Organizational change, health, and sick leave among health care employees: A longitudinal study measuring stress markers, individual, and work site factors

This controlled longitudinal study was conducted to investigate the effects of organizational change on employees' self-reported health, work satisfaction, work-related exhaustion, stress, and sick leave. The population consisted of 226 employees at T1 and 198 at T2, divided into a study group affected by organizational changes, and a reference group not affected by them. Group differences for the outcome measures self-rated health (SRH), work satisfaction, work-related exhaustion, and hormones associated with stress were analysed using a two-factor ANOVA design for repeated measurements. Our findings showed no significant differences, either across time or between groups for SRH, work satisfaction, and work-related exhaustion. However, we did find significant change across time and between groups for the recovery hormone DHEA-S. Days of sick leave increased by 7% for employees in the study group and by 2% in the reference group. Serum cortisol showed significantly decreased levels across time but not between groups. The decreased recovery potential in the study group might have long-term health implications. The study points to the importance of looking at the impact of organizational change on employee well-being from a number of perspectives, such as self-reported health parameters, registered sick-leave data, and biological stress markers.     

Job stress, satisfaction and mental health of factory workers in Bangladesh

The present study examined the relationship between job stress, job satisfaction and mental health, and attempted to assess the effects of job stress on different parameters of satisfaction and mental health in the context of two groups of Bangladeshi factory workers. There were 26 subjects in a 'high stress' group and 33 in a 'low stress' group. Individual data were collected by using the Stress and Arousal Checklist, the Job Satisfaction Scale, the General Health Questionnaire, absenteeism by sick leave, a self-esteem at work scale and heart rate monitor. Chi-square and t-tests were applied in the analyses of these data by group. The results, quite expectedly, showed that a greater number of high stress subjects were dissatisfied and had poorer mental health than low stress subjects. The results also showed that low stress subjects were significantly more satisfied and possessed better mental health than the high stress subjects. It would appear that the experience of stress plays an important role in determining the quality of working life of Bangladeshi factory workers having similar consequences in terms of health and well-being to those observed in developed countries. The dynamics of absenteeism in Bangladesh are discussed.     

Stress, health and the working environment of Swedish prison staff

A random stratified sample of just over 2000 was drawn from staff working in 67 different prisons in Sweden. Questionnaires on working conditions and symptoms of ill health were administered and subjects were given health examinations. Morning plasma Cortisol and gamma glutamyltransferase (g GT) levels were measured and factual information on the prisons was collected for use in the analyses.

There were differences between prisons in terms of both objective and self-reported working conditions which appeared to affect health status, physiological state and sick leave rate. Cardiovascular and hypertensive conditions were found more often among prison staff than among a large reference group made up of many different occupations. Sick leave rates among prison staff, especially those over 45 years old, were very high compared with this reference group. The situation appeared particularly difficult in prisons with a high proportion of drug abusing inmates.

The data allowed the identification of several factors which might counteract the effects of stress at work: a proactive management style, goal consensus among staff, a high degree of decision latitude, satisfaction with work performance and a supportive psychosocial climate.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

Stress,health and the working environment of Swedish prison staff

Abstract

A random stratified sample of just over 2000 was drawn from staff working in 67 different prisons in Sweden. Questionnaires on working conditions and symptoms of ill health were administered and subjects were given health examinations. Morning plasma Cortisol and gamma glutamyltransferase (g GT) levels were measured and factual information on the prisons was collected for use in the analyses.

There were differences between prisons in terms of both objective and self-reported working conditions which appeared to affect health status, physiological state and sick leave rate. Cardiovascular and hypertensive conditions were found more often among prison staff than among a large reference group made up of many different occupations. Sick leave rates among prison staff, especially those over 45 years old, were very high compared with this reference group. The situation appeared particularly difficult in prisons with a high proportion of drug abusing inmates.

The data allowed the identification of several factors which might counteract the effects of stress at work: a proactive management style, goal consensus among staff, a high degree of decision latitude, satisfaction with work performance and a supportive psychosocial climate.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

Variables related to psychiatric sick leave taken by Spanish secondary school teachers

This study analyses the relationships of certain sociodemographic, organizational, and personality variables with psychiatric sick leave taken by Spanish secondary school teachers. The sample comprised 200 teachers (84 men and 116 women) divided into two groups. The first group was composed of 100 teachers who had suffered from psychiatric disorders requiring sick leave. The second was a matched control group composed of 100 teachers with no history of psychiatric disorders. Both groups shared the same organizational variables (same centre, town, number of students, etc). Logistic regression analysis was conducted to determine any relationships and the risk and protection factors for psychiatric sick leave. It is concluded that the most significant variables related to psychiatric sick leave included competitiveness and hostility, as defined by Type A Behaviour Pattern, emotional exhaustion as a factor of burnout, and job dissatisfaction.     

