Digital Training Program for Line Managers (Managing Minds at Work): Protocol for a Feasibility Pilot Cluster Randomized Controlled Trial

BACKGROUND

Mental health problems affect 1 in 6 workers annually and are one of the leading causes of sickness absence, with stress, anxiety, and depression being responsible for half of all working days lost in the United Kingdom. Primary interventions with a preventative focus are widely acknowledged as the priority for workplace mental health interventions. Line managers hold a primary role in preventing poor mental health within the workplace and, therefore, need to be equipped with the skills and knowledge to effectively carry out this role. However, most previous intervention studies have directly focused on increasing line managers' understanding and awareness of mental health rather than giving them the skills and competencies to take a proactive preventative approach in how they manage and design work. The Managing Minds at Work (MMW) digital training intervention was collaboratively designed to address this gap. The intervention aims to increase line managers' knowledge and confidence in preventing work-related stress and promoting mental health at work. It consists of 5 modules providing evidence-based interactive content on looking after your mental health, designing and managing work to promote mental well-being, management competencies that prevent work-related stress, developing a psychologically safe workplace, and having conversations about mental health at work.

OBJECTIVE

The primary aim of this study is to pilot and feasibility test MMW, a digital training intervention for line managers.

METHODS

We use a cluster randomized controlled trial design consisting of 2 arms, the intervention arm and a 3-month waitlist control, in this multicenter feasibility pilot study. Line managers in the intervention arm will complete a baseline questionnaire at screening, immediately post intervention (approximately 6 weeks after baseline), and at 3- and 6-month follow-ups. Line managers in the control arm will complete an initial baseline questionnaire, repeated after 3 months on the waitlist. They will then be granted access to the MMW intervention, following which they will complete the questionnaire post intervention. The direct reports of the line managers in both arms of the trial will also be invited to take part by completing questionnaires at baseline and follow-up. As a feasibility pilot study, a formal sample size is not required. A minimum of 8 clusters (randomized into 2 groups of 4) will be sought to inform a future trial from work organizations of different types and sectors.

RESULTS

Recruitment for the study closed in January 2022. Overall, 24 organizations and 224 line managers have been recruited. Data analysis was finished in August 2023.

CONCLUSIONS

The results from this feasibility study will provide insight into the usability and acceptability of the MMW intervention and its potential for improving line manager outcomes and those of their direct reports. These results will inform the development of subsequent trials.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05154019; https://clinicaltrials.gov/study/NCT05154019.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/48758.

Using intervention mapping to develop evidence-based toolkits that support workers on long-term sick leave and their managers

BACKGROUND

Managing long-term sickness absence is challenging in countries where employers and managers have the main responsibility to provide return to work support, particularly for workers with poor mental health. Whilst long-term sick leave and return to work frameworks and guidance exist for employers, there are currently no structured return to work protocols for employers or for their workers encompassing best practice strategies to support a positive and timely return to work outcome.

PURPOSE

To utilise the intervention mapping (IM) protocol as a framework to develop return to work toolkits that are underpinned by relevant behaviour change theory targeting mental health to promote a positive return to work experiensce for workers on long-term sick leave.

METHODS

This paper provides a worked example of intervention mapping (IM) to develop an intervention through a six-step process to combine theory and evidence in the development of two toolkits - one designed for managers and one to be used by workers on long-term sick leave. As part of this process, collaborative planning techniques were used to develop the intervention. A planning group was set up, through which researchers would work alongside employer, worker, and mental health professional representatives to develop the toolkits. Additionally, feedback on the toolkits were sought from the target populations of workers and managers and from wider employer stakeholders (e.g., human resource specialists). The implementation and evaluation of the toolkits as a workplace intervention were also planned.

RESULTS

Two toolkits were designed following the six steps of intervention mapping. Feedback from the planning group (n = 5; psychologist, psychiatrist, person with previous experience of poor mental health, employer and charity worker) and participants (n = 14; employers = 3, wellbeing director = 1; human resources = 2, managers = 2, employees with previous experience of poor mental health = 5) target populations indicated that the toolkits were acceptable and much needed.

