Workplace interventions to improve well-being and reduce burnout for nurses, physicians and allied healthcare professionals: a systematic review.

There is a growing need for interventions to improve well-being in healthcare workers, particularly since the onset of COVID-19. OBJECTIVES: To synthesise evidence since 2015 on the impact of interventions designed to address well-being and burnout in physicians, nurses and allied healthcare professionals. DESIGN: Systematic literature review. DATA SOURCES: Medline, Embase, Emcare, CINAHL, PsycInfo and Google Scholar were searched in May-October 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies that primarily investigated burnout and/or well-being and reported quantifiable preintervention and postintervention outcomes using validated well-being measures were included. DATA EXTRACTION AND SYNTHESIS: Full-text articles in English were independently screened and quality assessed by two researchers using the Medical Education Research Study Quality Instrument. Results were synthesised and presented in both quantitative and narrative formats. Meta-analysis was not possible due to variations in study designs and outcomes. RESULTS: A total of 1663 articles were screened for eligibility, with 33 meeting inclusion criterium. Thirty studies used individually focused interventions, while three were organisationally focused. Thirty-one studies used secondary level interventions (managed stress in individuals) and two were primary level (eliminated stress causes). Mindfulness-based practices were adopted in 20 studies; the remainder used meditation, yoga and acupuncture. Other interventions promoted a positive mindset (gratitude journaling, choirs, coaching) while organisational interventions centred on workload reduction, job crafting and peer networks. Effective outcomes were reported in 29 studies, with significant improvements in well-being, work engagement, quality of life and resilience, and reductions in burnout, perceived stress, anxiety and depression. CONCLUSION: The review found that interventions benefitted healthcare workers by increasing well-being, engagement and resilience, and reducing burnout. It is noted that the outcomes of numerous studies were impacted by design limitations that is, no control/waitlist control, and/or no post intervention follow-up. Suggestions are made for future research.

The role of psychosocial safety climate on flexible work from home digital job demands and work-life conflict.

Due to the COVID-19 pandemic, the number of employees in flexible work from home has increased markedly along with a reliance on information communication technologies. This study investigated the role of an organisational factor, psychosocial safety climate (PSC; the climate for worker psychological health and safety), as an antecedent of these new kinds of demands (specifically work from home digital job demands) and their effect on work-life conflict. Data were gathered via an online survey of 2,177 employees from 37 Australian universities. Multilevel modelling showed that university level PSC to demands, y=-0.09, SE=0.03, p<0.01, and demands to work-life conflict, y=0.51, SE=0.19, p<0.05, relationships were significant. Supporting the antecedent theory, university level PSC was significantly indirectly related to work-life conflict via demands (LL -0.10 UL -0.01). Against expectations PSC did not moderate the demand to work-life conflict relationship. The results imply that targeting PSC could help prevent work from home digital job demands, and therefore, work-life conflict. Further research is needed on the role of digital job resources as flexible and hybrid work takes hold post COVID.

Psychosocial Factors That Influence the Health of Workers in Contemporary Workplaces.

This Special Issue of the IJERPH examines various psychosocial factors that influence the health of workers in contemporary workplaces [...].

A New Academic Quality at Work Tool (AQ@workT) to Assess the Quality of Life at Work in the Italian Academic Context.

The present study provides evidence for a valid and reliable tool, the Academic Quality at Work Tool (AQ@workT), to investigate the quality of life at work in academics within the Italian university sector. The AQ@workT was developed by the QoL@Work research team, namely a group of expert academics in the field of work and organizational psychology affiliated with the Italian Association of Psychologists. The tool is grounded in the job demands-resources model and its psychometric properties were assessed in three studies comprising a wide sample of lecturers, researchers, and professors: a pilot study (N = 120), a calibration study (N = 1084), and a validation study (N = 1481). Reliability and content, construct, and nomological validity were supported, as well as measurement invariance across work role (researchers, associate professors, and full professors) and gender. Evidence from the present study shows that the AQ@workT represents a useful and reliable tool to assist university management to enhance quality of life, to manage work-related stress, and to mitigate the potential for harm to academics, particularly during a pandemic. Future studies, such as longitudinal tests of the AQ@workT, should test predictive validity among the variables in the tool.

Cross-Sectional Study of Resilience, Positivity and Coping Strategies as Predictors of Engagement-Burnout in Undergraduate Students: Implications for Prevention and Treatment in Mental Well-Being.

In a population of young adults, this study analyzes possible linear relations of resilience and positivity to coping strategies and engagement-burnout. The aim was to establish a model with linear, associative, and predictive relations, to identify needs and make proposals for therapeutic intervention in different student profiles. A population of 1,126 undergraduate students with different student profiles gave their informed, written consent, and completed validated questionnaires (CD-RISC Scale; Positivity; Coping Strategies of Stress; Engagement, and Burnout). An ex post-facto design involved bivariate association analyses, multiple regression and structural predictions. The results offered evidence of associations and predictive relationships between resilience factors, positivity, coping strategies and engagement-burnout. The factors of resilience and positivity had significant differential associations (positive and negative) with factors of coping strategies. Their negative relationship to burnout factors, and positive relation to engagement factors, is especially important. Results of structural analysis showed an acceptable model of relationships between variables. We conclude with practical implications for therapeutic intervention: (1) the proactive factors of resilience reflect a perception of self-efficacy and the ability to change adaptively; (2) the reactive factors of resilience are usually associated with withstanding experiences of change, uncertainty or trauma.

Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment-A Narrative Review.

Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014-2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted.

Changes in growth and sleep across school nights, weekends and a winter holiday period in two Australian schools.

Studies suggest that there may be an association between sleep and growth; however, the relationship is not well understood. Changes in biology and external factors such as school schedule heavily impact the sleep of adolescents, during a critical phase for growth. This study assessed the changes in sleep across school days, weekends and school holidays, while also measuring height and weight changes, and self-reported alterations in food intake and physical activity. The impact of morningness-eveningness (M-E) on height change and weight gain was also investigated. In a sample of 63 adolescents (mean age = 13.13, SD = 0.33, 31 males) from two independent schools in South Australia, height and weight were measured weekly for 4 weeks prior to the school holidays and 4 weeks after the school holidays. Participants also completed a Morningness/Eveningness Scale and 7-day sleep, diet and physical activity diaries prior to, during and after the school holidays. Participants at one school had earlier wake times during the weekends than participants attending the other school, leading to a significantly shorter sleep duration on weekends for those participants. Regardless of school, sleep was significantly later and longer during the holidays (p < 0.001) and those with a stronger morning preference fell asleep (F18,36 = 3.4, p = 0.001) and woke (F18,44 = 2.0, p = 0.027) earlier than evening types. Growth rate was lower during the holiday weeks. For those attending the school with limited sleep in opportunities, growth after the holidays was lower for those with greater evening preference, whereas for those at the other school, growth was greater for those with greater evening preference. The increase in average weight from pre- to post-holidays was greater for those attending the school with limited opportunities to sleep longer. Participants reported greater food intake during the holidays compared to school days and greater physical activity levels on weekends compared to school days, and school days compared to holidays. Results suggest that time of day preference may impact growth, with evening types who cannot sleep in growing at a slower rate than evening types who can or morning types. This may be related to sleep restriction. Despite sleep being both later and longer during the school holidays, participants' growth slowed during the holiday period. It is possible that this may be a reflection of other behavioural changes in the holidays (increased food intake and reduced physical activity), as sleep timing during the school period was related to growth.

A Qualitative Study of HR/OHS Stress Interventions in Australian Universities.

To enhance the understanding of psychosocial factors and extend research on work stress interventions, we investigated the key human resource (HR)/occupational health and safety (OHS) stress interventions implemented at five Australian universities over a three-year period. Five senior HR Directors completed an online survey to identify the intervention strategies taken at their university in order to reduce stress and enhance employee well-being and morale. We also explored the types of individual-, organization-, and individual/organization-directed interventions that were implemented, and the strategies that were prioritized at each university. Across universities, the dominant interventions were strategies that aimed to balance the social exchange in the work contract between employee-organization with an emphasis on initiatives to: enhance training, career development and promotional opportunities; improve remuneration and recognition practices; and to enhance the fairness of organizational policies and procedures. Strategies to improve work-life balance were also prominent. The interventions implemented were predominantly proactive (primary) strategies focused at the organizational level and aimed at eliminating or reducing or altering work stressors. The findings contribute to the improved management of people at work by identifying university-specific HR/OHS initiatives, specifically leadership development and management skills programs which were identified as priorities at three universities.

Interventions: Employees' Perceptions of What Reduces Stress.

OBJECTIVE: To build upon research evaluating stress interventions, this qualitative study tests the framework of the extended Job Demands-Resources model to investigate employees' perceptions of the stress-reduction measures implemented at 13 Australian universities. METHODS: In a cross-sectional survey design, tenured and contract staff indicated whether their overall level of stress had changed during the previous three-four years, and, if so, they described the major causes. A total of 462 staff reported that their level of stress had decreased; the study examines commentary from 115 academic and 304 nonacademic staff who provided details of what they perceived to be effective in reducing stress. RESULTS: Thematic analyses show that the key perceived causes were changes in job or work role, new heads of departments or supervisors, and the use of organizational strategies to reduce or manage stress. A higher percentage of academic staff reported reduced stress due to using protective coping strategies or their increased recognition and/or success, whereas a higher percentage of nonacademic staff reported reduced stress due to increases in staffing resources and/or systems. CONCLUSION: These results identify the importance of implementing multilevel strategies to enhance employees' well-being. Nonacademic staff, in particular, specified a variety of organizational stress-reduction interventions.

Awareness of Stress-Reduction Interventions on Work Attitudes: The Impact of Tenure and Staff Group in Australian Universities.

