High Workload Research Articles

The impact of the nursing work environment on compassion fatigue: The mediating role of general self-efficacy.

To explore the interplay between the perceived nursing work environment, general self-efficacy, and compassion fatigue among registered nurses in Chinese hospitals. Compassion fatigue emerges as a significant occupational stress response globally, with the nursing work environment being a pivotal influencer. There is a knowledge gap in understanding how the nursing work environment and general self-efficacy interrelate to affect compassion fatigue, particularly among Chinese nurses. Employing a cross-sectional, descriptive design, this study utilized validated questionnaires to gather data from 7085 nurses across public and private hospitals in China. The analysis focused on assessing the interrelations among the perceived nursing work environment, general self-efficacy, and different dimensions of compassion fatigue. More than half (65.67%) of the participants experienced moderate or high burnout levels, with 76.43% experiencing secondary traumatic stress. The lowest rating in the nursing work environment was for nurse/physician collaboration (10±2.07), while general self-efficacy scored higher (27.54±6.26). A positive relationship existed between the work environment and both general self-efficacy and compassion satisfaction, with a negative correlation to burnout and traumatic stress. General self-efficacy was a partial mediator in the link between work environment and compassion fatigue, suggesting that improving the work environment can decrease compassion fatigue by boosting nurses' self-efficacy. This study underscores the profound impact of the nursing work environment on compassion fatigue, mediated by general self-efficacy. It highlights the necessity of fostering a supportive work environment to enhance nurses' self-efficacy and overall well-being. Healthcare managers and institutions must create supportive work environments to reduce compassion fatigue among nurses. This includes professional development programs to enhance self-efficacy and job satisfaction. Policies should address high workloads and inadequate support. Nurse leaders should foster environments that promote psychological well-being, improving outcomes for both nurses and patients. Regular assessments and adjustments of work conditions are essential to maintain a healthy work environment.

Unraveling the impact of subjective and objective workload on patient experience: Mediation and moderation by missed nursing care assessments in a nested multisource diary design

BackgroundPatient reporting of their care experience is crucial for evaluating healthcare quality. Negative patient reports are often associated with missed nursing care, with previous research primarily attributing this to objective workload, neglecting the role of subjective workload. Furthermore, there is a gap in understanding the combined impact of patient and nurse assessments of missed nursing care on the overall patient experience. ObjectiveThis study aims to explore how the interaction of objective and subjective workload influences nurse-reported missed nursing care. Additionally, it investigates how the interaction of missed nursing care, as assessed by both patients and nurses, influences the patient's overall experience. DesignA quantitative daily diary design, employing a nested (shifts within nurses) and multi-sourced (nurses, patients, and objective data) approach, was implemented. SettingThe study was conducted in two medium-sized public hospitals, encompassing internal medicine and surgical wards. ParticipantsA total of 141 registered nurses providing direct patient care and 627 patients treated by these nurses participated in the study. MethodsParticipating nurses completed questionnaires during five morning shifts, detailing their experiences with specific patients. Concurrently, the same patients provided feedback through questionnaires. A dual moderated mediation model was analyzed using mixed-model regression analyses, suitable for the nested design. ResultsThe study supported the dual moderated mediation model. Subjective workload emerged as a statistically significant moderator, influencing the impact of objective workload on nurse-reported missed nursing care (β = −0.476, p = .009). Particularly, under high subjective workload, missed nursing care was higher during low compared to high objective workload. Moreover, patient-reported missed nursing care moderated the relationship between nurse-reported missed nursing care and patient experience (β = −0.411, p < .001). In instances of high patient-reported missed nursing care, positive patient experiences were observed with low compared to high nurse-reported missed nursing care. ConclusionsThis research emphasizes the need to recognize and address subjective aspects of nursing workload. Effectively managing these perceptions is vital for upholding high care standards and enhancing patient experiences. The study advocates for targeted strategies to manage workload effectively and improve patient–nurse communication, especially in high-workload healthcare settings.Tweetable abstract: Exploring the link between nursing workload and patient experience: revealing the impact of patient and nurse assessments on missed nursing care. #HealthcareQuality #NursingResearch.

