Quantitative Work Demands Research Articles

Mental health of Australian frontline nurses during the COVID-19 pandemic: Results of a large national survey

This paper investigates the effects of work demands on burnout indices of emotional exhaustion, depersonalization and personal accomplishment, and mental health indices of anxiety, depression and stress, among Australian nurses and midwives. We used de-identified self-reported survey data from approximately 11,000 Australian nurses and midwives during the pandemic. Linear and quantile regression analyses explored how working conditions affect different aspects of nurses and midwives' burnout and mental health. Results show how working conditions affect burnout and mental health heterogeneously depending on the severity of the mental health symptoms. Increased quantitative and emotional work demands significantly impact occupational burnout indices of emotional exhaustion and depersonalization, and mental health indices of anxiety, depression, and stress among Australian nurses and midwives. Quantitative and emotional demands have more significant effects on people with higher levels of anxiety, depression, stress, and depersonalization than on those with milder or lesser symptoms. Given recent national and international policy focus on psychosocial hazards at work, this paper suggests that governments and health care providers need to monitor such hazards among nurses and midwives and introduce policies that reduce excessive quantitative or emotional burden to minimise risk of burnout and poor mental health and support good mental health among nurses and midwives.

Nursing Home, Ward and Worker Level Determinants of Perceived Quantitative Work Demands: A Multi-Level Cross-Sectional Analysis in Eldercare.

IntroductionPerceived quantitative demands at work have been associated with poor mental and physical health, long-term sickness absence and subsequent early retirement. Identifying modifiable determinants of perceived quantitative demands at different levels of the organization is key to developing effective interventions. The aim of the study was to identify determinants of perceived quantitative demands at work and examine the extent to which they occur at different levels of the eldercare organisation (i.e. the worker, ward and nursing home levels).MethodsWe collected data on 383 eldercare workers in 95 wards at 20 nursing homes in Denmark using workplace observations and questionnaires to workers and their managers. Perceived quantitative work demands were assessed using two items from the Copenhagen Psychosocial Questionnaire, II. We identified contributions to overall variability from the three organisational levels using variance components analysis, and examined associations between determinants at these three levels and quantitative demands.ResultsAlmost all (90.9%) the variability in perceived quantitative demands occurred between eldercare workers (within wards). Determinants significantly associated with lower quantitative demands were: having a job as a care helper, working fixed evening shifts, being born outside Denmark, having lower influence at work, higher quality of leadership and lower emotional demands. None of the investigated physical factors (e.g. resident handlings, push/pull tasks, step-count) were associated with perceived quantitative demands.ConclusionWe found that the variability in perceived quantitative demands occurred primarily between eldercare workers within wards. Our study indicates that psychosocial work environment factors are the strongest modifiable determinants of perceived quantitative demands in eldercare, while organisational factors related to job position, shift, and resident-staff ratio also play a role. Interventions should test if changes in these determinants can reduce perceived quantitative demands at work in eldercare.

Musculoskeletal pain trajectories of employees working from home during the COVID-19 pandemic

ObjectivesIn March 2020, the COVID-19 pandemic necessitated a rapid public health response which included mandatory working from home (WFH) for many employees. This study aimed to identify different trajectories of multisite musculoskeletal pain (MSP) amongst employees WFH during the COVID-19 pandemic and examined the influence of work and non-work factors.MethodsData from 488 participants (113 males, 372 females and 3 other) involved in the Employees Working from Home (EWFH) study, collected in October 2020, April and November 2021 were analysed. Age was categorised as 18–35 years (n = 121), 36–55 years (n = 289) and 56 years and over (n = 78). Growth Mixture Modelling (GMM) was used to identify latent classes with different growth trajectories of MSP. Age, gender, working hours, domestic living arrangements, workstation comfort and location, and psychosocial working conditions were considered predictors of MSP. Multivariate multinomial logistic regression was used to identify work and non-work variables associated with group membership.ResultsFour trajectories of MSP emerged: high stable (36.5%), mid-decrease (29.7%), low stable (22.3%) and rapid increase (11.5%). Decreased workstation comfort (OR 1.98, CI 1.02, 3.85), quantitative demands (OR 1.68, CI 1.09, 2.58), and influence over work (OR 0.78, CI 0.54, 0.98) was associated with being in the high stable trajectory group compared to low stable. Workstation location (OR 3.86, CI 1.19, 12.52) and quantitative work demands (OR 1.44, CI 1.01, 2.47) was associated with the rapid increase group.ConclusionsFindings from this study offer insights into considerations for reducing MSP in employees WFH. Key considerations include the need for a dedicated workstation, attention to workstation comfort, quantitative work demands, and ensuring employees have influence over their work.

