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Background: Healthcare workers frequently face ethically demanding situations in their work, potentially leading to stress of conscience. Long-term work intensification (more and more effort demanded year after year), organizational change and COVID-19 may be risk factors concerning stress of conscience. Aims: The main aim was to investigate the relationship between long-term work intensification and stress of conscience among the personnel in a healthcare organization. Organizational change management was considered a mediator and COVID-19-related work stress a moderator in the association between work intensification and stress of conscience. Research design, participants and context: A total of 211 healthcare district employees participated in a longitudinal survey using questionnaires collected in 2019 (major organizational change in the planning stage) and 2021 (organizational change completed). Ethical considerations: The study was implemented according to the guidelines of the Finnish National Board on Research Integrity. The Finnish instructions were that no review by an ethics committee was necessary because participation was voluntary, informed consent was requested, participants were assured that they were free to withdraw from the longitudinal study at any time and no health data were collected. Findings: Long-term work intensification was associated with more severe stress of conscience. Long-term work intensification was partially mediated through change management to stress of conscience. High COVID-19 stress strengthened the association between long-term work intensification and stress of conscience. Conclusions: Long-term work intensification must be addressed to reduce stress of conscience in healthcare, otherwise the healthcare system will be vulnerable to changes and crisis. Extra resources for personnel and management should be allocated because of work intensification during organizational change and health crises like the COVID-19 pandemic to alleviate stress of conscience. [ABSTRACT FROM AUTHOR]

Work intensification (WI) is a notable job stressor, which has been hypothesised to result in various negative outcomes for employees. However, earlier empirical studies regarding this stressor hypothesis have not yet been reviewed. Our narrative review focused on the outcomes for employees of WI as a perceived job stressor. Our review was based on selected qualitative and quantitative empirical studies (k = 44) published in peer-reviewed journals between the years 2000 and 2020. Altogether, the findings of these studies showed that WI was related to various negative outcomes for employees, such as impaired well-being and motivation, supporting the stressor hypothesis. Stressful WI manifested as perceived accelerated pace of work and increased effort and demands for effectivity at work. Nevertheless, other manifestations of WI (e.g. increased demands for learning) were not always associated with negative outcomes. The implications of these findings are discussed together with future directions. [ABSTRACT FROM AUTHOR]

Background: Nurses frequently face ethically demanding situations in their work, and these may lead to stress of conscience. Working life is currently accelerating and job demands are intensifying. These intensified job demands include (1) work intensification, (2) intensified job-related planning demands, (3) intensified career-related planning demands, and (4) intensified learning demands. At the same time, many healthcare organizations are implementing major organizational changes that have an influence on personnel. Aim: The aim of the study was to investigate the association between intensified job demands and stress of conscience, and whether their association is moderated by organizational change experiences among nurses. Experiences of organizational change may expose employees to stress of conscience or serve as a buffer because employees appraise, involve, and cope with changes differently. Research design: Questionnaires measuring stress of conscience, intensified job demands, and organizational change experiences were completed by nurses (n = 511) in a healthcare district undergoing a major organizational change. Ethical considerations: Throughout, the study procedures were implemented according to the guidelines of the Finnish National Board on Research Integrity and the 1964 Helsinki Declaration and its later amendments. According to the Finnish regulations, because participation was voluntary, informed consent was requested, and participants were advised of their right to withdraw from the study at will. No permission from an ethics committee was necessary. Findings: Work intensification and personal worry considering organizational change were associated with more severe stress of conscience among nurses. Nurses' experiences of managements' competent handling of organizational change buffered the association between work intensification and stress of conscience. Conclusions: During organizational changes, management may alleviate nurses' stress of conscience by proper communication and support procedures. [ABSTRACT FROM AUTHOR]