Managing the work stress of inpatient nurses during the COVID-19 pandemic: a systematic review of organizational interventions

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, inpatient nurses faced various work stressors. Little is known about organizational interventions that can mitigate the negative consequences of pandemic-related stressors.ObjectiveThe aim was to provide a synopsis of the literature concerning the types and outcomes of organizational interventions performed during the COVID-19 pandemic that directly (re)organized the work structures of inpatient nurses to address pandemic-related work stressors or to increase nurses’ ability to cope.MethodsWithin this preregistered systematic literature review, we searched four databases (PubMed, PsycINFO, PsycARTICLES, CINAHL) and two preprint databases (MedRxiv, PsyArXiv) for interventional studies of organizational interventions published between 01/2020 and 03/2023 (k = 990 records). We included 12 primary studies after title-abstract and full-text screening. A synthesis of results without meta-analysis was conducted. Risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials – version 2 (RoB-2) and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool.ResultsAll interventions were implemented in hospitals. The reasons given for implementation included pandemic-related work stressors such as a high workload, understaffing, and a lack of medical resources. To respond to the various work stressors, half of the studies took a multilevel approach combining organizational and person-oriented interventions (k = 6). Most studies (k = 8) took a secondary prevention approach, focusing on the organization of rest breaks (k = 5). With respect to outcomes, the studies examined nurse-related stress and resilience, turnover intention, job satisfaction, and other factors. Risk-of-bias analyses revealed that conclusions about the effectiveness of the interventions are limited due to confounding factors and self-selection.ConclusionsThe identified interventions provide a basis for future research to draw conclusions on the effectiveness of organizational interventions during pandemics. The promotion of adequate work breaks could be useful if the work stressors associated with strain and negative consequences cannot be changed directly. However, the same stressors (e.g., high workload) can hinder nurses from participating in offered interventions. This emphasizes the importance of directly addressing inpatient nurses’ work stressors.RegistrationProspero-ID CRD42023364807 (March 2023).

Assessing Creativity and User Experience in Immersive Virtual Reality with Cultural Heritage Learning

Virtual reality (VR) technology is widely used in the field of education and cultural heritage learning. However, few studies have focused on the impact on creativity regarding the use of different interaction modalities by users in cultural heritage learning. Furthermore, it is controversial whether VR can enhance user experience and learning outcomes. The study utilized a mixed research approach combining qualitative and quantitative methods, where qualitative data was collected using open-ended interviews, simultaneously quantitative data was collected using learning outcomes, intrinsic motivation, workload, self-report of creativity and expert assessments of creativity. A mixed research approach combining qualitative and quantitative methods was used; creativity self-reports were used to collect qualitative data, and learning outcomes, intrinsic motivation, and workload data were collected for the quantitative findings.90 university students were randomly assigned to the text group (TG), the video group (VG), and the immersive virtual reality group (IVRG), with 30 students in each group. The study assessed whether creativity, user experience and learning outcomes differed when using different interaction modalities in a cultural heritage context. The results demonstrated that the text interaction modality outperformed the other two groups in learning outcomes and expert assessments of creativity performance, while the IVRG performed better in self-report of creativity and user experience. In addition, participants in TG had higher workloads and poorer user experiences compared to the other two interaction modalities. This study encourages that different interaction modalities should be selected more appropriately depending on the purpose. The study found that interaction modalities creativity can be applied to digital cultural heritage and education and informs interaction design for the HCI community.

Exploring early- and mid-career academic work wellbeing challenges through a diversity and inclusion lens

BackgroundEarly- to mid-career academics (EMCAs) represent a core component of the Australian higher education workforce. These academics experience major challenges to their wellbeing, driving a strong desire to leave academia.ObjectivesDetermine (1) EMCA awareness of, and engagement with, previous University- and Faculty-level diversity and inclusion events/initiatives and (2) opportunities and solutions to address previously reported diversity and inclusion issues experienced in the workplace.Methods114 EMCAs in medicine, dentistry and health sciences completed an electronic cross-sectional survey. The survey contained a list of University- and Faculty-provided diversity and inclusion initiatives and sought respondent ratings of interest, awareness (knowing/hearing about) and engagement (attending/applying/participating). Two in-person focus groups comprising participants who opted in during the survey or who responded to broader advertising were conducted. Both groups explored opportunities and solutions to address diversity and inclusion issues reported in an earlier organisation-wide survey.ResultsWhilst early- and mid-career academics reported high interest in diversity and inclusion events, they also reported limited awareness and engagement with these events, feeling unsupported to engage or perceiving consequences for workload. Focus groups identified five themes related to opportunities and solutions to address diversity and inclusion issues experienced in the workplace (1) enhanced relational support for career progression, (2) clear and transparent processes for efficient working, (3) reducing structural barriers to create opportunity, (4) improved financial renumeration, and (5) improved transitions and pathways.ConclusionEarly- and mid-career academics often felt unable to engage with activities outside of their immediate work responsibilities, such as events about diversity and inclusion, due to feelings of high workload. A systems approach to deploying targeted strategies to address these wellbeing challenges is recommended to sustain and retain this critical workforce.

The selection traits of mite non-reproduction (MNR) and Varroa sensitive hygiene (VSH) show high variance in subsequent generations and require intensive time investment to evaluate

The honey bee ectoparasite Varroa destructor is the main cause of honey bee colony losses worldwide. Over the last decades, several projects have focused on improving the robustness of Apis mellifera against this parasitic mite. Selection traits, such as mite non-reproduction (MNR) and Varroa sensitive hygiene (VSH), are favored selection factors in Varroa resistance projects. VSH is a trait where adult honey bees remove the Varroa-infested brood. During this process, the female mites are arrested in their reproductive cycle leading to a reduction of the Varroa population within the bee colony. From 2019 to 2022, 1402 queens were instrumentally inseminated with single or multiple drones in a breeding program. Colonies headed by these queens were established annually, and the MNR and VSH levels were analyzed. VSH was evaluated in response to cells artificially infested with Varroa, and colonies with high VSH values were used to generate our selected VSH stock. Despite crossing high VSH drones and queens, we measured a remarkable heterogeneity of MNR and VSH in the next generation(s), most likely due to the well-described, high recombination rate in the honey bee genome. When assessed multiple times in the same colony, great variance between measurements was observed. Detailed evaluations of daughter colonies are thus required if selection programs want to breed colonies with reliable VSH traits. This constant need to evaluate all offspring to ensure the desirable resistance traits are present results in high workloads and great expenses in selection programs. Furthermore, such large-scale breeding programs are inefficient due to high fluctuations between measurements and generations, indicating we need to develop new approaches and improved methods for assessing Varroa resistance.

Nurses' health promotion practices in rural primary health care in Nigeria. A qualitative study.

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive-inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration.

Exploring the Correlation Between Occupational Well-Being and Burnout: An Analysis of Bhutanese Teachers` Data

Aims: This study examined the relationship between teachers` occupational well-being and burnout as well as challenges faced by teachers, key drivers of their job satisfaction, factors contributing to their burnout, and suggestion for improving their well-being at school. The well-being of teachers was assessed focusing on affective, behavioral, and health components. Methodology: A cross-sectional survey study design was used to collect data from the teachers. The target population consists of all primary, middle, and secondary school teachers across the country. To ensure a representative sample, 402 Bhutanese teachers (primary, middle, and secondary school) across the country were selected by employing stratified random sampling method. Different teachers from different grades, schools, and years of experience were selected proportionately. A self-created structured questionnaire was applied to 402 Bhutanese teachers across the country, selected through stratified random sampling method. The instrument demonstrated strong internal consistency reliability, with Cronbach`s alpha coefficient 0.85, 0.78, 0.70, and 0.77 for affective, behavioral, and health well-being, as well as burnout constructs, respectively. Data were analyzed using descriptive statistics and inferential statistics (correlation analysis and two sample independent t-test) in RStudio. Results: Among the dimensions of occupational well-being, affective components like anxiety, depression, and emotional exhaustion require significant attention, with emotional exhaustion being notably high. Regarding potential stressors, high workload, paperwork, students` behavioral and disciplinary issues, and insufficient resources are the most pressing issues for most of the teachers. The most satisfying aspects of the job for teachers are having supportive colleagues, experiencing positive interactions with students, and receiving competitive salary and benefits. Conclusion: For policy makers and school administrators, the findings of this study underscore the importance of implementing strategies to mitigate emotional exhaustion, such as providing mental health resources, fostering a supportive work environment, offering professional development opportunities focused on stress management, and improving students` behavioral and disciplinary issues. Addressing the foregoing issues can lead to a decrease in burnout rates, ultimately improving teacher retention and the overall quality of education.

