Is it time for a paradigmatic shift in relation to healthcare in the UK? A reflection.

CONTEXT: Conflict is a driver of change and unions representing professional groups across the National Health Service (NHS) are currently engaged in direct conflict with the government. For the first time in the history of the NHS, healthcare professionals have taken industrial strike action. Junior doctors and consultant physicians are currently engaged in their respective union ballots and indicative poll surveys regarding potential strike action in the future. In the wake of such widespread industrial action, we have taken time to think deeply about the confronting challenges and issues and offer this reflection as an opportunity to redefine and re-frame an unsustainable healthcare system into one that is the best it can be in terms of fit for purpose. INSIGHTS AND RESOURCE SIGNPOSTING: We present the current context with a reflective framework table focused on 'What do we do well? What is not done so well? What could some possible ideas and solutions be? and How could this change be supported?'We outline how a culture of well-being could be strategically and operationally introduced into the NHS workplace using research-based evidence and practical tools supported by expert guidance.

Patient Safety and Staff Well-Being: Organizational Culture as a Resource.

The present study examines the relationship between patient safety culture and health workers' well-being. Applying the conservation of resources mechanism, we tested theory-based hypotheses in a large cross-disciplinary sample (N = 3232) from a Taiwanese metropolitan healthcare system. Using the structural equation modeling technique, we found that patient safety culture was negatively related to staff burnout (ß = -0.74) and could explain 55% of the total variance. We also found that patient safety culture was positively related to staff work-life balance (ß = 0.44) and could explain 19% of the total variance. Furthermore, the above relationships were invariant across groups of diverse staff demography (gender, age, managerial position, and incident reporting) and job characteristics (job role, tenure, and patient contact). Our findings suggest that investing in patient safety culture can be viewed as building an organizational resource, which is beneficial for both improving the care quality and protecting staff well-being. More importantly, the benefits are the same for everyone in the healthcare services.

Sickness Presenteeism as a Link between Long Working Hours and Employees' Outcomes: Intrinsic and Extrinsic Motivators as Resources.

The aim of this study was to test the flow from long working hours to sickness presenteeism behavior and its outcomes for employees, while integrating intrinsic and extrinsic work value orientations as moderators in the process. We employed a two-wave design with a five-month interval. Data were obtained from 275 employees in Taiwan. The results of latent moderated structural equations (LMS) revealed that long working hours were positively associated with presenteeism, which in turn was negatively related to employees' well-being and job performance. Furthermore, the negative indirect effect of working long hours on job performance via presenteeism was weaker for those with a higher intrinsic work value orientation. The negative indirect effect of working long hours on well-being via presenteeism was weaker for those with a higher extrinsic work value orientation. We demonstrated that the long-term impact of presenteeism behavior could be understood by viewing work value orientations as resource gains to compensate resource depletion in a demanding work context. This resource dynamism is pivotal to realizing the functional or dysfunctional outcomes of presenteeism behavior. Theoretical and managerial implications of the findings for employees' well-being and organizational effectiveness are discussed.

Do Gender and Gender Role Orientation Make a Difference in the Link between Role Demands and Family Interference with Work for Taiwanese Workers?

Based on the gender role orientation perspective, this study extends the resource depletion mechanism that links role demands to family interference with work by testing the moderating effects of gender and gender role orientation (egalitarian vs. traditional) on the relationships. Analysis of the data from 251 employees in Taiwan revealed two significant three-way interactive effects. Specifically, for men, the positive relationship between work demands and family-to-work conflict (FWC) was stronger for egalitarian than traditional individuals. For women, the positive relationship between family demands and FWC was stronger for egalitarian than traditional individuals. We also found a significant two-way interactive effect; that is, within the egalitarian group, the positive relationship between work demands and FWC was stronger for women than men. Our findings, thus, suggest both within-gender and between-gender variations in the links between work-to-family demands and conflict, jointly affected by the individual's gender and gender role orientation. Contextualized within the cultural traditions of a Chinese society, we highlight the precarious position that egalitarian men and women (especially women) find for themselves in fulfilling work duties and family roles. The theoretical and managerial implications are also discussed.

Post-Pandemic Patient Safety Culture: A Case from a Large Metropolitan Hospital Group in Taiwan.

