Work Environment Survey Research Articles

Employment Precariousness in Spain: Prevalence, Social Distribution, and Population-Attributable Risk Percent of Poor Mental Health

As a consequence of labor market flexibilization, nonstandard employment has expanded and standard employment has declined. In many cases, these transformations are best described as an evolution toward precarious employment, which is considered a major determinant of health and health inequalities. Using the Employment Precariousness Scale (EPRES), this study aims to determine the prevalence of precarious employment in the waged and salaried workforce in Spain, to describe its distribution across social groups defined by occupational class, gender, age, and immigrant status, and to estimate the proportion of cases of poor mental health potentially attributable to employment precariousness. Data are from the Psychosocial Work Environment Survey conducted in 2004-5 on a representative sample of the Spanish workforce. Findings indicate a high prevalence of employment precariousness, affecting nearly 6.5 million workers, with almost 900,000 of them exposed to high precariousness. These estimates are higher than the proportion of fixed-term employment reported in regular statistical sources but may today be an underestimation, given the current economic crisis. Additionally, a significant proportion of cases of poor mental health are potentially attributable to employment precariousness. Both the proportion of cases of poor mental health attributable to and the prevalence of employment precariousness were highly unequally distributed across the study sample, indicating that this may be a significant contributor to social inequalities in mental health.

Building a Culture of Excellence in Boston and Beyond

There is mounting evidence that unhealthy work environments result in dissatisfied staff, breakdown in communication among disciplines, and poor patient outcomes. The American Association of Critical Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians (ACCP) Patient-Focused Care project were developed as complementary initiatives to provide direction for improving patient care environments. Hospitalized pediatric patients benefit from interdisciplinary collaboration, teamwork, and clinical innovation that are not obstructed by disciplinary silos and rigid roles. AACN's 6 evidence-based standards are used as a framework to guide this discussion about cultures of excellence in pediatric cardiovascular programs through the lens of an experienced nurse administrator. Each standard interacts in a dynamic way to promote clinical and operational excellence for optimal patient outcomes. Evidence-based examples of contemporary interdisciplinary practice from pediatric cardiovascular centers are described for each of the standards. The 2010 results from the AACN Healthy Work Environment Survey for the cardiovascular program at Children's Hospital Boston are documented. The AACN standards are aligned as a foundation for assessment and improvement of pediatric professional practice environments. Implementation of the standards may be helpful in achieving a culture of excellence in pediatric cardiovascular centers. Monitoring the standards across programs and organizations may be accomplished through the AACN Healthy Work Environment Survey.

Violence at Work—The Emergence of a Social Problem

This article analyses trends in violence at work on the basis of victim surveys, work-environment surveys, and press material. It proceeds from the two most common explanations of why violence at work appears to have increased over recent decades. These emphasize shifts in working conditions that have increased employees' victimization risk, and a broadened view of what is regarded as work-related violence. The empirical analyses provide support for both these explanations, and the various dimensions examined—increased reporting propensities, expanded definitions, a reduced tolerance of violence, and altered working conditions—are linked to one another.

Psychosocial working conditions and depressive symptoms among Swedish employees

To investigate prospective associations between working conditions and depressive symptoms in Swedish men and women. The study was based on SLOSH (N = 5,985), a follow-up of a representative sample of gainfully employed Swedes 16-64 years of age from the Swedish Work Environment Survey 2003. Work demands, decision authority, support and conflicts at work were measured in 2003. Depressive symptoms were recorded in 2006 by a short version of the depression subscale of the Symptom Checklist 90 (SCL-90). Linear regression analyses were performed. After adjusting for an indicator of previous depressive symptoms and covariates, conflicts with fellow workers in men were associated with depressive symptoms, whereas demands (men), support from fellow workers (women), and decision authority predicted lower scores. The study supports the theory that decision authority, support and conflicts at work are predictive of depressive symptoms in the general Swedish working population.

Ökat hot och våld i arbetslivet – en följd av förändrade arbetsförhållanden?