Взаимное влияние условий и оплаты труда на потребность системы здравоохранения в медицинских работниках

Healthcare quality depends on medical personnel, i.e., motivation, professional burnout, work-life balance, etc. The authors used standard research methods to investigate the relationship between performance, staff turnover, salary, and motivation in healthcare in various federal districts. The hypothesis was that the high workload and a disproportionate payment system reduce the motivation, which increases staff turnover and leads to shortage of qualified personnel. In this research, stronger labor intensity indeed contributed to lower motivation of medical personnel and triggered staff turnover. The labor intensity correlated with the level of staff turnover, but no correlation was revealed between the labor intensity and the wages. The article explains the need for a more effective labor rationing system and a more rational workload distribution.

Leaving the profession as a medical assistant: a qualitative study exploring the process, reasons and potential preventive measures

BackgroundWorldwide growing shortages among health care staff are observed. This also holds true for medical assistants in Germany. Medical assistants mainly work in outpatient care and are the first point of contact for patients while performing clinical and administrative tasks. We sought to explore profession turnover among medical assistants, that is, in terms of the underlying decision-making process, the reasons for leaving the medical assistant profession and potential retention measures from the perspective of former medical assistants.MethodsFor this qualitative study, we conducted semi-structured telephone interviews with 20 former medical assistants between August and November 2023. Eligible for participation were medical assistants who (i) were of legal age, (ii) completed medical assistant vocational training and ii) were formerly employed as a medical assistant, but currently employed in another profession. The interviews were recorded, transcribed verbatim and content-analyzed.ResultsFormer medical assistants expressed various, often interrelated reasons for leaving the profession. These were changes in priorities throughout their career (e.g., in terms of working hours and salary), a constant high workload, barriers to further training, poor career prospects, and poor interpersonal relationships particularly with supervisors, but also within the team and with patients as well as the perception of insufficient recognition by politics and society. Suggestions of former medical assistants to motivate medical assistants to stay in their profession included amongst others higher salaries, more flexible work structures, improved career prospects, and more recognition from supervisors, patients, and society.ConclusionOur study provides insights into the complex decision-making process underlying ultimate medical assistant profession turnover. In light of an already existing shortage of medical assistants, we suggest to further explore how the suggested interventions that aim at retention of working medical assistants can be implemented.

The Impact of the COVID‐19 Pandemic on Nurses' and Junior Doctors' Workloads

ABSTRACTAimsTo explore the impact of the COVID‐19 pandemic on nurses' and junior doctors' workload, changes to direct care and the impact of workload on resource allocation.DesignMixed‐method design was used.MethodsData were collected from direct observation, hospital administrative database and a survey. Nurses and junior doctors were observed on two COVID‐19 wards and one non‐COVID‐19 ward using a semi‐structured observation schedule. Survey data were collected from nurses and junior doctors that had worked on the COVID‐19 ward during the pandemic. Patient data were collected from Web Patient Administration System during the period of March–August 2021 and compared to March–August 2022.ResultsThe results of this study indicated that the workloads of nurses and junior doctors changed on the COVID‐19 wards. Nurses on the COVID‐19 ward spent less time on administration, communication and documentation compared to nurses working on the non‐COVID‐19 ward. For junior doctors, less time was being spent on direct care activities and administrative work compared to the non‐COVID ward. On the COVID‐19 wards, patients were older and had a shorter length of stay compared to the year before. Five themes were identified from the surveys, staffing shortages resulting in higher workloads and the need for overtime, unforeseen time to undertake tasks, lack of support and physical health and patient care compromised.ConclusionThe study highlights the need for systemic changes to staffing shortages and elevated workloads to improve the compromised mental and physical health caused during the pandemic and to retain the workforce for future sustainability.ImplicationsAs we collectively reflect on the lessons learned from this unprecedented period, it is imperative to address the challenges experienced proactively, fostering a healthcare environment that prioritises the well‐being of its front line heroes and, by extension, the quality of patient care.Reporting MethodSTROBE.Patient or Public ContributionNo patient or public contribution.