Associations between perceived quantitative work demands at different organisational levels and pain and sickness absence in eldercare workers: a multi-level longitudinal analysis

PurposeEldercare work is characterised by high quantitative work demands and high occurrence of musculoskeletal pain and sickness absence. Our aim was to investigate the association between quantitative demands aggregated at the different organizational levels of eldercare and low back pain (LBP) and sickness absence due to pain among workers.MethodsThis study was conducted in 527 eldercare workers from 105 wards across 20 nursing homes in Denmark. We collected workers’ perceived quantitative demands at baseline and workers’ LBP and sickness absence repeatedly over the following year. We aggregated worker-level quantitative demands to the ward and nursing home-levels, and used mixed-effects regression models to investigate the associations between quantitative demands at different organizational levels and LBP and sickness absence over 1 year.ResultsAcross all models, increased quantitative demands (0–100 scale) at the worker-level was associated with an increased likelihood (OR 1.02) and intensity of LBP (β = 0.01). We did not identify any associations between quantitative demands at the ward-level and either of our outcomes. Across all models, increased quantitative demands at the nursing home-level was associated with increased days with sickness absence due to pain (β = 0.03 to 0.06).ConclusionIn eldercare, workers’ perceived quantitative demands are associated with the presence and intensity of LBP. Further, quantitative demands across the overall nursing home-level are associated with sickness absence due to pain among eldercare workers. These results are of relevance to developing organisational interventions targeting quantitative demands to reduce sickness absence in eldercare.

Trajectories of cognitive symptoms and associated factors in cancer survivors after return to work: an 18-month longitudinal cohort study

PurposeCognitive symptoms affect cancer survivors’ functioning at work. To date, cognitive symptoms trajectories in working cancer survivors and the factors associated with these trajectories have not been examined.MethodsData from a heterogeneous group of working cancer survivors (n = 379) of the longitudinal “Work-Life-after-Cancer” study, linked with Netherlands Cancer Registry data, were used. The Cognitive Symptom Checklist-Work was administered at baseline (within the first 3 months after return to work), 6-, 12-, and 18-month follow-up to measure self-perceived memory and executive function symptoms. Data were analyzed using group-based trajectory modeling.ResultsFour trajectories of memory and executive function symptoms were identified. All memory symptoms trajectories were stable and labeled as “stable-high” (15.3% of the sample), “stable-moderately high” (39.6%), “stable-moderately low” (32.0%), and “stable-low” (13.0%). Executive function symptoms trajectories changed over time and were labeled as “increasing-high” (10.1%), “stable-moderately high” (32.0%), “decreasing-moderately low” (35.5%), and “stable-low” (22.4%). Higher symptoms trajectories were associated with older age, longer time from diagnosis to return to work, more quantitative work demands, and higher levels of depressive symptoms at baseline.ConclusionsIn cancer survivors who returned to work, four cognitive symptoms trajectory subgroups were identified, representing different but relatively stable severity levels of cognitive symptoms.Implications for Cancer SurvivorsTo identify cancer survivors with higher symptoms trajectories, health care providers should assess cognitive symptoms at baseline after return to work. In case of cognitive symptoms, it is important to also screen for psychological factors to provide appropriate guidance.

Gender Differences in the Work and Home Spheres for Teachers, and Longitudinal Associations with Depressive Symptoms in a Swedish Cohort

The high level of stress among teachers is a frequently reported problem globally but less is known about how demands and resources among teachers affect depressive symptoms, and to what extent gender differences in these conditions can explain potential differences in depressive symptoms. The present study investigated gender differences in teachers’ self-reported depressive symptoms, and differences in their demands and resources in both work and home spheres. Associations between demands and resources, respectively, and depressive symptoms as well as gender differences in these associations were examined. Results from univariate and parallel growth modelling (N = 1,022), using data from six time points (2008 to 2018), found higher levels of depressive symptoms, higher emotional and quantitative work demands, and more time doing unpaid work among female teachers, whereas male teachers reported more time on leisure activities. Emotional and quantitative work demands were associated with depressive symptoms at baseline, and these associations also developed in parallel over time. Leisure time had a negative association with depressive symptoms at baseline. There were no gender differences in the strength of these associations. Findings suggest that gender differences in teachers’ depressive symptoms could be attributable to women’s greater demands in the work sphere and fewer resources in the home sphere than men as opposed to their being more vulnerable to workplace stressors.

