Search

Abstract Background The Covid-19 pandemic led to increased work-related strain and psychosocial burden in nurses worldwide, resulting in high prevalences of mental health problems. Nurses in long-term care facilities seem to be especially affected by the pandemic. Nevertheless, there are few findings indicating possible positive changes for health care workers. Therefore, we investigated which psychosocial burdens and potential positive aspects nurses working in long-term care facilities experience during the Covid-19 pandemic. Methods We conducted a mixed-methods study among nurses and nursing assistants working in nursing homes in Germany. The survey contained the third German version of the Copenhagen Psychosocial Questionnaire (COPSOQ III). Using Welch’s t-tests, we compared the COPSOQ results of our sample against a pre-pandemic reference group of geriatric nurses from Germany. Additionally, we conducted semi-structured interviews with geriatric nurses with a special focus on psychosocial stress, to reach a deeper understanding of their experiences on work-related changes and burdens during the pandemic. Data were analysed using thematic coding (Braun and Clarke). Results Our survey sample (n = 177) differed significantly from the pre-pandemic reference group in 14 out of 31 COPSOQ scales. Almost all of these differences indicated negative changes. Our sample scored significantly worse regarding the scales ‘quantitative demands’, ‘hiding emotions’, ‘work-privacy conflicts’, ‘role conflicts’, ‘quality of leadership’, ‘support at work’, ‘recognition’, ‘physical demands’, ‘intention to leave profession’, ‘burnout’, ‘presenteeism’ and ‘inability to relax’. The interviews (n = 15) revealed six main themes related to nurses’ psychosocial stress: ‘overall working conditions’, ‘concern for residents’, ‘management of relatives’, ‘inability to provide terminal care‘, ‘tensions between being infected and infecting others’ and ‘technicisation of care’. ‘Enhanced community cohesion’ (interviews), ‘meaning of work’ and ‘quantity of social relations’ (COPSOQ III) were identified as positive effects of the pandemic. Conclusions Results clearly illustrate an aggravation of geriatric nurses’ situation and psychosocial burden and only few positive changes due to the Covid-19 pandemic. Pre-existing hardships seem to have further deteriorated and new stressors added to nurses’ strain. The perceived erosion of care, due to an overemphasis of the technical in relation to the social and emotional dimensions of care, seems to be especially burdensome to geriatric nurses.

Abstract Background Psychosocial working conditions were previously analyzed using the first recruitment wave of the Gutenberg Health Study (GHS) cohort (n = 5000). We aimed to confirm the initial analysis using the entire GHS population at baseline (N = 15,010) and at the five-year follow-up. We also aimed to determine the effects of psychosocial working conditions at baseline on self-rated outcomes measured at follow-up. Methods At baseline, working GHS participants were assessed with either the Effort-Reward-Imbalance questionnaire (ERI) (n = 4358) or with the Copenhagen Psychosocial Questionnaire (COPSOQ) (n = 4322); participants still working after five years received the same questionnaire again (ERI n = 3142; COPSOQ n = 3091). We analyzed the association between working conditions and the outcomes job satisfaction, general health, burnout, and satisfaction with life at baseline, at follow-up and also prospectively from baseline to follow-up using linear regression models. We examined the outcome variance explained by the models (R2) to estimate the predictive performance of the questionnaires. Results The models’ R2 was comparable to the original baseline analyses at both t0 and t1 (R2 range: ERI 0.10–0.43; COPSOQ 0.10–0.56). However, selected scales of the regression models sometimes changed between assessment times. The prospective analysis showed weaker associations between baseline working conditions and outcomes after five years (R2 range: ERI 0.07–0.19; COPSOQ 0.07–0.24). This was particularly true for job satisfaction. After adjusting for the baseline levels of the outcomes, fewer scales still explained some of the variance in the distribution of the outcome variables at follow-up. The models using only data from t0 or t1 confirmed the previous baseline analysis. We observed a loss of explained variance in the prospective analysis models. This loss was greatest for job satisfaction, suggesting that this outcome is most influenced by short-term working conditions. Conclusions Both the COPSOQ and ERI instruments show good criterion validity and adequately predict contemporaneously measured self-reported measurements of health and (occupational) well-being. However, the COPSOQ provides a more detailed picture of working conditions and might be preferable for improvment strategies in workplaces. Additional prospective research with shorter follow-up times would be beneficial for estimating dose-response relationships.

Abstrakt Hintergrund Seit fast 20 Jahren ist der COPSOQ (Copenhagen Psychosocial Questionnaire) ein weltweit etabliertes Instrument zur Messung psychischer Belastungen bei der Arbeit. In Deutschland wurde eine erste validierte Version des COPSOQ im Jahr 2005 eingeführt. Nachdem das internationale COPSOQ-Netzwerk die Verantwortung für die Entwicklung des COPSOQ übernommen hatte, wurde 2019 eine neue Konzeption veröffentlicht (COPSOQ III). Die deutsche Version dieses Fragebogens soll nun validiert werden. Methoden Die Messqualitäten des deutschen COPSOQ III werden gemäß den üblichen Anforderungen an eine Validierungsstudie untersucht, wie sie mit DIN EN ISO 10075-3 definiert werden. Eine Stichprobe aus Beobachtungen von mehr als 250,000 Teilnehmenden an COPSOQ-Befragungen steht für univariate und multivariate statistische Analysen zur Verfügung. Ergebnisse Neben der Einbeziehung sämtlicher psychosozialer Belastungsfaktoren gemäß der internationalen Festlegung, ist der deutsche COPSOQ III mit seinen 84 Items noch zu fast 70% inhaltlich mit der deutschen Version von 2005 kompatibel. Die psychometrischen Eigenschaften des Fragebogens (z. B. Validität und Reliabilität) sind für die meisten der 84 Items und 31 Skalen gut bis sehr gut. Jenseits der grundlegenden Ergebnisse bestehen insgesamt zufriedenstellende Übereinstimmungen mit weit verbreiteten theoretischen Ansätzen wie dem Demand-Control(−Support)-Modell oder dem Job Demand-Resources-Modell. Schlussfolgerungen Mit der Veröffentlichung des COPSOQ III in Deutschland lassen sich neue psychische Faktoren untersuchen. Wie bei der vorangehenden Version handelt es sich um ein Instrument von hohem Nutzen sowohl für die Wissenschaft als auch für die Gefährdungsbeurteilung in Unternehmen. Der COPSOQ III deckte eine Vielzahl theoretischer Ansätze ab liefert umfassende Informationen über Arbeitsbedingungen, aus denen sich Verbesserungsmaßnahmen ableiten lassen.