Using a combination of cognitive behavioral therapy, case management and eHealth components for patients with depression or panic disorders in primary care practices in Hesse, Germany: an exploration of healthcare professionals’ lived experiences

BackgroundDepression and panic disorders have high prevalence rates in primary care. Given the crucial role of general practitioners in diagnosing and treating mental disorders, the two-arm cluster-randomized, controlled PREMA trial was designed. PREMA was aimed at investigating a new intervention combining cognitive behavioral therapy, case management and eHealth components for patients with depression and/or panic disorder with or without agoraphobia in primary care practices in Germany. This qualitative study, embedded in the PREMA trial, explores primary healthcare professionals’ lived experiences in using the new treatment program. Using a qualitative design, we conducted eleven interviews with general practitioners and medical assistants from Hesse, Germany, between July 2021 and March 2022. For both groups we relied on a semi-structured interview guide covering the following subjects: study procedures, implementation, practicality, and individual components of the treatment program. Interviews were audio-recorded, transcribed verbatim and analyzed by two researchers using content analysis. A deductive-inductive approach was used for the analysis according to Kuckartz.ResultsWe narratively summarized the facilitators and barriers from two different stakeholders across five key themes regarding experiences of feasibility and practicability of the new treatment program: study instruction materials, individual components of the treatment program, practicality, target population, and benefits of the treatment program. Facilitators to become familiar with the study include study instruction materials that are easy to understand and not too complex, considering the limited time resources available; barriers included text-heavy instruction materials, lack of collegial exchange, and issues especially with digital materials also involved access and log-in difficulties on the online platform. Facilitators for using the treatment program include the combination of face-to-face consultations and the use of an online platform, enabling a structured approach and regularity; barriers included patients feeling unsupported in performing anxiety exercises independently at home. For practicality, the professional skills of medical assistants and their central role as points of contact for patients facilitated the implementation; barriers included time-intensive organization and planning of monitoring phone calls and consultations. Regarding the target population, general practitioners and medical assistants state that the treatment program would be most appropriate for patients with mild to moderate depression and for those waiting for psychotherapeutic treatment; it would be less suitable for older patients, and those with negative attitudes towards technological tools. For benefits of the program, facilitating factors included free and low-threshold access to the online platform and strengthening the relationship between medical assistants and patients; barriers included a preference for in-person conversations and the inability of some people to use online applications.ConclusionsThe complexity of the new treatment program and the associated high workload underline the need for further adjustments to the treatment approach. Team-based care and the expanded responsibilities of medical assistants demonstrated promising results.Trial registrationThe study was registered in the German Clinical Trials Register (DRKS00016622) on February 22, 2019.

Psychological Capital, Emotional Labour, and Burnout among Malaysian Workers

Burnout, characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, is an occupational phenomenon now recognized by the World Health Organization. This study explores the interplay between psychological capital and emotional labour in contributing to burnout among workers in a Malaysian non-profit organization (NPO). Psychological capital encompasses positive psychological states such as self-efficacy, optimism, hope, and resilience. Emotional labour involves managing emotions to fulfil job roles, often requiring workers to present emotions that may not reflect their true feelings. The constant need to maintain these emotional displays can lead to emotional dissonance and burnout. Given Malaysia's demographic shifts towards an ageing population, the implications of burnout among NPO workers, who provide critical services to vulnerable groups, are significant. The high workload and emotional demands placed on these workers can result in chronic stress, emotional exhaustion, and a decrease in job performance and motivation. This study aims to fill the research gap by examining the specific factors that contribute to burnout in the Malaysian context, considering the unique cultural and social dynamics that may influence these relationships. The findings of this research can provide valuable insights for developing interventions to enhance psychological resilience and manage emotional labour more effectively among NPO workers. By addressing these challenges, organizations can support their workforce in maintaining high levels of service quality and personal well-being, which is crucial for the sustainability of NPOs and the well-being of the communities they serve.

Data-Driven Implementation Strategy to Optimise Clinician Behaviour Change at Scale in Complex Clinical Environments: A Multicentre Emergency Care Study.

