Low Job Strain Research Articles

Sickness absence and associations with sociodemographic factors, health risk behaviours, occupational stressors and adverse mental health in 40,343 UK police employees.

Police employees may experience high levels of stress due to the challenging nature of their work which can then lead to sickness absence. To date, there has been limited research on sickness absence in the police. This exploratory analysis investigated sickness absence in UK police employees. Secondary data analyses were conducted using data from the Airwave Health Monitoring Study (2006-2015). Past year sickness absence was self-reported and categorised as none, low (1-5 days), moderate (6-19 days) and long-term sickness absence (LTSA, 20 or more days). Descriptive statistics and multinomial logistic regressions were used to examine sickness absence and exploratory associations with sociodemographic factors, occupational stressors, health risk behaviours, and mental health outcomes, controlling for rank, gender and age. From a sample of 40,343 police staff and police officers, forty-six per cent had no sickness absence within the previous year, 33% had a low amount, 13% a moderate amount and 8% were on LTSA. The groups that were more likely to take sick leave were women, non-uniformed police staff, divorced or separated, smokers and those with three or more general practitioner consultations in the past year, poorer mental health, low job satisfaction and high job strain. The study highlights the groups of police employees who may be more likely to take sick leave and is unique in its use of a large cohort of police employees. The findings emphasise the importance of considering possible modifiable factors that may contribute to sickness absence in UK police forces.

Exploring Job Stress Among Public Health Workforce in Northeastern Malaysia.

Introduction Job stress is recognized as a significant concern across various occupational settings which have profound implications for both individuals and organizations. During the COVID-19 pandemic, job stress among the public health workforce (PHW) has been a significant concern, as they face a significantly increased risk of infection and mortality due to excessive COVID-19 exposure. This study presents a descriptive exploration of key job stress-related factors among PHW in Terengganu, Malaysia. Methodology This is a cross-sectional study conducted from May 2022 to April 2023, encompassing all eight District Health Offices (DHO) and government health clinics in Terengganu. Data collection involved a Malay version of the Job Content Questionnaire (M-JCQ), which assesses job characteristics based on Karasek's demand-control-support model and consists of four main domains: decision latitude, psychological job demands, physical job demands, and social support. Data was collected from 1044 participants, and statistical analysis was performed using SPSS version 27 (IBM Corp., Armonk, NY, USA). Findings Of the 1044 participants, 18.9% experienced job stress. The highest percentage of job stress was observed among nurses (24.3%), followed by medical assistants (18.3%) and physicians (16.0%). In contrast, the public health assistant (PKA) group had the lowest rate of job stress. Job types based on Karasek's model also showed variations, with doctors having the highest percentage of active jobs (46.4%), while medical assistants had the highest percentage of low job strain (17.9%), and PKAs had the highest percentage of passive job types (44.7%). Conclusion This study offers significant insights into the work-related challenges faced by the public health workforce in Terengganu, Malaysia, especially during the COVID-19 pandemic. Job stress is a substantial concern, and understanding its underlying factors is essential for improving the well-being of PHWs. Decision latitude, job demands, and social support play critical roles in shaping job stress among PHWs. Strategies and interventions are needed to mitigate job stress, improve working conditions, and enhance the effectiveness of PHWs in public health initiatives. This study highlights the importance of addressing job stress in this sector, with potential benefits for both the mental and physical health of PHW.

Association of work-related psychosocial factors and day-to-day home blood pressure variation: the Finn-Home study.

Stress, and particularly job strain, has been found to associate with ambulatory blood pressure (BP). Moreover, BP is known to vary between days. One potential over-looked factor underlying this day-to-day BP variation could be work-related psychosocial factors. Thus, we aimed to study the association between job strain, job demands, job control and day-to-day BP variation. The home BP of 754 regularly working participants (mean age 50.9 ± 4.8, women 51%) of the Finn-Home Study was measured twice in the morning and twice in the evening over seven days. Average SBP and DBP were calculated for each day. Work-related psychosocial factors were measured with survey. Multivariable-adjusted generalized linear models were used for statistical analysis. We found a greater SBP/DBP decrease between weekdays and weekend among participants with high job strain (-1.8 [95% confidence interval, 95% CI, -2.7 to -0.8]/-1.7 [95% CI, -2.3 to -1.1] mmHg) compared to participants with low job strain (-0.7 [95% CI, -1.1 to -0.2]/-0.7 [95% CI, -1.0 to -0.4] mmHg). The participants with high job demands showed a higher BP decrease between weekdays and weekend (-1.4 [95% CI, -2.0 to -0.8]/-1.3 [95% CI, -1.6 to -0.9] mmHg) than the participants with low job demands (-0.5 [95% CI, -1.1 to 0.0]/-0.6 [95% CI, -1.0 to -0.3] mmHg). We did not find BP differences regarding job control. High job strain and high job demands were associated with a greater BP reduction from weekdays to the weekend. Work-related psychosocial factors should be considered when assessing day-to-day BP variation.