Aims: Intensified job demands (IJDs) and their effects on employee burnout, work engagement and patient satisfaction were investigated across different work units and occupational groups in a healthcare setting. Design: A multilevel study. Methods: One thousand twenty‐four healthcare employees responded to a survey in 2019 and rated their experiences of IJDs, burnout and work engagement. Nine hundred fifty‐one patients rated their satisfaction with care received from healthcare staff. Results: Work units and occupational groups who shared more experiences of increased time pressure and multitasking reported higher exhaustion. Shared perceptions of increased planning and performing one's work autonomously correlated with higher exhaustion and lower patient satisfaction at the work‐unit level. Moreover, work intensification was found to be highest in emergency care and among nurses, while job‐related planning demands were highest in leadership services. Conclusion: IJDs are a shared risk to employee well‐being among heterogeneous healthcare staff and relate negatively to customer‐rated patient satisfaction. We found that high time‐pressure demands increase the shared risk of burnout—especially among nurses and healthcare staff working in emergency care. Furthermore, increased independence and self‐determination in planning and executing work tasks also increase the shared risk of burnout especially among those in leadership services. This can lead to lower customer/care satisfaction among patients. Impact: With the accelerating pace of socio‐economic change, the pace of work is also getting faster. Our findings help understand how IJDs are experienced among heterogeneous healthcare staff. Because different occupational groups and work units had different demands, this research shows that attempts to mitigate the negative effects of IJDs need to be planned and implemented in a context‐specific way. It seems crucial to pay more attention especially to adequate nurse staffing so that the adverse effects of IJDs could be mitigated among them. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aims of the study were to identify content categories of unreasonable and unnecessary illegitimate tasks and to investigate how unreasonable and unnecessary tasks relate to occupational wellbeing. Background: Illegitimate tasks are a common stressor among healthcare professionals, and they have been shown to have negative associations with occupational well‐being. Despite this evidence, research has not yet uncovered what kinds of tasks healthcare professionals consider illegitimate. Design and method: The data gathered by means of an online survey consisted of 1024 municipal healthcare organisation employees. A theory‐driven qualitative content analysis was used to analyse freely reported illegitimate tasks. For occupational well‐being associations, a mixed‐methods approach was used (ANCOVA and linear regression analysis). The STROBE statement—checklist for cross‐sectional studies was used. Results: Eight content categories were found for illegitimate tasks. For unreasonable tasks, these were (1) tasks outside one's occupational role (78% of all unreasonable tasks), (2) conflicting or unclear demands (9%), (3) tasks with insufficient resources (8%) and (4) tasks with difficult consequences (5%), and for unnecessary tasks, these were (1) impractical or outdated working habits (31% of all unnecessary tasks), (2) tasks related to dysfunctional technology (30%), (3) unnecessary procedures (27%) and (4) tasks related to bureaucratic demands (12%). Unreasonable and unnecessary tasks were associated with higher levels of burnout and lower work engagement and the meaningfulness of work. Conclusions: Our findings support the theory that illegitimate tasks are an occupational stressor with negative effects on burnout, work engagement and meaningfulness of work. Relevance to clinical practice: The study offers insights into the types of tasks health care employees see as illegitimate and highlights the importance of good job design in promoting occupational well‐being in health care. [ABSTRACT FROM AUTHOR]

Work-related rumination is not a single construct, but consists of a dimension associated with negative emotions or affect (affective rumination), and a dimension associated with reflective thinking and applying strategies to solve problems (problem-solving pondering). In this three-wave longitudinal study across two years (N = 630) we investigated whether the relationships between work-related rumination, off-job recovery, and creativity at work varied along the two dimensions of work-related rumination. In addition, we tested whether the relationships followed normal, reversed, or reciprocal causation. The results showed, first, that in a one-year perspective affective rumination, but not problemsolving pondering, was negatively related to off-job recovery and that problem-solving pondering, but not affective rumination, was positively related to creativity at work. Second, in a two-year perspective, reversed effects were detected as creativity at work was negatively related to affective rumination and positively to off-job recovery. Our results suggest that the quality of workrelated thoughts determines whether the outcome is beneficial or detrimental. Occupational health interventions that only advise employees to stop thinking about work during off-job time, may therefore be too simplistic. [ABSTRACT FROM AUTHOR]

We used a longitudinal design and a person-centred methodology to test the strain and learning hypotheses of the job demands–control model among Finnish employees (n = 926), who were followed-up at three time points covering a period of 2 years (2008–2010). First, we identified longitudinal subgroups in demands and control across three measurement points. Second, we examined how these subgroups differed in strain (job exhaustion) and motivation-related outcomes (vigour at work, work–family enrichment). Growth mixture modelling revealed four subgroups: “stable high strain”, “stable low strain”, “increasing control”, and “decreasing control”. The stable high- and low-strain subgroups also differed in the outcomes studied (exhaustion, work–family enrichment) as suggested by the demands–control model. The findings also suggest that job control is subject to changes over time and that these changes are likely to be associated with changes in employee outcomes. Malleability of job control should be kept in mind in job stress interventions, likewise the fact that some employees suffer from chronic job stress. [ABSTRACT FROM PUBLISHER]