Increase in work related violence. A reflection of changes in working conditions? An analysis based on the Swedish Work Environment surveys.Victim surveys from Sweden show that the proportion reporting exposure to work related violence has increased. On the basis of the Swedish Work Environment surveys 1991–2005 this article focuses on the following questions: What kind of situations and working conditions are related to workplace violence? And, has the number of employees exposed to these working conditions increased parallel to the rise of reported workplace violence? Logistic regression analysis shows that some situations and working conditions are indeed related tothe risk of violence. To some extent exposure to these working conditions co-varies with exposure to violence. This result is more prominent for women than for men. Further research is needed to understand how changes in working conditions affect the risk of violence and the development thereof, not least from a gender perspective. Even so, changes in working conditions can not alone explain the increase of reported workplace violence in Sweden during this period. It seems that the influence of changed working conditions offers an interesting complement to criminological theories of broadened definitions and decreasing tolerance against violence in problematizing how an increase in reported workplace violence should and could be understood.

Demand, control and social climate as predictors of emotional exhaustion symptoms in working Swedish men and women

Most studies on burnout have been cross-sectional and focused on specific occupations. In the present study we prospectively investigated the association between demands, control, support and conflicts as well as downsizing and emotional exhaustion in men and women derived from a representative sample of the working population in Sweden. The study comprised working men (1,511) and women (1,493), who participated in the Swedish Work Environment Survey (SWES) in 2003 and had no physical exhaustion and prior sick leave at baseline. These participants were followed up in 2006 as part of the Swedish Longitudinal Occupational Survey of Health (SLOSH). Demands, decision authority, support from fellow workers and superiors, conflicts with fellow workers and superiors, and downsizing were utilized as predictors and the Maslach Burnout Inventory subscale of emotional exhaustion as the outcome in multiple logistic regression analyses. High demands were a highly significant predictor of symptoms of emotional exhaustion (>/=75th percentile). Downsizing and lack of support from superiors were also independent predictors for men as well as lack of support from fellow workers and low decision authority for women. This study indicates that high demands, low decision authority, lack of support at work and downsizing could be important predictors of emotional exhaustion symptoms among working men and women.

The Quality of Dental Faculty Work‐Life: Report on the 2007 Dental School Faculty Work Environment Survey

This report is the third in a series of articles on the dental school work environment commissioned by the American Dental Education Association's Commission on Change and Innovation in Dental Education. The report is based on the most extensive research to date on faculty satisfaction in the dental school environment. The purpose of the study was to assess faculty perceptions and recommendations related to work environment, sources of job satisfaction and dissatisfaction, and professional development needs. More broadly, the study intends to provide insight into the "change readiness" of dental schools to move forward with curricular improvements and innovations. Findings are based on 1,748 responses from forty-nine U.S. dental schools obtained during the time frame of February to April 2007. The total number of respondents constituted 17 percent of all U.S. dental school faculty. The average response rate per school was thirty-six (21 percent). To elucidate the data in terms of issues related to the quality of faculty work-life based on demographics, the authors compared perceptions of various aspects of the work culture in academic dentistry among faculty with different academic ranks and academic degrees and by other variables such as age and gender, tenure versus non-tenure appointments, and full- versus part-time status. Quantitative and qualitative analyses show that the majority of faculty members described themselves as very satisfied to satisfied with their dental school overall and with their department as a place to work. Tenured associate professors expressed the greatest level of dissatisfaction. Opportunities for and support of professional development emerged as an area requiring substantially more attention from dental schools. The authors of the study suggest that dental school leaders use these findings to assess their individual dental school's work environment and to plan changes as needed.

Confirmation of a Healthy Work Environment

Confirmation of a Healthy Work Environment

Work-Related Sleep Disturbances and Sickness Absence in the Swedish Working Population, 1993–1999

To examine secular trends in work-related sleep disturbances and their association with sickness absence in the Swedish working population. Nationally representative cross-sectional samples of the Swedish working population aged 16-64 (the biennial Swedish Work Environment Survey) in 1993, 1995, and 1999 respectively. Questionnaire data on work-related sleep disturbances were linked to records of medically-certified sick-leave spells exceeding 14 days obtained from national registers. All Sweden. A total of 28,424 individuals aged 16-65 with complete data (5162/5173 women/men in 1993; 4635/4764 in 1995; and 4422/4268 in 1999). N/A. The age-adjusted proportion of women with work-related sleep disturbances at least once a week increased from 12.3% in 1993 to 21.7% in 1999 (P < 0.001). The corresponding figures for men were 12.5% to 18.6% (P < 0.001). There was a strong cross-sectional association between work-related sleep disturbances and sickness absence in both genders and in each studied year. Using binary logistic regressions and adjusting for age, supervisory position, and geographical region, the odds ratios for sickness absence for those who reported work-related sleep disturbances every day, compared with those who answered "not at all/seldom last 3 months" varied between 3.22 (1.88-5.50) and 4.26 (2.56-7.19), with the strongest associations seen in 1999. Adjustment for health indicators, especially depressive symptoms, attenuated the relationship substantially. Self-reported sleep disturbances attributed to work-related causes were on the rise in Sweden and were associated with medically-certified sickness absence. Most of this association seems to be accounted for by depressive symptoms.

