Techno-Stress Creators, Burnout and Psychological Health among Remote Workers during the Pandemic: The Moderating Role of E-Work Self-Efficacy
Abstract
:1. Introduction
- (1)
- To explore whether techno-stressors are related to burnout, measured using the Burnout Assessment Tool [32];
- (2)
- To examine whether burnout mediates the relationship between techno-stressors and psychological health outcomes (i.e., anxiety symptoms and depressive moods);
- (3)
- To investigate whether the detrimental effects of techno-stressors on anxiety symptoms and depressive mood through burnout are buffered by e-work self-efficacy levels.
1.1. From Remote Working Techno-Stressors to Burnout
1.2. Techno-Stressors, Burnout, and Psychological Health Outcomes
1.3. E-Work Self-Efficacy as a Protective Personal Resource
2. Materials and Methods
2.1. Participants and Procedure
2.2. Measures
2.2.1. Techno-Stressors
2.2.2. Burnout
2.2.3. Depressive Mood and Anxiety Symptoms
2.2.4. E-Work Self-Efficacy
2.2.5. Resilience
2.3. Statistical Analysis
3. Results
3.1. Measurement Reliability of Study Constructs and Descriptive Analyses
3.2. Confirmatory Factor Analysis and Common Method Bias Check
3.3. Hypothesis Testing
4. Discussion
5. Practical Implications
6. Limitations and Future Research
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Nagel, L. The influence of the COVID-19 pandemic on the digital transformation of work. Int. J. Sociol. Soc. Policy 2020, 40, 861–875. [Google Scholar] [CrossRef]
- Milasi, S.; González-Vázquez, I.; Fernández-Macías, E. Telework before the COVID-19 Pandemic: Trends and Drivers of Differences across the EU 2021; OECD Publishing: Paris, France, 2021. [Google Scholar]
- Sostero, M.; Milasi, S.; Hurley, J.; Fernandez-Macías, E.; Bisello, M. Teleworkability and the COVID-19 Crisis: A New Digital Divide? JRC Working Papers Series on Labour, Education and Technology 2020, No. 2020/05; European Commission, Joint Research Centre (JRC): Seville, Spain, 2020. [Google Scholar]
- Pandey, N.; Pal, A. Impact of digital surge during COVID-19 pandemic: A viewpoint on research and practice. Int. J. Inf. Manag. 2020, 55, 102171. [Google Scholar]
- Golden, T.D. The role of relationships in understanding telecommuter satisfaction. J. Organ. Behav. Int. J. Ind. Occup. Organ. Psychol. Behav. 2006, 27, 319–340. [Google Scholar] [CrossRef]
- Barbuto, A.; Gilliland, A.; Peebles, R.; Rossi, N.; Shrout, T. Telecommuting: Smarter Workplaces. 2020. Available online: http://hdl.handle.net/1811/91648 (accessed on 1 April 2023).
- Thulin, E.; Vilhelmson, B.; Johansson, M. New telework, time pressure, and time use control in everyday life. Sustainability 2019, 11, 3067. [Google Scholar] [CrossRef]
- Tarafdar, M.; Tu, Q.; Ragu-Nathan, T.S.; Ragu-Nathan, B.S. Crossing to the dark side: Examining creators, outcomes, and inhibitors of technostress. Commun. ACM 2011, 54, 113–120. [Google Scholar] [CrossRef]
- Tarafdar, M.; Tu, Q.; Ragu-Nathan, B.S.; Ragu-Nathan, T.S. The impact of technostress on role stress and productivity. J. Manag. Inf. Syst. 2007, 24, 301–328. [Google Scholar] [CrossRef]
- Gaudioso, F.; Turel, O.; Galimberti, C. The mediating roles of strain facets and coping strategies in translating techno-stressors into adverse job outcomes. Comput. Hum. Behav. 2017, 69, 189–196. [Google Scholar] [CrossRef]
- Kossek, E.E.; Ruderman, M.N.; Braddy, P.W.; Hannum, K.M. Work–nonwork boundary management profiles: A person-centered approach. J. Vocat. Behav. 2012, 81, 112–128. [Google Scholar] [CrossRef]
- Santarpia, F.P.; Borgogni, L.; Consiglio, C.; Menatta, P. The Bright and Dark Sides of Resources for Cross-Role Interrupting Behaviors and Work–Family Conflict: Preliminary Multigroup Findings on Remote and Traditional Working. Int. J. Environ. Res. Public Health 2021, 18, 12207. [Google Scholar] [CrossRef]
- Cannito, M.; Scavarda, A. Childcare and remote work during the COVID-19 pandemic. Ideal worker model, parenthood and gender inequalities in Italy. Ital. Sociol. Rev. 2020, 10, 801–820. [Google Scholar]
- Eurofound. Living, Working and COVID-19; COVID-19 series 2020; European Union: Brussels, Belgium, 2020. [Google Scholar]
- Porter, G.; Kakabadse, N.K. HRM perspectives on addiction to technology and work. J. Manag. Dev. 2006, 25, 535–560. [Google Scholar] [CrossRef]
- Yener, S.; Arslan, A.; Kilinç, S. The moderating roles of technological self-efficacy and time management in the technostress and employee performance relationship through burnout. Inf. Technol. People 2021, 34, 1890–1919. [Google Scholar] [CrossRef]
- Wang, X.; Tan, S.C.; Li, L. Technostress in university students’ technology-enhanced learning: An investigation from multidimensional person-environment misfit. Comput. Hum. Behav. 2020, 105, 106208. [Google Scholar] [CrossRef]