Patient safety is the core goal of medical institutions. The present study focuses on the patient safety culture and staff well-being admit the COVID-19 pandemic. In a large metropolitan hospital group, 337 employees who had participated in the quality improvement interventions completed an anonymous questionnaire of patient safety culture and personal well-being. The multiple regression analyses indicated that managerial role, seniority, female gender and direct contact with a patient were significantly related to the positive attitude on overall or certain dimensions of safety culture. Multivariate analysis also found that dimensions of teamwork climate, safety climate, job satisfaction and stress recognition as patient safety culture predicted staff exhaustion. Finally, comparing with the available institutional historic data in 2018, the COVID group scored higher on the working condition dimension of patient safety culture, but lower on the stress recognition dimension. The COVID group also scored higher on exhaustion. In the post-pandemic era, there seems to be an improvement on certain aspect of the patient safety culture among hospital staff, and the improvement is more prevalent for managers. However, exhaustion is also a poignant problem for all employees. These findings can inform hospital decision-makers in planning and implementing future improvements of patient safety culture and promoting employee well-being and resilience. Our findings also reveal directions for future research.

The Compensatory Protective Effects of Social Support at Work in Presenteeism During the Coronavirus Disease Pandemic.

The present study investigated the lasting effects of sickness presenteeism on well-being and innovative job performance in the demanding Chinese work context compounded with the precarities of the post-pandemic business environment. Adopting the conservation of resources (COR) theory perspective, especially its proposition of compensation of resources, we incorporated social resources at work (supervisory support and collegial support) as joint moderators in the presenteeism-outcomes relationship. We employed a panel design in which all variables were measured twice with 6 months in between. Data were obtained from 323 Chinese employees working in diverse industries in Taiwan. We found that after controlling for the baseline level of well-being, presenteeism did not have a lasting effect on employees' exhaustion. However, presenteeism did have a negative lasting effect on employees' innovative behavior 6 months later. Moreover, we found a significant three-way interaction of presenteeism, supervisory support, and collegial support on employees' innovative job performance, after controlling for the baseline level of performance. Specifically, when working under illness, employees displayed the best innovative performance with high levels of both supervisory and collegial support, the worst performance with both support being low, and the intermediate when any one of the support being high. This can be taken as the preliminary evidence to support the COR proposition of resource caravans, showing that supervisory support and collegial support compensated for each other as critical resources in alleviating the impact of working under sickness on employees' innovative performance. Theoretical implications of the findings are discussed, taking into account the macro-cultural context of the East Asian Confucian societies. We also reflected on the managerial implications of the lasting damages of sickness presenteeism and benefits of mobilizing social resources on employees' well-being and performance.

Gender Diversity and Work-Life Conflict in Changing Times.

The aim of the study is to contribute to the "well-being, diversity, equity, and inclusion" dialogue of the post-pandemic era. Specifically, we explored the joint effects of biological sex and gender diversity in self-identity on the role demands-work and family conflict relationships. To advance the inclusion of scientific knowledge, the present study was conducted in the cultural context of a Chinese society. We surveyed a sample of 317 Taiwanese employees. We used structured questionnaires to collect data on biological sex, gender identity (self-endorsement on masculinity and femininity traits), work and family demands, work-to-family conflict (WFC), and family-to-work conflict (FWC). We found two sets of significant three-way interactions (sex × femininity × role demands) in predicting work and family conflict. First, for men, identifying with high femininity traits strengthened the positive relationship between work demands and FWC; for women, identifying with low femininity traits strengthened the same relationship. Second, for men, identifying with high femininity traits strengthened the relationship between family demands and WFC; for women, identifying with low femininity traits strengthened the same relationship. Our findings highlight the importance of jointly examining the biological, psychological, and social aspects of gender on the work and family interface. Contextualizing in an Eastern cultural tradition, we put the spotlight on societal pressure on people of nontraditional gender identities.

Occupational Stress and Its Economic Cost in Hong Kong: The Role of Positive Emotions.

