Search Results (519)

Background/Objectives: Prolonged working shifts may adversely affect healthcare workers’ health, well-being, cognitive performance, and patient safety. Nevertheless, 24-h shifts remain commonly used in Latvian healthcare. This study aimed to examine healthcare workers’ experiences of 24-h shift work, their attitudes toward revising this work schedule, and the main reported reasons underlying their preferences. Methods: A cross-sectional survey was conducted in Latvia between October 2025 and February 2026. A structured 64-item questionnaire assessed sociodemographic and professional characteristics, workload, shift patterns, health and emotional well-being, perceived patient-safety concerns, professional motivation, and attitudes toward alternative work schedules. Of 1524 submitted questionnaires, 1318 were included in the analysis. Quantitative data were summarized using descriptive statistics, while open-ended responses were examined using qualitative content analysis. Results: Most respondents regularly worked extended shifts, and 40.5% worked at more than one institution. More than half reported health changes that they perceived as potentially related to extended shift work, with 61.1% reporting emotional exhaustion and 49.2% reporting persistent fatigue. Fatigue during extended shift work had contributed to a self-reported error or perceived decline in care quality among 34.9% of respondents. Despite these concerns, a substantial proportion of participants preferred to retain 24-h shifts. Frequently reported reasons included schedule convenience, consecutive days off, financial considerations, and the ability to combine employment across multiple workplaces. Open-ended responses further highlighted preferences for flexibility, employee choice, adequate staffing, opportunities for rest, and consideration of financial consequences when revising work schedules. Conclusions: The findings demonstrate a tension between healthcare workers’ perceived health and patient-safety concerns associated with extended shift work and the practical and financial advantages associated with retaining 24-h shifts. Full article

Background: This study explored the associations between artificial intelligence (AI)-derived competency scores and nurse retention outcomes among newly employed nurses. Evidence regarding the relationship between AI-based competency assessments, nurse performance, and long-term retention remains limited. Methods: Data were collected from 156 newly employed nurses at hospitals in South Korea between March 2021 and August 2023. Retention status (retained vs. resigned) was specified as the dependent variable, while AI-derived competency scores served as independent variables in binary logistic regression analyses. Result: Self-reflection was significantly associated with retention (p = 0.032), whereas honesty (p = 0.051) and values (p = 0.072) did not achieve statistical significance and were therefore not associated with retention. Behavioral response was significantly associated with early turnover (p = 0.035), whereas relationship (p = 0.073) and understanding of others (p = 0.141) were not significantly associated with turnover. Conclusions: These findings provide preliminary evidence that selected AI-derived competency scores are associated with nurse retention outcomes. However, the findings should be interpreted cautiously because this study examined statistical associations rather than predictive performance, and further validation studies are required before AI-assisted competency assessments can be considered standalone decision-support tools for nurse recruitment. Full article

Psychosocial working conditions are important determinants of employee health, work ability, and organizational sustainability, yet existing instruments often assess job demands, job resources, psychosocial risks, or well-being outcomes separately. This study examined the structural validity of the Multidimensional Psychosocial Work Experience Scale for Employed Persons (MPWES), an instrument designed to assess a multidimensional occupational psychosocial profile comprising workplace conditions and demands, psychosocial resources, adverse exposures, health-related experiences, and subjective functioning. A cross-sectional validation study was conducted among 1631 employees from the pharmaceutical, energy, healthcare, and administrative sectors in Latvia. Confirmatory factor analysis with the robust WLSMV estimator was used to test the predefined measurement model. The refined eight-factor model demonstrated acceptable fit in the calibration subsample (N = 400; CFI = 0.930, TLI = 0.922, RMSEA = 0.066, SRMR = 0.078) and was replicated in the held-out validation subsample (N = 1231; CFI = 0.911, TLI = 0.901, RMSEA = 0.068, SRMR = 0.067). Reliability indices were acceptable for several domains, although some factors showed modest or borderline values. Discriminant validity was supported, with all HTMT values below 0.85, and measurement invariance testing supported configural, metric, scalar, and strict invariance across samples. The findings provide initial evidence of the MPWES’s structural validity and measurement stability in the present sample. However, further studies using external validity criteria, longitudinal designs, and culturally diverse samples are needed before the scale can be considered fully validated for broader occupational and public health applications. Full article