Practice assistants´ perceived mental workload: A cross-sectional study with 550German participants addressing work content, stressors, resources, and organizational structure.

Practice assistants represent a highly relevant occupational group in Germany and one of the most popular training professions in Germany. Despite this, most research in the health care sector has focused on secondary care settings, but has not addressed practice assistants in primary care. Knowledge about practice assistants' workplace-related stressors and resources is particularly scarce. This cross-sectional study addresses the mental workload of practice assistants working in primary care practices. Practice assistants from a network of 185 German primary care practices were invited to participate in this cross-sectional study. The standardized `Short Questionnaire for Workplace Analysis' (German: Kurzfragebogen zur Arbeitsanalyse) was used to assess practice assistants´ mental workload. It addresses eleven workplace factors in 26 items: versatility, completeness of task, scope of action, social support, cooperation, qualitative work demands, quantitative work demands, work disruptions, workplace environment, information and participation, and benefits. Sociodemographic and work characteristics were also obtained. A descriptive analysis was performed for sociodemographic data and "Short Questionnaire for Workplace Analysis" factors. The one-sided t-test and Cohen´s d were calculated for a comparison with data from 23 professional groups (n = 8,121). A total of 550 practice assistants from 130 practices participated. The majority of practice assistants was female (99.3%) and worked full-time (66.5%) in group practices (50.6%). Compared to the other professional groups, practice assistants reported higher values for the factor social support (4.0 versus 3.7 [d 0.44; p<0.001]), information and participation (3.6 versus 3.3 [d 0.38; p<0.001] as well as work disruptions (2.7 vs. 2.4 [d 0.42; p<0.001]), while practice assistants showed lower values regarding scope of action (3.4 versus 3.8 [d 0.43; p<0.001]). Our study identified social support and participation within primary care practices as protective factors for mental workload, while work disruptions and scope of action were perceived as stressors.

Quantitative work demands, emotional demands, and cognitive stress symptoms in surgery nurses

In surgery, cognitive stress symptoms, including problems in concentrating, deciding, memorising, and reflecting are risks to patient safety. Recent evidence points to social stressors as antecedents of cognitive stress symptoms in surgery personnel. The current study tests whether cognitive stress symptoms are positively associated with emotional abuse, emotional- and task-related demands and resources in surgery work. Forty-eight surgery nurses from two hospitals filled out the Copenhagen Psychosocial Questionnaire in its German version. Task-related and emotional demands were positively related to cognitive stress symptoms. In a stepwise, multiple, linear regression of cognitive stress symptoms on task-related and emotional demands, emotional abuse and emotional demands were unique predictors (p < .05). Efforts to increase patient safety should address emotional abuse, emotional demands, and, therefore, communication and cooperation team climate in surgery personnel.

Keeping Marketisation at Bay: The Quality of Academic Worklife in Czech Universities

This study examines quality of academic worklife in Czech public universities to assess the extent to which the global drive towards marketisation in higher education has affected Czech academic staff. A total of 2229 academics (men = 57.1%) completed a survey measuring their job satisfaction, job stress, and work environment perceptions. Findings revealed high levels of overall job satisfaction (83.6% satisfied with their jobs) and relatively low levels of stress (13.7% regularly stressed). Most academics reported positive features of their work environment including autonomy and quality, role clarity, influence over academic work, and a strong social community. Negative features included dissatisfaction with pay, poor leadership, and pressure to produce. Job satisfaction was significantly associated with traditional academic values (focus on quality, involvement in decision-making, commitment to the workplace, recognition), while stress was linked to market-related aspects (pressure to produce, quantitative work demands, job insecurity). The study highlighted relatively high levels of well-being among Czech faculty, which can be attributed to the continued prevalence of a traditional, professor-oriented academic system based on autonomy and collegiality. Despite recent market-oriented changes within Czech research policy, the negative effects of marketisation are not yet pronounced in the quality of academic worklife in public universities, except for the increasing pressure for productivity.

Perceived tension and relaxation ability in young adults

Purpose: To study the association between self-reported general tension and muscle tension, and clinically tested relaxation ability. Methods: Self-reports on muscle tension habits and on general tension, and the covariates neck and shoulder pain, perceived stress level, perceived mastery of work, quantitative work demands, and leisure time physical activity, were collected on a questionnaire (52 males, 81 females, mean age 23 years). A clinical test on relaxation ability was performed by a trained physiotherapist on a subsample (38 males, 39 females). Results: Perceived general tension showed a highly significant (p < 0.001) correlation with the muscle tension habit score (0.58), and the muscle tension factor (0.54). None of the self-reported tension measures correlated with the relaxation ability score. The self-reported tension measures, but not the clinical tension score, showed an association with neck and shoulder pain and perceived stress level. Conclusions: The self-reported measures of general tension and of muscle tension correlated and probably represented similar phenomenon. However, the subjects’ perceived stress level was to a higher degree reflected in the measure of general tension. The score of the clinical test on relaxation ability did not show an association with the self-reported tension measures.

