An Agenda for Advancing Research and Prevention at the Nexus of Work Organization, Occupational Stress, and Mental Health and Well-Being.

Work characteristics and worker well-being are inextricably connected. In particular, the characteristics of work organization shape and perpetuate occupational stress, which contributes to worker mental health and well-being outcomes. Consequently, the importance of understanding and addressing connections between work organization, occupational stress, and mental health and well-being-the focus of this Special Issue-increasingly demand attention from those affected by these issues. Thus, focusing on these issues in the long-haul truck driver (LHTD) sector as an illustrative example, the purpose of this commentary is as follows: (1) to outline current research approaches and the extant knowledge base regarding the connections between work organization, occupational stress, and mental health; (2) to provide an overview of current intervention strategies and public policy solutions associated with the current knowledge base to protect and promote worker mental health and well-being; and (3) to propose a two-pronged agenda for advancing research and prevention for workers during the 21st century. It is anticipated that this commentary, and this Special Issue more broadly, will both echo numerous other calls for building knowledge and engaging in this area and motivate further research within complementary current and novel research frameworks.

Steps toward a resilient future nurse workforce.

INTRODUCTION: The psychosocial needs of nursing students are a pressing matter as mental health disorders may affect nursing students' journeys as professional nurses. LITERATURE REVIEW: Psychological distress and burnout in nurses are threats to worldwide health care, as the stress associated with the COVID-19 pandemic could lead to an unstable future global nurse workforce. DISCUSSION: Resiliency training can positively impact nurse stress, mindfulness, and resilience, as resilient nurses are better able to manage their response to stress and adversity which will contribute to positive patient outcomes. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: Educating faculty on resilience will aid nurse educators to create new student instructional approaches to improve mental health wellness. CONCLUSIONS: Supportive faculty behaviors, self-care techniques, and resilience-building infused throughout the nursing curriculum may promote the effective transitioning of students into practice, providing the necessary foundation for improving workplace stress management and increasing longevity and satisfaction in the profession.

Effectiveness of auriculotherapy on stress reduction in health workers: a controlled randomized clinical trial.

OBJECTIVE: to assess the effectiveness of auriculotherapy in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. METHOD: a controlled randomized clinical trial divided into two groups, namely: auriculotherapy for stress group and placebo group. The Shapiro-Wilk test was used to assess data normality. The ANOVA test for repeated measures and the Tukey post-hoc test were applied to the group with normal samples. In turn, the Friedman and Durbin-Conover tests were employed in the group with non-normal distribution. Cohen's d index was calculated for the therapy effect size. A 95% significance level and p<0.05 were considered. RESULTS: the auriculotherapy group presented 16.3% and 23.7% reductions in occupational stress after the third and sixth auriculotherapy sessions, with Cohen's d indices of 1.12 (large effect) and 1.82 (very large effect), respectively. CONCLUSION: auriculotherapy proved to be effective in reducing occupational stress among Family Health Strategy workers during the COVID-19 pandemic. It is suggested that new studies are developed both during and after the pandemic in order to improve health workers' Quality of Life. ReBEC registration: RBR - 38hjyt3.

Response to NIOSH Request for Information on Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health.

The root causes of health care worker strain and depression include excessive job demands, extended work schedules, little decision-making opportunity, assault, bullying, and fear of injury. Potential links between working conditions and opioid overuse have also been discussed, beginning with psychological job strain or with physical pain leading to medication use. Promising solutions have been identified and many would be cost-effective, as enhanced working conditions could improve workers' mental health, job satisfaction, retention, and patient outcomes. Considering the number of health care workers leaving work during the global COVID-19 pandemic, it is urgent to address preventable root causes. In 2021, the US Congress called for educating health workers and first responders on the primary prevention of mental health conditions and substance use disorders. The CDC issued a Request for Information; this submission summarized research from CPH-NEW, a NIOSH Center of Excellence in Total Worker Health®, supplemented by a selective literature review.

Understanding the condition of disease prevention and control workforce by disciplines, duties, and work stress during the COVID-19 pandemic: A case from Beijing disease prevention and control system.

