Santé psychologique : nouveautés 07/2018

risquephyscologiqueVoici les nouvelles publications trouvés en juin et juillet sur des thèmes reliés à la santé psychologique. Les articles traitent de différents facteurs de risque tels les changements, la fatigue, ou la charge de travail, tout comme de facteurs organisationnels et psychosociaux. Plusieurs articles évoquent le rôle positif que peuvent avoir des superviseurs, gestionnaires et leaders pour lutter contre différents risques et établir un climat de sécurité psychologique.

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Consultez les articles par thèmes :

Adaptation aux changements
Charge de travail et fatigue
Épuisement professionnel
Gestion et leadership
Intimidation et agression
Lésion morale et fatigue de compassion
Promotion de la santé mentale au travail
Risques psychosociaux

Adaptation aux changements

Dual impact of organisational change on subsequent exit from work unit and sickness absence: a longitudinal study among public healthcare employees
Source : Occup Environ Med 75(7), juillet 2018

This study investigated work-unit exit, total and long-term sickness absence following organisational change among public healthcare employees. Reorganisation was associated with subsequent work-unit exit in the year after reorganisation. This association was specifically important for exposure to ≥3 types of changes, merger, demerger or change of management. Among the employees remaining in the work unit, reorganisation was also associated with more events of long-term sickness absence, which was particularly important for merger and employee layoff.

Charge de travail et fatigue

The Association Between Nurse Shift Patterns and Nurse-Nurse and Nurse-Physician Collaboration in Acute Care Hospital UnitsRessource en accès restreint (acheter à l'éditeur ou demandez un prêt entre bibliothèques)
Source : Journal of Nursing Administration 48(6), juin 2018

Collaboration between nurses and other healthcare providers is critical for ensuring quality patient care. Nurses perform collaboration during their shift work; thus, nurse shift patterns may influence collaboration. This cross-sectional study using data from 957 units in 168 acute care hospitals examined the impact of nurse shift patterns on nurses’ collaboration with nurses and physicians in US acute care hospital units. Overtime (more nurses working overtime or longer overtime hours) was associated with lower collaboration at the unit level; however, shift length was not. Authors conclude that working overtime may negatively influence nurses’ collaboration with other healthcare providers.

Bio-mathematical fatigue models predict sickness absence in hospital nurses: An 18 months retrospective cohort study
Source : Applied Ergonomics 73, juin 2018

This study examined the associations between bio-mathematical fatigue-risk scores and sickness absence (SA) in hospital nurses over 18 months. Work schedules and SA data were extracted from the hospital’s attendance system. Fatigue-risk scores were generated for work days using the Fatigue Audit InterDyne (FAID) and Fatigue Risk Index (FRI). Over the study period, 5.4% of the shifts were absence shifts. FAID-fatigue ranged from 7 to 154; scores for a standard 9–5 work schedule can range from 7 to 40. Nurses with high FAID-scores were more likely to be absent from work when compared to standard FAID-scores. FRI-fatigue ranged from 0.9 to 76.8. When FRI-scores were >60, nurses were at 1.58 times increased odds for SA compared to scores at or below 20. Nurse leaders can use these decision-support models to adjust high-risk schedules or the number of staff needed to cover anticipated absences from work.

Night work and risk of common mental disorders: analyzing observational data as a non-randomized pseudo trial
Source : Scandinavian Journal of Work, Environment & Health , juin 2018