Background: Counterproductive work behaviors (CWBs) are voluntary employee behaviors that harm the organization or its members, ranging from minor incivility and withdrawal to overt acts of misconduct. CWBs among nurses are widespread and carry adverse consequences for patients, nurses, and healthcare organizations, often reflecting problematic working conditions rather than individual character flaws. Perceived supportive resources, comprising individual resources (personal strengths and overall health), work resources (staffing and professional development), and interpersonal work resources (supervisor support and participation in unit decisions), have been proposed as protective factors. Thriving at work has been proposed as a potential protective motivational state that may account for how these resources are associated with behavior. Aim: This study examines how individual resources, work resources, and interpersonal work resources are associated with CWBs, and whether thriving at work mediates these associations among nurses in Saudi Arabia. Methods: One hundred twenty-nine nurses participated in this cross-sectional study between February and March 2026. Data were collected using the Thriving in Nursing Questionnaire (THINQ) and the Individual Work Performance Questionnaire (IWPQ). Data were analyzed via correlation, multiple regression, and mediation with bootstrapping. Results: Individual resources (r = −0.363), work resources (r = −0.270), and interpersonal work resources (r = −0.338) were each negatively associated with CWBs (all p < 0.001), and each was positively associated with thriving (r = 0.699, 0.793, and 0.794, respectively; all p < 0.001). Thriving at work was negatively associated with CWBs (r = −0.408, p < 0.001), and the associations of individual resources (indirect $\beta$ = −0.212), work resources ($\beta$ = −0.416), and interpersonal work resources ($\beta$ = −0.301) with CWBs were fully accounted for by indirect effects through thriving, with all direct effects nonsignificant and the largest indirect effect for work resources (95% CI [−0.611, −0.217]). Conclusions: Thriving at work emerged as a key correlate through which individual, work, and interpersonal work resources were linked to CWBs among nurses. Enhancing thriving may help reduce CWBs, though longitudinal research is needed to confirm directionality. Full article

Background: Education is a cornerstone of antimicrobial stewardship, yet evidence on its impact across the entire hospital workforce remains limited. This study aimed to assess knowledge, attitudes, and practices regarding antibiotic use and AMR among workers employed at an Italian tertiary-care hospital, and to explore the association between questionnaire performance and participation in antibiotic-related training activities. Methods: A repeated cross-sectional survey was conducted in 2024 and 2025 at a large Italian tertiary-care hospital (Padua, Northern Italy). A structured questionnaire adapted from an ECDC-validated instrument was distributed through the institutional email system to all hospital employees, including healthcare professionals and non-healthcare workers. The questionnaire investigated demographic and professional characteristics, participation in antibiotic-related training activities, and knowledge, attitudes and practices regarding antibiotic use and AMR. Questionnaire performance was assessed using both a binary scoring system and a partial credit scoring system. Multivariable linear regression analysis was performed to identify independent predictors of performance. Results: A total of 3193 participants completed the survey (1928 and 1265 in 2024 and in 2025, respectively). The mean (SD) total score was 5.75 ± 2.25 out of 15 points, with the lowest performance observed in the practice domain. No significant differences were found between the two survey years (2024 and 2025). Participants who attended antibiotic-related training performed significantly better than untrained participants (6.23 vs. 5.01; p < 0.001), with prior training emerging as the strongest independent predictor of questionnaire performance (β = 4.8; p < 0.001). Younger age was associated with better performance, while longer seniority (>30 years) was associated with lower scores. Among healthcare professionals, modestly higher scores were observed in 2025 compared with 2024, particularly in the practice domain. Conclusions: Persistent opportunities for improvement remain in AMR-related knowledge, attitudes and particularly practices across the hospital workforce. Participation in antibiotic-related training activities was associated with improved questionnaire performance, supporting the role of structured and continuous educational interventions within hospital AMS programs. Repeated institutional educational initiatives may contribute to strengthening stewardship-related awareness and practices over time. Full article