Trajectories of psychosocial working conditions and all-cause and cause-specific mortality: a Swedish register-based cohort study.

While psychosocial working conditions have been associated with morbidity, their associations with mortality, especially cause-specific mortality, have been less studied. Additionally, few studies considered the time-varying aspect of exposures. We aimed to examine trajectories of job demand-control status in relation to all-cause and cause-specific mortality, including cardiovascular diseases (CVD), suicide, and alcohol-related mortality. The study population consisted of around 4.5 million individuals aged 16-60 years in Sweden in 2005. Job control and demands were respectively measured using job exposure matrices (JEM). Trajectories of job control and demands throughout 2005-2009 were identified using group-based trajectory modelling, and job demand-control categories were subsequently classified. Deaths in 2010-2019 were recorded in the national cause of death register. Cox regression models were used. A total of 116 242 individuals died in 2010-2019. For both job control and demands, we identified four trajectories, which were parallel to each other and represented four levels of exposures. Low control and passive jobs were associated with higher all-cause, CVD, and suicide mortality among both men and women. High strain jobs were associated with higher all-cause and CVD mortality among men, while low control, passive jobs, and high strain jobs were associated with higher alcohol-related mortality among women. The trajectories identified may suggest stable levels of job control and demands over time. Poor psychosocial working conditions are related to all-cause and cause-specific mortality, and these patterns vary to some extent between men and women.

Employee empowerment, equality plans and job satisfaction: an empirical analysis of the demand-control model

PurposeThe paper investigates the effects of individual employees' empowerment on different forms of job satisfaction in British workplaces while controlling for the presence of job demands and whether these effects depend on the presence of an equality plan in the workplace. The demand-control model that the authors test proposes that imbalances between the demands placed on employees and the control they have in their job negatively affect employee well-being and health. Control may also be strengthened, and demands mitigated, by effective equality policies. This study looks at nine forms of job satisfaction and examines the individual effects of job demands, job control, the interaction of control and demands and their joint effects with equality plans.Design/methodology/approachThe study uses matched employee–employer British data from the 2011 Workplace Employment Relations Survey (WERS). The authors conduct principal component analysis (PCA) and logit estimations and estimate a recursive simultaneous bivariate probit model.FindingsEmployee empowerment, or job control, is a key predictor of job satisfaction, and job demands are negatively associated with various aspects of job satisfaction. The presence of equality plans strengthens the positive effects of job control and mitigates the detrimental effects of job demands. Consistent with the demand-control model, employees are more likely to be satisfied in low strain jobs (jobs with low demands and high control) than in high strain jobs (jobs with high demands and low control). Employees in passive jobs (jobs with low demand and low control) on the other hand are less likely to be satisfied with achievement and influence than employees in low strain job.Originality/valueMuch of the empirical literature has focused on collective empowerment practices and none has tested the demand-control model. This paper adds to the literature on employee empowerment practices with a focus on individualised job control and the way its effects interact with equality plans. In the process, the authors provide novel and rigorous empirical evidence on an extended version of the demand-control model.

Supported or stressed while being assessed? How motivational climates in UK University workplaces promote or inhibit researcher well‐being

AbstractAcademic culture now places high expectations on researchers to demonstrate research productivity alongside teaching, leadership and knowledge exchange. In two studies of researchers across career stages in UK higher education institutions (HEIs), we examined workplace climate within academic departments as (1) supportive of researchers' needs for autonomy, competence and relatedness, (2) publish‐or‐perish focused and (3) hyper‐competitive. In Study 1 (multiwave from 2018 to 2020), need support predicted researchers' lower turnover intention 2 years later, even when controlling for concurrent need support, and career and economic conditions. In Study 2, need support correlated with academic well‐being (lower job strain and turnover intention, greater job satisfaction) in a nationwide sample of 2951 researchers. Study 2 found that need support related to improved, and a hyper‐competitive motivational climate related to undermined, well‐being. Results were mixed for publish‐or‐perish climate. Performative demands can have deleterious effects on researcher well‐being.