Aim The study examined whether three resources, that is, compassion, transformational leadership and work ethic feasibility, buffer against the negative effects of emotional labour on work engagement. Background Emotional labour is a common job stressor among nurses, but little is known about whether certain personal and work resources buffer against it in relation to work engagement. Revealing buffers of emotional labour would help organizations to design tailored interventions. Design Cross-sectional online survey conducted in 2014. Methods Participants were 3466 Finnish nurses. Hypotheses were tested via hierarchical moderated regression analyses. Results Higher emotional labour related to lower engagement. Two interaction effects were found. First, work ethic feasibility buffered against emotional labour: the nurses who perceived work ethic feasibility as high in a situation of high emotional labour, scored higher on engagement compared with those nurses who in this stress situation perceived work ethic feasibility to be low. Second, high compassion was detrimental to engagement in the presence of high emotional labour. Transformational leadership did not act as a buffer but showed a positive relationship with engagement. Conclusion Work ethic feasibility (being able to work according to high ethical standards) is an important resource in nursing as it protects an employee against the negative effects of emotional labour and as it also directly promotes engagement. However, compassion may not always be beneficial in nursing, especially if co-occurring with high job stress. Transformational leadership has potential to improve engagement in nursing although it may not operate as a stress buffer. [ABSTRACT FROM AUTHOR]

Work-family barriers can be conceived as a stressor, as it refers to organizational time demands interfering with an employee's family-related needs and anticipated negative career outcomes as a result of prioritizing family over work. The negative effects of stressors can be buffered by various resources. In this study, we examined whether 4 specific job resources (i.e., work-family organizational support, supervisors' and coworkers' overall support, and job control) buffer against work-family barriers in relation to work-to-family enrichment. We sampled 447 Italian workers employed in the food-processing industry. The results of hierarchical regression analyses showed that all the studied resources, except work-family organizational support, buffered against the negative effects of work--family barriers on work-to-family enrichment. In addition, 3 of 4 resources (i.e., work-family organizational support, job control, and supervisors' overall social support) had a direct positive effect on work-to-family enrichment. The results call attention to job resources in boosting a positive work-family interface, and cross-validate the positive effects of resources in an Italian context. [ABSTRACT FROM AUTHOR]

The purpose of this quantitative diary study was to investigate daily vigor and exhaustion using a person-centered approach. The study also investigated whether and how experiences of vigor and exhaustion relate to a state of being recovered. A total of 256 Finnish employees filled in a diary questionnaire during five consecutive workdays. Vigor and exhaustion showed strong negative interdependence within and between days. However, by applying a person-centered analysis, we were able to differentiate three groups with meaningful variation in vigor and exhaustion. The groups were labeled asConstantly vigorous(n= 179),Concurrently vigorous and exhausted(n= 30) andConstantly exhausted(n= 43). The vigor-exhaustion groups were also characterized by their recovery experiences: TheConstantly vigorousemployees recovered well from work strain during the workweek whereas theConstantly exhaustedgroup recovered poorly. Overall, while the results indicate that, typically, vigor and exhaustion are exclusive experiences, it is also possible for them to be experienced simultaneously from day to day at the moderate levels. Thus, positive and negative experiences may co-occur. [ABSTRACT FROM PUBLISHER]

The modern labour market features job insecurity (JI) as an unavoidable stressor. This study considers the influence of personal coping strategies by combining the conservation of resources with spillover theory. Do coping strategies buffer the negative effects of JI on well-being (work engagement, marital satisfaction and emotional energy at work and home)? A cybernetic coping scale distinguishes five coping strategies and a survey of 2764 Finnish employees reveals that changing the situation and symptom reduction buffer the negative effect of JI on emotional energy at work and home, respectively. Devaluation and accommodation have buffering tendencies in relation to work engagement and marital satisfaction. Thus, more engaged coping strategies reduce the negative effects of JI on employee well-being. Employees who use disengaged coping (i.e. avoidance) instead are less likely to remain engaged at work, such that frequent use of avoidance coping strengthens the negative relationship between JI and employee well-being. [ABSTRACT FROM PUBLISHER]