Assessing an organizational culture instrument based on the Competing Values Framework: Exploratory and confirmatory factor analyses

BackgroundThe Competing Values Framework (CVF) has been widely used in health services research to assess organizational culture as a predictor of quality improvement implementation, employee and patient satisfaction, and team functioning, among other outcomes. CVF instruments generally are presented as well-validated with reliable aggregated subscales. However, only one study in the health sector has been conducted for the express purpose of validation, and that study population was limited to hospital managers from a single geographic locale.MethodsWe used exploratory and confirmatory factor analyses to examine the underlying structure of data from a CVF instrument. We analyzed cross-sectional data from a work environment survey conducted in the Veterans Health Administration (VHA). The study population comprised all staff in non-supervisory positions. The survey included 14 items adapted from a popular CVF instrument, which measures organizational culture according to four subscales: hierarchical, entrepreneurial, team, and rational.ResultsData from 71,776 non-supervisory employees (approximate response rate 51%) from 168 VHA facilities were used in this analysis. Internal consistency of the subscales was moderate to strong (α = 0.68 to 0.85). However, the entrepreneurial, team, and rational subscales had higher correlations across subscales than within, indicating poor divergent properties. Exploratory factor analysis revealed two factors, comprising the ten items from the entrepreneurial, team, and rational subscales loading on the first factor, and two items from the hierarchical subscale loading on the second factor, along with one item from the rational subscale that cross-loaded on both factors. Results from confirmatory factor analysis suggested that the two-subscale solution provides a more parsimonious fit to the data as compared to the original four-subscale model.ConclusionThis study suggests that there may be problems applying conventional CVF subscales to non-supervisors, and underscores the importance of assessing psychometric properties of instruments in each new context and population to which they are applied. It also further highlights the challenges management scholars face in assessing organizational culture in a reliable and comparable way. More research is needed to determine if the emergent two-subscale solution is a valid or meaningful alternative and whether these findings generalize beyond VHA.

The impact of moderate and major workplace expansion and downsizing on the psychosocial and physical work environment and income in Sweden

To describe the effect of organizational change (moderate and major expansion and downsizing) on psychosocial work characteristics, physical hazards, and income in a representative sample of larger workplaces in Sweden. Annual changes in workforce size for the years 1991-1996 were derived from tax registry data. Work environment characteristics were measured in a sub-set of participants from the biennial Swedish Work Environment Surveys for 1991, 1993, and 1995. Income data were derived from national registries. Not all organizational change resulted in a poorer work environment. The number of beneficial outcomes associated with moderate downsizing and moderate expansion in the public sector outweighed the number of adverse outcomes. However, in the private sector the overall effect of moderate organizational change was a poorer work environment. Major downsizing was associated with a better psychosocial work environment for private-sector men and major expansion with a poorer environment for public-sector women and private-sector men. Otherwise, associations between major organizational change and the psychosocial work environment were mixed across sex and sector, although major organizational change was consistently associated with a greater risk of physical hazards. Low income was associated exclusively with organizational downsizing in the private sector. More research is needed to determine whether the work environment can explain observed associations between organizational change and health. Data limitations prevented the authors from examining this in the present study. Their findings indicate that future research on the work environment should pay more attention to physical hazards.

Dual source support and control at work in relation to poor health

Social support and decision authority in relation to health has been examined in extensive research. However, research on the role of different constellations of support sources is conspicuously lacking. The aim of the present study is to describe the health of employees in eight contrasting situations that differ with regard to support from superiors and from workmates and with regard to decision authority. Men and women were studied separately. STUDY SAMPLE AND METHODS: A large sample of Swedish employees (n = 53,371, after exclusion of supervisors) who participated in a national work environment survey was utilized. In addition prospective long-term sick leave data (60 days or more during the 12 months after questionnaire completion) were collected from the national insurance register. Employees who reported below median decision authority had higher prevalence of pains after work and general physical symptoms as well as a higher incidence of long-term sick leave than those with higher decision authority in all subgroups. Those with good support from both workmates and superiors had lower symptom prevalence and long-term sick leave incidence than those with poor support. The groups with either poor support from superiors or from workmates were in an intermediate category with regard to symptom prevalence. The group with good support from superiors but weak support from workmates, however, had as high long-term sick leave incidence as the group with poor support from both superiors and workmates. The patterns were similar for men and women. Long-term sick leave was related mainly to poor support from workmates. Prevalence of symptoms, on the other hand, was related to both sources of support and absence of both sources was associated with particularly high prevalence of physical symptoms. This illustrates that it is meaningful to separate the social support sources.