CONCLUSIONS

Using IM allowed the development of an evidence-based practical intervention, whilst incorporating the views of all the impacted stakeholder groups. The feasibility and acceptability of the toolkits and their supporting intervention components, implementation process and methods of assessment will be evaluated in a feasibility pilot randomised controlled trial.

Work fatigue during COVID-19 lockdown teleworking: the role of psychosocial, environmental, and social working conditions

Background

During national lockdowns in response to the COVID-19 pandemic, previously office-based workers who transitioned to home-based teleworking faced additional demands (e.g., childcare, inadequate homeworking spaces) likely resulting in poor work privacy fit. Previous office research suggests poor work privacy fit is associated with lower wellbeing and higher work fatigue. Emerging evidence suggests a relationship between childcare duties during pandemic teleworking and work fatigue. In addition to psychosocial working conditions (job demand, job control, and job change management), which are acknowledged predictors of work fatigue, this poses a significant threat to occupational health during pandemic teleworking. However, the relative effects of aspects of the psychosocial environment (job demands and resources), the home office environment (including privacy fit), and the social environment (childcare) on work fatigue as well as their interactions are under-explored.

Objective

This study examined the relationships between the psychosocial, environmental, and social working conditions of teleworking during the first COVID-19 lockdown and work fatigue. Specifically, the study examined teleworkers' physical work environment (e.g., if and how home office space is shared, crowding, and noise perceptions) as predictors of privacy fit and the relationship between privacy fit, childcare, psychosocial working conditions (job demand, job control, and job change management), and work fatigue. Work privacy fit was hypothesized to mediate the relationship between childcare and work fatigue.

Methods

An online cross-sectional survey was conducted with teleworkers (n = 300) during the first COVID-19 lockdown in April and May 2020; most participants were in Germany, Switzerland, and the United Kingdom.

Results

Path analysis was used to examine the hypothesized relationships. Privacy fit was lower for those reporting greater levels of noise in home-working spaces and those feeling crowded at home. Work fatigue was lower amongst those with greater privacy fit and higher amongst those with high levels of job demand. An indirect relationship was observed between childcare and work fatigue with privacy fit mediating this relationship.

Conclusion

The influence of privacy fit has so far been largely neglected in research on teleworking, especially during the pandemic. However, its contribution to workers' wellbeing should be acknowledged in occupational health strategies.

Managing Minds at Work: development of a digital line manager training programme

Background

Mental ill health is the leading cause of sickness absence with high economic burden. Workplace interventions aimed at supporting employers with prevention of mental ill-health in the workforce are urgently required. Managing Minds at Work (MMW) is a digital intervention targeting support for line managers in any work setting to promote better mental health at work through a preventative approach.

Objectives

To describe the design and development of the MMW digital training programme, prior to feasibility testing. We adopted a collaborative participatory design involving co-design (users as partners) and principles of user-centred design (pilot and usability testing). Agile methodology was used to co-create intervention content with a stakeholder community of practice. Development processes were mapped to core elements of the Medical Research Council (MRC) framework for developing and evaluating complex interventions.

Results

The program covers five broad areas: (i) promoting self-care techniques among line managers; (ii) designing work to prevent work-related stress; (iii) management competencies to prevent and reduce stress; (iv) having conversations with employees about mental health; (v) building a psychologically safe work environment. Pilot and usability testing (n = 37 surveys) aligned with the Technology Acceptance Model (TAM) demonstrated that MMW was perceived to be useful, relevant, and easy to use by managers across sectors, organization types and sizes. We identified positive impacts on manager attitudes and behavioural intentions related to preventing mental ill-health and promoting good mental well-being at work.

Conclusions

MMW is a digital training programme for line managers that has been co-created using rigorous development processes and aims to support employers with primary prevention in mental health. The next step is to explore the feasibility and acceptability of this intervention with line managers in diverse employment settings.

Key messages

Protocol for a feasibility randomised controlled study of a multicomponent intervention to promote a sustainable return to work of workers on long-term sick leave — PROWORK: PROmoting a Sustainable and Healthy Return to WORK

Background

The cost of sickness absence has major social, psychological and financial implications for individuals and organisations. Return-to-work (RTW) interventions that support good quality communication and contact with the workplace can reduce the length of sickness absence by between 15 and 30 days. However, initiatives promoting a sustainable return to work for workers with poor mental health on long-term sickness absence across small, medium and large enterprises (SMEs and LEs) are limited. This paper describes the protocol of a pilot randomised controlled trial (RCT) to test the feasibility of implementing a RTW intervention across SMEs and LEs across all sectors.

