The influence of transformational leadership on employee well-being: results from a survey of companies in the information and communication technology sector in Germany.

OBJECTIVE: The aim of this study was to investigate the impact of a transformational leadership style on employee well-being. METHODS: Data for the study were taken from an on-line survey of all employees from six German companies in the information and communication technology sector. The data obtained were analyzed using multiple logistic regressions. RESULTS: Analysis of data from a total of 318 employees (response rate 58.4%) revealed a significant relationship between transformational leadership and employee well-being (P = 0.00; OR = 1.13; 95% CI = 1.05 to 1.22). A higher degree of perceived transformational leadership is associated with greater well-being. CONCLUSIONS: The results of this study suggest that a transformational leadership style, which both conveys a sense of trust and meaningfulness and individually challenges and develops employees, also has a positive effect on employee well-being.

[Work engagement of hospital physicians: do social capital and personal traits matter?]. / Work Engagement von Krankenhausärzten: Welche Rolle spielen Sozialkapital und Persönlichkeitseigenschaften?

Work engagement has been proven to be a viable indicator of physical and mental well-being at work. Research findings have shown a link between work engagement and both individual and organizational resources. The aim of the present study is to test the hypothesized relationships between personal traits (Big-5), the quality of the social work environment (social capital) and work engagement among hospital (n=35) physicians (n=387) in North-Rhine-Westphalia, Germany. Structural equation modeling (SEM), combining confirmatory factor analysis (CFA) and path analysis, was employed to conduct the statistical analyses. The results of the SEM indicated that social capital and neuroticism were significantly associated with work engagement. The relationship between agreeableness and work engagement was fully mediated by social capital. Findings suggest that social capital plays a key role in promoting work engagement of physicians.

Employees' negative and positive work-home interaction and their association with depressive symptoms.

BACKGROUND: Depression is the leading cause of disability and high costs worldwide. One possibility for preventing depression in the workplace, which has received little consideration so far, is the promotion of a successful balance between work and personal life. The aim of this study was to investigate employees' negative and positive work-home interaction and their association with depressive symptoms. METHODS: A cross-sectional study was conducted in the micro- and nanotechnology sector in Germany. A stepwise multivariate logistic regression analysis was performed using data from N = 213 employees. RESULTS: The results suggest that while negative work-home interaction is associated with an increased risk for depressive symptoms, positive work-home interaction is correlated with a lower risk. Neither positive nor negative interaction in the home-to-work direction demonstrated a significant association with depressive symptoms. CONCLUSION: When attempting to prevent mental illnesses, such as depression, it is important to develop strategies aimed at reducing conflict between work and personal life and promoting a positive exchange between these two domains.

Work-life balance culture, work-home interaction, and emotional exhaustion: a structural equation modeling approach.

OBJECTIVE: To examine the relationships among employees' emotional exhaustion, positive and negative work-home interaction, and perceived work-life balance culture in companies. METHODS: Data for this study were collected through online surveys of employees from companies in the micro- and nanotechnology sectors (N = 509). A structural equation modeling analysis was performed. RESULTS: A company culture perceived by employees as supportive of their work-life balance was found to have both a direct negative effect on emotional exhaustion and an indirect negative effect meditated by negative work-home interaction. In addition, whereas negative work-home interaction associated positively with emotional exhaustion, positive work-home interaction had no significant effect. CONCLUSIONS: The direct and indirect relationship between work-life balance culture and emotional exhaustion has practical implications for health promotion in companies.

The association between active participation in a sports club, physical activity and social network on the development of lung cancer in smokers: a case-control study.

BACKGROUND: This study analyses the effect of active participation in a sports club, physical activity and social networks on the development of lung cancer in patients who smoke. Our hypothesis is that study participants who lack social networks and do not actively participate in a sports club are at a greater risk for lung cancer than those who do. METHODS: Data for the study were taken from the Cologne Smoking Study (CoSmoS), a retrospective case-control study examining potential psychosocial risk factors for the development of lung cancer. Our sample consisted of n = 158 participants who had suffered lung cancer (diagnosis in the patient document) and n = 144 control group participants. Both groups had a history of smoking.Data on social networks were collected by asking participants whether they participated in a sports club and about the number of friends and relatives in their social environment. In addition, sociodemographic data (gender, age, education, marital status, residence and religion), physical activity and data on pack years (the cumulative number of cigarettes smoked by an individual, calculated by multiplying the number of cigarettes smoked per day by the number of years the person has smoked divided by 20) were collected to control for potential confounders. Logistic regression was used for the statistical analysis. RESULTS: The results reveal that participants who are physically active are at a lower risk of lung cancer than those who are not (adjusted OR = 0.53*; CI = 0.29-0.97). Older age and lower education seem also to be risk factors for the development of lung cancer. The extent of smoking, furthermore, measured by pack years is statistically significant. Active participation in a sports club, number of friends and relatives had no statistically significant influence on the development of the cancer. CONCLUSIONS: The results of the study suggest that there is a lower risk for physically active participants to develop lung cancer. In the study sample, physical activity seemed to have a greater protective effect than participation in a sports club or social network of friends and relatives. Further studies have to investigate in more detail physical activity and other club participations.