The aim of this study was to examine the status of night work as a risk factor for common mental disorders (CMD). A cohort study with three data waves was conducted on populations of social and healthcare employees for a duration of eight years (total N=46 010). Data were analyzed as a non-randomized pseudo trial to examine (i) whether moving from non-night work to night work is associated with the development of CMD, (ii) the extent to which moving back to non-night work biases this association and (iii) whether moving from night to non-night work is associated with the recovery from CMD. Results According to logistic regression with generalized estimating equation and without bias-correction, changing to night work was not associated with the odds of acquiring CMD [odds ratio (OR) 1.03, 95% confidence interval (CI) 0.82-1.30]. However, night workers with CMD had higher odds of recovery from CMD when changing to non-night work compared to continuing night work (1.99, 95% CI 1.20-3.28). When night workers developed CMD, the odds of moving back to non-night work increased by 68%. In analyses corrected for this bias, changing from non-night to night work was associated with a 1.25-fold (95% CI 1.03-1.52) increased odds of acquiring CMD. Conclusions A change from non-night to night work may increase the risk of CMD, while moving back from night to non-night work increased recovery from CMD.

The impact of workload on the ability to localize audible alarms
Source : Applied Ergonomics 72, juin 2018

Very little is known about people’s ability to localize sound under varying workload conditions, though it would be expected that increasing workload should degrade performance. A set of eight auditory clinical alarms already known to have relatively high localizability (the ease with which their location is identified) when tested alone were tested in six conditions where workload was varied. Participants were required to indicate the location of a series of alarms emanating at random from one of eight speaker locations. They were also asked to read, carry out mental arithmetic tasks, be exposed to typical ICU noise, or carry out either the reading task or the mental arithmetic task in ICU noise. Performance in the localizability task was best in the control condition (no secondary task) and worst in those tasks which involved both a secondary task and noise. Performance in the control condition results in a missed alarm on one in ten occurrences, whereas performance in the heaviest workload conditions results in a missed alarm on every fourth occurrence. The data demonstrates the typical pattern of increasing workload affecting a primary task in an area where there is little data. This finding has implications for the understanding of both ‘inattentional deafness’ and ‘alarm fatigue’ in clinical environments.

Épuisement professionnel

Do age and gender contribute to workers’ burnout symptoms?Ressource en accès restreint (acheter à l'éditeur ou demandez un prêt entre bibliothèques)
Source : Occupational Medicine , juin 2018

This study aims to evaluate the relationship between age, gender and their interaction with burnout in a sample of Canadian workers. Data were collected in 2009–12 from a sample of 2073 Canadian workers from 63 workplaces in the province of Quebec. Age followed a non-linear relationship with emotional exhaustion and total burnout, while it was linearly related to cynicism and reduced professional efficacy. Burnout level reduced with increasing age in men, but the association was bimodal in women, with women aged between 20–35 and over 55 years showing the highest burnout level. These results suggest that burnout symptoms varied greatly according to different life stages of working men and women. Younger men, and women aged between 20–35 and 55 years and over are particularly susceptible and should be targeted for programmes to reduce risk of burnout.

Femmes et travail: le manque de latitude décisionnelle en mène plusieurs à l’épuisement professionnel
Source : udemnouvelles , juin 2018

Cet article présente une étude en relations industrielles de l’UdeM démontre que les causes de l’épuisement professionnel sont différentes pour les hommes et les femmes. Voir aussi l’étude «Gendered Pathways to Burnout: Results from the SALVEO Study», Annals of Work Exposures and Health, 19 février 2018. (https://academic.oup.com/annweh/advance-article/doi/10.1093/annweh/wxx114/4870017)

Improvements of the working conditions for physicians and patient safety in emergency departments
Source : Journal of Hospital Administration 7(4), juin 2018

High staff turn-over and crowding are common problems in emergency departments (EDs). These problems coexist with a gradual decrease in hospital beds per capita. Many emergency physicians report burnout and plan to resign. Therefore, mostly inexperienced physicians, early in their career, are responsible for front-line emergency care. Based on a literature review and analysis of work environment in EDs, structural and individual measures were proposed in order to optimize the work environment for physicians. Authors find that working conditions in the ED could be improved through modified back-up, checklists/algorithms, increased number of hospital beds, and optimal use of available beds, and a revision of the current shift organization. We hope that this analysis will prompt a debate that may lead to improvements in work satisfaction, resource utilization and quality of care.