Methods and design

A two-arm feasibility RCT with a 4-month intervention will be conducted in SMEs and LE enterprises from the Midlands region, UK. At least 8 organisations (4 controls and interventions), and at least 60 workers and/or managers, will be recruited and randomised into the intervention and control group (30 interventions, 30 controls). Workers on long-term sickness absence (LTSA) (between 8 and 50 days) and managers with a worker on LTSA will be eligible to participate. The intervention is a behavioural change programme, including a managers and workers RTW toolkit, focused on supporting sickness absence and RTW through the provision of knowledge, problem-solving, action planning, goal setting and positive communication that leads to a sustainable RTW. Organisations assigned to the control group will continue with their usual practice. Measurements of mental health, RTW, work outcomes, quality-of-life, workplace support and communication and other demographic data will be taken at baseline, 2 months and 4 months. Feasibility will be assessed based on recruitment, retention, attrition, completion of measures and intervention compliance for which specific process and research outcomes have been established. A process evaluation will explore the experiences and acceptability of the intervention components and evaluation measures. Exploratory economic evaluation will be conducted to further inform a definitive trial.

Discussion

This is a novel intervention using a worker-manager approach to promote a sustainable return to work of workers on long-term sick leave due to poor mental wellbeing. If this intervention is shown to be feasible, the outcomes will inform a larger scale randomised control trial.

Trial registration

ISRCTN90032009 (retrospectively registered, date registered 15th December 2020)

Future Teleworking Inclinations Post-COVID-19: Examining the Role of Teleworking Conditions and Perceived Productivity

Organisations have implemented intensive home-based teleworking in response to global COVID-19 lockdowns and other pandemic-related restrictions. Financial pressures are driving organisations to continue intensive teleworking after the pandemic. Understanding employees' teleworking inclinations post COVID-19, and how these inclinations are influenced by different factors, is important to ensure any future, more permanent changes to teleworking policies are sustainable for both employees and organisations. This study, therefore, investigated the relationships between the context of home-based teleworking during the pandemic (pandemic-teleworking conditions), productivity perceptions during home-based teleworking, and employees' future teleworking inclinations (FTI) beyond the pandemic. Specifically, the study examined whether pandemic-teleworking conditions related to the job, and the physical and social environments at home, influenced employees' FTI, and if perceptions of improved or reduced productivity mediated these relationships. Data were collected during April and May 2020 with a cross-sectional online survey of teleworkers (n = 184) in Germany, Switzerland, the United Kingdom, and other countries during the first COVID-19 lockdowns. Reported FTI were mixed. Most participants (61%) reported wanting to telework more post-pandemic compared to before the pandemic; however, 18% wanted to telework less. Hierarchical multiple regression analysis revealed that some teleworking conditions (job demands and work privacy fit) were positively associated with FTI. Other teleworking conditions (specifically, job change, job control, home office adequacy, and childcare) were not associated with FTI. Perceived changes in productivity mediated the relationship between work privacy fit and FTI. Findings highlight the role of work privacy fit and job demands in influencing pandemic productivity perceptions and teleworking inclinations post-pandemic. Results raise questions about the suitability and sustainability of home-based teleworking for all staff. As organisations plan to increase the proportion of teleworking post-pandemic, this study suggests there is a need to support employees who perceived their productivity to be poor while home-working during the pandemic.

Evaluation of a natural workspace intervention with active design features on movement, interaction and health

BACKGROUND

There is increasing focus on designing workspaces that promote less sitting, more movement and interaction to improve physical and mental health.

OBJECTIVE

This study evaluates a natural intervention of a new workplace with active design features and its relocation to a greener and open space.

METHODS

An ecological model was used to understand how organisations implement change. Pre and post survey data from 221 matched cases of workers and accelerometery data (n = 50) were analysed.