Workplace expansion, long-term sickness absence, and hospital admission

Downsizing has in previous studies, as well as in public debate, been associated with increased sickness absence. No studies have, however, looked at the long-term relation between workplace expansion and morbidity. We investigated exposure to personnel change during 1991-96 in relation to long-term (90 days or longer) medically certified sickness absence and hospital admission for specified diagnoses during 1997-99 in 24?036 participants with a complete employment record in the biennial national Swedish Work Environment Surveys from 1989 to the end of 1999. Accumulated exposure to large expansion (> or =18% per year) was related to an increased risk of long-term sickness absence (odds ratio 1.07 [95% CI 1.01-1.13], p=0.013) and hospital admission (1.09 [1.02-1.16], p=0.017). In this context, odds ratio signifies the change in odds for each additional year of exposure, varying from 0 to 6. Moderate expansion (> or =8% and <18% per year), was associated with a decreased risk of admission (0.91 [0.84-0.98], p=0.012). Moderate downsizing (> or =8% and <18% per year) was associated with an increased risk of sickness absence (1.07 [1.02-1.12], p=0.003). The strongest association between large expansion and sickness absence was in women in the public sector (1.18 [1.08-1.30], p=0.0002), corresponding to an odds ratio of 2.77 [1.62-4.74] between full exposure (all 6 years) and no exposure. This study confirms earlier findings that downsizing is associated with health risks. It also shows that repeated exposure to rapid personnel expansion, possibly connected with centralisation of functions, statistically predicts long-term sickness absence and hospital admission. Although no conclusions about causal pathways can be drawn from our results, this exposure should be considered in future studies, policy making, and occupational health care practice.

How state-funded home care programs respond to changes in Medicare home health care: resource allocation decisions on the front line.

To examine how case managers in a state-funded home care program allocate home care services in response to information about a client's Medicare home health care status, with particular attention to the influence of work environment. Primary data collected on 355 case managers and 26 agency directors employed in June 1999 by 26 of the 27 regional agencies administering the Massachusetts Home Care Program for low-income elders. Data were collected in a cross-sectional survey study design. A case manager survey included measures of work environment, demographics, and factorial survey vignette clients (N = 2,054), for which case managers assessed service eligibility levels. An agency director survey included measures of management practices. Hierarchical linear models estimated the effects of work environment on the relationship between client receipt of Medicare home health care and care plan levels while controlling for case-mix differences in agencies' clients. Case managers did not supplement extant Medicare home health services, but did allocate more generous service plans to clients who have had Medicare home health care services recently terminated. This finding persisted when controlling for case mix and did not vary by work environment. Work environment affected overall care plan levels. Study findings indicate systematic patterns of frontline resource allocation shaping the relationships among community-based long-term care payment sources. Further, results illustrate how nonuniform implementation of upper-level initiatives may be partially attributed to work environment characteristics.

The Academic Work Environment in Australian Universities: A motivating place to work?

This paper identifies positive (motivating) and negative (demotivating) sources of academic work motivation in Australian universities. In 1998, the Academic Work Environment Survey (Winter, Taylor, & Sarros, 2000) was administered to a stratified sample (five positions, five disciplines) of 2,609 academics in four types of university (research, metropolitan, regional, university of technology). A total of 1,041 usable surveys were returned (response rate of 40 per cent). Across the sample, academics reported moderate levels of work motivation. Work motivation was found to be relatively strong at professorial levels but weak at lecturer levels. Quantitative and qualitative findings indicated the work environment in academe is motivating when roles are clear, job tasks are challenging, and supervisors exhibit a supportive leadership style. The work environment is demotivating where there is role overload, low job feedback, low participation, and poor recognition and rewards practices. The paper concludes by discussing the implications of study findings for university leadership.

