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 job

I do not have enough time to get everything done in my job

It 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 control

I make my own decisions as to how I do my work

I 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 life

I feel I am positively influencing other people’s lives through my work

I am satisfied with my life in general

I definitely enjoy my job

I 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