RESULTS

Results show a decrease in occupational sitting (-20.65 mins/workday, p = 0.001) and an increase in workplace walking (+5.61 mins/workday, p = 0.001) using survey data, and accelerometery data (occupational sitting time: -31.0 mins/workday, p = 0.035, standing time: +22.0 mins/workday, p = 0.022, stepping time: +11.0 mins/workday, p = 0.001). Improvements in interaction, musculoskeletal pain and mental health were reported.

CONCLUSIONS

Application of the ecological model shows that the organisation understands how to target the built environment and social/cultural environment but not how to target behaviour change at the individual level.

Lessons for leadership and culture when doctors become second victims: a systematic literature review

This review set out to understand what leaders and organisational cultures can learn about supporting doctors who experience second victim phenomenon; the types, levels and availability of support offered; and the psychological symptoms experienced. A systematic review of keywords ‘Medical Error’ [MeSH], ‘Near Miss’, ‘Adverse Event’, ‘Second Victim’ and ‘Support’ was carried out using CINAHL Plus, Medline and Embase Classic and Embase 1947-2017 databases. Results show that poor organisational culture and leadership negatively influences and hinders doctors who make mistakes. Leaders who promote and create environments for open and constructive dialogue following adverse events enable the concept of fallibility and imperfection to be assimilated into new ways of learning. Guilt and fear are the most consistently reported psychological symptoms along with a perception of loss of professional respect and standing. Doctors often carry unresolved trauma for several years causing them to constantly relive an event. Unchecked, this can lead to poor relationships with colleagues and impact greatly on their ability to sleep and performance at work. The review concludes that a prevailing silence, exacerbated by poor organisational culture, inhibits proper disclosure to the first victim, the patient and family. It also impedes a healthy recovery trajectory for the doctor, the second victim. Leaders of organisations have a vital strategic and operational role in creating open, transparent and compassionate cultures where dialogue and understanding takes place for those affected by second victim phenomenon.

Work stress and cancer researchers: an exploration of the challenges, experiences and training needs of UK cancer researchers

Work stress is a significant issue for many UK healthcare professionals, in particular those working in the field of oncology. However, there have been very few attempts to explore the challenges, experiences or training needs of researchers working in cancer research. In doing so, we will be better positioned to support and develop these researchers. Eighteen UK oncology researchers from a variety of backgrounds took part in a semi-structured interview. Interviews were transcribed and analysed using thematic analysis. The analysis identified two overarching themes: logistical research issues (workload, accessing/recruiting participants, finances) and sensitive research issues (emotional demands, professional boundaries, sensitivity around recruitment). One cross-cutting theme, supportive strategies (support and training, coping mechanisms), was seen to influence both logistical and sensitive research issues. While further research is needed to fully understand the causes and impact of work stress on cancer researchers, three specific issues were highlighted: emotional demands are relevant to quantitative and mixed methods researchers as well as those engaged in qualitative research; the researchers' background (experience; clinical/non-clinical) was influential and an exploration of effective coping strategies is required; and there is a clear need for adequate support systems and training to be available, particularly for early career researchers.

Brain natriuretic peptide and NT-proBNP levels reflect pulmonary artery systolic pressure in trekkers at high altitude

Our objective was to evaluate the utility of the natriuretic peptides BNP (brain natriuretic peptide) and NT-proBNP as markers of pulmonary artery systolic pressure (PASP) in trekkers ascending to high altitude (HA). 20 participants had BNP and NT-proBNP assayed and simultaneous echocardiographic assessment of PASP performed during a trek to 5150 m. PASP increased significantly (p=0.006) with ascent from 24+/-4 to 39+/-11 mm Hg at 5150 m. At 5150 m those with a PASP>/=40 mm Hg (n=8) (versus those with PASP<40 mm Hg) had higher post-exercise BNP (pg/ml): 54.5+/-36 vs. 13.4+/-17 (p=0.012). Their resting BNP at 5150 m was also higher: 57.3+/-43.4 vs. 12.6+/-13 (p=0.017). In those with a pathological (>/=400 pg/ml) rise in NT-proBNP at 5150 m (n=4) PASP was significantly higher: 45.9+/-7.5 vs. 32.2+/-6.2 mm Hg (p=0.015). BNP and NT-proBNP may reflect elevated PASP, a central feature of high altitude pulmonary oedema, at HA.

