How Do Employees Understand Negative Leadership? The Non-linear Relationship Between Abusive Supervision and Employee Innovation Behavior: Job Performance as a Moderator.

This study aims to investigate the non-linear relationship between abusive supervision and employee innovation behavior and further examine how job performance moderates this relationship. Two hundred and seventy-six employees across three industries (restaurant service, tourism, and financial service) in China participated in this study and completed the survey at two time points. The results of curve regression show as follows: (1) There exists a non-linear relationship between abusive supervision and innovation behavior, and (2) job performance moderates the non-linear relationship between abusive supervision and employee innovation behavior. For employees who perform well at work, there exists a U-shaped relationship between abusive supervision and innovative behavior. Whereas, for employees with poor job performance, when abusive supervision reaches a certain level, it will promote employee innovation behavior; and the excess of abusive supervision will inhibit employee innovation behavior, showing an inverted U-shaped curve relationship. The finding suggests it is important for managers to understand the stakes arising from abusive supervision. That is, managers should manipulate the right level of abuse supervision to promote employee innovation behavior.

Environmental stressors and well-being on middle-aged and elderly people: the mediating role of outdoor leisure behaviour and place attachment.

This study develops a relational model of how environmental stressors, place attachment and outdoor leisure are related to urban green zones and, accordingly, Fujian Province in China is studied as our case problem. The research is participated by primarily middle-aged and elderly residents. In total, 871 valid questionnaires are retrieved. Structural equation modelling and path analysis are used to verify the model's fitness. The results indicate that environmental stressors and outdoor leisure are significantly negatively correlated. In addition, the outdoor leisure and place attachment are significantly positively correlated. As such, the place attachment and well-being are significantly positively correlated. However, the place attachment and outdoor leisure mediated the relationship between environmental stressors and well-being. The mediating path indicated that middle-aged and elderly residents face severe environmental stressors and will engage in a few outdoor leisure activities, resulting in low well-being. Furthermore, when middle-aged and elderly residents face severe environmental stressors, they have increased place attachment, thereby increasing their well-being. The findings can serve as a reference for environmental management agencies and future researchers.

Exploring Links between Polychronicity and Job Performance from the Person-Environment Fit Perspective-The Mediating Role of Well-Being.

Polychronicity refers to the preference of some individuals to structure their time in order to deal with multiple tasks simultaneously in a short period of time. Past research regarding the correlation between individual polychronicity and performance presented distinct arguments. Although most studies supported a positive correlation with performance, empirical findings showed inconsistent results, indicating the presence of other influencing factors. According to the person-environment fit theory and self-determination theory, the effect of polychronicity on job performance was verified and the mediation effect of well-being was tested in this study. Dual-mode questionnaires were collected from 532 subordinators and their direct supervisors in 98 chain restaurants and hierarchical regression analysis was performed to test the research hypotheses. The results showed that polychronicity positively affected well-being, that is, well-being was a full mediator between polychronicity and job performance. This study provides valuable insight for managers to understand employee polychronicity and, in turn, improve their well-being, which could help improve job performance.

Prolonged touch screen device usage is associated with emotional and behavioral problems, but not language delay, in toddlers.

BACKGROUND: Touch screen devices are now ubiquitous, and their usage by young children is increasing. However, the effects of these devices on young children are still unknown. Therefore, this study aimed to address the associations of touch screen device exposure with symptomatic emotional and behavioral problems and language development in children between the ages of 18 and 36 months. METHOD: A total of 161 primary caregivers of children between the ages of 18 and 36 months were recruited from the pediatric ward and outpatient clinic at a medical center in southern Taiwan. All caregivers were asked to fill out the Child Behavior Checklist for Ages 1½-5 (CBCL 1½-5) and a questionnaire on basic personal information and touch screen device usage, and they were also interviewed with the Communication and Language Screening Test for Birth to Three Chinese-Speaking Infant-Toddlers (CLST). Independent t-test and one-way ANOVA were used to examine the differences among the categories in the demographic variables and to characterize the touch screen device usage behaviors. Pearson's correlation was used to analyze the relationship between language delay and the extent of touch screen device exposure. After primary univariate analysis, we used multiple regression models to examine the relationships among the effects of touch screen device usage behaviors on children's emotional and behavioral problems and language development. RESULT: The children's mean age was 25.63 months (SD = 5.35). Children who spent more time on touch screen devices were more likely to have emotional problems (ß = .219, p < .010, 95 % CI: .279-1.518), anxious/depressive symptoms (ß = .206, p < .050, 95 % CI: .170-1.244), somatic complaints (ß = .291, p < .001, 95% CI: .455-1.462), social withdrawal symptoms (ß = .194, p < .050, 95 % CI: 0.133-1.150), attention problems (ß = .300, p < .001, 95 % CI: .432-1.267), and aggressive behaviors (ß = .247, p < .010, 95 % CI: .967-3.983). The effects were not noted on language development (ß = -.136, p < .100, 95 % CI: -2.595-.147). CONCLUSION: Young children who spent more time on touch screen devices were more likely to have emotional problems, anxious/depressive symptoms, somatic complaints, social withdrawal symptoms, attention problems, and aggressive behaviors, but not language delay.

