Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)-A Cross-Sectional Study among Medical Assistants.

Viola Mambrey,Adrian Loerbroks,Peter Angerer,Patricia Vu-Eickmann

doi:10.3390/ijerph18189693

Abstract

Adverse psychosocial working conditions in the health care sector are widespread and have been associated with a reduced quality of patient care. Medical assistants (MA) assume that their unfavorable working conditions predominantly lead to a poorer quality of care in terms of slips and lapses, and poorer social interactions with patients. We examined those associations for the first time among MAs. A total of 944 MAs in Germany participated in a survey (September 2016–April 2017). Psychosocial working conditions were measured by the effort-reward imbalance (ERI) questionnaire and a questionnaire specifically designed for MAs. Slips and lapses (3 items, e.g., measurement or documentation errors) and the quality of interactions (3 items) with patients were measured by a questionnaire developed by the study team based on prior qualitative research. We ran Poisson regression to estimate multivariable prevalence ratios (PRs). The ERI ratio and MA-specific working conditions were significantly associated with frequent self-reported slips and lapses (PR = 2.53 and PR ≥ 1.22, respectively) or poor interactions with patients (PR = 3.62 and PR ≥ 1.38, respectively) due to work stress. Our study suggests that various types of adverse psychosocial working conditions are associated with perceptions of slips and lapses or poorer interaction with patients due to work stress among MAs.

Highlights

A high workload [1,2,3], low job control [1,2,3], poor organization of work processes [2,3]as well as a lack of social support [3,4] and resources [3] are amongst the adverse psychosocial working conditions that healthcare workers face in their everyday work
Numerous studies suggest that adverse psychosocial working conditions [10,11,12], the perception of work stress [11,12,13], and mental health [14] in health care staff are associated with poorer patient care as indicated, for instance, by increased rates of medical errors or lower ratings of the quality of care as provided by patients or the health care workers themselves
We found that a large set of psychosocial working conditions was associated with a perceived frequent impact of work stress on slips and lapses or poor social interaction with patients among medical assistant (MA)

Summary

Introduction

As well as a lack of social support [3,4] and resources [3] are amongst the adverse psychosocial working conditions that healthcare workers face in their everyday work. Such unfavorable psychosocial working conditions are associated with stress [5,6,7]. Numerous studies suggest that adverse psychosocial working conditions [10,11,12], the perception of work stress [11,12,13], and mental health (e.g., burnout) [14] in health care staff are associated with poorer patient care as indicated, for instance, by increased rates of medical errors or lower ratings of the quality of care as provided by patients or the health care workers themselves. They perform a wide range of tasks in the practice, including administration, management, documentation, and to some extent medical procedures (e.g., blood collection, injections, wound care, X-rays, and laboratory diagnostic)

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