Returning employees back to work: developing a measure for Supervisors to Support Return to Work (SSRW)

INTRODUCTION

Evidence suggests that supervisors' behaviors have a strong influence on employees' health and well-being outcomes. Few have examined the specific behaviors associated with managing an employee back to work following long-term sick leave. This study describes the development of a behavior measure for Supervisors to Support Return to Work (SSRW) using qualitative and quantitative research methods.

METHODS

Qualitative data were collected between 2008 and 2010 from a UK population of organisational stakeholders (N = 142), line managers (N = 20) and employees (N = 26). Data from these samples were used to develop a 42 item questionnaire and to validate it using a further sample of line managers (N = 186) and employees (N = 359).

RESULTS

Based on a factor structure and reliability results, four scales emerged. The measure demonstrated good internal reliability, construct and concurrent validity. Longitudinal data analyses demonstrated test-retest reliability and promising predictive validity.

CONCLUSIONS

This is a potentially valuable tool in research and in organisational settings, both during long-term sick leave and after employees have returned to work.

Helping cancer survivors return to work: what providers tell us about the challenges in assisting cancer patients with work questions

INTRODUCTION

Cancer patients and survivors report receiving little work-related advice from healthcare providers about how to manage their work during treatment or when to return after completing primary treatment. This study explores the extent to which health professionals involved with colorectal cancer patients address work matters during active treatment.

METHODS

Eighteen health professionals from oncology, occupational health and general practice were interviewed. Interviews were transcribed verbatim and analysed using thematic analysis.

RESULTS

Health professionals provide conflicting and limited information to patients regarding ability to work during treatment, or when to return to work thereafter. Lack of knowledge about impacts of treatment and symptoms on work ability and sustainability, particularly in relation to different occupations and work tasks resulted in providers offering minimal guidance to patients. Current practices relied on providers' previous experiences with employed patients, rather than a sound evidence-base.

CONCLUSIONS

The type of work-related information given to patients by providers is not systematic. It is necessary to develop a better knowledge base about the impacts of cancer and its treatment on work ability, sustainability and return to work that would help providers to offer more tailored advice to patients, consistently. Therefore, it is appropriate to recommend that formal training for providers is necessary. Enhancing the quality of information and training for health professionals to provide better work-related support to patients during the early stages of treatment could enable individuals to manage their work more effectively and facilitate a successful transition from patient to survivor.

The impact of colorectal cancer and self-efficacy beliefs on work ability and employment status: a longitudinal study

We examined how colorectal cancer patients' treatment and symptom management impacted perceptions of work ability and subsequent work decisions. Fifty patients completed questionnaires at baseline (post-surgery/pretreatment), 3 months and 6 months. Questionnaires assessed fatigue, depression, quality-of-life (QoL), cancer self-efficacy, job self-efficacy (JSE) and work ability. Factors related to perceived work ability were occupation (β= 0.31, P= 0.0005) and QoL (β= 0.42, P= 0.01) at baseline, treatment type (β=-0.19, P= 0.05) at 3 months, and JSE at 3 months (β= 0.57, P= 0.0005) and 6 months (β= 0.50, P= 0.006). Factors related to being on sick leave were lower levels of JSE (OR = 2.20, 95% CI: 1.17-4.13) at baseline and being employed in a manual occupation (OR = 0.03, 95% CI: 0.00-0.86), and perceived work ability (OR = 3.05, 95% CI: 1.00-12.80) at 6 months. Along with self-assessed work ability at baseline (β= 0.67, P= 0.0005), receiving chemotherapy or a combination of treatments (β=-0.24, P= 0.05) were the strongest predictors of poorer perceptions of follow-up work ability. Self-efficacy beliefs may add to understanding and should be considered in future research.

Employment and the common cancers: correlates of work ability during or following cancer treatment

AIMS

To provide an in-depth review of the impact of cancer and cancer-related issues on work ability for those working during or following cancer treatment.

METHODS

Of total, 19 papers published between 1999 and 2008 on cancer and work ability were reviewed.