PSYCHOSOCIAL WORKING CONDITIONS IN MID-LIFE AND COGNITIVE AND PHYSICAL IMPAIRMENT IN OLDER AGE

Abstract Background Psychosocial working conditions have been associated with cognitive and physical impairment among older adults. However, less is known on whether psychosocial working conditions are associated with a combination of cognitive and physical impairments. The aim of this study was to investigate the associations between midlife psychosocial working conditions and physical and cognitive impairment among older adults, and to assess whether there are sex differences in these associations. Methods The data were derived from two Swedish nationally representative surveys (n=839) with a follow-up time of 20-24 years. Multinomial and binary logistic regressions were used to assess the associations between work stressors according to the job demand-control model, and a combination of cognitive and physical impairment. Results Low control jobs were significantly associated with higher odds of both cognitive and physical impairment as well as a combination of cognitive and physical impairment. Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment, and cognitive and physical impairment in combination. Active jobs (high control, high demand) were associated with lower odds of cognitive impairment. Sex-stratified analyses showed stronger associations among men than among women. Among men passive jobs were significantly associated with both cognitive and physical impairment. Low strain jobs were significantly associated with less physical impairment. Conclusions These results highlight the importance of midlife psychosocial working conditions for late-life physical and cognitive impairment, and especially among men. Jobs characterised by higher control, lower strain and active jobs may promote resilience and cognitive reserve among older populations.

The associations of job strain and leisure-time physical activity with the risk of hypertension: the population-based Midlife in the United States cohort study.

Job strain is positively associated with incident hypertension, while increasing leisure-time physical activity (LTPA) can reduce incident hypertension. However, the joint associations of job strain and LTPA with incident hypertension among United States workers have yet to be investigated. This study examined the independent and joint associations of job strain and LTPA with incident hypertension. This prospective cohort study (n=1,160) utilized data from the population-based Midlife in the United States study. The associations of job strain and LTPA at baseline with incident hypertension during follow-up were examined using Cox proportional hazards models. High job strain was derived from a combination of high job demands and low job control, and high LTPA was defined as engagement in moderate or vigorous LTPA at least once per week. During 9,218 person-years of follow-up, the hypertension incidence rate was 30.6 (95% confidence interval [CI], 27.3 to 34.3) per 1,000 person-years. High job strain was associated with a higher risk for hypertension than low job strain (adjusted hazard ratio [aHR], 1.29; 95% CI, 1.00 to 1.67). High LTPA was associated with lower hypertension risk than low LTPA (aHR, 0.77; 95% CI, 0.60 to 0.98). Hypertension risk was higher among workers with high job strain and low LTPA than among those with low job strain and high LTPA (aHR, 1.70; 95% CI, 1.18 to 2.43). Job strain and LTPA showed positive and inverse associations, respectively, with incident hypertension. The combination of high job strain and low LTPA was associated with the highest risk for hypertension.

Psychosocial working conditions and cognitive and physical impairment in older age

BackgroundPsychosocial working conditions are associated with cognitive and physical impairments. The aim of this study was to investigate the associations between mid-late life psychosocial working conditions and the combination of physical and cognitive impairment among older adults, and the potential sex differences in these associations. MethodsData were derived from two Swedish nationally representative surveys (n = 839; follow-up: 20–24 years). Multinomial and binary logistic regressions assessed the associations between work stressors (job demand-control model), and a combination of cognitive and physical impairment. ResultsLow control jobs were significantly associated with higher odds of cognitive (OR: 1.41, CI: 1.15–1.72) and physical impairment (OR: 1.23, CI: 1.02–1.47), and cognitive and physical impairment combined (OR: 1.50, CI: 1.19–1.89). Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment (OR: 1.57, CI: 1.12–2.20), and combined cognitive and physical impairment (OR: 1.59, CI: 1.07–2.36). Active jobs (high control, high demand) were associated with lower odds of cognitive impairment (OR: 0.48, CI: 0.29–0.80). Sex-stratified analyses showed stronger associations among men; passive jobs were associated with both cognitive (OR: 2.18, CI: 1.31–3.63) and physical impairment (OR: 1.78, CI: 1.13–2.81), while low strain jobs were associated with less physical impairment (OR: 0.55, CI: 0.33-0.89). No significant associations between work stressors and impairment were found for women. ConclusionsThese results highlight the importance of psychosocial working conditions for late-life physical and cognitive impairment, especially among men. Jobs characterised by low control and low demands are associated with higher risk for impairments.

