monotonous for the operators. Cable yarding presents an ideal opportunity for early adoption of automation technology; specifically the carriage movement along a defined corridor. A Valentini V-850 cable yarder was used in an Italian harvesting setting, in order to gauge the ergonomic benefit of carriage control automation. The study showed that automating yarder carriage movements improved the ergonomic situation of the workers directly involved in the related primary tasks. However, the caveat is that improving one work task may negatively affect the other work tasks, and therefore introducing automation to a worksite must be done after considering all impacts on the whole system. Practitioner summary: Automation decreased the winch operator's mental workload while improving overall productivity. At the same time, the mental and physiological workload of the operator tasked with bucking were slightly increased. Ideally, winch automation should be coupled with bucking mechanisation to balance the intervention and boost both operator well-being and productivity.

[Burnout syndrome due to workload in the care for cancer patients]

Background

The burnout syndrome (BS) is defined as a response to chronic work stress. It appears as a subjective phenomenon and its main symptoms are the loss of enthusiasm towards work, a feeling of professional failure, feelings of guilt, emotional exhaustion and indifference to patients' problems.

Objective

To evaluate the prevalence of BS in health personnel who care for cancer patients in a tertiary hospital.

Material and methods

Descriptive cross-sectional study. The sample consisted of 41 health professionals dedicated to providing direct care to cancer patients, which were selected through an intentional non-probabilistic sampling. The Questionnaire for the Evaluation of the Burnout Syndrome was applied.

Results

In the sample studied, BS presented a prevalence of 51.21% at the medium level, 9.75% at the high level and 2.43% at the critical level. Significant differences were found between groups by service and work seniority.

Conclusions

A high prevalence of symptoms of BS was found in the study participants, derived mainly from the excessive workload, the type of care provided, as well as experiences related to contact with people living with cancer, the hospital environment, and the type of interpersonal relationships that emerge there. The personnel most affected was that one belonging to Medical Oncology, Psychology, and Social Work.

Mental workload variations during different cognitive office tasks with social media interruptions

Interruption at work by social media (SM) is a pervasive phenomenon. This study investigated the impact of SM interruptions and task cognitive levels on mental workload (MWL) and physiological indexes. Each subject performed six simulated computer tasks differentiated by two factors: task cognitive level and performing condition. MWL was reflected through three categories of data: perceived mental workload, physiological indexes, and primary task performance. The results revealed significant effects of SM interruptions on heart rate, low-frequency/high-frequency (LF/HF) ratio, and skin conductance. ANOVA results showed there were main effects of task cognitive level on LF/HF and skin conductance. These effects during interrupted tasks were more profound. In addition, participants experienced higher MWL and recorded lower primary task performance in the knowledge-based task than the rule- and skill-based tasks. Our findings can guide managers and employees regarding appropriate use of SM in the workplace and better managing interruption and workload.Practitioner Summary: Office workers suffer from increased overall mental workload due to unpredictable interruptions while working. This study shows that participants' mental workload increased when receiving SM interruptions, which was more profound during complex tasks. This highlights the importance of SM interruptions management for employees' health, performance, and mobile application developers.Abbreviations: ANOVA: analysis of variance; DSSQ: dundee stress state questionnaire; ECG: electrocardiographic; EDA: electrodermal activity; EEG: electroencephalographic; HPA: hypothalamus-pituitaryadrenocortical; HR: heart rate; HRV: heart rate variability; LF/HF: low frequency/high frequency; MSDs: musculoskeletal disorders; MWL: mental workload; NN: normal to normal; RMS: root means square; RR: time duration between two successive R peaks; RT: response time; SC: skin conductance; SDNN: standard deviation of normal to normal; SM: social media; TCL: task cognitive level; TPC: task performing condition; WMC: working memory capacity.

Exploring the Effects of Interruptions in Different Phases of Complex Decision-Making Tasks

OBJECTIVE

The study aims to examine the effects of interruptions in major phases (i.e., problem-identification, alternative-development, and evaluation-and-selection) of complex decision-making tasks.

BACKGROUND

The ability to make complex decisions is of increasing importance in workplaces. Complex decision-making involves a multistage process and is likely to be interrupted, given the ubiquitous prevalence of interruptions in workplaces today.

METHOD

Sixty participants were recruited for the experiment to complete a procurement task, which required them to define goals, search for alternatives, and consider multiple attributes of alternatives to make decisions. Participants in the three experimental conditions were interrupted to respond to messages during one of these three phases, whereas participants in the control condition were not interrupted. The impacts of interruptions on performance, mental workload, and emotional states were measured through a combination of behavioral, physiological, and subjective evaluations.

RESULTS

Only participants who were interrupted in the evaluation-and-selection phase exhibited poorer task performance, despite their positive feelings toward interruptions and confidence. Participants who were interrupted in the problem-identification phase reported higher mental workload and more negative perceptions toward interruptions. Interruptions in the alternative-development phase led to more temporal changes in arousal and valence than interruptions in other phases.

