Comparing Job Demands, Coping Resources and Well-being Across Different Health Care Providers Working Together

Jane B Lemaire MD, Jean E Wallace PhD, Janet Gilmour MD

Health of the Health Professional ConferenceAuckland, New Zealand

November 3-5, 2011

No conflict of interest

*HCPs work collaboratively within multidisciplinary teams*They may have different work attitudes and experiences

Background

*To compare job demands, coping resources and well-being across different groups of health care providers (HCPs) working as a team in the same setting

Aim

*Setting: Single medicine ward in a teaching hospital*Design: Descriptive, cross-sectional study, structured questionnaire *Sample: 164 health care providers, response rate 63%

Methods

*Data collection and measures:-closed-ended survey items-response range strongly disagree (coded 1) to strongly agree (coded 5)-scale scores computed by summing items and dividing by the # of items

Methods

*Job demands

Workload My workload is too heavy in my jobI do not have enough time to get everything done in

my jobIt is difficult to meet the demands of my patients, co-

workers and the hospital

Work hoursOn average in a typical week, how many hours do you

work on the unit?

Methods

*Coping resources

Job controlI make my own decisions as to how I do my workI am my own boss in almost every work situation

Co-worker supportMy colleagues are good at helping me solve work-

related problems

Methods

*Well-beingI feel I have a pretty balanced lifeI feel I am positively influencing other people’s lives through my workI am satisfied with my life in generalI definitely enjoy my jobI am satisfied with the way my career is going

Methods

Table 1 Characteristics of Survey Participants

GenderFemale n=78 (86%)

Male n=13 (14%)

AgeMean = 35.81(SD = 10.87)

Missing n=2

Years of experienceMean = 7.78 (SD=9.07)

Missing n=9

OccupationNurse n=47 (52%)

Nursing attendant n=13 (14%)Staff physician n=13 (14%)

Resident physician n=18 (20%)

Table 2Aggregate Results for all Health Care Providers and Mean Difference Tests between Nursing Staff and Physicians

Variables

All HCPs(n=91)

Mean (SD)

Nursing staff(n=60)

Mean (SD)

Physicians(n=31)

Mean (SD)

Workload 3.19 (.80) 3.03 (.75) 3.44 (.83)*

Work Hours 40.71 (23.04) 28.76 (10.57) 66.52 (21.53)*

Control 3.26 (.78) 3.46 (.81) 2.89 (.99)*

Co-worker Support 4.11 (.70) 4.33 (.54) 3.71 (.78)*

Well-Being 3.96 (.58) 4.10 (.51) 3.70 (.60)*

* indicates a statistically significant difference at the .10 level between nursing staff and physicians

Table 3Mean Difference Tests between Nurses versus Nursing Attendants (NAs), and Staff Physicians versus Resident Physicians

Variables

Nurses(n=47)

Mean (SD)

NAs(n=13)

Mean (SD)

Staff MDs(n=13)

Mean (SD)

Resident MDs(n=18)

Mean (SD)

Workload 3.12 (.78) 2.75 (.65)+ 3.46 (.89) 3.42 (.81)

Work Hours 30.14 (9.41) 22.73 (13.57)+ 58.45 (22.34) 72.86 (19.32) †

Control 3.55 (.78) 3.11 (.82)+ 3.42 (1.04) 2.50 (.77) †

Co-worker Support

4.38 (.49) 4.15 (.69)+ 3.69 (.95) 3.72 (.67)

Well-Being 4.19 (.47) 3.80 (.58)+ 3.60 (.73) 3.77(.50)

+ indicates a statistically significant difference at the .10 level between nurses and nursing attendants† indicates a statistically significant difference at the .10 level between staff physicians and resident physicians

Table 4Regression Results for Well-Being for Pooled, Nursing Staff and Physicians

** p<.05; *p<.10b comparing nurses (coded 1) to nursing attendants (coded 0)c comparing staff physicians (coded 1) to resident physicians (coded 0)

Variables

Pooled(n=91)

b(β)

Nursing Staff(n=58)

b(β)

Physicians(n=31)

b(β)

Workload -.17 (-.23)** -.17 (-.25)** -.22 (-.30)*

Work Hours .00 (.04) .00 (.09) .00 (.07)

Control .20 (.29)** .24 (.38)** .22 (.36)*

Co-worker Support .20 (.24)** .11 (.12) .23 (.29)*

Constant 2.99** 2.94** 2.99**

R2 .33** .38** .32**

*Greater perceived workload and longer work hours for physicians*Lower job control for nursing assistants and resident physicians*Higher levels of well-being for nurses

Summary

*Cross sectional study of HCPs at a single site*Limited generalizability *Small numbers*Standardized measures may not be sensitive enough to capture the various ways the different groups experience job demands and coping resources

Limitations

Health care providers-work in unison to provide quality health care to the patients they serve-share a common work environment-experience varying amounts of job demands, coping resources and well-being

Conclusions

*Broad-based interventions may be improved by knowledge of specific occupational group issues*Areas of similarity may provide as important insight as those of difference

Conclusions

Staff wellness Lao PDR