Trouble at Mill: Quality of academic worklife issues within a comprehensive Australian university

This study describes the quality of academic worklife (QAWL) within a comprehensive university in Australia. Academics responded to the Academic Work Environment Survey, a diagnostic instrument designed to assess the relationships between and among academics' demographic characteristics (age, gender, position, discipline area), work environment perceptions (role, job, supervisor, structure, sector characteristics), and work attitudes (self-estrangement, organisational commitment). Findings revealed positive QAWL features such as role clarity, motivating job characteristics, and low levels of self-estrangement (alienation). Negative QAWL features included role overload, low levels of job feedback, and limited opportunities to influence university decisionmaking. Comments indicated that many academics feel disenchanted and demoralised with the tenets and practices of managerialism. The study concludes that comprehensive universities suffer from strategic dissonance. They want to deliver cost efficiencies and maintain institutional reputation (i.e. centralise), but also want to serve distinct market sectors and expand their revenue base (i.e. decentralise).

Results of a gender-climate and work-environment survey at a midwestern academic health center.

AND CLIMATE determine how faculty's perceptions of medical school gender climate differ by gender, track, rank, and departmental affiliation. In 1997, a 115-item questionnaire was sent to all University of Wisconsin Medical School faculty to assess their perceptions of mentoring, networking, professional environment, obstacles to a successful academic career, and reasons for considering leaving academic medicine. Using Fisher's exact two-tailed test, the authors assessed gender differences both overall and by track, rank, and departmental cluster. Of the 836 faculty on tenure, clinician-educator, and clinical tracks, 507 (61%) responded. Although equal proportions of men and women had mentors, 24% of the women (compared with 6% of men; p < .001) felt that informal networking excluded faculty based on gender. Women's and men's perceptions differed significantly (p < .001) on 12 of 16 professional environment items (p < .05 on two of these items) and on five of six items regarding obstacles to academic success. While similar percentages of women and men indicated having seriously considered leaving academic medicine, their reasons differed: women cited work-family conflicts (51%), while men cited uncompetitive salaries (59%). These gender differences generally persisted across tracks, ranks, and departmental clusters. The greatest gender differences occurred among clinician-educators, associate professors, and primary care faculty. Women faculty perceived that gender climate created specific, serious obstacles to their professional development. Many of those obstacles (e.g., inconvenient meeting times and lack of child care) are remediable. These data suggest that medical schools can improve the climate and retain and promote women by more inclusive networking, attention to meeting times and child care, and improved professional interactions between men and women faculty.

Perceptions of the Work Environment and Burnout in Canadian Child Care Providers

The results of a study of 137 female child care providers in Winnipeg, Manitoba, are presented. The participants completed the Maslach Burnout Inventory and the Early Childhood Work Environment Survey. Stepwise multiple regression analyses were performed in order to explore the relative strength of the work environment dimensions as predictors of burnout. Age, decision-making, and goal consensus were the only significant predictors of burnout in this sample, suggesting the need for a balance between the freedom of individuals to make decisions and a shared vision of the goals of the program. The implications of these results for child care programs is discussed.

The Quality of Work Life in NAEYC Accredited and Nonaccredited Early Childhood Programs

This study assessed differences in the work environments of NAEYC accredited and nonaccredited centers. The sample included 5,008 directors, teachers, and support staff who worked in 60 accredited and 320 nonaccredited child care centers in 33 states. Individuals completed the Early Childhood Work Environment Survey assessing their perceptions of different organizational practices. Data were aggregated using the center as the unit of analysis. The results revealed that there were notable differences between accredited and nonaccredited programs relating to the quality of work life for staff. In 10 dimensions of organizational climate, there were statistically significant differences between accredited and nonaccredited programs. The four dimensions which together accounted for the greatest variation in differences were innovativeness, goal consensus, opportunities for professional growth, and clarity. Statistically significant differences were also registered in staffs level of job commitment, staff turno...

Work and mental health: A preliminary test of Warr's model in sheltered workshops for the mentally ill

Sheltered work settings offer continuing care clients the opportunities of work within a protective environment. However, little is known about which particular aspects of work environments positively or negatively affect mental health. Fourteen features of sheltered work environments were identified according to the model proposed by Warr (1987). The Work Environment Survey (WES) was developed to assess clients' perceptions of the degree to which each feature was present in their work environment. The relationship between clients' mental health and different features of the work environment was then examined. Contrary to prediction, only one feature of the work environment was found to be associated with psychological well-being. Clients' levels of self-esteem were positively related to the degree of importance they felt the general public ascribed to their job. This finding provides empirical support for the notion that sheltered work provision within rehabilitation services should reflect the principle...