Workload demand: a significant factor in the overall well-being of directors of associate degree nursing programs

This descriptive study of workload in relation to the overall well-being of academic program directors was conducted among 242 associate degree nursing program directors in the United States. The Copenhagen Psychosocial Questionnaire II from researchers in Denmark was the instrument used. Participants reported high levels of quantitative and emotional work demands that correlated with high levels of stress, burnout, sleep problems, and decreasing overall physical health. These results support international research findings that have analyzed similar variables in other employment positions. As we face a growing international shortage of nurses, the need for nurse faculty and nurse program directors continues to grow. However, given the state of the nurse program director position, it is not surprising that few qualified faculty prospective applicants are expressing interest in an administrative role. Results are discussed in relation to other recent workload studies, and recommendations follow.

Psychosocial stress among Danish vicars

Burnout and depression are common among clergy members of several religions and denominations. Despite this, no studies have analysed whether differences in psychosocial workloads between vicars and others explain their higher prevalence of stress-related symptoms. To test the hypothesis that elements of the job strain model (high work demands, low decision latitude and/or low job support) are mediators of the excess prevalence of stress-related health complaints among vicars compared with other employees in the Church of Denmark. Data for this cross-sectional study were collected by means of a self-administered questionnaire sent to all employees in 500 Danish parishes (n = 2254). The study response rate was 73%, 35% of respondents were vicars and 43% were female. Compared with other employees, vicars felt quiet and relaxed less often (53 versus 67%), had less time for pleasure and relaxation (28 versus 11%) and felt happy and satisfied (53 versus 67%) less often. Vicars had significantly higher quantitative, cognitive and emotional work demands, lower work support, less influence on whom to collaborate with and less influence on their workload. Psychosocial workloads were more favourable for the vicars who had greater influence on job decisions and on job organization. The higher prevalence of stress-related symptoms among vicars was strongly modified by high work demands, in particular high quantitative demands. The higher prevalence of stress-related symptoms among vicars could largely be attributed to high-quantitative work demands.

With long hours of work, might depression then lurk? A nationwide prospective follow up study among Danish senior medical consultants employed in hospitals

ObjectivesTo examine depression as a potential negative health effect of long work hours. An exposure-response relationship was anticipated.MethodsA prospective cohort study of 4520 Danish senior medical consultants was conducted. Average...

Characteristics associated with intent to stay among Quality Improvement nurses

The study aims to investigate characteristics associated with intent to stay among Quality Improvement (QI) nurses in Korean hospitals. QI nurses have recently emerged as a new specialty area in the nursing profession in Korea. They have played a major role in coordinating and facilitating hospital-wide QI activities. However, their frequent turnover degrades the continuity of overall QI programmes and incurs additional costs in human resource management. A cross-sectional questionnaire survey was administered to 123 QI nurses in 123 general hospitals. The collected data included their hospital and department characteristics, work demand, job satisfaction, organizational commitment and demographics. The response rate was 94.3% (n=116). Multiple logistic regression analysis was performed to determine the factors associated with intent to stay. Only 32.8% intended to stay in their current job. Significant factors associated with intent to stay were affective commitment and work demands. QI nurses with a higher level of affective commitment were more likely to stay [odds ratios (OR)=2.50], whereas those with higher quantitative work demands in QI education and support were less likely to stay (OR=0.40). The findings indicated that intent to stay was closely associated with work environment characteristics. Efforts to enhance their affective commitment and support their workload management are needed to increase the retention of qualified and experienced QI nurses.

Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences

BackgroundGermany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict – namely work interfering with family conflict (WIF) – which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made.MethodsData were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April–July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences.ResultsGerman hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, p < .01). No significant gender difference was found. Predictors for the WIF were lower age, high quantitative demands at work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, p < .01). High values of WIF were significantly correlated to higher rates of personal burnout, behavioural and cognitive stress symptoms, and the intention to leave the job. In contrast, low levels of WIF predicted higher job satisfaction, better self-judged general health status, better work ability, and higher satisfaction with life in general. Compared to the German general population, physicians showed significantly higher levels of individual stress and quality of life as well as lower levels for well-being. This has to be judged as an alerting finding regarding the state of physicians' health.ConclusionIn our study, work interfering with family conflict (WIF) as part of Work-Family Conflict (WFC) was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.