- Sommovigo, V.; Bernuzzi, C.; Finstad, G.L.; Setti, I.; Gabanelli, P.; Giorgi, G.; Fiabane, E. How and When May Technostress Impact Workers’ Psycho-Physical Health and Work-Family Interface? A Study in Italy during the COVID-19 Pandemic in Italy. Int. J. Environ. Res. Public Health 2023, 20, 1266. [Google Scholar] [CrossRef] [PubMed]
- Torales, J.; O’Higgins, M.; Castaldelli-Maia, J.M.; Ventriglio, A. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int. J. Soc. Psychiatry 2020, 66, 317–320. [Google Scholar] [CrossRef]
- Özdin, S.; Bayrak Özdin, Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int. J. Soc. Psychiatry 2020, 66, 504–511. [Google Scholar] [CrossRef]
- Chen, F.; Zheng, D.; Liu, J.; Gong, Y.; Guan, Z.; Lou, D. Depression and anxiety among adolescents during COVID-19: A cross-sectional study. Brain Behav. Immun. 2020, 88, 36. [Google Scholar] [CrossRef]
- Korpinen, L.H.; Pääkkönen, R.J. Self-report of physical symptoms associated with using mobile phones and other electrical devices. Bioelectromagnetics 2009, 30, 431–437. [Google Scholar] [CrossRef]
- Wu, J.; Wang, N.; Mei, W.; Liu, L. Technology-induced job anxiety during non-work time: Examining conditional effect of techno-invasion on job anxiety. Int. J. Netw. Virtual Organ. 2020, 22, 162–182. [Google Scholar] [CrossRef]
- Vazquez, I.G.; Milasi, S.; Gomez, S.C.; Napierala, J.; Bottcher, N.R.; Jonkers, K.; Vuorikari, R. The Changing Nature of Work and Skills in the Digital Age; No. JRC117505; European Commission, Joint Research Centre (JRC): Seville, Spain, 2019. [Google Scholar]
- Grant, C.A.; Wallace, L.M.; Spurgeon, P.C.; Tramontano, C.; Charalampous, M. Construction and initial validation of the E-Work Life Scale to measure remote e-working. Empl. Relat. 2019, 41, 16–33. [Google Scholar] [CrossRef]
- Delpechitre, D.; Black, H.G.; Farrish, J. The dark side of technology: Examining the impact of technology overload on salespeople. J. Bus. Ind. Mark. 2018, 34, 317–337. [Google Scholar] [CrossRef]
- Tramontano, C.; Grant, C.; Clarke, C. Development and validation of the e-Work Self-Efficacy Scale to assess digital competencies in remote working. Comput. Hum. Behav. Rep. 2021, 4, 100129. [Google Scholar] [CrossRef]
- Charalampous, M.; Grant, C.A.; Tramontano, C.; Michailidis, E. Systematically reviewing remote e-workers’ well-being at work: A multidimensional approach. Eur. J. Work Organ. Psychol. 2019, 28, 51–73. [Google Scholar] [CrossRef]
- Shoji, K.; Cieslak, R.; Smoktunowicz, E.; Rogala, A.; Benight, C.C.; Luszczynska, A. Associations between job burnout and self-efficacy: A meta-analysis. Anxiety Stress Coping 2016, 29, 367–386. [Google Scholar] [CrossRef]
- Hobfoll, S.E. Conservation of resources: A new attempt at conceptualizing stress. Am. Psychol. 1989, 44, 513. [Google Scholar] [CrossRef] [PubMed]
- Hobfoll, S.E.; Halbesleben, J.; Neveu, J.P.; Westman, M. Conservation of resources in the organizational context: The reality of resources and their consequences. Annu. Rev. Organ. Psychol. Organ. Behav. 2018, 5, 103–128. [Google Scholar] [CrossRef]
- Schaufeli, W.B.; Desart, S.; De Witte, H. Burnout Assessment Tool (BAT)—Development, validity, and reliability. Int. J. Environ. Res. Public Health 2020, 17, 9495. [Google Scholar] [CrossRef]
- Boell, S.K.; Campbell, J.; Cecez-Kecmanovic, D.; Cheng, J.E. The transformative nature of telework: A review of the literature. In Proceedings of the 19th Americas Conference on Information Systems, AMCIS 2013—Hyperconnected World: Anything, Anywhere, Anytime, Chicago, IL, USA, 15–17 August 2013. [Google Scholar]
- Akinci, B.; Kiziltas, S.; Ergen, E.; Karaesmen, I.Z.; Keceli, F. Modeling and analysing the impact of technology on data capture and transfer processes at construction sites: A case study. J. Constr. Eng. Manag. 2006, 132, 1148–1157. [Google Scholar] [CrossRef]
- Melville, N.; Kraemer, K.; Gurbaxani, V. Information technology and organizational performance: An integrative model of IT business value. MIS Q. 2004, 28, 283–322. [Google Scholar] [CrossRef]
- Perry, S.J.; Rubino, C.; Hunter, E.M. Stress in remote work: Two studies testing the Demand-Control-Person model. Eur. J. Work Organ. Psychol. 2018, 27, 577–593. [Google Scholar] [CrossRef]
- Nelson, D.L. Individual adjustment to information-driven technologies: A critical review. MIS Q. 1990, 14, 79–98. [Google Scholar] [CrossRef]
- Chan, X.W.; Shang, S.; Brough, P.; Wilkinson, A.; Lu, C.Q. Work, life and COVID-19: A rapid review and practical recommendations for the post-pandemic workplace. Asia Pac. J. Hum. Resour. 2023, 61, 257–276. [Google Scholar] [CrossRef]
- Clark, K.; Kalin, S. Technostressed out? How to cope in the digital age. Libr. J. 1996, 121, 30–32. [Google Scholar]
- Ragu-Nathan, T.S.; Tarafdar, M.; Ragu-Nathan, B.S.; Tu, Q. The consequences of technostress for end users in organizations: Conceptual development and empirical validation. Inf. Syst. Res. 2008, 19, 417–433. [Google Scholar] [CrossRef]
- Weil, M.M.; Rosen, L.D. Don’t let technology enslave you: Learn how technostress can affect the habits of your employees and yourself. Workforce 1999, 78, 56–59. [Google Scholar]
