Temporal work stressors and satisfaction with work, life and health among health professionals in Switzerland.

BACKGROUND: Working in a hospital can be both rewarding and stressful. Whether one or the other is dominant depends on a number of factors ranging from shift work, physical demands, responsibilities and time pressure to job autonomy, work climate and leisure time. AIM: This study aimed to examine associations between temporal work stressors and satisfaction with work, life and health among health professionals in general, and nurses and physicians in particular. Associations were further investigated for possible mediating and intervening factors. METHODS: Cross-sectional survey data on 1232 health professionals at three public hospitals and two rehabilitation clinics were collected in 2015/2016. Stepwise multiple linear regression analyses were used to estimate the standardised effects (beta coefficients) of temporal work stressors (overtime and time pressure), and organisational and personal resources (job autonomy, work climate, internal control belief) on general stress as the assumed mediator and finally on satisfaction with work, life and health. RESULTS: Temporal work stressors were found to strongly predict general stress symptoms among health professionals (ß = 0.25) and particularly physicians (ß = 0.30), independently of the observed stress-buffering effects of organisational resources such as job autonomy (ß = −0.09) or work climate (ß = −0.22). Associations between temporal work stressors (as predictors) and satisfaction with work, life and health (as outcomes) turned out to be mostly indirect, mediated by general stress. General stress in turn was observed to be the strongest predictor of domain-specific satisfaction (ß = −0.17 to −0.34), sometimes only surpassed by resources such as work climate or internal control belief. Explained variance of the three satisfaction outcomes in the fully specified regression or explanatory models ranged between 14% and 45% depending on the (sub-)sample (nurses, physicians, all health professionals) or the outcome. Control belief was revealed to be a strong and independent personal resource, particularly regarding satisfaction with life and health in general (ß = 0.25/0.21). CONCLUSION: Satisfaction and well-being of health professionals are strongly affected by job stressors such as frequent or excessive overtime work or permanent time pressure at work. Negative consequences of temporal work stressors are attenuated by organisational and personal resources such as a high level of job autonomy, a good work climate or a strong internal control belief.

Predictors of Presenteeism Among Hospital Employees-A Cross-Sectional Questionnaire-Based Study in Switzerland.

OBJECTIVE: The aim of this cross-sectional study was to examine work- and person-related predictors of the largely "invisible" behavior and phenomenon of presenteeism among employees in a health-care setting in German-speaking Switzerland. METHODS: Self-reported survey data from 1840 employees of four hospitals and two rehabilitation clinics collected in 2015 and 2016 were utilized and analyzed. RESULTS: All studied work-related factors such as patient contact, job satisfaction, high work load, forced overtime, fear of job-loss, and particularly mental strain turned out to be significant and relevant predictors of presenteeism. Younger employees, female workers, and employees with a chronic disease also were more likely to show presenteeism. CONCLUSION: Work stress, work without patients, job dissatisfaction, a chronic disease, and/or a younger age or rather less work experience seem to increase the chances of presenteeism among health-care workers.

Assessing adherence to multiple medications and in daily life among patients with multimorbidity.

OBJECTIVE: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity). DESIGN: Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires. A randomly assigned subsample additionally completed a 30-day daily diary. MAIN OUTCOME MEASURE: The Non-Adherence Report; a brief self-report measure of adherence to each prescribed medication (NAR-M), and in daily life. We further assessed the Medication Adherence Report Scale (MARS), and a subsample of participants were randomised to electronic adherence monitoring. RESULTS: The NAR-M indicated M = 94.7% adherence at Time 1 (SD = 9.3%). The NAR-M was significantly correlated with the MARS (rt1 = .52, rt2 = .57, and rt3 = .65; p < .001), and in tendency with electronically assessed adherence (rt2 = .45, rt3 = .46, p < .10). Variance components analysis indicated that between-person differences accounted for 10.2% of the variance in NAR-M adherence rates, whereas 22.9% were attributable to medication by person interactions. CONCLUSION: This study highlights the importance and feasibility of studying adherence to multiple medications differentially, and in daily life. Future studies may use these measures to investigate within-person and between-medication differences in adherence.