Objective: The duties, discipline cross-complementation, and work stress of professional staff during the COVID-19 pandemic are analyzed and summarized to provide a scientific basis for workforce allocation and reserve in respect of infectious disease prevention and control in the disease prevention and control (DPC) system. Method: The cross-sectional survey was made in April-May 2021 on professional staff in the Beijing DPC system by way of typical + cluster sampling. A total of 1,086 staff were surveyed via electronic questionnaire, which was independently designed by the Study Group and involves three dimensions, i.e., General Information, Working Intensity & Satisfaction, and Need for Key Capacity Building. This paper focuses on the former two dimensions: General Information, Working Intensity, and Satisfaction. The information collected is stored in a database built with Microsoft Excel 2010 and analyzed statistically with SPSS 22.0. The results are expressed in absolute quantities and proportions. Assuming that the overload of work stress is brought by incremental duties and cross-discipline tasks, a binary logistic regression model is constructed. Results: Among the 1086 staff surveyed, 1032 staff were engaged in COVID-19 prevention and control works, and they can be roughly divided into two groups by their disciplines: Public Health and Preventive Medicine (hereinafter referred to P, 637 staff, as 61.72%) and Non-Public Health and Preventive Medicine (hereinafter referred to N-P, 395 staff, as 38.28%). During the COVID-19 pandemic, the 1,032 staff assumed a total of 2239 duties, that is, 2.17 per person (PP), or 2.45 PP for the P group and 1.72 PP for the N-P group. As to four categories of duties, i.e., Spot Epidemiological Investigation and Sampling, Information Management and Analysis, On-site Disposal, Prevention, Control Guidance, and Publicity, the P group accounts for 76.14, 78.50, 74.74, and 57.66%, respectively, while the N-P group accounts for 23.86, 21.50, 25.26, and 42.34%, respectively. Obviously, the former proportions are higher than the latter proportions. The situation is the opposite of the Sample Detection and Other Works, where the P group accounts for 25.00 and 31.33%, respectively, while the N-P group accounts for 75.00 and 68.67%, respectively. The analysis of work stress reveals that the P group and N-P group have similar proportions in view of full load work stress, being 48.67 and 50.13%, respectively, and the P group shows a proportion of 34.38% in view of overload work stress, apparently higher than the N-P group (24.05%). Moreover, both groups indicate their work stresses are higher than the pre-COVID-19 period levels. According to the analysis of work stress factors, the duty quantity and cross-discipline tasks are statistically positively correlated with the probability of overload work stress. Conclusion: The front-line staff in the DPC system involved in the COVID-19 prevention and control primarily fall in the category of Public Health and Preventive Medicine discipline. The P group assumes the most duties, and the N-P group serves as an important cross-complement. The study results indicate that the prevention and control of same-scale epidemic require the duty post setting at least twice than usual. As to workforce recruitment, allocation, and reserve in respect of the DPC system, two solutions are optional: less addition of P staff, or more addition of N-P staff. A balance between P and N-P staff that enables the personnel composition to accommodate both routine DPC and unexpected epidemic needs to be further discussed.

Short-Term Effects of Short-Term Work: Dynamics in Fatigue Across Two National Lockdowns.

OBJECTIVE: Anecdotal evidence suggests work fatigue has increased during the COVID-19 pandemic, and work interventions to offset stresses have been effective. Our study sought to test these propositions, documenting and describing the complexity of worker well-being around two lockdown periods. METHODS: Using 17 waves of data from a longitudinal study in Germany (December 2019 to June 2021, n = 1053 employees), we model discontinuous changes in work fatigue and how participation in a government-sponsored short-term work program (Kurzarbeit) affected change trajectories. RESULTS: The COVID-19 pandemic has not invariably resulted in work fatigue, and individuals with Kurzarbeit at the first lockdown (but not the second) showed significantly larger decreases in each form of fatigue at this transition. CONCLUSIONS: Future policy interventions will require more contextual nuance and to effectively support worker well-being during public health crises.

A multimodal sensor dataset for continuous stress detection of nurses in a hospital.

Advances in wearable technologies provide the opportunity to monitor many physiological variables continuously. Stress detection has gained increased attention in recent years, mainly because early stress detection can help individuals better manage health to minimize the negative impacts of long-term stress exposure. This paper provides a unique stress detection dataset created in a natural working environment in a hospital. This dataset is a collection of biometric data of nurses during the COVID-19 outbreak. Studying stress in a work environment is complex due to many social, cultural, and psychological factors in dealing with stressful conditions. Therefore, we captured both the physiological data and associated context pertaining to the stress events. We monitored specific physiological variables such as electrodermal activity, Heart Rate, and skin temperature of the nurse subjects. A periodic smartphone-administered survey also captured the contributing factors for the detected stress events. A database containing the signals, stress events, and survey responses is publicly available on Dryad.

Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions.

BACKGROUND: Workplace-related stress is a major risk factor for mental and physical health problems and related sickness absence and productivity loss. Despite evidence regarding the effectiveness of different workplace-based interventions, the implementation of stress prevention interventions is rare, especially in micro and small-sized enterprises (MSE) with fewer than 50 employees. The joint research project "PragmatiKK"+ aims to identify and address the specific barriers to the implementation of stress prevention interventions in MSE. This study protocol describes a mixed method study design to evaluate the effectiveness of adapted stress prevention interventions and the implementation process via an integrated web-based platform ("System P") specifically targeted at MSE. METHODS: First, we develop a web-based intervention, which accounts for the specific working conditions in MSE and addresses stress prevention at a structural and behavioral level. Second, we use common methods of implementation research to perform an effect and process evaluation. We analyze the effectiveness of the web-based stress prevention interventions by comparing depressive symptoms at baseline and follow-up (after 6 months and 12 months). Indicators for a successful implementation process include acceptability, adoption, feasibility, reach, dose, and fidelity, which we will measure with quantitative web-based questionnaires and qualitative interviews. We will also analyze the accumulated usage data from the web-based platform. DISCUSSION: Collecting data on the implementation process and the effectiveness of a web-based intervention will help to identify and overcome common barriers to stress prevention in MSE. This can improve the mental health of employees in MSE, which constitute more than 90% of all enterprises in Germany. + Full Project Name: "PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben "(= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). TRIAL REGISTRATION: German Register of Clinical Studies (DRKS): DRKS00026154 , date of registration: 2021-09-16.

Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19.

BACKGROUND: Prolonged exposure to work-related stress can lead to nurse burnout, potentiating clinical and medication errors and low-quality patient care. Holistic approaches (such as mindfulness training, "zen rooms," and massage chairs, among others) have been shown to reduce nurses' anxiety, stress, and burnout. PURPOSE: To evaluate the use of "serenity lounges" (dedicated rooms where nurses can take workday breaks for the purposes of relaxation and rejuvenation) and massage chairs on nurses' anxiety, stress, and burnout. METHODS: This quality improvement project analyzed 67 paired responses to surveys filled out by nurses before and after their use of serenity lounges at a medical center in Los Angeles between November 2020 and May 2021. Following successful implementation of a serenity lounge on a pilot unit, this project was expanded to a total of 10 units, including COVID-19 cohort units. As part of this expansion, massage chairs were added to 10 serenity lounges, along with items such as wipes, gloves, and shoe covers to enable nurses to adhere to infection control protocols. RESULTS: Analysis of the 67 paired responses to pre- and post-lounge-use surveys revealed a significant reduction in feelings of emotional exhaustion, burnout, frustration, being worn out, stress, and anxiety after use of the serenity lounge. Improvements in feelings of emotional exhaustion, being worn out, and being anxious were also noted after using the massage chair for at least 10 to 20 minutes. CONCLUSIONS: These results highlight the importance of providing a holistic approach, including a serene space, massage equipment, and other amenities, to help nurses reduce feelings of anxiety, stress, and burnout, particularly during challenging times such as the COVID-19 pandemic.

Influence of Hospital Outdoor Rest Space on the Eye Movement Measures and Self-Rating Restoration of Staff.

Objective: To investigate the effect of hospital outdoor rest space on the eye movement measures and self-rating restoration of staff. Background: Relieving the pressure of hospital staff through exposure to hospital outdoor rest space is essential, but there is a scarcity of research on the impact of hospital outdoor rest space on the eye movement measures and self-rating restoration of staff, especially for large Chinese hospitals. Methods: Cross-analysis was conducted based on the eye movement measures of 76 staff members obtained by eye movement tracking equipment in combination with the self-rating restoration scale and hospital outdoor rest space picture attributes (element proportion and position, brightness and saturation). Results: The differences in eye movement measures of different staff attributes (occupation, age, and gender) were identified, and the effects of hospital outdoor rest space picture attributes on the eye movement measures and self-rating restoration scale of staff were summarized. A number of proposals were also formulated: hospital outdoor rest space should be set up close to the working area of the group of medical staff; attention should be paid to the actual needs of senior staff members and the work pressure of junior nurses; the exposure to natural environment should be increased and the proportion of hard artificial elements should be reduced; the natural environment should be placed in the visual center; the saturation and brightness of hospital outdoor rest space should be increased; and staff members should have access to the sky environment in a variety of ways. Conclusion: The present study is an empirical study of evidence-based design on hospital outdoor rest space in China, and the results reveal the effects of hospital outdoor rest space on the eye movement measures and self-rating restoration of staff.

[Burn-On Instead of Burn-Out: Self-Care and Functional Coping Strategies Protect Psychotherapists from Psychological Stress During the Corona Pandemic]. / Burn-on statt Burn-out: Selbstfürsorge und funktionale Bewältigungsstrategien schützen PsychotherapeutInnen vor psychischen Belastungen während der Corona-Pandemie.

BACKGROUND AND OBJECTIVES: Due to the Corona pandemic, psychotherapists are confronted with new professional challenges. Regarding the patient care to be provided, the question of risk and protective factors for maintaining well-being during the pandemic appears relevant to prevent negative long-term consequences such as burnout. This is the first study investigating the influence of coping and self-care strategies on the psychological distress of psychotherapists in Germany during the Corona pandemic. METHODS: From April to June 2020, 155 psychotherapists completed an online questionnaire. Additionally, to job related changes, stress level, symptoms of burnout and well-being were assessed. Furthermore, the influence of active and passive coping strategies as well as of different areas of self-care (e. g., professional support, cognitive awareness for work-related stress and work-life balance) on psychological burden was examined. RESULTS: Psychotherapists worked an average of 1,22 hours less per week during the pandemic than before. On average, 38% of treatments were delivered via video therapy. Avoidant coping strategies were associated with increased stress levels, which predicted higher burnout scores and lower well-being. In contrast, a good work-life balance, a good daily balance at work and active coping had a positive effect. Contrary to expectation, cognitive awareness for work-related stress was related to lower well-being. DISCUSSION: Work-life balance can serve as a preventive strategy to reduce stress during the Corona pandemic and thereby reduce the risk for burnout and improve well-being. Avoidant coping strategies, on the other hand, are a risk factor for increased stress levels during pandemic and promote burnout and lower well-being. CONCLUSION: This study contributes to our knowledge regarding preventive measures to prevent stress and to maintain the well-being of psychotherapist in order to contribute to ongoing high quality patient care during the pandemic.

Management of work stress and burnout among community nurses arising from the COVID-19 pandemic.

The COVID-19 pandemic has increased workload demands for many NHS staff including those working in the community. Nurse managers can make a difference by being authentic leaders, nurturing a supportive organisation where the workload is managed participatively and self-kindness is legitimate. Unfortunately some staff may experience burnout and this article presents a personal management plan to address the symptoms of burnout and aid recovery, although it cannot promote a total recovery if the cause of the symptoms remains unaddressed.

Facility preparedness for an obstetric unit during the Covid-19 pandemic.

Covid-19 infection has placed health systems under unprecedented strain and foresight for preparedness is the key factor to avert disaster. Every facility that provides obstetric service needs a certain level of preparedness to be able to handle at least Covid-suspect pregnant women awaiting test reports, who need to be managed as Covid-positive patients till reports are available. Thus, these facilities need to have triage areas and Covid-suspect labour rooms. Healthcare facilities can have designated areas for Covid-positive patients or have referral linkages with designated Covid-positive hospitals. Preparation includes structural reorganization with setting up a Covid-suspect and Covid-positive facility in adequate space, as well as extensive training of staff about infection control practices and rational use of personal protective equipment (PPE). A systematic approach involving five essential steps of making standard operating procedures, infrastructural reorganization for a triage area and a Covid-suspect labour ward, procurement of PPE, managing the personnel and instituting appropriate infection control practices can ensure uninterrupted services to patients without compromising the safety of healthcare providers.

Experiences of nurses caring for respiratory patients during the first wave of the COVID-19 pandemic: an online survey study.