Exploring the association between social capital and depressive symptoms: results of a survey in German information and communication technology companies.

OBJECTIVE: This study examines the association between social capital at work and depressive symptoms in employees. METHODS: Data for this cross-sectional study were collected through an online survey with the full population of employees from six companies in the German information and communication technology sector (response rate: 58.4%). A multivariate logistic regression analysis was performed. RESULTS: Results of data from a total of 328 employees suggest that, after controlling for sociodemographic factors, health awareness, and job strain, lower levels of perceived social capital at work are associated with the experience of depressive symptoms (OR = 0.76; 95% CI: 0.64-0.90). CONCLUSIONS: Our findings suggest that characteristics of high social capital at work, such as an established environment of trust and a sense of common values and convictions, could be an essential resource for preventing depressive disorders.

Effect of guideline orientation on the outcomes of peripheral arterial disease in primary care.

OBJECTIVE: Peripheral arterial disease (PAD), an established marker of premature death and cardiovascular risk in general, is highly prevalent. We analysed factors associated with poor outcomes in an observational cohort, with particular focus on the effect of guideline orientation in the management of these patients. METHODS: PACE-PAD is a multicentre, prospective, observational study of PAD patients in primary care. PAD guideline orientation was stated, if patients received the following: exercise training, (if applicable) advice for smoking cessation and diet, therapy for diabetes mellitus, hypertension, hypercholesterolaemia, or antiplatelets/anticoagulants. Multivariate regression models were applied to assess factors associated with all cause death, cardiovascular/cerebrovascular death, or cardiovascular/cerebrovascular/peripheral vascular non-fatal events. RESULTS: After an 18-month follow-up, of the 5099 PAD patients analysed (mean age 68.0 ± 9.0 years, 68.5% males), only 28.4% of patients met all applicable quality indicators for guideline-oriented treatment. However, most patients were to a large extent managed in line with guidelines. While exercise training was reported in 41.8%, rates were very high for smoking cessation (90.7%), therapy for hypertension (92.5%), diabetes mellitus (82.0%), hypercholesterolemia (83.3%) and antiplatelet therapy (86.7%). Regarding events, there were inhomogeneous results with a statistically significant higher rate of cardiovascular/cerebrovascular deaths and all-cause deaths, but a lower rate of non-fatal vascular events in patients treated according to guidelines compared to those who were not. Limitations of this study include the open, non-controlled design, possible patient selection bias and misclassification of events. CONCLUSION: Even if the guideline orientation for the various indicators was remarkably stable across the three follow-up visits, the rate of patients comprehensively treated according to the guidelines was relatively low, which calls for optimisation. There was a lack of differentiation between the guideline-oriented and non-guideline-oriented therapy in terms of outcomes, which may be due to patient-related or other factors, and warrants further research.

The relationship between perceived social capital and the health promotion willingness of companies: a systematic telephone survey with chief executive officers in the information and communication technology sector.

OBJECTIVE: This study examines the association between perceived social capital and health promotion willingness (HPW) of companies from a chief executive officer's perspective. METHODS: Data for the cross-sectional study were collected through telephone interviews with one chief executive officer from randomly selected companies within the German information and communication technology sector. A hierarchical multivariate logistic regression analysis was performed. RESULTS: Results of the logistic regression analysis of data from a total of n = 522 interviews suggest that higher values of perceived social capital are associated with pronounced HPW in companies (odds ratio = 3.78; 95% confidence intervals, 2.24 to 6.37). CONCLUSIONS: Our findings suggest that characteristics of high social capital, such as an established environment of trust as well as a feeling of common values and convictions could help promote HPW.

The relationship between social capital in hospitals and emotional exhaustion in clinicians: a study in four German hospitals.