Relationship between Salivary Cortisol, Salivary Immunoglobulin A, Serum Oxidative Stress Indices, and Job Stress among Healthcare Workers in A Nigerian Tertiary Hospital

Background: Healthcare workers (HCWs) are highly susceptible to job-related and psychological stress. The current study evaluated the physiological reactions to stress and its biochemical correlates which could add objective evidence to a perception of job stress among HCWs. Methodology: This was a prospectively designed cross-sectional study to compare stress markers amongst 84 healthy male HCW in a tertiary hospital. They were recruited from various hospital units and categorized as rated by survey responses using Karasek’s Job Content Questionnaires as follows: (1) based on job demand (JD): high and low JD; (2) based on job control (JC): low and high JC; (3) based on job strain (JS): no and high JS. Stress markers evaluated were salivary cortisol, salivary immunoglobulin A (IgA), and oxidative stress indices (Malondialdehyde [MDA], Ascorbic Acid, and Total Antioxidant Capacity [TAC]). All laboratory analyses including statistical protocols were carried out according to well-established standard guidelines. Result: Salivary cortisol was higher in low JC than high JC (p=0.003) subgroups while salivary IgA was higher in high JS compared to the no JS (p=0.041) subgroups. Additionally, JC inversely correlated (r= -0.268; p=0.014) with salivary cortisol. However, other biochemical variables did not differ significantly across categorized groups. However, while the medical doctors had higher MDA compared to other HCWs, the radiographers had higher TAC compared to others; this may indicate oxidative stress among these HCWs (p<0.05). Conclusion: From the foregoing, HCWs with high JS are under higher stress with low JC which stimulates the HPA axis as an adaptive mechanism. Hence, efforts to promote low JS with high JC are highly recommended among HCWs for optimal service delivery.

Determining factors affecting job strain for nurse practitioners in acute care practice.

To investigate nurse practitioners' (NPs) experience of job strain in acute care settings, and to examine the factors that may affect job strain in that context. Descriptive design using a national survey was employed. A total of 1396 NPs completed online surveys that recorded demographic characteristics and included a Job Content Questionnaire (JCQ), a Condition for Work Effectiveness Questionnaire (CWEQ), and the Dempster Practice Behavior Scale (DPBS). Multiple logistic regressions were conducted to explore the factors associated with job strain types. NPs were classified into job strain categories of passive (24.4%), active (31.4%), low (19.2%), or high (24.9%). The passive job strain type was associated with overtime hours, organizational empowerment, and autonomy. The active job type was associated with higher organizational empowerment and autonomy. The high-strain and low-strain job types were both associated with overtime hours and autonomy. Nearly 25% of acute care NPs are in a high job strain type. Organizational empowerment and autonomy were two major factors associated with the passive and active job strain types. Overtime hours and autonomy were both associated with the high-strain and low-strain job types. Supportive hospital/nursing leadership should acknowledge the impact of NP practice as they can contribute to the operational efficacy of their organization. Hospital administrators should provide a supportive practice environment by empowering NPs, enhancing autonomy, and addressing working conditions for NPs to decrease the odds of having a passive or high-strain job type in practice.

Occupational stress and pregnancy-related hypertension and diabetes: Results from a nationwide prospective cohort.

ObjectivesUsing a large, national, prospective cohort, while adjusting for other work exposures, this study aims to investigate whether exposure to occupational stress during pregnancy is associated with hypertensive disorders of pregnancy (HDP) and gestational diabetes.MethodsOur cohort consisted of 1 102 230 singleton births between 1994–2014 in Sweden, based on high-quality register data of Swedish pregnancies. Exposure to occupational stress was obtained from a job exposure matrix (JEM) constructed from 12 questions pertaining to the psychosocial work environment from the 1997–2013 cycles of Swedish Work Environment Survey, including approximately 75 000 individuals. We utilized the decision authority, demands, and social support indices. Decision authority and demands were combined to categorize occupations into low, active, passive, and high strain work. We estimated relative risks (RR) and adjusted for relevant confounders, such as age, smoking and other work exposures.ResultsOccupations with lower levels of decision authority were associated with increased risks of 12–23% for HDP and preeclampsia and 36–58% for gestational diabetes compared to occupations with the highest levels of decision authority. Passive occupations had increased risks of 10% for HDP and preeclampsia and 15% for gestational diabetes when compared to low strain jobs. No significant associations were found for high strain occupations.ConclusionsAs a whole, occupational stress was not consistently associated with pregnancy outcomes in our study. However, decision authority was associated with an increased risk for pregnancy-related complications. Further studies should investigate whether improvements in working conditions can help decrease these risks.