To develop an evidence-driven, behaviour change focused strategy to maximise implementation and uptake of HIRAID (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) in 30 Australian rural, regional and metropolitan emergency departments. An embedded, mixed-methods study. This study is the first phase of a step-wedge cluster randomised control trial of HIRAID involving over 1300 emergency nurses. Concurrent quantitative and qualitative data were collected via an electronic survey sent to all nurses to identify preliminary barriers and enablers to HIRAID implementation. The survey was informed by the Theoretical Domains Framework, which is a synthesis of behavioural change theories that applies the science of intervention implementation in health care to effect change. Quantitative data were analysed using descriptive statistics and qualitative data with inductive content analysis. Data were then integrated to generate barriers and enablers to HIRAID implementation which were mapped to the Theoretical Domains Framework. Corresponding intervention functions and Behaviour Change techniques were selected and an overarching implementation strategy was developed through stakeholder consultation and application of the APEASE criteria (Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Side-effects/safety and Equity). Six barriers to HIRAID implementation were identified by 670 respondents (response rate ~58%) representing all 30 sites: (i) lack of knowledge about HIRAID; (ii) high workload, (iii) lack of belief anything would change; (iv) not suitable for workplace; (v), uncertainty about what to do and (vi) lack of support or time for education. The three enablers were as follows: (i) willingness to learn and adopt something new; (ii) recognition of the need for something new and (iii) wanting to do what is best for patient care. The 10 corresponding domains were mapped to seven intervention functions, 21 behaviour change techniques and 45 mechanisms. The major components of the implementation strategy were a scaffolded education programme, clinical support and environmental modifications. A systematic process guided by the behaviour change wheel resulted in the generation of a multifaceted implementation strategy to implement HIRAID across rural, regional and metropolitan emergency departments. Implementation fidelity, reach and impact now require evaluation. HIRAID emergency nursing assessment framework reduced clinical deterioration relating to emergency care and improved self-confidence and documentation in emergency departments in pilot studies. Successful implementation of any intervention in the emergency department is notoriously difficult due to workload unpredictability, the undifferentiated nature of patients and high staff turnover. Key barriers and enablers were identified, and a successful implementation strategy was developed. This study uses theoretical frameworks to identify barriers and enablers to develop a data-driven, behavioural-focused implementation strategy to optimise the uptake of HIRAID in geographically diverse emergency departments which can be used to inform future implementation efforts involving emergency nurses. The CROSS reporting method (Supporting Information S3) was used to adhere to EQUATOR guidelines. No Patient or Public Contribution. Australian New Zealand; Clinical Trials Registry (ANZCTR) number: ACTRN12621001456842, registered 25/10/2021.

Intensive care unit caseload and workload and their association with outcomes in critically unwell patients: a large registry-based cohort analysis

BackgroundToo high or too low patient volumes and work amounts may overwhelm health care professionals and obstruct processes or lead to inadequate personnel routine and process flow. We sought to evaluate, whether an association between current caseload, current workload, and outcomes exists in intensive care units (ICU).MethodsRetrospective cohort analysis of data from an Austrian ICU registry. Data on patients aged ≥ 18 years admitted to 144 Austrian ICUs between 2013 and 2022 were included. A Cox proportional hazards model with ICU mortality as the outcome of interest adjusted with patients’ respective SAPS 3, current ICU caseload (measured by ICU occupancy rates), and current ICU workload (measured by median TISS-28 per ICU) as time-dependent covariables was constructed. Subgroup analyses were performed for types of ICUs, hospital care level, and pre-COVID or intra-COVID period.Results415 584 patient admissions to 144 ICUs were analysed. Compared to ICU caseloads of 76 to 100%, there was no significant relationship between overuse of ICU capacity and risk of death [HR (95% CI) 1.06 (0.99–1.15), p = 0.110 for > 100%], but for lower utilisation [1.09 (1.02–1.16), p = 0.008 for ≤ 50% and 1.10 (1.05–1.15), p < 0.0001 for 51–75%]. Exceptions were significant associations for caseloads > 100% between 2020 and 2022 [1.18 (1.06–1.30), p = 0.001], i.e., the intra-COVID period. Compared to the reference category of median TISS-28 21–30, lower [0.88 (0.78–0.99), p = 0.049 for ≤ 20], but not higher workloads were significantly associated with risk of death. High workload may be associated with higher mortality in local hospitals [1.09 (1.01–1.19), p = 0.035 for 31–40, 1.28 (1.02–1.60), p = 0.033 for > 40].ConclusionsIn a system with comparably high intensive care resources and mandatory staffing levels, patients’ survival chances are generally not affected by high intensive care unit caseload and workload. However, extraordinary circumstances, such as the COVID-19 pandemic, may lead to higher risk of death, if planned capacities are exceeded. High workload in ICUs in smaller hospitals with lower staffing levels may be associated with increased risk of death.