- Gupta, M.; Hassan, Y.; Pandey, J.; Kushwaha, A. Decoding the dark shades of electronic human resource management. Int. J. Manpow. 2021, 43, 12–31. [Google Scholar] [CrossRef]
- Baumeister, V.M.; Kuen, L.P.; Bruckes, M.; Schewe, G. The relationship of work-related ICT use with well-being, incorporating the role of resources and demands: A meta-analysis. SAGE Open 2021, 11, 21582440211061560. [Google Scholar] [CrossRef]
- Salanova, M.; Llorens, S.; Ventura, M. Technostress: The dark side of technologies. In The Impact of ICT on Quality of Working Life; Springer: Berlin/Heidelberg, Germany, 2014; pp. 87–103. [Google Scholar]
- Mahapatra, M.; Pati, S.P. Technostress creators and burnout: A job demands-resources perspective. In Proceedings of the 2018 ACM SIGMIS Conference on Computers and People Research, Bufallo, NY, USA, 18–20 June 2018; pp. 70–77. [Google Scholar]
- Derks, D.; Bakker, A.B.; Gorgievski, M. Private smartphone use during worktime: A diary study on the unexplored costs of integrating the work and family domains. Comput. Hum. Behav. 2021, 114, 106530. [Google Scholar] [CrossRef]
- Molino, M.; Ingusci, E.; Signore, F.; Manuti, A.; Giancaspro, M.L.; Russo, V.; Cortese, C.G. Wellbeing costs of technology use during COVID-19 remote working: An investigation using the Italian translation of the technostress creators scale. Sustainability 2020, 12, 5911. [Google Scholar] [CrossRef]
- Lulli, L.G.; Giorgi, G.; Pandolfi, C.; Foti, G.; Finstad, G.L.; Arcangeli, G.; Mucci, N. Identifying psychosocial risks and protective measures for workers’ mental wellbeing at the time of COVID-19: A narrative review. Sustainability 2021, 13, 13869. [Google Scholar] [CrossRef]
- Maslach, C.; Schaufeli, W.B.; Leiter, M.P. Job burnout. Annu. Rev. Psychol. 2001, 52, 397–422. [Google Scholar] [CrossRef] [PubMed]
- Van den Broeck, A.; Elst, T.V.; Baillien, E.; Sercu, M.; Schouteden, M.; De Witte, H.; Godderis, L. Job demands, job resources, burnout, work engagement, and their relationships. J. Occup. Environ. Med. 2017, 59, 369–376. [Google Scholar] [CrossRef] [PubMed]
- Schaufeli, W.B.; Taris, T.W. The conceptualization and measurement of burnout: Common ground and worlds apart. Work Stress 2005, 19, 256–262. [Google Scholar] [CrossRef]
- Srivastava, S.C.; Chandra, S.; Shirish, A. Technostress creators and job outcomes: Theorizing the moderating influence of personality traits. Inf. Syst. J. 2015, 25, 355–401. [Google Scholar] [CrossRef]
- Peterka-Bonetta, J.; Sindermann, C.; Sha, P.; Zhou, M.; Montag, C. The relationship between Internet Use Disorder, depression and burnout among Chinese and German college students. Addict. Behav. 2019, 89, 188–199. [Google Scholar] [CrossRef] [PubMed]
- Maslach, C.; Leiter, M.P. Early predictors of job burnout and engagement. J. Appl. Psychol. 2008, 93, 498. [Google Scholar] [CrossRef] [PubMed]
- Maslach, C.; Jackson, S.E.; Leiter, M.P. Maslach Burnout Inventory: Manual, 3rd ed.; Consulting Psychologists Press: Palo Alto, CA, USA, 1996. [Google Scholar]
- Wheeler, D.L.; Vassar, M.; Worley, J.A.; Barnes, L.L.B. A Reliability Generalization Meta-Analysis of Coefficient Alpha for the Maslach Burnout Inventory. Educ. Psychol. Meas. 2011, 71, 231–244. [Google Scholar] [CrossRef]
- Worley, J.A.; Vassar, M.; Wheeler, D.L.; Barnes, L.L.B. Factor Structure of Scores from the Maslach Burnout Inventory: A Review and Meta-Analysis of 45 Exploratory and Confirmatory Factor-Analytic Studies. Educ. Psychol. Meas. 2008, 68, 797–823. [Google Scholar] [CrossRef]
- Galanakis, M.; Moraitou, M.; Garivaldis, F.J.; Stalikas, A. Factorial Structure and Psychometric Properties of the Maslach Burnout Inventory (MBI) in Greek midwives. Eur. J. Psychol. 2009, 5, 52–70. [Google Scholar] [CrossRef]
- De Beer, L.T.; Bianchi, R. Confirmatory Factor Analysis of the Maslach Burnout Inventory: A Bayesian Structural Equation Modeling Approach. Eur. J. Psychol. Assess. 2019, 35, 217–224. [Google Scholar] [CrossRef]
- Aboagye, M.O.; Qin, J.; Qayyum, A.; Antwi, C.O.; Jababu, Y.; Affum-Osei, E. Teacher Burnout in Preschools: A Cross-Cultural Factorial Validity, Measurement Invariance and Latent Mean Comparison of the Maslach Burnout Inventory, Educators Survey (MBI-ES). Child. Youth Serv. Rev. 2018, 94, 186–197. [Google Scholar] [CrossRef]
- Maslach, C.; Leiter, M.P.; Jackson, S.E. Maslach Burnout Inventory Manual, 4th ed.; Mind Garden, Inc.: Palo Alto, CA, USA, 2017. [Google Scholar]
- Bosmans, M.W.; Setti, I.; Sommovigo, V.; van der Velden, P.G. Do Type D personality and job demands-resources predict emotional exhaustion and work engagement? A 3-wave prospective study. Personal. Individ. Differ. 2019, 149, 167–173. [Google Scholar] [CrossRef]
- Androulakis, G.S.; Georgiou, D.A.; Lainidi, O.; Montgomery, A.; Schaufeli, W.B. The Greek Burnout Assessment Tool: Examining Its Adaptation and Validity. Int. J. Environ. Res. Public Health 2023, 20, 5827. [Google Scholar] [CrossRef]