Why do men extend their employment beyond pensionable age more often than women? a cohort study

Men extend their employment beyond pensionable age more often than women, but the factors that contribute to this sex difference are unknown. This study aimed to examine sex differences in extending employment and the contribution of sociodemographic, work- and health-related factors to these differences. Participants of this prospective cohort study were 4,263 public sector employees from Finland who reached their individual pensionable date between 2014 and 2019 and responded to a survey on work- and non-work-related issues before that date. Extended employment was defined as continuing working for over six months beyond the individual pensionable date. We used mediation analysis to examine the contribution of explanatory factors to the association between sex and extended employment. Of the participants, 29% extended employment beyond the pensionable date. Men had a 1.29-fold (95% confidence interval 1.11–1.49) higher probability of extending employment compared with women. Men had a higher prevalence of factors that increase the likelihood of extended employment than women (such as spouse working full-time, no part-time retirement, low job strain, high work time control, and lack of pain) and this mediated the association of sex with extended employment by up to 83%. In conclusion, men were more likely to extend their employment beyond pensionable age than women. This difference was largely explained by men being more likely to have a full-time working spouse, low job strain, high work time control, no pain, and not being on part-time retirement.

Association of job strain with accelerometer-based sleep duration and timing of sleep among older employees.

Job strain has been associated with poor sleep quality and could lead to changes in duration and timing of sleep as well. This study examined the association of job strain with sleep duration, bedtimes and awakening times among public sector employees close to their retirement age. Differences in these sleep parameters between workdays and free days across job strain groups were examined. Duration and timing of sleep were measured repeatedly with accelerometers among 466 public sector employees in Finland (mean age 63years, 86% women), who contributed to 759measurements in total. Job demands (low/high) and control (low/high) measured by self-reports and job exposure matrix were used to identify low strain (low demand, high control), passive (low, low), active (high, high) and high strain (high, low) jobs. No differences in sleep duration were observed on workdays, whereas on free days those in the high strain group had longer sleep duration than those in the low strain and passive job groups. The high strain group also extended their sleep from workdays to free days more, the extension being on average 59min (95% CI 42min-75min) when adjusted for several sociodemographic, work and health factors. This extension of sleep duration resulted mostly from a greater delay of awakening times from workdays to free days. Psychosocial work factors, such as job strain, need to be considered when promoting sufficient sleep duration among older employees, as those with job strain may have a greater need for recovery and sleep.

Working life job strain status and cognitive aging in Europe: A 12-year follow-up study

BackgroundTo examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline. MethodsData were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline. ResultsBoth passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job. LimitationsInformation on working conditions was based on self-reported recollections. ConclusionsWorking life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

Social factors and chronic pain: the modifying effect of sex in the Stockholm Public Health Cohort Study.

ObjectivesTo assess the relationship between social factors (socio-economic status, household load and job strain) and chronic pain occurrence, and the role of gender in this relationship.MethodsWe used data corresponding to 8 years of follow-up of the Stockholm Public Health Cohort Study (2006–2014) to compute Adjusted Incidence Rate Ratios (IRRs) and additive interaction measures of chronic pain episodes, social factors, and sex in 16 687 subjects.ResultsFor men, increased rates of chronic pain occurrence were observed for skilled workers (IRR = 1.27, 95% CI: 0.99, 1.61) and lower non-manual employees (IRR = 1.37, 95% CI: 1.05, 1.78), compared with unskilled workers; subjects with high household load (IRR = 1.39; 95% CI: 1.03, 1.88), compared with those with a null score; and subjects with active jobs (IRR = 1.27, 95% CI: 1.06, 1.51), compared with those with low-strain jobs. For women, we observed decreased rates of chronic pain occurrence in lower (IRR = 0.82, 95% CI: 0.68, 0.99), intermediate (IRR = 0.74, 95% CI: 0.63, 0.88) and higher non-manual employees (IRR = 0.65, 95% CI: 0.54, 0.79), compared with unskilled workers. Compared with subjects with a null score, women with low household load showed a lower rate of chronic pain occurrence (IRR = 0.85; 95% CI: 0.72, 1.00). Compared with subjects with low-strain jobs, those with passive jobs (IRR = 1.21; 95% CI: 1.02, 1.44) and high-strain jobs (IRR = 1.46; 95% CI: 1.02, 2.09) showed higher rates of chronic pain occurrence.ConclusionIn general, our analysis yielded different, if not opposite, results when data were stratified by sex. Sex may then represent an effect modifier of the relationship between social factors and chronic pain.

