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.

Acting Proactively to Manage Job Insecurity: How Worrying About the Future of One's Job May Obstruct Future-Focused Thinking and Behavior.

An increasing number of people experience insecurity about the future of their job, making it more important than ever to manage this insecurity. While previous research suggests that proactive coping is a promising way to alleviate job insecurity, we suggest that, paradoxically, it may be particularly difficult to act proactively when feeling emotionally distressed about the future of one's job. Drawing on the principle of resource scarcity and the Conservation of Resources theory, we propose that affective job insecurity ignites a scarcity mindset that inhibits workers' future focus and cognitive functioning, thereby undermining proactive career behavior. Additionally, we examine whether income adequacy can compensate for these negative consequences of job insecurity. Results of a three-wave survey study among 108 self-employed professionals during the COVID-19 pandemic showed that initial affective job insecurity was negatively related to cognitive functioning but unrelated to future focus. Yet, the latter relationship was moderated by income adequacy: affective job insecurity was positively related to future focus when participants reported high income adequacy. In turn, future focus was positively related to proactive career behavior, which was subsequently related to lower cognitive job insecurity. Thus, while replicating the finding that workers can proactively manage their cognitive job insecurity, we also showed that initial affective job insecurity may obstruct people's cognitive functioning. We discuss how our results signal a Matthew effect, in which job insecure people with sufficient means are able to look ahead and proactively build resources to change their career, while job insecure people with insufficient means may fall behind.