Emotional Labor in Health Care: The Moderating Roles of Personality and the Mediating Role of Sleep on Job Performance and Satisfaction.

The objective of this study is to investigate the effects of emotional labor on job performance and satisfaction, as well as to examine the mediating effect of sleep problems and the moderating effects of personality traits. A time-lagged study was conducted on 864 health professionals. Scales for emotional labor, sleep, personality traits, and job satisfaction were used and job performance data was obtained from records maintained by human resources. Structural equation modeling was performed to investigate the relations. Sleep problems only partially mediated the relationship between surface acting and job satisfaction but completely mediated the relationship between surface acting and job performance. Several personality traits were shown to moderate the relationship between surface acting and sleep problems. The effects were stronger for people with low agreeableness and high neuroticism. The relationship between high levels of deep acting and low levels of sleep problems was more pronounced in individuals with low extraversion. Supervisors should be conscious of emotional labor in the work context and provide necessary deep acting training to facilitate emotional regulation.

Effectiveness of early rehabilitation on patients with chronic obstructive lung disease and acute respiratory failure in intensive care units: A case-control study.

The effect of early rehabilitation on the outcome of patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF) in intensive care units (ICUs) remains unclear. We examined the effect of early rehabilitation on the outcomes of COPD patients requiring mechanical ventilation (MV) in the ICU. This retrospective, observational, case-control study was conducted in a medical center with a 19-bed ICU. The records of all 105 ICU patients with COPD and ARF who required MV from January to December 2011 were examined. The outcomes (MV duration, rates of successful weaning and survival, lengths of ICU and hospital stays, and medical costs) were recorded and analyzed. During the study period, 35 patients with COPD underwent early rehabilitation in the ICU and 70 demographically and clinically matched patients with similar COPD stage, cause of intubation, type of respiratory failure, and levels of disease severity who had not undergone early rehabilitation in the ICU were selected as comparative controls. Multiple regression analysis showed that early rehabilitation was significantly negatively associated with MV duration. Early rehabilitation for COPD patients in the ICU with ARF shortened the duration of their MV.

Isocapnic buffering phase: a useful indicator of exercise endurance in patients with coronary artery disease.

OBJECTIVES: The significance of the isocapnic buffering (IB) phase - the period between the first ventilatory threshold (1st VT) and respiratory compensation point (RCP) - has not been adequately established in patients. This study aimed to determine the clinical significance of the IB phase in patients with coronary artery disease (CAD). METHODS: This retrospective study included data of sixty-two CAD patients after coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) performed in a single medical center between 2010 - 2014. According to their physical conditions, the patients performed incremental cardiopulmonary exercise test (CPET) using a cycle ergometer by the ramp of 5-20 W/min. Correlations between the corrected IB phase duration and age, body mass index (BMI), left ventricular ejection fraction (LVEF), and CPET parameters were evaluated using Pearson correlation coefficients. Variables predicting peak oxygen consumption (VO2) were evaluated using multiple regression. RESULTS: Peak VO2 (p < 0.001), VO2 at RCP (p < 0.001), ∆O2/∆WR slope (p < 0.001), maximal partial pressure of end tidal CO2 (PetCO2) (p = 0.0012), VE/VCO2 slope (p = 0.010), BMI (p = 0.012), and age (p = 0.017) were significantly correlated, whereas LVEF (p = 0.246) and VO2 at 1st VT (p = 0.179) were not significantly correlated with the corrected IB phase duration. In multiple regression analysis, the corrected IB phase duration, VO2 at 1st VT, and ∆O2/∆WR slope were significantly associated with peak VO2. CONCLUSION: The findings indicate that the IB phase duration is a useful indicator of peripheral cardiopulmonary function and endurance performance in CAD patients. These findings could assist the exercise prescription of cardiac rehabilitation for patients with CAD.

Outcomes of patients with severe influenza infection admitted to intensive care units: a retrospective study in a medical centre.