Cumulative exposure to psychosocial stressors at work and global cognitive function: the PROspective Quebec Study on Work and Health

ObjectivesPsychosocial stressors at work have been proposed as modifiable risk factors for mild cognitive impairment (MCI). This study aimed to evaluate the effect of cumulative exposure to psychosocial stressors at...

Psychosocial work factors and blood pressure among 63 800 employees from The Netherlands in the Lifelines Cohort Study

ObjectivesPrevious studies on the association between psychosocial work factors and blood pressure mainly focused on specific occupations or populations and had limited sample sizes. We, therefore, investigated the associations between...

Job strain is prospectively associated with a lower frequency of fruit consumption in schoolteachers.

The current study aimed to analyse the prospective association between perceived work demand and changes in eating behaviours in schoolteachers. This was a prospective cohort study with self-reported information obtained on the Demand Control Support Questionnaire and eating behaviours at baseline and after a 2-year follow-up. The analyses were performed using mixed-effects models adjusted for the main confounders. The setting consisted of elementary and secondary schools located in a large city in southern Brazil. The participants were 502 schoolteachers (65·9 % females, median age of 42·7 years [interquartile range 34·2, 49·4]). A total of 39·2 % of the schoolteachers were classified at baseline with job strain, 28·9 % with passive job, 12·2 % with active job and 19·7 % with low-strain job. In the fully adjusted models, compared with teachers who reported low-strain job, those with higher levels of job strain were more likely to reduce (coefficient = 0·064; 95 % CI 0·018, 0·109) and less likely to increase (coefficient = -0·066; 95 % CI -0·115, -0·016) their frequency of fruit consumption regardless of sociodemographic, lifestyle, health conditions and social support at work. Job strain plays a relevant role in the frequency of fruit consumption over time in schoolteachers. The balance between demand and control at work must be considered in strategies for promoting healthy eating despite perceived social support.

Psychological Safety in Intensive Care Unit Rounding Teams.

Rationale: Psychological safety is the condition by which members of an organization feel safe to voice concerns and take risks. Although psychological safety is an important determinant of team performance, little is known about its role in the intensive care unit (ICU). Objectives: To identify the factors associated with psychological safety and the potential influence of psychological safety on team performance in critical care. Methods: We performed daily surveys of healthcare providers in 12 ICUs within an integrated health system over a 2-week period. Survey domains included psychological safety, leader familiarity, leader inclusiveness, role clarity, job strain, and teamwork. These data were linked to daily performance on lung-protective ventilation and spontaneous breathing trials. We used regression models to examine the antecedents of psychological safety as well as the influence of psychological safety on both perceived teamwork and actual performance. Results: We received 553 responses from 270 unique providers. At the individual provider level, higher leader inclusiveness (adjusted β = 0.32; 95% confidence interval [CI], 0.24 to 0.41) and lower job strain (adjusted β = -0.07, 95% CI, -0.13 to -0.02) were independently associated with greater psychological safety. Higher psychological safety was independently associated with greater perception of teamwork (adjusted β = 0.30; 95% CI, 0.25 to 0.36). There was no association between team psychological safety and performance on either spontaneous breathing trials (incident rate ratio for each 1-unit change in team psychological safety, 0.85; 95% CI, 0.81 to 1.10) or lung-protective ventilation (incident rate ratio, 0.77; 95% CI, 0.57 to 1.04). Conclusions: Psychological safety is associated with several modifiable factors in the ICU but is not associated with actual use of evidence-based practices.