Technostress Among Health Professionals - A Multilevel Model and Group Comparisons between Settings and Professions.

OBJECTIVE: Health organizations increasingly digitize. However, studies reveal contradictory findings regarding the impact of healthcare information technology on health professionals. Therefore, the aim of this study is to describe the prevalence of technostress among health professionals and elaborate on the influencing factors. PARTICIPANTS: A secondary analysis was conducted utilizing cross-sectional data from the study, "Work-related stress among health professionals in Switzerland", which included 8,112 health professionals from 163 health organizations in Switzerland. METHODS: ANOVA for group comparisons followed by post-hoc analyses, along with a Multilevel Model to identify influencing factors for technostress ranging from "0" (never/almost never) to "100" (always), were conducted. RESULTS: Health professionals experienced moderate technostress (mean 39.06, SD 32.54). Technostress differed between settings (p <.001) and health professions (p < .001). The model explains 18.1% of the variance with fixed effects, or 24.7% of the variance with fixed and random effects. Being a physician (ß = 12.96), a nurse (ß = 6.49), or the presence of an effort-reward-imbalance, increased technostress most (ß = 6.11). A professional with no professional qualification (ß = -7.94) showed the most reduction. CONCLUSION: Health professionals experience moderate technostress. However, decision-makers should consider the cognitive and social aspects surrounding digitalization, to reach a beneficial and sustainable level of usage.

Factors associated with work-private life conflict and leadership qualities among line managers of health professionals in Swiss acute and rehabilitation hospitals - a cross-sectional study.

BACKGROUND: The workforce shortage of health professionals is a matter of global concern. Among possible causative factors in this shortage are the incompatibility of health professionals' work with their private life, which may lead to increased stress and burnout symptoms, job dissatisfaction and a higher intention to leave the profession prematurely. Also, poor leadership qualities among direct line managers (e.g. clinic directors, leading physicians, ward managers, team leaders) have been associated with health professionals' job dissatisfaction and intention to leave in previous studies. This study therefore aimed to identify key factors associated with health professionals' work-private life conflicts and their managers' leadership quality. METHODS: The study is based on a cross-sectional survey in 26 Swiss acute and rehabilitation hospitals, consisting of 3398 health professionals from various disciplines. For data analysis, multilevel models (with hospitals as the second level variable) were performed for 'work-private life conflict' and 'quality of leadership', considering significant main effects (using AIC) and significant interactions (using BIC) of potential explanatory variables. RESULTS: The main findings reveal that the compatibility of health professionals' work and private life is associated with how much they can influence shift planning (possibility of exchanging shifts, B = -2.87, p < 0.01), the extent to which their individual preferences are considered (e.g. working on one specific shift only, B = 6.31, p < 0.01), number of work shifts per weekend (B = 1.38, p < 0.01) and working hours per week (B = 0.13, p < 0.01). In addition, the factors high quantitative demands (B = 0.25, p < 0.01), being required to hide their emotions (B = 0.16, p < 0.01) and poor social community support at work (B = -0.12, p < 0.01) were related to severe work-private life conflicts among health professionals. Regarding managerial leadership, health professionals perceived the leadership qualities of their direct line manager as being better if they received more social support (B = 0.61, p < 0.01) and rewards (B = 0.41, p < 0.01) at work. CONCLUSIONS: The results show key components of improving the compatibility of work and private life for health professionals as well as managerial leadership qualities, and may help leaders working in acute or rehabilitation hospitals to develop appropriate interventions.

Development and psychometric testing of an observation-based assessment tool focusing on work-related stressors among health professionals: the STRAIN-External Observation of work Stressors.

BACKGROUND: Health professionals are especially affected by various stressors in their daily work, such as a high workload, physical and emotional challenges. The aim of this study was to develop and test the validity, reliability and usability of an observation-based instrument designed to assess work stressors in the healthcare sector. METHODS: Using a cross sectional design, 110 health professionals were observed during one entire shift by an external observer. Factor analysis was used to test construct validity, Cronbach's alpha to test internal consistency and correlations using Kendall's Tau were computed to test for convergent validity. RESULTS: For 9 out of 10 tested scales the results showed a one-factor solution for all observation scales (explained variance ranged from 55.5 to 80.2%), satisfactory reliability (Cronbach's alpha between .67 and .92), sufficient usability and satisfactory convergent validity. CONCLUSIONS: The newly developed STRAIN-EOS, an observation-based assessment tool designed to assess stressors specifically in the healthcare sector, was shown to be potentially useful. However, further refinement and testing is necessary before it can be widely used.

Investigating work-related stress among health professionals at different hierarchical levels: A cross-sectional study.

Aim: To determine the extent of stress at work among health professionals working in upper-, middle- and lower-management positions and those not working in management positions. Design: Cross-sectional design and randomly selected hospitals, nursing homes and home care organizations. Methods: The study sample included nursing staff and midwives, physicians, medical-technical and medical-therapeutic professionals at all hierarchical levels (N = 8,112). Data were collected using self-report questionnaires and analysed using multiple regression models. Results: Health professionals in upper- and middle-management positions reported higher quantitative demands, severe work-private life conflicts (p < .05) as well as less role clarity in middle-management positions (B = -1.58, p < .05). In lower-management positions, health professionals reported higher physical (B = 3.80, p < .001) and emotional demands (B = 1.79, p < .01), stress symptoms (B = 1.81, p < .05) and job dissatisfaction (B = -1.17, p < .05). Health professionals without management responsibilities reported the poorest working conditions in relation to various stressors, job satisfaction (B = -5.20, p < .001) and health-related outcomes (e.g. burnout symptoms: B = 1.89, p < .01).

Nurse managers: Determinants and behaviours in relation to patient and visitor aggression in general hospitals. A qualitative study.

AIM(S): To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals. BACKGROUND: Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored. DESIGN: A qualitative descriptive study underpinned by the Reasoned Action Approach. METHOD(S): Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis. FINDINGS: We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments". CONCLUSION(S): Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff.