Abstract
BackgroundWorkplace stress is a complex phenomenon that may often be dynamic and evolving over time. Traditional linear modeling does not allow representation of recursive feedback loops among the implicated factors. The objective of this study was to develop a multidimensional system dynamics model (SDM) of workplace stress among nursing aides and conduct simulations to illustrate how changes in psychosocial perceptions and workplace factors might influence workplace stress over time.MethodsEight key informants with prior experience in a large study of US nursing home workers participated in model building. Participants brainstormed the range of components related to workplace stress. Components were grouped together based on common themes and translated into feedback loops. The SDM was parameterized through key informant insight on the shape and magnitude of the relationship between model components. Model construction was also supported utilizing survey data collected as part of the larger study. All data was entered into the software program, Vensim. Simulations were conducted to examine how adaptations to model components would influence workplace stress.ResultsThe SDM included perceptions of organizational conditions (e.g., job demands and job control), workplace social support (i.e., managerial and coworker social support), workplace safety, and demands outside of work (i.e. work-family conflict). Each component was part of a reinforcing feedback loop. Simulations exhibited that scenarios with increasing job control and decreasing job demands led to a decline in workplace stress. Within the context of the system, the effects of workplace social support, workplace safety, and work-family conflict were relatively minor.ConclusionSDM methodology offers a unique perspective for researchers and practitioners to view workplace stress as a dynamic process. The portrayal of multiple recursive feedback loops can guide the development of policies and programs within complex organizational contexts with attention both to interactions among causes and avoidance of adverse unintended consequences. While additional research is needed to further test the modeling approach, findings might underscore the need to direct workplace interventions towards changing organizational conditions for nursing aides.
Highlights
Workplace stress is a complex phenomenon that may often be dynamic and evolving over time
Aligning with previous workplace stress models, key informants indicated that job demands and job control represented two secondary stocks and flows that impacted workplace stress
The model was developed through key informant insights and consisted of multiple feedback loops containing a diverse range of components including perceptions of organizational conditions, workplace social support, workplace safety, and work-family conflict
Summary
Workplace stress is a complex phenomenon that may often be dynamic and evolving over time. Workplace stress can be operationalized as both an outcome of factors inside and outside of work, and can be a determinant to health and quality of life and performance of work roles This may be especially the case for nursing aides who report challenging working conditions that may include little assistance with job tasks, high psychological and emotional demands, few opportunities for decision-making, and poor safety climate [3,4,5]. While little research has focused on workplace stress among nursing aides, several studies of allied health professionals have sought to examine the association between workplace factors and stress These studies find that work factors including job demands and lack of time, low managerial support, patient aggression, nonstandardized working conditions (e.g., shift work) and scheduling unpredictability were related to high perceptions of workplace stress [6,7,8,9,10,11,12]. No studies to our knowledge have examined workplace stress through the lens of a feedback model
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