Job burnout: The contribution of emotional stability and emotional self-efficacy beliefsRessource en accès restreint (acheter à l'éditeur ou demandez un prêt entre bibliothèques)
Source : Journal of Occupational and Organizational Psychology Prépublication, juin 2018

This study presents a theoretical model positing emotional self-efficacy beliefs in managing negative emotions at work as a key mechanism that contributes to mediate the negative relationship between emotional stability – a trait highly associated with positive affect and mental health – and job burnout. Self-efficacy in managing negative emotions at work proved to be an important resource for workers in managing job-related stress: practitioners interested in reducing burnout symptoms in stressful working environments should take into account this variable. Self-efficacy beliefs in managing negative emotions at work are cognitive structures malleable to change. Literature on social cognitive theory offers several suggestions on how to promote individuals’ positive beliefs on managing negative emotions and dysphoric affect. Hence, findings and literature reported in this study may be useful for practitioners aiming at strengthen workers’ self-efficacy in managing negative emotions at work, through the development and application of coaching and training programmes.

Gestion et leadership

Content and quality of workplace guidelines developed to prevent mental health problems: results from a systematic review
Source : Scandinavian Journal of Work, Environment & Health , mai 2018

A wide range of guidelines have been developed to prevent work-related mental health problems (MHP), but little is known about the quality of such guidelines. We systematically reviewed the content and quality of workplace guidelines aiming to prevent, detect, and/or manage work-related MHP. Of the seventeen guidelines which were quality assessed, four guidelines had developed recommendations of good quality, but the evidence of two guidelines was outdated and studies documenting the effect of implementation were not yet available. Few guidelines have been developed with sufficient rigor to help employers prevent or manage work-related MHP and evidence of their effectiveness remains scarce.

Effectiveness of training workplace managers to understand and support the mental health needs of employees: a systematic review and meta-analysis91px-Lock-blue.svgSource : Occup Environ Med 75(6), juin 2018

Managers are in an influential position to make decisions that can impact on the mental health and well-being of their employees. As a result, there is an increasing trend for organisations to provide managers with training in how to reduce work-based mental health risk factors for their employees. A systematic search of the literature was conducted to identify workplace interventions for managers with an emphasis on the mental health of employees reporting directing to them. Our meta-analysis indicates that training managers in workplace mental health can improve their knowledge, attitudes and self-reported behaviour in supporting employees experiencing mental health problems. At present, any findings regarding the impact of manager training on levels of psychological distress among employees remain preliminary as only a very limited amount of research evaluating employee outcomes is available. Our review suggests that in order to understand the effectiveness of manager training on employees, an increase in collection of employee level data is required.

How Can Supervisors Contribute to the Return to Work of Employees Who have Experienced Depression?
Source : Journal of Occupational Rehabilitation 28(2), juin 2018

The goal of this study was to determine the types and prevalence of supervisor contributions during the different phases of the return-to-work (RTW) process (before and during the sick-leave absence, and during the RTW preparations) of employees diagnosed with depression. Moreover, we sought to determine which contributions actually facilitate employees’ RTW, and to identify the work accommodations most frequently implemented by supervisors at the actual time of their employee’s RTW. Cox regression analyses performed for the entire sample revealed that “the supervisors’ intention to take measures to facilitate their employees’ RTW” was the only significant predictor of the RTW at the time of the interview. Four of the most frequently implemented work accommodations were actions directly involving the supervisor (i.e. providing assistance, feedback, recognition, and emotional support to the employee).

Management of psychosocial risks in European workplaces – evidence from the second European survey of enterprises on new and emerging risks (ESENER-2)
Source : European agency for safety and health at work (EU-OSHA), 2018

This report examines barriers to and drivers of workplace psychosocial risk management, and how this is influenced by different national and organisational contexts. The exposure of workers to psychosocial risks is increasing. However, the level of risk and the effectiveness of management vary across sectors and countries. Based on the findings of a quantitative analysis of ESENER-2 data combined with other country-specific data, it shows that the national context — culture, economy and occupational safety and health initiatives by social partners — is related to the level of psychosocial risk management in the workplace. It also reveals that management commitment and worker involvement are likely to be most effective organisational drivers of managing psychosocial risks, regardless of the national context. The practical implications of these findings are also discussed.