BACKGROUND: About 30% of doctors working in inpatient and outpatient departments suffer from burnout, characterized, for example, by emotional exhaustion. The prevention of burnout constitutes a great challenge for those responsible for the healthcare system. AIMS: Research into the relationship between social capital in hospitals and the occurrence of emotional exhaustion in clinicians is still at an early stage. The aim of the current study is to examine the effects of social capital in the workplace on the emotional exhaustion of clinicians. METHOD: A questionnaire was posted to 2,644 employees working in four German hospitals, and 1,645 responded. Responses from the 277 clinicians (61%) are analyzed here. The questionnaire looked at symptoms of emotional exhaustion and levels of organizational social capital. RESULTS: Logistic regression identified two significant predictors of emotional exhaustion in clinicians: low self-efficacy and subjectively perceived lower levels of social capital in the hospitals where they worked. The model accounted for 26 % of Nagelkerke's R(2). CONCLUSION: Efforts to create a good working atmosphere, with the readiness to provide mutual support and the pursuit of joint values and objectives within a hospital, may reduce the development of, or even prevent, emotional exhaustion in clinicians.

Burnout in nurses - the relationship between social capital in hospitals and emotional exhaustion.

AIMS: The aim of this study is to examine the relationship between a hospital's social capital, individual decision latitude, workload and emotional exhaustion in nurses, controlling for age, sex, years of professional experience and job tenure. BACKGROUND: In western countries between 15-45% of nurses working in hospitals suffer from burnout, characterised by emotional exhaustion, depersonalisation and decreased personal performance. The prevention of burnout constitutes a great challenge to those responsible for the health care system, not least because burnout may cause increasing turnover rates in nurses and lead to medical mistakes. DESIGN: Survey. METHOD: A questionnaire was mailed to 1325 nurses working at four hospitals in east and west Germany in 2002. Nine hundred and fifty nine nurses responded (response rate: 72.4%). RESULTS: Logistic regression identified three significant predictors of emotional exhaustion in nurses: workload (OR: 4.523, CI: 3.230-6.333) was positively associated with emotional exhaustion. Decision latitude (OR: 0.376, CI: 0.254-0.557) and social capital in the hospitals (OR: 0.549, CI: 0.403-0.746) were negatively associated with emotional exhaustion. Emotional exhaustion was not affected by age, sex, years of professional experience and job tenure. Nagelkerke's Pseudo R(2) was 0.225. CONCLUSIONS: The findings underline the importance of social capital and organisational development in hospital management. RELEVANCE TO CLINICAL PRACTICE: Efforts to create a good working atmosphere with readiness to provide mutual support and the pursuit of joint values in a hospital, the reduction of workload and increased decision latitude may prevent the development of emotional exhaustion in nurses.

Associations between emotional exhaustion, social capital, workload, and latitude in decision-making among professionals working with people with disabilities.

BACKGROUND: Many people working in human services in Western countries suffer from burnout, characterized by emotional exhaustion, depersonalization, and decreased personal performance. Prevention of emotional exhaustion (the first phase of burnout) constitutes a great challenge because emotional exhaustion may cause increasing turnover rates in staff and lead to a lesser quality of care. Prevention of emotional exhaustion requires knowledge of its predictors. The aim of this study was to investigate the associations between emotional exhaustion, social capital, workload, and latitude in decision-making among German professionals working in the care of persons with intellectual and physical disabilities. MATERIALS AND METHODS: The study was based on a survey in a sheltered workshop and 5 homes for disabled persons with 175 professionals. Burnout was measured with the German version of the Maslach Burnout Inventory-General Survey (MBI-GS). A multivariate logistic regression analysis was computed. RESULTS: Logistic regression identified the following three significant predictors of emotional exhaustion in the sample: workload (OR, 4.192; CI, 2.136-8.227), latitude in decision-making (OR, 0.306; CI, 0.115-0.811), and male gender (OR, 4.123; CI, 1.796-9.462). Nagelkerke's Pseudo-R(2) was 0.344. CONCLUSIONS: The results of this study demonstrate that specific factors in work organization are associated with emotional exhaustion. Taking into account sociodemographic changes and the upcoming challenges for human services professionals, the results underline the importance of considering aspects of organization at the workplace to prevent burnout. Specific circumstances of male employees must be considered.

Social capital and risk management in nursing.

The purpose of the study was to examine the relationship between social capital and clinical risk management in hospitals from nurses' perspective. The results of our investigation suggest that higher values of social capital are associated with better ratings in clinical risk management behavior. An established atmosphere of trust and a feeling of common values and convictions can help nurses integrate clinical risk management into their daily work.

