Healthcare managers' experiences of technostress and the actions they take to handle it - a critical incident analysis.

BACKGROUND: Healthcare managers, in comparison with other healthcare professionals, have an increased likelihood of experiencing technostress at work. Since knowledge about the causes and severity of technostress and about the strategies healthcare managers use to handle it is limited, the aim of this study was to describe their experience of technostress and the actions they employ to address it. METHODS: An explorative design based on the critical incident technique was used. In total, 20 healthcare managers (10 women, 10 men) from four hospitals in two county councils in Sweden were purposively selected according to professional background, hierarchical management position, control span, time in the management position, and sex. Semi-structured interviews with regard to critical incidents and actions taken to handle technostress were conducted. RESULTS: Healthcare managers' experiences of technostress (n = 279) were categorised related to three main areas. These involved 'negative aspects of digital communication' (e.g. high workload, invasion of private life, and negative feelings related to digital communication), 'poor user experience of ICT systems (such as illogicality of the ICT system, time-consuming ICT system, or malfunctioning ICT system) and 'needs to improve organisational resources' (e.g. needs associated with digital literacy, user influence and distribution of work and ICT systems). Actions taken to handle technostress (n=196) were described relating to three main areas involving 'culture, norms and social support' (such as good email culture, and co-worker support), 'individual resources' (e.g. individual strategies and competence) and 'organisational resources' (such as IT-related assistance and support). CONCLUSIONS: Healthcare managers described negative aspects of digital communication, poor user experience of ICT systems, and lack of organisational resources as potential technostress creators. These problems were handled by taking action related to culture, norms and social support, and individual as well as organisational resources. All these features, along with consideration of healthcare managers' job demands and resources in general, should be incorporated into actions monitored by healthcare organisations to improve or maintain a sustainable digitalised environment for healthcare managers. TRIAL REGISTRATION: Regional Ethics Board in Linköping #2017/597-31. Registered 20 March 2018. URL not available.

Repeated exposure to high ICT demands at work, and development of suboptimal self-rated health: findings from a 4-year follow-up of the SLOSH study.

PURPOSE: The knowledge about the association between Information and Communication Technology (ICT) demands at work and self-rated health (SRH) is insufficient. The aim of this study was to examine the association between repeated exposure to high ICT demands at work, and risk of suboptimal SRH, and to determine modifications by sex or socioeconomic position (SEP). METHODS: A prospective design was used, including repeated measurement of ICT demands at work, measured 2 years apart. SRH was measured at baseline and at follow-up after 4 years. The data were derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including 4468 gainfully employees (1941 men, 2527 women) with good SRH at baseline. RESULTS: In the total study sample, repeated exposure to high ICT demands at work was associated with suboptimal SRH at follow-up (OR 1.34 [CI 1.06-1.70]), adjusted for age, sex, SEP, health behaviours, BMI, job strain and social support. An interaction between ICT demands and sex was observed (p = 0.010). The risk was only present in men (OR 1.53 [CI 1.09-2.16]), and not in women (OR 1.17 [CI 0.85-1.62]). The risk of suboptimal SRH after consistently high ICT demands at work was most elevated in participants with high SEP (OR 1.68 [CI 1.02-2.79]), adjusted for age, sex, health behaviours, BMI and job strain. However, no significant interaction between ICT demands and SEP regarding SRH was observed. CONCLUSION: Repeated exposure to high ICT demands at work was associated with suboptimal SRH at follow-up, and the association was modified by sex.

Information about first-trimester screening and self-reported distress among pregnant women and partners - comparing two methods of information giving in Sweden.

INTRODUCTION: Balanced information before prenatal diagnosis (PND) aims to help expectant parents to make an informed choice. However, it is important that the information does not increase the expectant parents' psychological distress. The aim was to examine psychological distress among expectant parents, before and after receiving information about PND, to evaluate the possible differences between two different procedures of information giving, and to evaluate the association between satisfaction with the information and psychological distress. MATERIAL AND METHODS: A longitudinal design, based on questionnaire data from 380 expectant parents from four counties in Sweden. The measurement points; T1, before the information about PND was given and T2, 2 weeks after the prenatal screening or 15 weeks of gestation. The Hospital Anxiety and Depression Scale (HADS) and the Swedish version of the Cambridge Worrying Scale (CWS) measured psychological distress. The Satisfaction with Genetic Counseling Scale (SCS) measured satisfaction with information about PND. RESULTS: The rate of psychological distress was stable among the pregnant women, but decreased among their partners, after the information was received. General anxiety and the social-medical dimension of pregnancy-related worry decreased among the participants who received information, using the more distinct two-stage process (group A), but was unchanged in group B (less distinct two-stage process). Health-related worry decreased in both groups, whereas relational worry and level of depressive symptoms were unchanged in both groups. CONCLUSION: Information about PND does not increase the psychological distress among expectant parents. A more distinct two-stage process of information giving might even decrease their anxiety.

Information and communication technology demands at work: the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata.

PURPOSE: The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-related stress measures and self-rated health, in general and in different SES strata. METHODS: This study is based on cross-sectional data from the Swedish Longitudinal Occupational Survey of Health collected in 2014, from 14,873 gainfully employed people. ICT demands, job strain, ERI and self-rated health were analysed as the main measures. Sex, age, SES, lifestyle factors and BMI were used as covariates. RESULTS: ICT demands correlated significantly with the dimensions of the job strain and ERI models, especially with the demands (r = 0.42; p < 0.01) and effort (r = 0.51; p < 0.01) dimensions. ICT demands were associated with suboptimal self-rated health, also after adjustment for age, sex, SES, lifestyle and BMI (OR 1.49 [95 % CI 1.36-1.63]), but job strain (OR 1.93 [95 % CI 1.74-2.14) and ERI (OR 2.15 [95 % CI 1.95-2.35]) showed somewhat stronger associations with suboptimal self-rated health. CONCLUSION: ICT demands are common among people with intermediate and high SES and associated with job strain, ERI and suboptimal self-rated health. ICT demands should thus be acknowledged as a potential stressor of work-related stress in modern working life.

The Association between Job Strain and Atrial Fibrillation: Results from the Swedish WOLF Study.

INTRODUCTION: Atrial fibrillation (AF) is a common heart rhythm disorder. Several life-style factors have been identified as risk factors for AF, but less is known about the impact of work-related stress. This study aims to evaluate the association between work-related stress, defined as job strain, and risk of AF. METHODS: Data from the Swedish WOLF study was used, comprising 10,121 working men and women. Job strain was measured by the demand-control model. Information on incident AF was derived from national registers. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and AF risk. RESULTS: In total, 253 incident AF cases were identified during a total follow-up time of 132,387 person-years. Job strain was associated with AF risk in a time-dependent manner, with stronger association after 10.7 years of follow-up (HR 1.93, 95% CI 1.10-3.36 after 10.7 years, versus HR 1.11, 95% CI 0.67-1.83 before 10.7 years). The results pointed towards a dose-response relationship when taking accumulated exposure to job strain over time into account. CONCLUSION: This study provides support to the hypothesis that work-related stress defined as job strain is linked to an increased risk of AF.