Mission Critical: Nursing Leadership Support for Compassion to Sustain Staff Well-being
Ressource en accès restreint (acheter à l'éditeur ou demandez un prêt entre bibliothèques)Source : Nursing Administration Quarterly 42(3), septembre 2018

Increasingly, the fast pace and volume of care and documentation requirements diminish time with patients and families and hinder the enactment of compassion. These issues and other aspects of the work environment decrease the satisfaction and well-being of professional caregivers and are contributing to a rising tide of burnout. Research suggests that employee engagement emerges from their satisfaction and well-being; however, it is difficult for an individual to engage when she or he feels depleted and unsupported. Nursing leaders and managers can play a significant role in support of compassionate practices for staff and improvement of the work environment and staff well-being. This article describes an example of a compassion practice, Schwartz Rounds®, a program that has been implemented internationally to enhance staff caring and compassion, teamwork, and psychological well-being. Schwartz Rounds have been included as a component of organizational initiatives to enhance staff well-being and patient experience, and as an individual program. Nurse leaders and managers who wish to engage their staff can do so by supporting their compassion and well-being. Voir aussi http://www.theschwartzcenter.org/supporting-caregivers/schwartz-center-rounds/

New perspectives on psychosocial safety climate in healthcare: A mixed methods approach
Source : Safety Science 109, novembre 2018

Psychosocial Safety Climate (PSC) theory may be applicable to a wide range of industries. This study looks at how how PSC manifests in healthcare, noting that it plays a role in balancing conflicting pressures of safe work and patient care. Practical implications of the study include three methods by which management and Australian policy makers can mitigate psychosocial risks, enacting a positive change in safety climates that better value frontline worker psychological health.

Spiritual leadership as an emergent solution to transform the healthcare workplace
Source : Journal of Nursing Management 26(4), mai 2018

A new approach to leading and managing is suggested to foster environments that nurture staff. There is also an emerging gap for research and education on the type of leadership that can effectively drive and harness the required attributes necessary in individuals or organisations to navigate this journey. Key emerging attributes are supporting, recognising and encouraging staff; relationship building and demonstrating compassion. Leaders need to connect with workers and the wider communities at an emotional and spiritual level. Consequently, a values based leadership model might be more useful to healthcare organisations and spiritual leadership is an emergent approach that warrants further research and exploration in this context.

Intimidation et agression

‘First, Do No Harm’: The Role of Negative Emotions and Moral Disengagement in Understanding the Relationship Between Workplace Aggression and Misbehavior
Source : Frontiers in Psychology 9, 2018

Workplace aggression is a critical phenomenon particularly in the healthcare sector, where nurses are especially at risk of bullying and third-party aggression. While workplace aggression has been frequently examined in relation to health problems, less is known about the possible negative impact such aggression may have on the (un)ethical behavior of victims. Our research aims to fill this gap. Drawing on literature on counterproductive work behavior and the social-cognitive literature on aggression, we investigated the role of negative emotions – in particular anger, fear, and sadness, – and of moral disengagement in the paths between workplace aggression, counterproductive work behavior and health symptoms. The focus on these relationships is rooted in two reasons. First, misbehavior at work is a pervasive phenomenon worldwide and second, little research has been conducted in the healthcare sector on this type of behavior despite the potential importance of the issue in this context. We empirically tested our hypotheses considering a specific form of workplace aggression in each study: workplace bullying or third-party aggression. Results confirm the hypotheses that being target of workplace aggression (bullying or third-party aggression) is not only associated with health symptoms but also with misbehavior. In addition, the results of structural equation modelling attest the importance of examining specific discrete negative emotions and moral disengagement for better understanding misbehavior at work. In particular, this research shows for the first time that anger, fear, and sadness, generally aggregated into a single dimension, are indeed differently associated with moral disengagement, misbehavior and health symptoms. Specifically, in line with the literature on discrete emotions, while sadness is only associated with health symptoms, anger and fear are related to both health and misbehavior.