This study assessed longitudinal individual and crossover relationships between work-family conflict and well-being in the domains of work (job satisfaction) and family (parental distress) in a sample of 239 dual-earner couples. The results revealed only longitudinal individual effects over a 1-year period. First, high family-to-work conflict (WFC) at Time 1 was related to a high level of work-to-family conflict (WFC) 1 year later in both partners. Second, the wife's high level of FWC was related to her decreased job satisfaction 1 year later. Thus, the longitudinal effects identified supported normal causality, that is, work-family conflict led to poor well-being outcomes or increased perceived work-family conflict later on. Longitudinal crossover effects from one partner to another were not observed within a 1-year perspective. [ABSTRACT FROM AUTHOR]

The article presents information on effects of psychosocial work characteristics on general well-being, and on occupational well-being via sense of coherence (SOC). Researcher A. Antonovsky's, SOC theory, is an attempt to gain further insight into three issues. First, much of the evidence relating SOC to well-being comes from the life-stress literature whereas the possible health promoting role of SOC in the work context has received much less attention. Second, most studies of SOC hitherto have primarily focused on its main effect on well-being, whereas its possible mediating role has remained under-examined. In the work context an important issue is to what extent differences in work characteristics may cause differences in SOC, and how these differences, in turn, may affect the number and the quality of an individual's health outcomes. Third, the great majority of SOC studies have been based on cross-sectional data and, therefore, the issue concerning the effects of changes in psychosocial work characteristics on SOC has not been investigated profoundly enough.

Job insecurity has grown dramatically in Finland, as elsewhere. This study examined the relationships between a specific job stressor, i.e. job insecurity, and occupational, overall and family well-being, by utilizing one-year follow-up data collected among male and female employees in Finland. Occupational well-being was assessed via job exhaustion, overall well-being via somatic symptoms, and family well-being via work spillover into parenthood. The study was carried out by means of questionnaires, which were completed twice, in 1995 and in 1996 by employees in four organizations. This article is based on the data of those respondents (n = 219), who participated in the study in both years. The results indicated gender differences in the predictive relationships between the job insecurity and well-being indicators. For the women job insecurity perceived in 1995 increased job exhaustion and negative work spillover into parenthood in the subsequent year. For the men, in turn, job insecurity did not have negative effects on well-being over a one-year period. Hence, job insecurity seemed to operate as a long-lasting job stressor for the women only. Job insecurity and well-being were both relatively Stable among the sexes during the follow-up period. Implications for supporting work and family in the context of increased job insecurity and other changes in working life in Finland and other industrialized countries are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Changes in autonomic nervous system function have been related to work stress induced increases in cardiovascular morbidity and mortality. Our purpose was to examine whether various heart rate variability (HRV) measures and new HRV-based relaxation measures are related to self-reported chronic work stress and daily emotions. The relaxation measures are based on neural network modelling of individual baseline heart rate and HRV information. Nineteen healthy hospital workers were studied during two work days during the same work period. Daytime, work time and night time heart rate, as well as physical activity were recorded. An effort–reward imbalance (ERI) questionnaire was used to assess chronic work stress. The emotions of stress, irritation and satisfaction were assessed six times during both days. Seventeen subjects had an ERI ratio over 1, indicating imbalance between effort and reward, that is, chronic work stress. Of the daily emotions, satisfaction was the predominant emotion. The daytime relaxation percentage was higher on Day 2 than on Day 1 (4 ± 6% vs. 2 ± 3%, p < 0.05) and the night time relaxation (43 ± 30%) was significantly higher than daytime or work time relaxation on the both Days. Chronic work stress correlated with the vagal activity index of HRV. However, effort at work had many HRV correlates: the higher the work effort the lower daytime HRV and relaxation time. Emotions at work were also correlated with work time (stress and satisfaction) and night time (irritation) HRV. These results indicate that daily emotions at work and chronic work stress, especially effort, is associated with cardiac autonomic function. Neural network modelling of individual heart rate and HRV information may provide additional information in stress research in field conditions. [Copyright &y& Elsevier]