Explaining young registered Finnish nurses’ intention to leave the profession: A questionnaire survey

Background Regardless of the current global nursing shortage, many nurses are planning to leave their profession. According to previous research, young nurses in particular are the most eager to leave—there is, however, no research available as to why this is. Objectives The aim of this survey study was to discover what proportion of young nurses intends to leave the profession in Finland and what the reasons behind this are. Design Quantitative, survey study. Settings Six hospital districts in Finland. Participants A total of 147 Registered Nurses, under the age of 30, working mainly in hospitals. Method Data was collected as part of the NEXT (Nurses Early Exit) -Study. A structured postal questionnaire, BQ-12, was used to collect the data in autumn 2003. Quantitative data were analysed using χ 2, the Fisher exact-test and Mann–Whitney U-test, and qualitative data were analysed using quasi-statistics. Results During the course of the past year, 26% of young nurses have often thought of giving up nursing. This was associated with personal burnout, poor opportunities for development, lack of affective professional commitment, low job satisfaction, work–family conflicts and higher quantitative work demands. In open-ended question, nurses stated that the main reasons for them considering leaving the profession included dissatisfaction with salary, the demands of nursing work, the inconvenience of shift work/working hours and uncertain work status. Conclusions Findings illustrate that there were several factors influencing the young nurses’ intentions. By identifying the factors responsible, it could be possible to retain young nurses in the field.

Practice area and work demands in nurses' aides: a cross-sectional study

BackgroundKnowledge of how work demands vary between different practice areas could give us a better understanding of the factors that influence the working conditions in the health services, and could help identify specific work-related challenges and problems in the different practice areas. In turn, this may help politicians, and healthcare administrators and managers to develop healthy work units. The aim of this study was to find out how nurses' aides' perception of demands and control at work vary with the practice area in which the aides are working.MethodsIn 1999, 12 000 nurses' aides were drawn randomly from the member list of the Norwegian Union of Health – and Social Workers, and were mailed a questionnaire. 7478 (62.3 %) filled in the questionnaire. The sample of the present study comprised the 6485 nurses' aides who were not on leave. Respondents working in one practice area were compared with respondents not working in this area (all together). Because of multiple comparisons, 0.01 was chosen as statistical significance level.ResultsTotal quantitative work demands were highest in somatic hospital departments, nursing homes, and community nurse units. Physical demands were highest in somatic hospital departments and nursing homes. Level of positive challenges was highest in hospital departments and community nurses units, and lowest in nursing homes and homes or apartment units for the aged. Exposure to role conflicts was most frequent in nursing homes, homes or apartment units for the aged, and community nurse units. Exposure to threats and violence was most frequent in psychiatric departments, nursing homes, and institutions for mentally handicapped. Control of work pace was highest in psychiatric departments and institutions for mentally handicapped, and was lowest in somatic hospital departments and nursing homes. Participation in decisions at work was highest in psychiatric departments and community nurse units, and was lowest in somatic hospital departments and nursing homes.ConclusionThe demands and control experienced by Norwegian nurses' aides at work vary strongly with the practice area. Preventive workplace interventions should be tailored each area.

Perceived work demands, felt stress, and musculoskeletal neck/shoulder symptoms among elderly female computer users. The NEW study

The aim of the present study was to test a structural model of the relationship between the perceived quantitative (time pressure and unevenly distributed workload) and emotional work demands and self-reported musculoskeletal symptoms from the neck and shoulder region with felt stress (rested, relaxed, calm, tense, stressed, and pressured at the end of a normal workday) as a mediating variable. As part of the NEW (Neuromuscular assessment in the Elderly Worker) study, a European case-control study, the present cross-sectional study was based on a questionnaire survey among Danish, Dutch, Swedish and Swiss female computer users aged 45 or older (n =148). The hypothesized structural model was tested using structural equation modelling. The results indicate that perceived work demands influence neck/shoulder musculoskeletal symptoms through their effect on felt stress. The results further indicate complete mediation, which means that all of the effect of the perceived work demands on symptoms could be attributed to the stress mechanism. As regards the percentage of explained variance in the endogenous variables, 36% of the variation in felt stress was explained by the perceived work demands, and about 20% of the variation in musculoskeletal neck/shoulder symptoms was explained by the combination of the perceived work demands and the felt stress.