- Tuan, L.T. How and when does hospitality employees’ core beliefs challenge foster their proactive coping for technostress?: Examining the roles of promotion focus, job insecurity, and technostress. J. Hosp. Tour. Manag. 2022, 52, 86–99. [Google Scholar] [CrossRef]
- Ding, Y.; Qu, J.; Yu, X.; Wang, S. The Mediating Effects of Burnout on the Relationship between Anxiety Symptoms and Occupational Stress among Community Healthcare Workers in China: A Cross-Sectional Study. PloS ONE 2014, 9, e107130. [Google Scholar] [CrossRef] [PubMed]
- Bianchi, R.; Schonfeld, I.S.; Laurent, E. Burnout–depression overlap: A review. Clin. Psychol. Rev. 2015, 36, 28–41. [Google Scholar] [CrossRef]
- Bianchi, R.; Schonfeld, I.S.; Laurent, E. Is burnout separable from depression in cluster analysis? A longitudinal study. Chest 2015, 50, 1005–1011. [Google Scholar] [CrossRef] [PubMed]
- McKnight, J.D.; Glass, D.C. Perceptions of control, burnout, and depressive symptomatology: A replication and extension. J. Consult. Clin. Psychol. 1995, 63, 490. [Google Scholar] [CrossRef] [PubMed]
- Schaufeli, W.; Enzmann, D. The Burnout Companion to Study and Practice: A Critical Analysis; CRC Press: Philadelphia, PA, USA, 1998. [Google Scholar]
- Bianchi, R.; Laurent, E.; Schonfeld, I.S.; Bietti, L.M.; Mayor, E. Memory bias toward emotional information in burnout and depression. J. Health Psychol. 2018, 25, 1567–1575, [Epub ahead of print]. [Google Scholar] [CrossRef]
- Hakanen, J.J.; Schaufeli, W.B. Do burnout and work engagement predict depressive symptoms and life satisfaction? A three-wave seven-year prospective study. J. Affect. Disord. 2012, 141, 415–424. [Google Scholar] [CrossRef] [PubMed]
- Ahola, K.; Hakanen, J. Job strain, burnout, and depressive symptoms: A prospective study among dentists. J. Affect. Disord. 2007, 104, 103–110. [Google Scholar] [CrossRef]
- Toker, S.; Biron, M. Job burnout and depression: Unraveling their temporal relationship and considering the role of physical activity. J. Appl. Psychol. 2012, 97, 699. [Google Scholar] [CrossRef]
- De Amorim Macedo, M.J.; de Freitas, C.P.P.; Bermudez, M.B.; Vazquez, A.C.S.; Salum, G.A.; Dreher, C.B. The shared and dissociable aspects of burnout, depression, anxiety, and irritability in health professionals during COVID-19 pandemic: A latent and network analysis. J. Psychiatr. Res. 2023, 166, 40–48. [Google Scholar] [CrossRef] [PubMed]
- Pereira, H.; Feher, G.; Tibold, A.; Costa, V.; Monteiro, S.; Esgalhado, G. Mediating effect of burnout on the association between work-related quality of life and mental health symptoms. Brain Sci. 2021, 11, 813. [Google Scholar] [CrossRef] [PubMed]
- Deligkaris, P.; Panagopoulou, E.; Montgomery, A.J.; Masoura, E. Job burnout and cognitive functioning: A systematic review. Work Stress 2014, 28, 107–123. [Google Scholar]
- Webb, T.L.; Miles, E.; Sheeran, P. Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychol. Bull. 2012, 138, 775–808. [Google Scholar] [CrossRef]
- Dragano, N.; Lunau, T. Technostress at work and mental health: Concepts and research results. Curr. Opin. Psychiatry 2020, 33, 407–413. [Google Scholar] [CrossRef]
- Hobfoll, S.E.; Shirom, A. Stress and burnout in the workplace: Conservation of resources. Handb. Organ. Behav. 1993, 1, 41–61. [Google Scholar]
- Chiappetta, M. The technostress: Definition, symptoms and risk prevention. Senses Sci. 2017, 4, 358–361. [Google Scholar] [CrossRef]
- Lin, J.S.; Lee, Y.I.; Jin, Y.; Gilbreath, B. Personality traits, motivations, and emotional consequences of social media usage. Cyberpsychol. Behav. Soc. Netw. 2017, 20, 615–623. [Google Scholar] [CrossRef]
- Leiter, M.P.; Maslach, C. A mediation model of job burnout. In Research Companion to Organizational Health Psychology; Edward Elgar Publishing: Cheltenham, UK, 2005; 544p. [Google Scholar]
- Stajkovic, A.D.; Luthans, F. Self-efficacy and work-related performance: A meta-analysis. Psychol. Bull. 1998, 124, 240–261. [Google Scholar] [CrossRef]
- Miao, C.; Qian, S.; Ma, D. The relationship between entrepreneurial self-efficacy and firm performance: A meta-analysis of main and moderator effects. J. Small Bus. Manag. 2017, 55, 87–107. [Google Scholar] [CrossRef]
- Sheeran, P.; Maki, A.; Montanaro, E.; Avishai-Yitshak, A.; Bryan, A.; Klein, W.M.; Rothman, A.J. The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis. Health Psychol. 2016, 35, 1178. [Google Scholar] [CrossRef]
- Bandura, A. The explanatory and predictive scope of self-efficacy theory. J. Soc. Clin. Psychol. 1986, 4, 359–373. [Google Scholar] [CrossRef]
- Bandura, A. Self-efficacy mechanism in human agency. Am. Psychol. 1982, 37, 122. [Google Scholar] [CrossRef]
- Bandura, A. Social cognitive theory: An agentic perspective. Annu. Rev. Psychol. 2001, 52, 1–26. [Google Scholar] [CrossRef] [PubMed]