PURPOSE: This study assessed clinical manifestations and prognostic factors of critically ill patients with severe influenza admitted to the intensive care unit (ICU) in Taiwan's recent outbreak. METHODOLOGY: Patients admitted to ICU for severe influenza between January 1, 2015, and March 31, 2016, were identified and their medical records were retrospectively reviewed. The primary endpoints were outcomes and predictors of in-hospital mortality. RESULTS: There were 125 patients with an average Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 20.8. Hypertension (62.4 %) and diabetes mellitus (40.8 %) were the two most common underlying diseases. Ninety-eight (78.4 %) patients had at least one organ failure: the lungs were the most common (71.2 %), followed by the heart (53.6 %). Two of the most common symptoms of patients at ICU admission were fever (68.0 %) and cough (78.4 %). Thirty-three patients (26.4 %) died; most (40.9 %) were middle-aged (50-65 years old). A Cox regression analysis showed that multiple organ failure (MOF) [hazard ratio (HR)=3.618; 95 % CI=1.058-13.662] was significantly associated with higher risk of death. In contrast, a fluid-negative balance within 7 days of admission (HR=0.362; 95 % CI=0.140-0.934) was significantly associated with a lower risk of death. CONCLUSION: The mortality rate of severe influenza patients admitted to the ICU was high, especially in middle-aged adults. The risk of mortality was associated with ≥2 organ failures. A negative fluid balance predicts survival.

Early Mobilization Reduces Duration of Mechanical Ventilation and Intensive Care Unit Stay in Patients With Acute Respiratory Failure.

OBJECTIVE: To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). DESIGN: A retrospective observational study. SETTING: Nineteen-bed ICU at a medical center. PARTICIPANTS: Adults patients with MV (N=153) admitted to a medical ICU. INTERVENTIONS: A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible. MAIN OUTCOME MEASURES: MV duration, rate of successful weaning, and length of ICU and hospital stay. RESULTS: We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P<.001) and ICU stays (6.9d vs 9.9d; P=.001) than did before protocol group patients. Early mobilization was negatively associated with the duration of MV (ß=-.269; P<.002; 95% confidence interval [CI], -4.767 to -1.072), and the risk of MV for ≥7 days was lower in patients who underwent early mobilization (odds ratio, .082; 95% CI, .021-.311). CONCLUSIONS: The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes.

The moderating effect of leadership on the relationship between personality and performance.

AIM: To examine how personality and leadership influence efficiency in the nursing service environment. BACKGROUND: Leadership and personality contribute to the success and failure of a unit. However, how they interact to influence performance is still understudied. METHODS: We used matched pairs sample design to survey 135 head nurses and 1353 registered nurses on validated instruments of demographic characteristics, leadership styles and personality during June and July of 2014. Efficiency was calculated using Data Envelopment Analysis. Tobit regression was used for analysis. RESULTS: High conscientiousness and low neuroticism were significantly associated with higher efficiency. Particularly, under the initiating structure leadership style, high conscientiousness, high extraversion, high agreeableness, high openness and low neuroticism were related to higher efficiency. Openness would improve efficiency under a low consideration leadership style. CONCLUSIONS: Most personality traits were related to higher efficiency under the initiating leadership style. Only openness would improve leaders' efficiency under a high initiating structure and a low consideration leadership style. IMPLICATIONS FOR NURSING MANAGEMENT: Considering personality as one factor of selecting head nurses, selecting the right person can improve the fit between individuals and organisations, which in turn, improves job performance. Training head nurses to develop better leadership styles in nurses is another way to enhance efficiency.

Can Early Rehabilitation after Total Hip Arthroplasty Reduce Its Major Complications and Medical Expenses? Report from a Nationally Representative Cohort.

OBJECTIVE: To investigate whether early rehabilitation reduces the occurrence of posttotal hip arthroplasty (THA) complications, adverse events, and medical expenses within one postoperative year. METHOD: We retrospectively retrieve data from Taiwan's National Health Insurance Research Database. Patients who had undergone THA during the period from 1998 to 2010 were recruited, matched for propensity scores, and divided into 2 groups: early rehabilitation (Early Rehab) and delayed rehabilitation (Delayed Rehab). RESULTS: Eight hundred twenty of 999 THA patients given early rehabilitation treatments were matched to 205 of 233 THA patients given delayed rehabilitation treatments. The Delayed Rehab group had significantly (all p < 0.001) higher medical and rehabilitation expenses and more outpatient department (OPD) visits than the Early Rehab group. In addition, the Delayed Rehab group was associated with more prosthetic infection (odds ratio (OR): 3.152; 95% confidence interval (CI): 1.211-8.203; p < 0.05) than the Early Rehab group. CONCLUSIONS: Early rehabilitation can significantly reduce the incidence of prosthetic infection, total rehabilitation expense, total medical expenses, and number of OPD visits within the first year after THA.