Workplace aggression may be cyclical, study of nurses shows91px-Lock-blue.svg
Source : Safety & Health , juin 2018

Frequent victims of workplace aggression and bullying may experience adverse health effects and, in turn, behave cruelly toward others, according to a new study from the University of East Anglia.

Lésion morale et fatigue de compassion

Are medical students in prehospital care at risk of moral injury?
Source : Emerg Med J Prépublication, juin 2018

Background The term ‘moral injury’ may be useful in conceptualising the negative psychological effects of delivering emergency and prehospital medicine as it provides a non-pathological framework for understanding these effects. This is in contrast to concepts such as burnout and post-traumatic stress disorder which suggest practitioners have reached a crisis point. We conducted an exploratory, pilot study to determine whether the concept of moral injury resonated with medical students working in emergency medicine and what might mitigate that injury for them. The term moral injury was useful in exploring the experience of medical students in emergency medicine. More effort should be made to ensure that students effectively access debrief and other support opportunities. It is hoped that future work will be undertaken with different professional groups and explore the potential psychological and neuropsychological impact of witnessing trauma.

Assessing the Degree of Compassion Satisfaction and Compassion Fatigue Among Critical Care, Oncology, and Charge NursesRessource en accès restreint (acheter à l'éditeur ou demandez un prêt entre bibliothèques)
Source : Journal of Nursing Administration 48(6), juin 2018

Cumulative grief resulting from caring for critically/terminally ill patients may result in CF, leading to lower quality care and higher nurse attrition. The aim of this study was to assess the degree of compassion satisfaction and compassion fatigue (CF) among critical care, oncology and charge nurses. Charge nurses had higher secondary traumatic stress (STS) than direct care nurses. Nurses with less than 10 years of experience had lower CS than experienced nurses. Higher levels of burnout (BO) and STS were reported among charge nurses, whereas less direct care nurses had average to high BO and STS ratings. Previous studies focused on direct care nurses; our findings suggest that CF is prevalent among charge nurses as well. Interventions should be considered for clinical providers and charge nurses including debriefing, stress reduction, peer support, and team building.

Promotion de la santé mentale au travail

Do Health Promotion Behaviors Affect Levels of Job Satisfaction and Job Stress for Nurses in an Acute Care Hospital?Ressource en accès restreint (acheter à l'éditeur ou demandez un prêt entre bibliothèques)
Source : Journal of Nursing Administration 48(6), juin 2018

The aim of this study was to explore the relationships between nurse-reported health-promoting behaviors (HPBs), job stress, and job satisfaction in a hospital setting. Results from a cross-sectional, 144-item survey was administered to nurses working in an acute care, community hospital in the southeastern United States showed that higher levels of HPB were associated with lower job stress and higher job satisfaction. Total HPB was associated with the competence subscale of job stress. Lower job stress was significantly associated with HPB subscales: spiritual growth, interpersonal relations, and stress management.

Promotion de la santé mentale au travail
Source : Office des publications de l’Union européenne, mars 2018

La santé mentale et le bien-être de la main-d’œuvre européenne sont de plus en plus reconnus comme une question importante pour les parties prenantes du travail en Europe. Les objectifs spécifiques du document d’orientation sont les suivants: placer la prise en charge des problèmes de santé mentale au travail (prévention, promotion et retour au travail) dans le contexte de la directive-cadre ainsi que de la législation et des bonnes pratiques y afférentes; sensibiliser à l’importance de la prise en charge de la santé mentale et du bien-être au travail; fournir un aperçu des procédures nécessaires concernant la gestion des questions liées à la santé mentale au travail pour les employeurs, les syndicats, les employés, les décideurs politiques et les praticiens; fournir des exemples pratiques concernant la manière d’atteindre ces objectifs à l’aide d’études de cas; fournir des références à d’autres sources pertinentes d’orientation, de recherche et d’informations.