CONCLUSION

Interruptions during the evaluation-and-selection phase undermine overall performance, and there is a discrepancy between behavioral outcomes and subjective perceptions of interruption effects.

APPLICATION

Interruptions should be avoided in the evaluation-and-selection phase in complex decision-making. This phase information can be either provided by users or inferred from coarse-grained interaction activities with decision-making information systems.

Understanding user behaviour in activity-based offices

Little is known about the factors that explain the differences in the ways that individuals use activity-based offices (ABOs). This study aimed to investigate whether person-related and situational factors are associated with self-reported use of workspaces and the perceived person-environment (P-E) fit in ABOs, independently of the job profile. Survey data were gathered in one organisation (N = 332) 7-11 months after an office re-design. Younger age, male gender, managerial position, and better work ability were associated with more frequent use of different workspaces. Workspace switching was perceived as more time-consuming by employees who worked at the office less, had a high workload, and were dissatisfied with ergonomics. All variables except gender were associated with the P-E fit. Person-related and situational factors appear relevant to workspace use and P-E fit, independently of job contents. Contextual, cultural, and office design differences should be considered when generalising these results.Practitioner summary: This case study investigated individual differences in how activity-based offices are used. Being younger, male, a manager, or having good work ability were associated with using workspaces more actively. Person-related and situational factors appear relevant to how offices are used and perceived, in addition to job characteristics.Abbreviations: ABO: activity-based office; P-E fit: person-environment fit; RQ: research question; SD: standard deviation; IN: interactive needs; CD: cognitive demands; OR: odds ratio; M: mean; ref.: reference category; CI: confidence interval; h: hour; PO: proportional odds.

The Relationships of Human-Cobot Interaction Fluency with Job Performance and Job Satisfaction among Cobot Operators-The Moderating Role of Workload

Modern factories are subject to rapid technological changes, including the advancement of robotics. A key manufacturing solution in the fourth industrial revolution is the introduction of collaborative robots (cobots), which cooperate directly with human operators while executing shared tasks. Although collaborative robotics has tangible benefits, cobots pose several challenges to human-robot interaction. Proximity, unpredictable robot behavior, and switching the operator's role from a co-operant to a supervisor can negatively affect the operator's cognitive, emotional, and behavioral responses, resulting in their lower well-being and decreased job performance. Therefore, proper actions are necessary to improve the interaction between the robot and its human counterpart. Specifically, exploring the concept of human-robot interaction (HRI) fluency shows promising perspectives. However, research on conditions affecting the relationships between HRI fluency and its outcomes is still in its infancy. Therefore, the aim of this cross-sectional survey study was twofold. First, the relationships of HRI fluency with job performance (i.e., task performance, organizational citizenship behavior, and creative performance) and job satisfaction were investigated. Second, the moderating role of the quantitative workload in these associations was verified. The analyses carried out on data from 200 male and female cobot operators working on the shop floor showed positive relationships between HRI fluency, job performance, and job satisfaction. Moreover, the study confirmed the moderating role of the quantitative workload in these relations. The results showed that the higher the workload, the lower the relationships between HRI fluency and its outcomes. The study findings are discussed within the theoretical framework of the Job Demands-Control-Support model.

A Systematic Review of Associations and Predictors for Job Satisfaction and Work Engagement in Prehospital Emergency Medical Services-Challenges for the Future

Ambulance services are changing, and the SARS-CoV-2 pandemic has been a major challenge in the past three years. Job satisfaction and work engagement are important characteristics for a healthy organization and success in one's profession. The purpose of the current systematic review was to evaluate the predictors of job satisfaction and work engagement in prehospital emergency medical service personnel. Electronic databases, such as PubMed, Ovid Medline, Cochrane Library, Scopus, Web of Science, PsycINFO, PSYNDEX, and Embase, were utilized in this review. Predictors (ß coefficient, odds ratio, rho) of higher job satisfaction and work engagement were examined. Only prehospital emergency medical service personnel were considered. The review included 10 studies worldwide with 8358 prehospital emergency medical service personnel (24.9% female). The main predictor for job satisfaction was supervisors' support. Other predictors were younger or middle age and work experience. Emotional exhaustion and depersonalization, as burnout dimensions, were negative predictors for higher job satisfaction or work engagement. Quality demands for health care systems are a significant challenge for future emergency medical services. The psychological and physical strengthening of employees is necessary and includes constant supervision of managers or facilitators.

Physician exhaustion and work engagement during the COVID-19 pandemic: A longitudinal survey into the role of resources and support interventions

BACKGROUND

Physicians increasingly show symptoms of burnout due to the high job demands they face, posing a risk for the quality and safety of care. Job and personal resources as well as support interventions may function as protective factors when demands are high, specifically in times of crisis such as the COVID-19 pandemic. Based on the Job Demands-Resources theory, this longitudinal study investigated how monthly fluctuations in job demands and job and personal resources relate to exhaustion and work engagement and how support interventions are associated with these outcomes over time.