- Van den Heuvel, M.; Demerouti, E.; Bakker, A.B.; Schaufeli, W.B. Personal resources and work engagement in the face of change. In Contemporary Occupational Health Psychology: Global Perspectives on Research and Practice; John Wiley & Sons: Hoboken, NJ, USA, 2010. [Google Scholar]
- Bandura, A. Self-Efficacy: The Exercise of Control; Freeman: New York, NY, USA, 1997. [Google Scholar]
- Bandura, A. Guide for constructing self-efficacy scales. Self-Effic. Beliefs Adolesc. 2006, 5, 307–337. [Google Scholar]
- Xie, T.; Zheng, L.; Liu, G.; Liu, L. Exploring structural relations among computer self-efficacy, perceived immersion, and intention to use virtual reality training systems. Virtual Real. 2022, 26, 1725–1744. [Google Scholar] [CrossRef] [PubMed]
- Compeau, D.R.; Higgins, C.A. Computer Self-Efficacy: Development of a Measure and Initial Test. MIS Q. 1995, 19, 189–211. [Google Scholar] [CrossRef]
- Raghuram, S.; Wiesenfeld, B.; Garud, R. Technology enabled work: The role of self-efficacy in determining telecommuter adjustment and structuring behavior. J. Vocat. Behav. 2003, 63, 180–198. [Google Scholar] [CrossRef]
- Lipnack, J.; Stamps, J. Virtual teams: The new way to work. Strategy Leadersh. 1999, 27, 14–19. [Google Scholar] [CrossRef]
- Hobfoll, S.E. Conservation of resource caravans and engaged settings. J. Occup. Organ. Psychol. 2011, 84, 116–122. [Google Scholar] [CrossRef]
- Xanthopoulou, D.; Bakker, A.B.; Demerouti, E.; Schaufeli, W.B. Work engagement and financial returns: A diary study on the role of job and personal resources. J. Occup. Organ. Psychol. 2009, 82, 183–200. [Google Scholar] [CrossRef]
- Beas, M.I.; Salanova, M. Self-efficacy beliefs, computer training and psychological well-being among information and communication technology workers. Comput. Hum. Behav. 2006, 22, 1043–1058. [Google Scholar] [CrossRef]
- Salanova, M.; Grau, R.M.; Cifre, E.; Llorens, S. Computer training, frequency of usage and burnout: The moderating role of computer self-efficacy. Comput. Hum. Behav. 2000, 16, 575–590. [Google Scholar] [CrossRef]
- Luthans, F. The need for and meaning of positive organizational behavior. J. Organ. Behav. 2002, 23, 695–706. [Google Scholar] [CrossRef]
- Hobfoll, S.E.; Stevens, N.R.; Zalta, A.K. Expanding the science of resilience: Conserving resources in the aid of adaptation. Psychol. Inq. 2015, 26, 174–180. [Google Scholar] [CrossRef] [PubMed]
- Mazzetti, G.; Consiglio, C.; Santarpia, F.P.; Borgogni, L.; Guglielmi, D.; Schaufeli, W.B. Italian Validation of the 12-Item Version of the Burnout Assessment Tool (BAT-12). Int. J. Environ. Res. Public Health 2022, 19, 8562. [Google Scholar] [CrossRef] [PubMed]
- Consiglio, C.; Mazzetti, G.; Schaufeli, W.B. Psychometric properties of the Italian version of the burnout assessment tool (BAT). Int. J. Environ. Res. Public Health 2021, 18, 9469. [Google Scholar] [CrossRef]
- Hadžibajramović, E.; Schaufeli, W.B.; De Witte, H. Shortening of the Burnout Assessment Tool (BAT)—From 23 to 12 items using content and Rasch analysis. BMC Public Health 2022, 22, 56. [Google Scholar] [CrossRef]
- Henry, J.D.; Crawford, J.R. The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. Br. J. Clin. Psychol. 2005, 44, 227–239. [Google Scholar] [CrossRef] [PubMed]
- Luthans, F.; Youssef, C.M.; Avolio, B.J. Psychological capital: Investing and developing positive organizational behavior. Posit. Organ. Behav. 2007, 1, 9–24. [Google Scholar]
- Kline, R.B. Principles and Practice of Structural Equation Modeling, 2nd ed.; The Guilford Press: New York, NY, USA, 2011. [Google Scholar]
- Hulland, J. Use of partial least squares (PLS) in strategic management research: A review of four recent studies. Strateg. Manag. J. 1999, 20, 195–204. [Google Scholar] [CrossRef]
- Hair, J.F.; Hult, G.T.M.; Ringle, C.M.; Sarstedt, M.; Thiele, K.O. Mirror, mirror on the wall: A comparative evaluation of composite-based structural equation modeling methods. J. Acad. Mark. Sci. 2017, 45, 616–632. [Google Scholar]
- Cronbach, L.J.; Meehl, P.E. Construct validity in psychological tests. Psychol. Bull. 1955, 52, 281. [Google Scholar] [CrossRef]
- Little, T.D.; Cunningham, W.A.; Shahar, G.; Widaman, K.F. To parcel or not to parcel: Exploring the question, weighing the merits. Struct. Equ. Model. Multidiscip. J. 2002, 9, 151–173. [Google Scholar] [CrossRef]
- Little, T.D. Longitudinal Structural Equation Modeling; Guilford Press: New York, NY, USA, 2013. [Google Scholar]
- Montani, F.; Setti, I.; Sommovigo, V.; Courcy, F.; Giorgi, G. Who responds creatively to role conflict? Evidence for a curvilinear relationship mediated by cognitive adjustment at work and moderated by mindfulness. J. Bus. Psychol. 2020, 35, 621–641. [Google Scholar]
- Alavi, M.; Visentin, D.C.; Thapa, D.K.; Hunt, G.E.; Watson, R.; Cleary, M. Chi-square for model fit in confirmatory factor analysis. J. Adv. Nurs. 2020, 76, 2209–2211. [Google Scholar] [CrossRef]