Design, Implementation, and Adaptation of a Tutoring Program for the Competency Development of New Nurses in a Hospital Emergency Department.

The healthcare environment faced by nurses is complex, with high workloads and situations of high comorbidity. The integration of nurses into the work environment is a cause for concern, and improvements are sought for their incorporation into the workforce. The benefits of mentoring programs are described not only for nurses but also for patients with safer practices and benefits for the institution due to the increased commitment of its professionals. A methodological article that illustrates the complete process to design and implement a tutoring program for new nurses in an emergency department is presented. The competency profile required for the figure of tutor was developed, including the steps followed for the development of the program and the structure and phases of which it is composed, as well as the validation of the evaluation instruments of the process. A strength was the participation of experts during the in-depth analysis of the competency profile, as well as in the adaptation of the evaluation items, which endorses the pertinence, relevance, usefulness, and clarity of the content of this program. The transparency in this methodology makes it possible to follow the steps for its reproduction and applicability in other hospitals.

Pengukuran Beban Kerja Mental Mahasiswa Pekerja Fakultas Ekonomi Dan Bisnis Universitas Muhammadiyah Gresik Menggunakan Metode Nasa-TLX

Background – Mental workload is the difference between the workload demands of a task and capacity. Mental workload is a human evaluation or assessment of the limits of attentional load while carrying out tasks optimally, which is influenced by the workload demands of a task and the worker's capacity to handle the task, especially for students who carry out work activities while studying. Therefore, it is necessary to examine how much mental workload is actually borne by student workers so that the negative impacts it causes can be minimized. Aim – To measure the mental workload of student workers at the Faculty of Economics and Business, Muhammadiyah University of Gresik using the NASA-TLX method Design / methodology / approach – The research approach used is Quantitative Descriptive. Quantitative data was obtained from the results of questionnaire responses from student workers at the Faculty of Economics and Business, Muhammadiyah University of Gresik regarding the level of mental workload using the NASA-TLX method. Findings – High mental workload can have a negative impact on a person's mental health, especially for students who work while studying. Mental workload is defined as the difference between task demands and an individual's capacity to handle the task, focusing more on the mental aspect than the physical. Students who work while studying often experience fatigue, lack of time to rest and socialize, and experience sleep disorders and stress which can reduce their academic and work performance. Therefore, it is important to measure and analyze the level of mental workload experienced by student workers in order to reduce its negative impact. The method used to measure mental workload is NASA-TLX (Task Load Index). Conclusion – Student workers at the Faculty of Economics and Business, Muhammadiyah University of Gresik experience a high mental workload, with the time demand indicator (Temporal Demand/TD) having the highest weight and the level of effort (Effort/EF) getting the highest score. The time requirement (TD) indicator most dominantly influences their mental workload, while the level of frustration (FR) has the lowest influence. Overall, their average mental workload score was in the high category, namely 77.64. Research implication – This research is aimed at students who are studying while working, with the aim of measuring the level of mental load that objects experience. The load in question is a high mental workload, with indicators of time requirements (Temporal Demand/TD), level of effort (Effort/EF) and indicators of time requirements (TD), as well as levels of frustration (Frustration/FR). Limitations – The limitations of this research only include the mental workload variable on the research object (student workers)

Exploring nurse mentors' job crafting: A longitudinal study on missed nursing care across student supervision