RESULTS

Studies have shown that most types of cancers result in decreased work ability compared to healthy controls or those with other chronic conditions. Some cancer types have more decreased work ability than other types. Decreased work ability is associated with type of treatment (chemotherapy), treatment-related side-effects (e.g. fatigue) and co-morbidity with other health conditions. For most cancers, work ability improves over time irrespective of age.

CONCLUSIONS

More longitudinal research is required to fully determine the impact of cancer and its treatment on work ability, occupational health services can help such employees make a full recovery and maintain employment by regularly assessing work ability and working hours so that work adjustment and support can be appropriately tailored.

The role of communication and support in return to work following cancer-related absence

OBJECTIVE

Many cancer survivors experience difficulties returning to work. However, there have been relatively few attempts to understand why problems with employer support and work adjustment occur. This paper aims to extend previous work in two ways: first, through exploring the way in which communication and support at work effect cancer survivors on their return to work and during the post-return period; and second, by drawing on a research sample working in the United Kingdom.

METHODS

In all, 26 cancer survivors took part in a semi-structured telephone interview. Interviews were transcribed and analysed using thematic analysis.

RESULTS

The analysis revealed three key findings. First, the central role of communication and support from (and between) occupational health, line managers, and colleagues was highlighted. Second, two discrete processes or periods of return to work were identified: the experience of return to work during the initial period of return and the experiences of post-return to work. Third, during the post-return period, the importance of the delayed impact of cancer on the ability to work, the lack of follow-up and monitoring, and the wear-off effect of empathy and support were highlighted as contributing to return-to-work difficulties.

CONCLUSIONS

This qualitative study highlights the importance of communication within the workplace with regard to the return-to-work process and the need to provide better support and guidance to cancer survivors, line managers and colleagues. Research is required in delineating how employers without occupational health or human resources support manage the return-to-work process.

The influence of employer support on employee management of chronic health conditions at work

INTRODUCTION

This study examined the relationship between employer support, self-efficacy and self-management of chronic illness at work.

METHOD

772 employees reporting musculoskeletal pain (n = 230), arthritis and rheumatism (n = 132), asthma (n = 129), depression and anxiety (n = 121), heart disease (n = 80) and diabetes(n = 80) completed a questionnaire distributed across four large organizations. A modified version of the Self-Efficacy to Manage Symptoms Scale and the Self-Management Behaviors Scale were used. Support from line manager and occupational health were assessed.

RESULTS

Structural equation modelling analyses revealed that line managers support was directly related to employees' self-management of symptoms and medication at work. All three self-efficacy measures (beliefs about the ability to make adjustments,take medication and manage symptoms at work) partially mediated the relationship between line manager support and the use of medication at work. Self-efficacy beliefs in taking medication and making work adjustments also partially mediated the relationship between line manager support and self-management of symptoms at work. In contrast, there were no direct relationship between occupational health support and two self-management behaviors. Self-efficacy beliefs about making adjustments at work fully mediated the relationship between support from occupational health and self-management behaviors.

CONCLUSIONS

Employer support in developing both symptom-related and work-related self-efficacy for medication adherence and symptom management is important for those working with a chronic illness.

Self-management of health-behaviors among older and younger workers with chronic illness

OBJECTIVE

To examine the self-management of health behaviors carried out by older (aged 50-69 years) and younger workers (aged 20-49 years) with a chronic illness.

METHODS

Questionnaire data was collected from 759 employees with a diagnosed chronic illness. Four categories of self-managing health behaviors were examined: using prescribed medication, monitoring and responding to symptoms, managing an appropriate diet and exercising.

RESULTS

The majority of participants (56-97%) reported being advised to carry out health behaviors at home and at work. Controlling for confounding factors, medication use was associated with younger and older workers. Managing an appropriate diet was associated with younger workers with asthma, musculoskeletal pain or diabetes. Exercising was associated with younger workers with asthma and with older workers with heart disease, arthritis and rheumatism or diabetes.

CONCLUSIONS

The findings indicate that there are differences in diet and exercise activities among younger and older workers.

PRACTICE IMPLICATIONS

To increase self-management in health behaviors at work, improved communication and understanding between the different health professions and the patient/employee is required so that different tailored approaches can be effectively targeted both by age and within the context of the working environment, to those managing asthma, heart disease, diabetes and arthritis and rheumatism.