- Hu, L.T.; Bentler, P.M. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct. Equ. Model. Multidiscip. J. 1999, 6, 1–55. [Google Scholar] [CrossRef]
- Marsh, H.W.; Hau, K.T.; Wen, Z. In search of golden rules: Comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Struct. Equ. Model. 2004, 11, 320–341. [Google Scholar] [CrossRef]
- Podsakoff, P.M.; MacKenzie, S.B.; Podsakoff, N.P. Sources of method bias in social science research and recommendations on how to control it. Annu. Rev. Psychol. 2012, 63, 539–569. [Google Scholar] [CrossRef]
- Maffoni, M.; Sommovigo, V.; Giardini, A.; Argentero, P.; Setti, I. The Italian Version of the Hospital Ethical Climate Survey: First Psychometric Evaluations in a Sample of Healthcare Professionals Employed in Neurorehabilitation Medicine and Palliative Care Specialties. TPM Test. Psychom. Methodol. Appl. Psychol. 2021, 28, 441–466. [Google Scholar]
- Kim, J.H.; Yeasmin, M. The size and power of the bias-corrected bootstrap test for regression models with autocorrelated errors. Comput. Econ. 2005, 25, 255–267. [Google Scholar] [CrossRef]
- Feng, Z.; Savani, K. COVID-19 created a gender gap in perceived work productivity and job satisfaction: Implications for dual-career parents working from home. Gend. Manag. Int. J. 2020, 35, 719–736. [Google Scholar] [CrossRef]
- Dawson, J.F. Moderation in management research: What, why, when, and how. J. Bus. Psychol. 2014, 29, 1–19. [Google Scholar] [CrossRef]
- Harman, H.H. Modern Factor Analysis; University of Chicago Press: Chicago, IL, USA, 1976. [Google Scholar]
- Borle, P.; Reichel, K.; Niebuhr, F.; Voelter-Mahlknecht, S. How are techno-stressors associated with mental health and work outcomes? A systematic review of occupational exposure to information and communication technologies within the technostress model. Int. J. Environ. Res. Public Health 2021, 18, 8673. [Google Scholar] [CrossRef]
- Schaufeli, W.B.; Bakker, A.B. Job demands, job resources, and their relationship with burnout and engagement: A multi-sample study. J. Organ. Behav. 2004, 25, 293–315. [Google Scholar] [CrossRef]
- Schaufeli, W.B.; Bakker, A.B.; Van Rhenen, W. How changes in job demands and resources predict burnout, work engagement, and sickness absenteeism. J. Organ. Behav. 2009, 30, 893–917. [Google Scholar] [CrossRef]
- La Paglia, F.; Caci, B.; La Barbera, D. Technostress: A Research Study about Computer Self-Efficacy, Internet Attitude and Computer Anxiety. Annu. Rev. CyberTherapy Telemed. 2008, 61, 63–69. [Google Scholar]
- Savolainen, I.; Oksa, R.; Savela, N.; Celuch, M.; Oksanen, A. COVID-19 anxiety—A longitudinal survey study of psychological and situational risks among Finnish workers. Int. J. Environ. Res. Public Health 2021, 18, 794. [Google Scholar] [CrossRef] [PubMed]
- Salanova, M.; Peiró, J.M.; Schaufeli, W.B. Self-efficacy specificity and burnout among information technology workers: An extension of the job demand-control model. Eur. J. Work. Organ. Psychol. 2002, 11, 1–25. [Google Scholar] [CrossRef]
- Jex, S.M.; Bliese, P.D. Efficacy beliefs as a moderator of the impact of work-related stressors: A multilevel study. J. Appl. Psychol. 1999, 84, 349. [Google Scholar] [CrossRef] [PubMed]
- Allan, C.E.; Valkanova, V.; Ebmeier, K.P. Depression in older people is underdiagnosed. Practitioner 2014, 258, 19–22. [Google Scholar] [PubMed]
- Brown, M.J.; Hill, N.L.; Haider, M.R. Age and gender disparities in depression and subjective cognitive decline-related outcomes. Aging Ment. Health 2022, 26, 48–55. [Google Scholar] [CrossRef] [PubMed]
- Carstensen, L.L.; Fung, H.H.; Charles, S.T. Socioemotional selectivity theory and the regulation of emotion in the second half of life. Motiv. Emot. 2003, 27, 103–123. [Google Scholar] [CrossRef]
- Charles, S.T.; Mather, M.; Carstensen, L.L. Aging and emotional memory: The forgettable nature of negative images for older adults. J. Exp. Psychol. Gen. 2003, 132, 310. [Google Scholar] [CrossRef] [PubMed]
- Sasaki, N.; Yasuma, N.; Obikane, E.; Narita, Z.; Sekiya, J.; Inagawa, T.; Nishi, D. Psycho-educational interventions focused on maternal or infant sleep for pregnant women to prevent the onset of antenatal and postnatal depression: A systematic review. Neuropsychopharmacol. Rep. 2021, 41, 2–13. [Google Scholar] [CrossRef] [PubMed]
- Noble, R.E. Depression in women. Metabolism 2005, 54, 49–52. [Google Scholar] [CrossRef] [PubMed]
- Zender, R.; Olshansky, E. Women’s mental health: Depression and anxiety. Nurs. Clin. 2009, 44, 355–364. [Google Scholar] [CrossRef]
- Stich, J.F.; Tarafdar, M.; Cooper, C.L. Electronic communication in the workplace: Boon or bane? J. Organ. Eff. People Perform. 2018, 5, 98–106. [Google Scholar] [CrossRef]
- Stich, J.F.; Farley, S.; Cooper, C.; Tarafdar, M. Information and communication technology demands: Outcomes and interventions. J. Organ. Eff. People Perform. 2015, 2, 327–345. [Google Scholar] [CrossRef]