AimTo compare the job crafting strategies nurse mentors use when mentoring students versus during periods of respite and to assess the effectiveness of these strategies in reducing instances of missed nursing care (MNC). BackgroundNurses who serve as mentors may have to train a group of nursing students on top of their routine nursing duties. The corresponding high workloads and limited resources may force them to decide which nursing care to delay or omit (i.e., MNC). The mentors’ initiative and the actions they take to address the multiple job requirements which do not align with the organization's resources are referred to as job crafting strategies. Mentors can use these strategies to shape their role as nurses as well as their role as mentors, depending on their motives and personality. DesignA longitudinal study with data collected at two time points. MethodsOne hundred nurse mentors completed validated questionnaires assessing job crafting strategies, MNC and work overload while actively mentoring students. Eighty returned for a follow-up during a non-mentoring period three months later. Data analysis included paired t-tests and hierarchical multivariable linear regressions. ResultsNo significant differences were found in MNC between the two points (1.83 SD 0.6 vs. 1.82 SD 0.75; p=0.942). A decrease in hindering demands was noted during active mentoring compared with respite (2.6 SD 0.97 vs. 2.84 SD 0.96; p=0.038). Enhancing structural job resources was significantly negatively correlated with MNC during active mentoring, while enhancing challenging job demands was positively correlated with MNC during these periods (β=0.48, p=0.18 and β=-0.35, p=0.014, respectively). ConclusionNurse mentors can effectively reduce MNC by focusing on enhancing structural resources and limiting challenging demands during mentoring periods. It is essential for healthcare organizations to support nurse mentors with manageable workloads and necessary resources to maintain high-quality care.

Understanding depression and anxiety rates of school psychology graduate students.

School psychology graduate students experience many risk factors for problems with mental health, including high workloads, financial distress, and challenging relationships with faculty that can exacerbate feelings of anxiety and depression. Although there have been studies that have investigated depression and anxiety amongst graduate students in general (Eisenberg et al., 2007) and health service psychology students in particular (Hobaica et al., 2021), there are reasons to believe that school psychology graduate students may have different experiences. To date, no research has been found investigating the depression and anxiety symptoms of graduate students in school psychology programs. A survey was sent to 194 school psychology training programs, and 291 graduate students completed it. Approximately one in four graduate students reported moderate to severe levels of depressive symptoms, while one in three reported moderate to severe levels of anxiety symptoms. These symptoms were significantly higher in graduate students identifying as lesbian, gay, bisexual, transgender, queer/questioning, and more identities, women, or reported being from a lower socioeconomic background. There were no differences in depression or anxiety symptoms between the type of program (i.e., doctoral or specialist) or years in program. Implications for trainers of school psychology are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Influence of brick laying height on biomechanical load in masons: Cross-sectional field study with technical measurements.

Work-related musculoskeletal disorders (WMSDs) located in the low back and neck/shoulder regions are major concerns for both workers, workplaces, and society. Masons are prone to WMSD, because their work is characterized by repetitive work and high physical workload. However, the knowledge on the physical workload during bricklaying is primarily based on subjective measurements. This cross-sectional field study with technical measurements aimed to quantify physical workload in terms of muscular activity and degree of forward bending during bricklaying at different working heights among masons, i.e., knee, hip, shoulder, and above shoulder height. Twelve male (36.1±16.1 years) experienced masons participated in a cross-sectional field study with technical measurements. Surface electromyography from erector spinae longissimus and upper trapezius muscles and an inertial measurement unit-sensor placed on the upper back were used to assess the physical workload (level of muscle activation and degree of forward bending) different bricklaying heights. Manual video analysis was used to determine duration of work tasks, frequency, type, and working height. The working heights were categorized as 'knee', 'hip', 'shoulder', and 'above shoulder'. The 95 percentiles of the normalized Root Mean Square (RMSn) values were extracted assess from erector spinae and trapezius recordings to assess strenuous level muscle of muscle activation. The RMSn of dominant erector spinae muscle increased from hip- to shoulder height (from 26.6 to 29.6, P < 0.0001), but not from hip to above shoulder height and decreased from hip to knee height (from 26.6 to 18.9, P < 0.0001). For the dominant trapezius muscle, the RMSn increased from hip- to shoulder- and above shoulder height (from 13.9 to 19.7 and 24.0, respectively, P < 0.0001) but decreased from hip- to knee height (from 13.9 to 11.5, P < 0.0001). Compared to hip height (27.9°), an increased forward bending was detected during bricklaying at knee height (34.5°, P < 0.0001) and a decreased degree of forward bending at shoulder- and above shoulder height (17.6° and 12.5°, P < 0.0001, respectively). Based on technical measurements, bricklaying at hip height showed the best compromise between muscular load and degree of forward bending. This study contributes to the development of the work environment for masons and can help guide preventive initiatives to reduce physical workload.