Evaluating health care work settings: A holistic conceptual framework

Abstract

After offering a systems perspective that considers a diversity of job-related and personal factors, we discuss the determinants and impacts of health care work climates and how staff morale and performance can influence the treatment milieu and quality of patient care. We also describe the physical features, organizational structure and policies, and suprapersonal and task factors that help to shape health care work climates. We then review research on the connections between work climate and staff morale and performance, the interplay of work climate factors, and the role of personal factors in these relationships. Finally, we orovide some ideas about how to improve health care work settings and focus on some promising new research directions.     

The impact of structuring information in a patient decision aid

The current study aims to investigate the relationship between the components of the Karasek model and burnout, somatic complaints and job satisfaction in teachers. Questionnaires were collected from 166 teachers from six secondary schools in the greater London area. The European reference group consisted of 2017 teachers from 10 other countries who participated in the EUROTEACH Project. Regression analyses show that of the Karasek components, job demands was the most consistent predictor for the study outcomes, whereas control and social support appeared to have less predictive power. The inclusion of other job aspects (e.g. physical exertion, environmental risks, and job meaningfulness) significantly added varying degrees to the explained variance of the outcomes. The addition of coping strategies marginally adds to overall explained variances of the burnout components. The UK teachers were considerably worse off than their European colleagues on all outcome measures, and the majority of the predictor variables. They appear to use different coping strategies, work under worse conditions and report lower levels of psychological and physical well-being.     

Outcome expectations and work design characteristics in post-retirement work planning

Today, a growing number of individuals decide to work beyond normal retirement age (Eurofound, 2012). Research has revealed influencing factors for post-retirement work at the individual, job and organizational, family, and socioeconomic levels. However, not much is known about post-retirement work planning and its antecedents. The purpose of this study is to examine the effects of outcome expectations regarding post-retirement work and two work design characteristics (i.e., physical demands and social support at work) on post-retirement work planning by applying the framework of social cognitive career theory (SCCT; Lent, Brown, & Hackett, 1994). Data from 1065 employees of a German logistics company were used in this study. Results provide support for SCCT to be a suitable theoretical framework for understanding post-retirement career planning and thereby expand the application of SCCT to a new field. Furthermore, multilevel analysis revealed that physical demands were negatively related to the intention to continue to work for the pre-retirement employer after retirement entry, whereas social support at work strengthened the relationship between outcome expectations and same-employer-post-retirement work intention. Organizations who want their retired employees to continue to work in retirement should develop interventions to strengthen post-retirement work outcome expectations. An increase in social support at work as well as a reduction in physical demands may also contribute to increased participation in continued work with the same employer in retirement.     

Is a change in work motivation related to a change in mental well-being?

The purpose of the study was to investigate the effect of changes on work motivation and the effect of the changes on future mental well-being. This prospective study comprised 577 employees who were followed up 18 months after a comprehensive baseline measurement. The response rate was 81% for the baseline and 72% for the follow-up. The results show that both negative and positive changes in work motivation over time (18 months) were related to exhaustion. A similar correlation was found between negative changes in work motivation and depression. The results show that employees with a decreased level of work motivation had a higher risk of experiencing more exhaustion and depression in the future. Thus, investing in activities to promote work motivation may be an effective means of preventing long-term sick leave for stress-related mental illness and of providing energy for successful career advancement.     

Book Reviews

Abstract

Johnson, J.V., & Hohansson, G. (Eds.)- (1991). The psychosocial work environment: Work organization, democratization and health. Essays in memory of Bertil Gar dell. New York: Baywood. pp. 335. ISBN 0-89503-078-0 (hardback). ISBN 0-89503-077-2 (paperback).

Shackel, B., & Richardson, S. (Eds.) (1991). Human factors of informatics usability. Cambridge: Cambridge University Press. Pp. 438. ISBN 0-521-36570-8. Hardback £35.00

Frese, M., & Brodbeck, F.C. (1989). Computer in Büro und Verwaltung. Berlin: Springer. Pp. 237. ISBN: 3-540-50774-4. DM 88. Published in German.     