- Venkatesh, V.; Speier, C. Creating an effective training environment for enhancing telework. Int. J. Hum. Comput. Stud. 2000, 52, 991–1005. [Google Scholar] [CrossRef]
- Franken, E.; Bentley, T.; Shafaei, A.; Farr-Wharton, B.; Onnis, L.A.; Omari, M. Forced flexibility and remote working: Opportunities and challenges in the new normal. J. Manag. Organ. 2021, 27, 1131–1149. [Google Scholar] [CrossRef]
- Massa, N.; Santarpia, F.P.; Consiglio, C. Work characteristics as determinants of remote working acceptance: Integrating UTAUT and JDR models. In Proceedings of the 25th International Conference of Human-Computer interaction (HCII International 2023), Copenhagen, Denmark, 23–28 July 2023; Lecture Notes in Computer Science. Springer: Berlin/Heidelberg, Germany, 2023; Volume 1401. [Google Scholar]
- Avolio, B.J.; Sosik, J.J.; Kahai, S.S.; Baker, B. E-leadership: Re-examining transformations in leadership source and transmission. Leadersh. Q. 2014, 25, 105–131. [Google Scholar] [CrossRef]
- Fischer, T.; Reuter, M.; Riedl, R. The digital stressors scale: Development and validation of a new survey instrument to measure digital stress perceptions in the workplace context. Front. Psychol. 2021, 12, 607598. [Google Scholar] [CrossRef] [PubMed]
- Chowdhury, R.; Shah, D.; Payal, A.R. Healthy worker effect phenomenon: Revisited with emphasis on statistical methods–a review. Indian J. Occup. Environ. Med. 2017, 21, 2. [Google Scholar] [CrossRef]
M | SD | Skew | Kurt | CR | AVE | ω | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1. Techno-stressors | 2.40 | 0.81 | 0.22 | −0.54 | 0.94 | 0.55 | 0.94 | 0.94 | ||||||||
2. Burnout | 2.24 | 0.63 | 0.38 | −0.17 | 0.93 | 0.53 | 0.92 | 0.43 **a | 0.92 | |||||||
3. Depressive mood | 1.78 | 0.49 | 0.58 | 0.26 | 0.87 | 0.57 | 0.81 | 0.29 **a | 0.48 **a | 0.81 | ||||||
4. Anxiety symptoms | 1.54 | 0.49 | 1.08 | 1.48 | 0.88 | 0.59 | 0.82 | 0.44 **a | 0.36 **a | 0.54 **a | 0.82 | |||||
5. E-work self-efficacy | 5.67 | 0.88 | −0.74 | 0.26 | 0.85 | 0.52 | 0.77 | −0.30 **a | −0.34 **a | −0.21 **a | −0.14 *a | 0.77 | ||||
6. Resilience | 5.02 | 1.16 | −0.44 | −0.14 | 0.89 | 0.66 | 0.83 | −0.21 **a | −0.22 **a | −0.31 **a | −0.15 **a | 0.51 **a | 0.83 | |||
7. Gender | - | - | - | - | - | - | - | 0.13 **b | 0.12 b | 0.21 **b | 0.23 **b | −0.03 b | −0.17 *b | - | ||
8. Age | - | - | - | - | - | - | - | 0.06 c | −0.09 c | −0.14 **c | 0.04 c | 0.13 *c | 0.09 c | 0.02 b | - | |
9. Education level | - | - | - | - | - | - | - | −0.05 c | −0.08 c | −0.05 c | −0.04 c | 0.02 c | −0.03 c | 0.04 b | −0.09 b | - |
10. Children | 0.77 | 1.01 | - | - | - | - | - | 0.06 c | −0.06 c | −0.01 c | 0.08 c | 0.12 *c | 0.09 c | 0.07 b | 0.68 ***b | −0.24 **b |
Model | χ2 | df | χ2/df | p | RMSEA | 90% CI RMSEA | SRMR | CFI | TLI |
---|---|---|---|---|---|---|---|---|---|
5 factor_cmb g | 721.19 | 364 | 1.98 | 0.00 | 0.06 | [0.05, 0.07] | 0.06 | 0.91 | 0.90 |
5-factor model with 2nd order factor f | 565.03 | 388 | 1.45 | 0.00 | 0.04 | [0.04, 0.05] | 0.05 | 0.96 | 0.95 |
5-factor model e | 521.34 | 360 | 1.45 | 0.00 | 0.04 | [0.04, 0.05] | 0.05 | 0.96 | 0.95 |
4-factor model d | 675.18 | 392 | 1.72 | 0.00 | 0.06 | [0.05, 0.06] | 0.06 | 0.93 | 0.92 |
3-factor model c | 1251.99 | 399 | 3.14 | 0.00 | 0.10 | [0.09, 0.10] | 0.09 | 0.79 | 0.77 |
2-factor model b | 1761.18 | 404 | 4.36 | 0.00 | 0.12 | [0.12, 0.13] | 0.10 | 0.67 | 0.64 |
1-factor model a | 2479.40 | 405 | 6.12 | 0.00 | 0.15 | [0.14, 0.16] | 0.12 | 0.49 | 0.45 |
Model | χ2 | df | χ2/df | p | RMSEA [90%CI] | SRMR | CFI | TLI |
---|---|---|---|---|---|---|---|---|
Expected model with controls | 805.49 | 466 | 1.73 | 0.00 | 0.06 [0.05, 0.06] | 0.08 | 0.92 | 0.91 |
Expected model without controls | 634.00 | 366 | 1.73 | 0.00 | 0.06 [0.05, 0.06] | 0.08 | 0.93 | 0.92 |
Reverse model with controls | 878.39 | 467 | 1.88 | 0.00 | 0.06 [0.06, 0.07] | 0.10 | 0.90 | 0.89 |
Reverse model without controls | 634.00 | 366 | 1.73 | 0.00 | 0.06 [0.05, 0.06] | 0.09 | 0.93 | 0.92 |
Effects | B | S.E. | 95% CI | |||||
Techno-stressors → Burnout | 0.47 *** | 0.08 | [0.34, 0.61] | |||||
Burnout → Depressive mood | 0.44 *** | 0.10 | [0.28, 0.62] | |||||
Burnout → Anxiety symptoms | 0.22 ** | 0.08 | [0.08, 0.36] | |||||
Techno-stressors → Depressive mood | 0.16 | 0.10 | [−0.01, 0.32] | |||||
Techno-stressors → Anxiety symptoms | 0.38 *** | 0.08 | [0.24, 0.52] | |||||
Gender → Techno-stressors | 0.12 | 0.07 | [0.01, 0.24] | |||||
Age → Techno-stressors | 0.03 | 0.10 | [−0.15, 0.18] | |||||
Educational level → Techno-stressors | −0.03 | 0.08 | [−0.18, 0.10] | |||||
Number of children → Techno-stressors | 0.06 | 0.10 | [−0.10, 0.23] | |||||
Gender → Burnout | 0.08 | 0.07 | [−0.04, 0.18] | |||||
Age → Burnout | −0.16 * | 0.07 | [−0.28, −0.03] | |||||
Educational level → Burnout | −0.11 | 0.07 | [−0.23, 0.01] | |||||
Number of children → Burnout | −0.05 | 0.08 | [−0.18, 0.07] | |||||
Gender → Depressive mood | 0.15 * | 0.07 | [0.04, 0.25] | |||||
Age → Depressive mood | −0.24 ** | 0.08 | [−0.37, −0.11] | |||||