There has been less research on the costs of occupational stress attributed to certain job stressors in Chinese contexts. This study identified and validated common job stressors and estimated the economic cost in Hong Kong. The role of positive emotions in alleviating the economic costs of job stressors was also examined. Both qualitative and quantitative approaches were adopted. The findings obtained from five focus group discussions and a survey validated five common job stressors: Job insecurity; quantitative workload; organizational constraints; interpersonal conflicts; and work/home interface. A total of 2511 employees were surveyed, with 2032 valid questionnaires returned (925 males, 1104 females, and 3 unidentified, whose ages ranged from 18 to 70 years). The economic costs were estimated by combining the costs of absenteeism, presenteeism, and medical expenses. Absenteeism mainly caused by job stressors of the work/home interface, job insecurity, and quantitative workload accounted for an annual economic cost of HK$550 million to HK$860 million. The annual economic cost due to presenteeism mainly caused by job stressors of job insecurity, interpersonal conflict, quantitative workload, and organizational constraints ranged from HK$1.373 billion to HK$2.146 billion. The cost of medical treatments associated with occupational stress was HK$2.889 billion to HK$4.083 billion. Therefore, the total annual economic cost of occupational stress was approximately HK$4.81 billion to HK$7.09 billion. Positive emotions, representing a less explored individual factor in the cost of occupational stress studies, was found to be negatively correlated with presenteeism and buffered the negative impact of job stressors on absenteeism. The theoretical contributions and practical implications of findings are discussed.

Research priorities for the COVID-19 pandemic and beyond: A call to action for psychological science.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has caused the coronavirus disease 2019 (COVID-19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter- and longer-term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID-19 pandemic to facilitate immediate and longer-term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high-quality, open, and rigorous research standards.

Stress, health and well-being: the mediating role of employee and organizational commitment.

This study investigates the mediating impact of organizational commitment on the relationship between organizational stressors and employee health and well-being. Data were collected from 401 operator level employees working in business process outsourcing organizations (BPOs) based in New Delhi, India. In this research several dimensions from ASSET, which is an organizational stress screening tool, were used to measure employee perceptions of stressors, their commitment to the organization, their perception of the organization's commitment to them, and their health and well-being. Data were analyzed using structural equation modeling on AMOS software. Results of the mediation analysis highlight both employee commitment to their organization and their perceptions of the organization's commitment to them mediate the impact of stressors on physical health and psychological well-being. All indices of the model fit were found to be above standard norms. Implications are discussed with the view to improving standards of health and well-being within the call center industry, which is a sector that has reported higher turnover rates and poor working conditions among its employees internationally.

Unhealthy and present: motives and consequences of the act of presenteeism among Taiwanese employees.

The aim of this study was twofold: first, to delineate the underlying motives of the act of presenteeism and develop suitable measures for both the motives and the behavioral manifestation of the act; second, to systematically examine work and health consequences of the act of presenteeism in a Chinese work context. Using structured questionnaires, we employed a 2-wave panel study design in which antecedents, motives, and consequences of the act of presenteeism were measured in a diverse sample of 245 full-time Chinese employees in Taiwan. Hierarchical regression analyses showed that self-efficacy and neuroticism were significantly associated with approach and avoidance motives for the act of presenteeism, respectively. Moreover, analyzing the panel data with fixed effects specifications, we found that the act of presenteeism was negatively associated with employees' physical health, mental health, and job satisfaction, whereas it was positively associated with exhaustion. In conclusion, the present study shed some light on motives, behavioral manifestations, antecedents, and consequences of the act of presenteeism to extend the existing literature.

Turnover and intent to leave among speech pathologists.

Sound, large scale and systematic research into why health professionals want to leave their jobs is needed. This study used psychometrically-sound tools and logistic regression analyses to determine why Australian speech pathologists were intending to leave their jobs or the profession. Based on data from 620 questionnaires, several variables were found to be significantly related to intent to leave. The speech pathologists intending to look for a new job were more likely to be under 34 years of age, and perceive low levels of job security and benefits of the profession. Those intending to leave the profession were more likely to spend greater than half their time at work on administrative duties, have a higher negative affect score, not have children under 18 years of age, and perceive that speech pathology did not offer benefits that met their professional needs. The findings of this study provide the first evidence regarding the reasons for turnover and attrition in the Australian speech pathology workforce, and can inform the development of strategies to retain a skilled and experienced allied health workforce.

The costs of suicide and sudden death within an organization.

The effect of any death spreads out to many people. Deaths that occur in the workplace need to be handled with particular care given that the bereaved family as well as work colleagues will have been affected. Death by suicide or situations when an employee becomes suicidal can challenge even the most experienced manager. This article aims to raise some of the issues surrounding sudden death and suicide at work and suggests a number of ways that an organization can respond to such challenges.