Risques psychosociaux

Clustering of job strain, effort−reward imbalance, and organizational injustice and the risk of work disability: a cohort study
Source : Scandinavian Journal of Work, Environment & Health , mai 2018

The aim of this study was to examine the association between co-occurring work stressors and risk of disability pension. The work stressors job strain, effort−reward imbalance (ERI), and organizational injustice were measured by a survey in 2008 of 41 862 employees linked to national records of all-cause and cause-specific disability pensions until 2011. Co-occurring work stressors were examined as risk factors of work disability using Cox regression marginal models. Data showed that work stressors tend to cluster in the same individuals. The highest risk of disability pension was observed among those with work stressor combinations strain+ERI or strain+ERI+injustice, rather than for those with single stressors.

Facteurs organisationnels et psychosociaux associés aux contraintes posturales en milieu professionnel : résultats à partir de l’enquête Sumer 2010
Source : Bulletin épidémiologique hebdomadaire (43447), mai 2018

Parmi les contraintes biomécaniques associées aux troubles musculo-squelettiques (TMS), les contraintes posturales (CP) font partie des plus fréquemment observées chez les travailleurs. L’objectif de cette étude était d’évaluer les associations entre l’exposition à des facteurs organisationnels et psychosociaux et celle à au moins une CP ≥10 h par semaine dans la population salariée française. L’exposition à au moins une CP ≥10 h par semaine était relevée chez 14% des hommes et 12% des femmes. Les contraintes industrielles, les normes de production ainsi que le manque de flexibilité, la surveillance hiérarchique et la polyvalence des postes de travail étaient positivement associées à l’exposition à une CP, quel que soit le genre. De même, un environnement psychosocial délétère (faible soutien social, faibles utilisation et développement des compétences et forte demande psychologique) était associé à un risque accru d’exposition à une CP. Ces résultats suggèrent la nécessité de prendre en compte les dimensions organisationnelles et psychosociales, au-delà des facteurs biomécaniques et socioprofessionnels, dans la prévention des TMS en milieu professionnel.

Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position: analyses of 64 934 individuals from four prospective cohort studies
Source : Occup Environ Med , mai 2018

This study aims to quantify the extent to which poor psychosocial working conditions reduce healthy or chronic disease-free life expectancy (HLE or CDFLE). Multistate life table models showed that job strain was consistently related to shorter healthy life expectancy, particularly among men and participants in lower occupational positions. Similar differences in HLE, although smaller, were observed among those in intermediate or high occupational positions. Job strain was additionally associated with shorter CDFLE, although this association was weaker and somewhat inconsistent. These findings suggest that individuals with job strain have a shorter health expectancy compared with those without job strain.

Mortalité prématurée par maladies cardiovasculaires chez les femmes selon la catégorie sociale et le secteur d’activité : synthèse
Source : Santé publique France, juin 2018

Les maladies cardiovasculaires (MCV) sont moins bien documentées chez les femmes que chez les hommes. Les principaux déterminants socioprofessionnels établis dans la littérature scientifique sont les risques psychosociaux, le travail de nuit, le travail posté, les horaires atypiques, et les bruits nocifs. La mortalité prématurée par maladies cardiovasculaires diminue entre 1976 et 2002 et présente un gradient social croissant des cadres vers les ouvrières et de sdifférences selon les secteurs. Les secteurs professionnels les plus à risque, notamment l’hôtellerie-restauration et l’industrie manufacturière, pourraient être particulièrement ciblés par les actions de prévention, avec une attention encore plus grande aux catégories les plus défavorisées.

 

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