[Health services research activities in North Rhine-Westphalia. An analysis of the project database health services research NRW]. / Versorgungsforschungsaktivitäten in Nordrhein-Westfalen. Eine Analyse der Projektdatenbank Versorgungsforschung NRW.

BACKGROUND AND PURPOSE: Health services research is gaining increasing importance in the field of public health. To present its activities and findings more clearly, the "Clearingstelle Versorgungsforschung NRW" (clearinghouse health services research North Rhine-Westphalia) has set up a database of projects in the field of health services research in North Rhine-Westphalia. This article is evaluating these projects assigning them to specific medical fields, funding resources, methods of data acquisition and key words. METHODS: In a first step, all institutions and funders in North Rhine-Westphalia acting in the field of health services research have been identified. Those who responded to a standardized questionnaire with a description of their project were included into the database. RESULTS: By the end of May 2008, the project database contained 184 projects. The results demonstrate that health services research activities can be found in all medical fields. Many projects use quantitative as well as qualitative methods. A documentary and secondary data analysis is performed in half of the projects. Concerning the thematic focal point, the present projects show a wide multiplicity. The projects are mainly funded by the ministries of the German Federal Republic, the federal states and the social insurance agencies. In many cases, several institutions are engaged in the funding of one project. CONCLUSION: The evaluation of health services research projects in North Rhine-Westphalia allows a first insight into health services research activities in Germany. The extension of the database and regular analysis of the research activities are considered desirable.

The relationship between social capital in hospitals and physician job satisfaction.

BACKGROUND: Job satisfaction in the hospital is an important predictor for many significant management ratios. Acceptance in professional life or high workload are known as important predictors for job satisfaction. The influence of social capital in hospitals on job satisfaction within the health care system, however, remains to be determined. Thus, this article aimed at analysing the relationship between overall job satisfaction of physicians and social capital in hospitals. METHODS: The results of this study are based upon questionnaires sent by mail to 454 physicians working in the field of patient care in 4 different German hospitals in 2002. 277 clinicians responded to the poll, for a response rate of 61%. Analysis was performed using three linear regression models with physician overall job satisfaction as the dependent variable and age, gender, professional experience, workload, and social capital as independent variables. RESULTS: The first regression model explained nearly 9% of the variance of job satisfaction. Whereas job satisfaction increased slightly with age, gender and professional experience were not identified as significant factors to explain the variance. Setting up a second model with the addition of subjectively-perceived workload to the analysis, the explained variance increased to 18% and job satisfaction decreased significantly with increasing workload. The third model including social capital in hospital explained 36% of the variance with social capital, professional experience and workload as significant factors. CONCLUSION: This analysis demonstrated that the social capital of an organisation, in addition to professional experience and workload, represents a significant predictor of overall job satisfaction of physicians working in the field of patient care. Trust, mutual understanding, shared aims, and ethical values are qualities of social capital that unify members of social networks and communities and enable them to act cooperatively.

Psychometric evaluation of an instrument to assess patient-reported 'psychosocial care by physicians': a structural equation modeling approach.

OBJECTIVE: The objective of our study was to develop a theory-based and empirically tested instrument for measuring patient-reported 'psychosocial care by physicians'. We propose a model integrating patients' perceptions with respect to: (i) devotion by physicians, (ii) support by physicians, (iii) information by physicians and (iv) shared decision-making (SDM). DESIGN: Data were gathered during 2001 within a cross-sectional, retrospective mail survey. PARTICIPANTS AND SETTING: A total of 4192 inpatients of six German hospitals. MAIN OUTCOME MEASURE: Specific scales of the Cologne Patient Questionnaire were used. A two-step structural equation model procedure was applied. In the first structural equation model, all items were modeled as indicators of the intended underlying latent construct, 'psychosocial care by physicians'. In the second structural equation model, criterion-related validity of the intended construct was tested with respect to patients' 'satisfaction', 'trust in physicians' and the 'image of the hospital'. RESULTS: The results confirmed that the aspects of psychosocial care provided by physicians measured by the scale items are indeed indicators of the same construct. Furthermore, indicator reliabilities and selectivities revealed that the content of all 13 items was highly representative of the underlying construct. The second structural equation model showed that 'psychosocial care by physicians' is related to 'patients' satisfaction', 'trust in physicians' and 'hospital-image' in a significant and relevant manner. CONCLUSION: On the basis of our instrument's reported psychometric characteristics and of the initial validity indicators, it may be regarded as an adequate measure for further use in outcome and intervention research, and as a quality indicator for the physician-patient relationship.