BACKGROUND: Nurses have been at the forefront of the pandemic response, involved in extensive coordination of services, screening, vaccination and front-line work in respiratory, emergency and intensive care environments. The nature of this work is often intense and stress-provoking with an inevitable psychological impact on nurses and all healthcare workers. This study focused on nurses working in respiratory areas with the aim of identifying and characterising the self-reported issues that exacerbated or alleviated their concerns during the first wave of the COVID-19 pandemic. METHODS: An online survey was developed consisting of 90 questions using a mixture of open-ended and closed questions. Participant demographic data were also collected (age, gender, ethnicity, number of years qualified, details of long-term health conditions, geographical location, nursing background/role and home life). The online survey was disseminated via social media and professional respiratory societies (British Thoracic Society, Primary Care Respiratory Society, Association of Respiratory Nurse Specialists) over a 3-week period in May 2020 and the survey closed on 1 June 2020. RESULTS: The study highlights the experiences of nurses caring for respiratory patients during the first wave of the pandemic in early 2020. Concerns were expressed over the working environment, the supply and availability of adequate protective personal equipment, the quality of care individuals were able to deliver, and the impact on mental health to nurses and their families. A high number provided free-text comments around their worries and concerns about the impact on their household; these included bringing the virus home, the effect on family members worrying about them, mental health and the impact of changing working patterns, and managing with children. Although both formal and informal support were available, there were inconsistencies in provision, highlighting the importance of nursing leadership and management in ensuring equity of access to services. CONCLUSIONS: Support for staff is essential both throughout the pandemic and afterwards, and it is important that preparation of individuals regarding building resilience is recognised. It is also clear that psychological support and services for nurses and the wider healthcare team need to be available and quickly convened in the event of similar major incidents, either global or local.

Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis.

Importance: Mental health and coping difficulties among health care workers (HCWs) have been reported during pandemics and particularly during the COVID-19 pandemic. Objective: To examine sources of distress and concern for HCWs in Canada during the COVID-19 pandemic. Design, Setting, and Participants: In this qualitative study, a critical discourse analysis was performed of questions posed by HCWs to hospital senior leadership between March 16, 2020, and December 1, 2020, through an online employee forum as part of a larger mixed-methods evaluation of a stepped-care mental health support program for HCWs at 1 of Canada's largest health care institutions. Questions could be submitted online anonymously in advance of the virtual forums on COVID-19 by any of the University Health Network's 21 555 employees, and staff members were able to anonymously endorse questions by upvoting, indicating that an already posed question was of interest. Main Outcomes and Measures: Themes, text structure, and rhetorical devices used within the questions were analyzed, taking into consideration their larger institutional and societal context. Results: Unique individual views of the forums ranged from 2062 to 7213 during the study period. Major individual-level concerns related to risks of contamination and challenges coping with increased workloads as a result of the pandemic intersected with institutional-level challenges, such as feeling or being valued within the health care setting and long-standing stratifications between types of HCWs. Concerns were frequently reported in terms of calls for clarity or demands for transparency from the institutional leadership. Conclusions and Relevance: The findings of this qualitative study suggest that larger institutional-level and structural concerns need to be addressed if HCWs are to be engaged in support and coping programs. Potential service users may be dissuaded from seeing their needs as being met by workplace mental health interventions that solely relate to individual-level concerns.

Beyond the Outbreak of COVID-19: Factors Affecting Burnout in Nurses in Iran.

Background: Nurses working in treating patients with COVID-19 are exposed to various stressors, such as fear of COVID-19, stress, and high workload, leading to burnout. Objectives: This study aimed to identify the level of burnout and its predictors in nurses working in hospitals for COVID-19 patients. Methods: Participants in this study were nurses working in 11 hospitals for COVID-19 patients in the Fars province of Iran. The Maslach burnout and the UK Health and Safety stress questionnaires were used to assess burnout and stress, respectively. Analysis, using multiple regression in the SPSS21 software, aimed to identify the factors affecting burnout. Findings: The mean level of burnout in the nurses at the COVID-19 hospitals was 57 out of 120, and burnout was affected by workload (ß = 0.69, p < 0.001), job stress (ß = 0.25, p < 0.001) and inadequate hospital resources for the prevention of COVID-19 (ß = -0.16, p < 0.001). These three variables explained 87% of the variance in burnout. Conclusions: The burnout of nurses directly exposed to COVID-19 patients is more than nurses in other wards, and workload is the most significant cause of burnout in them. Therefore, necessary measures such as hiring more nurses, reducing working hours and increasing rest periods are necessary to reduce workload. In addition, the job stress of these nurses should be managed and controlled, and the hospital resources needed to prevent this disease should be provided.