Psychosocial predictors of health status

This prospective study examined, in a sample of male and female adults, the relationship between specific psychosocial factors and health status. Measures of stress, health habits, social support, Type A behaviour, and coping style were collected for 203 professional employees in a large aerospace organization in 1988. One year later a follow-up questionnaire assessing self-reported physical illness and job burn-out was administered resulting in a final sample of 95 employees. When adjustments for age, sex, education, and initial psychological well-being were made, perceived stress, physical exercise, and an avoidant coping style significantly contributed to predictions of physical illness in multiple regression analyses. Employees who possessed less hardy appraisals of work/life and expressed greater Type A behaviour reported significantly more fatigue and exhaustion one year later. Type A individuals also reported being significantly less sensitive and caring towards others. Finally, individuals who perceived less stress and expressed more cognitive hardiness reported significantly greater work/life satisfaction. Overall, the data supported the view that psychosocial factors may be differentially associated with diverse physical and psychological health outcomes.     

Variables related to psychiatric sick leave taken by Spanish secondary school teachers

Abstract

This study analyses the relationships of certain sociodemographic, organizational, and personality variables with psychiatric sick leave taken by Spanish secondary school teachers. The sample comprised 200 teachers (84 men and 116 women) divided into two groups. The first group was composed of 100 teachers who had suffered from psychiatric disorders requiring sick leave. The second was a matched control group composed of 100 teachers with no history of psychiatric disorders. Both groups shared the same organizational variables (same centre, town, number of students, etc). Logistic regression analysis was conducted to determine any relationships and the risk and protection factors for psychiatric sick leave. It is concluded that the most significant variables related to psychiatric sick leave included competitiveness and hostility, as defined by Type A Behaviour Pattern, emotional exhaustion as a factor of burnout, and job dissatisfaction.     

Personality and organizational health: the role of conscientiousness

Organizational health research identifies processes through which the work environment and individual differences combine to influence both individual and organizational outcomes. This study investigated the contribution of conscientiousness to organizational health. Research in the areas of occupational stress, work performance, and organizational climate was used to develop a framework for integrating different elements of organizational health. Within this framework, the work environment was assessed by perceptions of workload and role clarity ; individual well-being was assessed by psychological distress and job satisfaction ; and behaviour important for organizational success was assessed by contextual performance. Conscientiousness was investigated within the framework using self-reports from a sample of 104 Australian employees. Conscientiousness directly influenced contextual performance but did not influence well-being or perceptions of the work environment. Conscientiousness also reduced the impact of role clarity on both psychological distress and job satisfaction. The role of conscientiousness in a comprehensive model of organizational health is discussed.     

Long-term profiles of work-related rumination associated with leadership,job demands,and exhaustion: A three-wave study

This study extends previous research on recovery from work stress by investigating the role of qualitative job demands and leadership in employees’ work-related rumination (WRR). The long-term development of WRR was examined from a person-centred approach across 22 months. Drawing on the stressor-detachment framework and conservation of resources theory, we investigated whether different WRR profiles could be understood in terms of levels of and changes in quantitative, cognitive, and emotional job demands, several aspects of supervisory leadership, and exhaustion that was expected to result from the impeded energy restoration process. A three-wave questionnaire study was conducted among Finnish municipal employees in heterogeneous occupations. Factor mixture modelling was used to identify latent classes (i.e. subgroups of participants with similar mean levels and mean-level changes) of WRR. The results indicated five distinct classes of WRR. Participants in the higher WRR classes reported higher levels of job demands, less supervisor fairness, and more abusive supervision. In the decreasing class, WRR decreased concurrently with decreasing job demands. Exhaustion showed considerable congruence with WRR both between and within persons. The findings are discussed from the point of view of a loss cycle concerning energetic psychological resources and difficulties in goal attainment.     

Rumination for innovation? Analysing the longitudinal effects of work-related rumination on creativity at work and off-job recovery

Work-related rumination is not a single construct, but consists of a dimension associated with negative emotions or affect (affective rumination), and a dimension associated with reflective thinking and applying strategies to solve problems (problem-solving pondering). In this three-wave longitudinal study across two years (N?=?630) we investigated whether the relationships between work-related rumination, off-job recovery, and creativity at work varied along the two dimensions of work-related rumination. In addition, we tested whether the relationships followed normal, reversed, or reciprocal causation. The results showed, first, that in a one-year perspective affective rumination, but not problem-solving pondering, was negatively related to off-job recovery and that problem-solving pondering, but not affective rumination, was positively related to creativity at work. Second, in a two-year perspective, reversed effects were detected as creativity at work was negatively related to affective rumination and positively to off-job recovery. Our results suggest that the quality of work-related thoughts determines whether the outcome is beneficial or detrimental. Occupational health interventions that only advise employees to stop thinking about work during off-job time, may therefore be too simplistic.     

Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

Work satisfaction, health, and stress: A study of Dutch nurses

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Abusive interaction and role state stressors: Relative impact on student residence assistant stress and work attitudes

Despite the recognition that poor working relationships can contribute to strain (Chen and Spector 1991, Cooper and Marshall 1978, Kahn and Byosiere lY92, Spector 1987, Spector et al. 1988) and increasing concern over violence and aggression in the workplace (Northwestern National Life Insurance Co. 1993), little research attention has been paid to hostile interpersonal interaction as a work-related stressor. While recent work has focused on interpersonal conflict and sexual harassment as stressors, emotionally abusive interactions have remained largely unaddressed by the organizational stress literature. These interactions are characterized by hostile verbal and non-verbal, non-physical behaviours directed by one or more persons towards another that negatively affect the target's sense of him/herself as a competent person and worker (Keashly et al. 1994, Leymann 1990). The current study examined whether emotional abuse contributed uniquely to understanding work-related stress in student residence assistants (RAs). Seventy-six RAs employed by a Canadian university responded to a questionnaire on the quality of their work experience. The stressors examined were role conflict, role overload, role ambiguity, and number, frequency, and impact of abusive events with dormitory residents. Outcome variables included job-related tension, job satisfaction, job commitment, and intention to leave. Emotional abuse contributed similar amounts of unique variance as the role state stressors to the variables of tension, job satisfaction and intention to leave suggesting emotional abuse is an important and uniquc workplace stressor. Implications of these findings for future research are discussed.     

Work satisfaction,health, and stress: A study of Dutch nurses

Abstract

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health

ABSTRACT

The aim of the study was to identify trajectories of effort-reward imbalance (ERI), to examine these with respect to demographic (age, gender, socio-economic position) and work-related (employment contract, work hours, shift work, sector) factors, and to investigate associations with different health indicators (self-rated health, depressive symptoms, migraine, sickness absence). The study used four waves of data (N?=?6702), collected biennially within the Swedish Longitudinal Occupational Survey of Health (SLOSH). Using latent class growth modelling, we identified four trajectories: a stable low imbalance trajectory, which comprised 90% of all participants, and three change trajectories including a decreasing trajectory (4% of the participants), an inverted U-shaped trajectory and an increasing imbalance trajectory, both in 3% of the participants. Results indicate that a sizeable proportion of Swedish employees’ experience imbalance between efforts and rewards at work. The most favourable trajectory comprised relatively more men and was characterised by better work-related characteristics than the less favourable ERI trajectories. All change trajectories were dominated by women and employees in the public sector. Health developments followed ERI trajectories, such that less favourable trajectories associated with impaired health and more favourable trajectories associated with better health. Sickness absence increased among all ERI trajectories, most so for the decreasing and increasing ERI trajectory.     

Personnel turnover in health care organizations: Test of a predictive model based on work assessments by employees

Abstract

It is predicted that institutions in Dutch intramural health care will be increasingly confronted with problems in personnel supply. Instead of making great efforts to keep the inflow of new personnel on the desired level, control of turnover is an alternative solution. In this paper, an explanatory model is constructed, based on previous theories and research findings. It is hypothesized that the more employees have positive attitudes concerning their work and work situation, the greater their satisfaction and commitment and hence the less their intention to leave and the lower actual turnover. This model was tested using a large scale employee questionnaire. The instrument turned out to be reliable (internal consistencies above .70). The questionnaire was administered in eight institutions in four health care sectors (n = 1456). Results indicate that attitudes about work content and personnel management are relevant in predicting intention to leave. All in all, 8 work-related aspects predicted 21% of intention to leave. Aspects with the most predictive value were career guidance, work safety, responsibilities and job discretion. Furthermore, general satisfaction was shown to play an intermediary role in predicting intention to leave. It is concluded that improvements in work content and personnel management can reduce intention to leave and hence the demand for new personnel.     

Associations between overtime and psychological health in high and low reward jobs

This study focused on the relationship between overtime and psychological health in high and low reward jobs, and in jobs with high and low external pressure to work overtime. Data were collected for 535 full-time employees of the Dutch Postal Service. In general, overtime was associated with negative work-home interference and negative home-work interference. Split-sample logistic regression analyses showed that employees reporting low rewards had elevated risks of burnout, negative work-home interference and slow recovery. In addition, the combination of overtime and low rewards was associated with negative home-work interference. A second analysis was conducted separately for employees who reported overtime in order to study the effects of external pressure to work overtime. In this subgroup, low rewards were associated with elevated risks of health complaints, emotional exhaustion and negative home-work interference. Moreover, employees who reported overtime and a high pressure to work overtime in combination with low rewards had elevated risks of poor recovery, cynicism, and negative work-home interference. The results suggest that even a limited number of hours of involuntary overtime is associated with adverse mental health, but only in low reward situations.