METHODS

A longitudinal survey consisting of eight monthly measures in the period 2020-2021, completed by medical specialists and residents in the Netherlands. We used validated questionnaires to assess job demands (i.e., workload), job resources (e.g., job control), personal resources (e.g., psychological capital), emotional exhaustion, and work engagement. Additionally, we measured the use of specific support interventions (e.g., professional support). Multilevel modeling and longitudinal growth curve modeling were used to analyze the data.

RESULTS

378 medical specialists and residents were included in the analysis (response rate: 79.08%). Workload was associated with exhaustion (γ = .383, p < .001). All job resources, as well as the personal resources psychological capital and self-judgement were associated with work engagement (γs ranging from -.093 to .345, all ps < .05). Job control and psychological capital attenuated the workload-exhaustion relationship while positive feedback and peer support strengthened it (all ps < .05). The use of professional support interventions (from a mental health expert or coach) was related to higher work engagement (estimate = .168, p = .032) over time. Participation in organized supportive group meetings was associated with higher exhaustion over time (estimate = .274, p = .006).

CONCLUSIONS

Job and personal resources can safeguard work engagement and mitigate the risk of emotional exhaustion. Professional support programs are associated with higher work engagement over time, whereas organized group support meetings are associated with higher exhaustion. Our results stress the importance of professional individual-level interventions to counteract a loss of work engagement in times of crisis.

Influence of Job Insecurity on Musculoskeletal Disorders: A Mediation Model with Nursing Aides

Work-related musculoskeletal disorders are some of the most prevalent diseases in the world. They have a multifactorial aetiology encompassing ergonomic and psychosocial risk factors. The aim of this study is to analyse the way job insecurity and physical workload are linked to musculoskeletal disorders, as well as the mediating role other psychosocial work risks can have on this potential relationship. A parallel mediation path regression analysis was designed using a sample of 457 nursing aides. The influence job insecurity and physical workload has on the onset of musculoskeletal symptoms together with the variables which mediate this relationship were examined. The results prove that both independent variables explain the onset of musculoskeletal symptoms in these professionals. The influence exerted by job insecurity is mediated by the social support received at work and the demands of the job. However, when analysing the physical workload, the social support received at work is not relevant as a mediator in this relationship. Job insecurity and physical workload are significant variables on the occurrence of musculoskeletal symptoms. The data obtained supports the need to focus on physical and psychosocial factors in order to prevent these disorders.

Predicting Challenge and Threat Appraisal of Job Demands among Nurses: The Role of Matching Job Resources

(1) Background: Empirical studies have started to examine employees' subjective appraisals of job demands and their relations to employees' health. However, knowledge of working conditions, which might contribute to how employees appraise specific job demands, is scarce. The present study aimed to examine predictors of nurses' appraisals of job demands (i.e., time pressure, emotional demands, physical demands, and role ambiguity) as challenges and/or threats among corresponding job resources (i.e., autonomy, social support, physical resources, participation in decision-making). It also examined moderating effects of these predictors. (2) Methods: Cross-sectional data were collected via an online survey in a sample of 425 nurses working in Luxembourg. (3) Results: Multiple regression analyses indicated that matching job resources predicted nurses' appraisal of job demands as challenging. Threat appraisal was predicted by three out of four kinds of job resources (i.e., autonomy, physical resources, participation in decision-making). However, the current study did not find any moderating effects between job demands and job resources on challenge/threat appraisals. (4) Conclusions: The present study identified domain-specific job resources that contribute to how employees perceive selected job demands. Accordingly, we encourage scholars and practitioners to align job demands with matching job resources to prevent nurses' threat appraisal of job demands, and to promote their challenge appraisals.

Cognitive Analyses for Interface Design Using Dual N-Back Tasks for Mental Workload (MWL) Evaluation

In the manufacturing environments of today, human-machine systems are constituted with complex and advanced technology, which demands workers' considerable mental workload. This work aims to design and evaluate a Graphical User Interface developed to induce mental workload based on Dual N-Back tasks for further analysis of human performance. This study's contribution lies in developing proper cognitive analyses of the graphical user interface, identifying human error when the Dual N-Back tasks are presented in an interface, and seeking better user-system interaction. Hierarchical task analysis and the Task Analysis Method for Error Identification were used for the cognitive analysis. Ten subjects participated voluntarily in the study, answering the NASA-TLX questionnaire at the end of the task. The NASA-TLX results determined the subjective participants' mental workload proving that the subjects were induced to different levels of mental workload (Low, Medium, and High) based on the ANOVA statistical results using the mean scores obtained and cognitive analysis identified redesign opportunities for graphical user interface improvement.