Educational level → Depressive mood | 0.02 | 0.07 | [−0.11, 0.11] | |||||
Number of children → Depressive mood | 0.15 | 0.08 | [0.02, 0.26] | |||||
Gender → Anxiety symptoms | 0.23 *** | 0.06 | [0.12, 0.33] | |||||
Age → Anxiety symptoms | −0.03 | 0.08 | [−0.16, 0.11] | |||||
Educational level → Anxiety symptoms | −0.01 | 0.07 | [−0.13, 0.10] | |||||
Number of children → Anxiety symptoms | 0.07 | 0.08 | [−0.05, 0.20] | |||||
Techno-stressors → Burnout → Depressive mood | 0.21 *** | 0.06 | [0.12, 0.33] | |||||
Techno-stressors → Burnout → Anxiety symptoms | 0.11 * | 0.04 | [0.05, 0.18] | |||||
Total effects for depressive mood | 0.37 *** | 0.07 | [0.25, 0.48] | |||||
Total effects for anxiety symptoms | 0.48 *** | 0.07 | [0.37, 0.60] |
Model | AIC | BIC | ||
---|---|---|---|---|
Expected model | 13,485.92 | 13,899.27 | ||
Alternative model with resilience | 13,651.74 | 14,065.09 | ||
Effects | B | S.E. | 95% CI | |
Techno-stressors → Burnout | 0.29 *** | 0.06 | [0.19, 0.38] | |
E-work self-efficacy → Burnout | −0.12 | 0.06 | [−0.22, −0.01] | |
Techno-stressors * E-work self-efficacy → Burnout | −0.15 ** | 0.05 | [−0.24, −0.06] | |
Burnout → Depressive mood | 0.35 *** | 0.07 | [0.23, 0.47] | |
Burnout → Anxiety symptoms | 0.17 ** | 0.06 | [0.07, 0.27] | |
Techno-stressors → Depressive mood | 0.09 | 0.04 | [−0.01, 0.16] | |
Techno-stressors → Anxiety symptoms | 0.20 *** | 0.04 | [0.13, 0.27] | |
Gender → Techno-stressors | 0.17 | 0.11 | [−0.01, 0.35] | |
Age → Techno-stressors | 0.01 | 0.05 | [−0.08, 0.10] | |
Educational level → Techno-stressors | −0.04 | 0.07 | [−0.17, 0.08] | |
Number of children → Techno-stressors | 0.04 | 0.07 | [−0.07, 0.15] | |
Gender → Burnout | 0.05 | 0.07 | [−0.05, 0.16] | |
Age → Burnout | −0.05 | 0.03 | [−0.10, 0.01] | |
Educational level → Burnout | −0.08 | 0.05 | [−0.16, 0.01] | |
Number of children → Burnout | −0.01 | 0.04 | [−0.08, 0.06] | |
Gender → Depressive mood | 0.13 * | 0.05 | [0.04, 0.22] | |
Age → Depressive mood | −0.08 ** | 0.03 | [−0.12, −0.04] | |
Educational level → Depressive mood | 0.01 | 0.04 | [−0.06, 0.06] | |
Number of children → Depressive mood | 0.06 | 0.03 | [0.01, 0.12] | |
Gender → Anxiety symptoms | 0.19 *** | 0.05 | [0.10, 0.27] | |
Age → Anxiety symptoms | −0.01 | 0.02 | [−0.05, 0.03] | |
Educational level → Anxiety symptoms | −0.00 | 0.03 | [−0.06, 0.05] | |
Number of children → Anxiety symptoms | 0.03 | 0.03 | [−0.02, 0.08] | |
Techno-stressors × Low E-work self-efficacy→ Burnout → Depressive mood | 0.15 *** | 0.04 | [0.09, 0.22] | |
Techno-stressors × Moderate E-work self-efficacy→ Burnout → Depressive mood | 0.10 *** | 0.03 | [0.06, 0.14] | |
Techno-stressors × High E-work self-efficacy→ Burnout → Depressive mood | 0.05 | 0.03 | [0.00, 0.09] | |
Techno-stressors × Low E-work self-efficacy→ Burnout → Anxiety symptoms | 0.08 ** | 0.03 | [0.03, 0.12] | |
Techno-stressors × Moderate E-work self-efficacy→ Burnout → Anxiety symptoms | 0.05 ** | 0.02 | [0.02, 0.08] | |
Techno-stressors × High E-work self-efficacy→ Burnout → Anxiety symptoms | 0.02 | 0.01 | [0.00, 0.05] | |
Moderated indirect effect for Depressive mood | −0.05 * | 0.02 | [−0.09, −0.02] | |
Moderated indirect effect for Anxiety symptoms | −0.03 * | 0.01 | [−0.05, −0.01] | |
Total effects for Depressive mood at Low levels of E-work self-efficacy | 0.24 *** | 0.05 | [0.16, 0.32] | |
Total effects for Depressive mood at Moderate levels of E-work self-efficacy | 0.19 *** | 0.04 | [0.12, 0.26] | |
Total effects for Depressive mood at High levels of E-work self-efficacy | 0.14 ** | 0.05 | [0.06, 0.22] | |
Total effects for Anxiety symptoms at Low levels of E-work self-efficacy | 0.28 *** | 0.05 | [0.20, 0.35] | |
Total effects for Anxiety symptoms at Moderate levels of E-work self-efficacy | 0.25 *** | 0.04 | [0.18, 0.32] | |
Total effects for Anxiety symptoms at High levels of E-work self-efficacy | 0.22 *** | 0.04 | [0.15, 0.30] |
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Consiglio, C.; Massa, N.; Sommovigo, V.; Fusco, L. Techno-Stress Creators, Burnout and Psychological Health among Remote Workers during the Pandemic: The Moderating Role of E-Work Self-Efficacy. Int. J. Environ. Res. Public Health 2023, 20, 7051. https://doi.org/10.3390/ijerph20227051
Consiglio C, Massa N, Sommovigo V, Fusco L. Techno-Stress Creators, Burnout and Psychological Health among Remote Workers during the Pandemic: The Moderating Role of E-Work Self-Efficacy. International Journal of Environmental Research and Public Health. 2023; 20(22):7051. https://doi.org/10.3390/ijerph20227051
Chicago/Turabian StyleConsiglio, Chiara, Nicoletta Massa, Valentina Sommovigo, and Luigi Fusco. 2023. "Techno-Stress Creators, Burnout and Psychological Health among Remote Workers during the Pandemic: The Moderating Role of E-Work Self-Efficacy" International Journal of Environmental Research and Public Health 20, no. 22: 7051. https://doi.org/10.3390/ijerph20227051