This study explored the impact of staff group role and length of organizational tenure in the relationship between the awareness of stress interventions (termed intervention awareness: IA) and the work-related attitudinal outcomes of university employees. A two-wave longitudinal study of a sample of 869 employees from 13 universities completed a psychosocial work factors and health questionnaire. Hierarchical regression analyses examined the contribution of staff role and different lengths of organizational tenure with IA and employees' reports of job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. Employees' length of tenure affected the relation between IA and work attitudes, and there were also differences between academic and non-academic staff groups. For non-academic employees, IA predicted job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. However, for academics, IA only predicted job satisfaction and trust which identifies a need to increase the visibility of organizational interventions. Across the tenure groups, IA predicted: (1) perceived procedural justice for employees with five or less years of tenure; (2) job satisfaction for employees with 0-19 years of tenure; (3) trust in senior management for employees with 6-19 years of tenure; and (4) affective organizational commitment for employees with a tenure length of 6-10 years. Employees working at the university for an intermediate period had the most positive perceptions of their organization in terms of IA, job satisfaction, trust in senior management, and affective organizational commitment, whereas employees with 20-38 years of tenure had the least positive perceptions. Results suggest that employees in the middle of their careers report the most positive perceptions of their university. The findings highlight the need to attend to contextual issues in organizational stress and wellbeing interventions and suggest that management may need to implement new strategies and/or promote existing stress-management and reduction strategies to academics, and employees whom are either new to the university or those who have been working for the organization for longer periods of time to ensure that they are aware of organizational strategies to promote employee wellbeing and morale within their work environments.

A Longitudinal Study of the Predictors of Perceived Procedural Justice in Australian University Staff.

PURPOSE: This study examined the factors that predict employees' perceptions of procedural justice in university settings. The paper also reviews the ethical aspects of justice and psychological contracts within employment relationships. DESIGN/METHODOLOGY/APPROACH: The study examined the predictors of perceived procedural justice in a two-wave longitudinal sample of 945 employees from 13 universities by applying the Job Demands-Resources theoretical model of stress. The proposed predictors were classified into two categories: Job demands of work pressure and work-home conflict; and job resources of job security, autonomy, trust in senior management, and trust in supervisor. The predictor model also examined job satisfaction and affective organizational commitment, demographic (age, gender, tenure, role) and individual characteristics (negative affectivity, job involvement) as well as Time 1 (T1) perceptions of procedural justice to ensure that tests were rigorous. FINDINGS: A series of hierarchical multiple regression analyses found that job satisfaction at T1 was the strongest predictor of perceived procedural justice at Time 2. Employees' trust in senior management, and their length of tenure also positively predicted justice perceptions. There were also differences between academic and non-academic staff groups, as non-academic employees' level of job satisfaction, trust in senior management, and their length of organizational tenure predicted procedural justice perceptions, whereas for academics, only job satisfaction predicted perceived justice. For the "all staff" category, job satisfaction was a dominant and enduring predictor of justice, and employees' trust in senior management also predicted justice. RESEARCH LIMITATIONS/IMPLICATIONS: Results highlight the importance of workplace factors in enhancing fair procedures to encourage reciprocity from employees. As perceived procedural justice is also conceptually linked to the psychological contract between employees-employers, it is possible that employees' levels of job satisfaction and perceptions of trust in senior management, relative to other work attitudinal outcomes, may be more effective for improving the broader working environment, and promoting staff morale. ORIGINALITY/VALUE: This study adds to research on applied business ethics as it focuses on the ethical aspects of perceived procedural justice and highlights the importance of workplace factors in enhancing fair procedures in organizational policy to encourage reciprocity and promote healthy organizational environments.

Awareness of Stress-reduction Interventions: The Impact on Employees' Well-being and Organizational Attitudes.

Employing the social-exchange theoretical framework, we examined the effect of employees' awareness of stress-reduction interventions on their levels of psychological strain, job satisfaction, organizational commitment, perceptions of senior management trustworthiness and procedural justice. We present longitudinal panel data from 869 employees who completed questionnaires at two time points at 13 Australian universities. Our results show that employees who reported an awareness of stress-reduction interventions undertaken at their university scored lower on psychological strain and higher on job satisfaction and commitment than those who were unaware of the interventions. The results suggest that simply the awareness of stress interventions can be linked to positive employee outcomes. The study further revealed that senior management trustworthiness and procedural justice mediate the relationship between awareness and employee outcomes. Copyright © 2014 John Wiley & Sons, Ltd.

Stress-reduction interventions in an Australian university: a case study.

We examined the effects of awareness of stress-reduction interventions on employee well-being and work attitudes using a mixed methods design. Cross-sectional data are presented from 247 employees who completed questionnaires in 2004 at one Australian university. Analyses indicated that employees, who reported that interventions had been undertaken, scored higher on job satisfaction, affective organizational commitment, perceived procedural justice and trust in senior management than those who were not aware of the measures, although they did not differ in psychological strain. Details of the stress-reduction interventions implemented by the Occupational Health and Safety department at the university are also reported. Thematic analyses of the perceived causes of both decreases and increases in stress for employees showed that staff reported workload and staffing pressures as key sources of increases in stress. On the other hand, new supervisors and/or management were identified as sources of decreased stress. Areas for consideration in future efforts to develop and refine stress interventions are also discussed.