Mobbing–prevention and management in organizations

Abstract

So far, only a few companies have dealt with the issue of “mobbing”. This article describes some of the variables required for a successful implementation of an anti-mobbing programme, as well as measures of prevention and intervention. A successful anti-mobbing programme depends on the pressure the problem exerts on the company, the competition with other company programmes, the negative image of mobbing, and the slow diffusion of social issues in companies. Various prevention measures are outlined and suggested in connection with the causes of mobbing: changes in work design, changes in leadership behaviour, the protection of the individual social position, and the moral standard of employees. Depending on the stage of conflict escalation, different intervention measures apply. The concepts of appointing contact people for mobbing victims and the setting up of neutral clearing posts are discussed.     

Effects of work–family culture on employee well-being: Exploring moderator effects in a longitudinal sample

This present panel study had three aims: (1) to shed new light on the work–family culture (WFC)–well-being (work–family conflict, work engagement, job exhaustion) linkage by investigating lagged associations between the phenomena; (2) to consider the multidimensional nature of WFC by specifying whether its lagged effects on well-being would vary by its dimensions; and (3) to explore whether the positive aspects of WFC would prevent its negative ones from spilling over into employee well-being. The study was based on a 2-year longitudinal sample (N = 409) gathered among Finnish health care workers. The results showed that WFC was a bidimensional construct containing both negative (work–family barriers) and positive (work–family support) facets. Only its positive facets (work–family support) showed a lagged negative effect on the outcomes studied (work–family conflict). No signs of moderator effects were observed.     

Making sense of “resistance”: Responses to organizational change in a private nursing home for the elderly

Abstract

This article reports a study of resistance to change amongst organizational employees. It focuses on the introduction of skill development programmes to give staff nationally recognized qualifications. Resistance to the innovation is interpreted in light of the values of staff and how they are consistent or inconsistent with the value base of the innovation.     

Conflict escalation and coping with workplace bullying: A replication and extension

Bullying or mobbing is used for systematically harassing a person for a long time. In the context of stress theory, bullying is a severe form of social stressors at work, whereas in terms of conflict theory, bullying signifies an unsolved social conflict having reached a high level of escalation and an increased imbalance of power. Based on a qualitative study with 20 semi-structured interviews with victims of bullying and a quantitative questionnaire study with a total of 149 victims of bullying and a control group (N = 81), it was investigated whether bullying victims use specific conflict management strategies more often compared with individuals who are not bullied, and whether coping strategies used by successful copers with bullying differ from those of the unsuccessful copers. Successful copers were those victims who believe that their situation at work has improved again as a result of their coping efforts. The qualitative data showed that most victims started with constructive conflict-solving strategies, changed their strategies several times, and finally tried to leave the organization. In the interviews, the victims of bullying most often recommended others in the same situation to leave the organization and to seek social support. They more often showed conflict avoidance in the quantitative study. Successful victims fought back with similar means less often, and less often used negative behaviour such as frequent absenteeism. Moreover, they obviously were better at recognizing and avoiding escalating behaviour, whereas in their fight for justice, the unsuccessful victims often contributed to the escalation of the bullying conflict.     

Workplace violence and the changing nature of work in Europe: Trends and risk groups

Incidence rates of third party workplace violence in Europe have increased, but little is known about the causes thereof. It has been suggested that the growth of the service sector and the intensification of work could be responsible for the increase. This study aimed to identify trends in the prevalence of physical workplace violence across Europe, as well as to uncover factors explaining these trends. Three cross-sectional waves (1995, 2000, and 2005) of the European Working Conditions Survey were used, involving 58,520 workers and covering 15 European member states. Logistic regression analyses were performed to investigate associations between work characteristics and violence prevalence. Workplace violence increased significantly during the study interval. Although violence was clearly related to specific characteristics of the labour market (gender, age, sector, etc.) and the work environment (client contact frequency, time pressure, control, and computer work), recent changes in the European labour market composition and work environment could not explain the increase in violence. In jobs characterized by high levels of computer work in particular, violence appears to be an emerging risk. Our results suggest that the nature (and perhaps quality) of client contact is changing, leading to higher violence risks.