The mediating effects of team and self-efficacy on the relationship between transformational leadership, and job satisfaction and psychological well-being in healthcare professionals: a cross-sectional questionnaire survey

BACKGROUND

The importance of transformational leadership for the health and well-being of staff in the healthcare sector is increasingly acknowledged, however, there is less knowledge about the mechanisms that may explain the links between transformational leaders and employee health and well-being.

OBJECTIVES

To examine two possible psychological mechanisms that link transformational leadership behaviours to employee job satisfaction and well-being.

DESIGN

Cross-sectional study design.

SETTINGS

The study took place in two elderly care centers in large Danish local government. Staff were predominantly healthcare assistants but also nurses and other healthcare-related professions participated in the study.

PARTICIPANTS

274 elderly care employees completed the questionnaire. Surveys were sent to all employees working at the centers. 91% were female, the average age was 45 years.

METHODS

A questionnaire was distributed to all members of staff in the elderly care centers and where employees were asked to rate their line manager's leadership style and were asked to evaluate their own level of self-efficacy as well as the level of efficacy in their team (team efficacy) and their job satisfaction and psychological well-being.

RESULTS

Both team and self-efficacy were found to act as mediators, however, their effects differed. Self-efficacy was found to fully mediate the relationship between transformational leadership and well-being and team efficacy was found to partially mediate the relationship between transformational leadership and job satisfaction and fully mediate the relationship between transformational leadership and well-being.

CONCLUSIONS

Within the pressurised environment faced by employees in the healthcare sector today transformational leaders may help ensure employees' job satisfaction and psychological well-being. They do so through the establishment of a sense of being in control as individuals but also as being part of a competent group.

Sickness absence management: encouraging attendance or 'risk-taking' presenteeism in employees with chronic illness?

PURPOSE

To investigate the organizational perspectives on the effectiveness of their attendance management policies for chronically ill employees.

METHODS

A mixed-method approach was employed involving questionnaire survey with employees and in-depth interviews with key stakeholders of the organizational policies.

RESULTS

Participants reported that attendance management polices and the point at which systems were triggered, posed problems for employees managing chronic illness. These systems presented risk to health: employees were more likely to turn up for work despite feeling unwell (presenteeism) to avoid a disciplinary situation but absence-related support was only provided once illness progressed to long-term sick leave. Attendance management polices also raised ethical concerns for 'forced' illness disclosure and immense pressures on line managers to manage attendance.

CONCLUSIONS

Participants felt their current attendance management polices were unfavourable toward those managing a chronic illness. The policies heavily focused on attendance despite illness and on providing return to work support following long-term sick leave. Drawing on the results, the authors conclude that attendance management should promote job retention rather than merely prevent absence per se. They outline areas of improvement in the attendance management of employees with chronic illness.

Work factors related to psychological and health-related distress among employees with chronic illnesses

OBJECTIVE

This study examined specific psychosocial factors associated with psychological and health-related distress amongst employees reporting different chronic illnesses.

METHODS

The sample consisted of 1029 employees managing either musculoskeletal pain (n=324), arthritis and rheumatism (n=192), asthma (n=174), depression and anxiety (n=152), heart disease (n=96) or diabetes (n=91). Information on psychological distress, work limitations, illness management, disclosure, absence, presenteeism, support and demographic factors were obtained through self-administered questionnaires.

RESULTS

Both low psychological well-being and high health-related distress were associated with an increase in work limitations (beta=0.20, SE=.03; and beta=0.19, SE=.01, respectively), poorer management of illness symptoms at work (beta=-0.17, SE=.12; and beta=-0.13, SE=.02), high presentieesm (beta=0.19, SE=.25; and beta=0.14, SE=.05) and low workplace support (beta=-0.05, SE=.22; and beta=-0.12, SE=.05). Health-related distress was additionally associated with disclosure of illness at work (beta=0.18, SE=.08) and long-term sickness absence (beta=0.10, SE=.06).

CONCLUSIONS

To enable individuals to effectively manage both their illness and their work without serious repercussions, it is important for both healthcare professionals and employers alike, to improve the well-being of workers with chronic illness by supporting and facilitating their efforts to over-come health-related limitations at work.