Background/Objectives: Quiet quitting, workplace gaslighting, and moral resilience are increasingly recognized as important to employee wellbeing, yet they have rarely been studied together, and evidence from white-collar workforces outside healthcare is scarce. This study examined these three constructs, as well as the associations between them, among white-collar employees of a governmental organization in Greece. Methods: A cross-sectional study was conducted with a self-report questionnaire completed by 433 employees, about 90% of the target population. Quiet quitting, workplace gaslighting, and moral resilience were measured with the Quiet Quitting Scale, the Gaslighting at Work Scale, and the revised Rushton Moral Resilience Scale (RMRS-16). Results: The mean quiet quitting score was 2.26 (SD 0.69), the mean gaslighting score was 1.84 (SD 0.76), and the mean moral resilience score was 3.08 (SD 0.43). In multivariable analysis, higher moral resilience was independently associated with lower quiet quitting (b = −0.52, 95% CI: −0.65 to −0.39) and lower gaslighting (b = −0.49, 95% CI: −0.65 to −0.34). Higher gaslighting was associated with higher quiet quitting (b = 0.27, 95% CI: 0.19 to 0.35). Men and younger employees reported higher levels of both. Conclusions: Moral resilience was independently associated with both lower supervisory gaslighting and lower quiet quitting. These cross-sectional findings cannot establish causality. If confirmed in longitudinal research, interventions that strengthen moral resilience and improve supervisory practices may support employee engagement and wellbeing in white-collar workforces. Full article

Background: Job stress is a pervasive issue in modern workplaces and is associated with numerous adverse outcomes, including employees’ turnover intention when stress levels are high. Objective: This study aimed to examine the association between job stress and turnover intention among employees working in healthcare institutions through meta-analysis. Methods: A systematic literature review and meta-analysis were performed following PRISMA guidelines. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; ID: CRD42024581906). Considering variations in sample sizes, publication years, and measurement scales, a random-effects model was employed. Effect sizes were illustrated with a forest plot, and publication bias analyses were performed. Subgroup analyses were conducted by occupational group, COVID-19 period, and geographic region, while meta-regression tested the moderating effects of publication year. Study quality was assessed using the AXIS tool. Results: Based on predefined inclusion criteria, 38 independent studies were included. Findings revealed a moderate-to-high, positive, and statistically significant relationship (r = 0.441; 95% CI [0.389, 0.490]) between job stress and turnover intention among healthcare workers. Moreover, although between-study heterogeneity was substantial (I² = 95.5%), the direction and statistical significance of the association remained consistent across different countries and healthcare systems. Conclusions: This meta-analysis demonstrated a statistically significant positive association between job stress and turnover intention among healthcare workers (r = 0.441). Although substantial heterogeneity was observed across studies, the relationship remained consistent across occupational groups, regions, and study contexts. Addressing job stress may therefore play an important role in supporting workforce retention in healthcare organizations. Full article

Background/Objectives: Healthcare staff, especially nurses, face high occupational stress, yet objective biological indicators that complement self-report are not well established. We examined whether metabolic, hormonal and physiological markers act as indicators of stress and relate to anxiety, depression and burnout in nurses and other healthcare workers. Methods: We conducted a cross-sectional study of 300 hospital employees (239 in healthcare, of whom 123 were nurses; 61 non-healthcare) at a Croatian university hospital; of 329 completed questionnaires, 300 (91.2%) met the inclusion criteria and were analysed. Fasting glucose, lipids, thyroid hormones, cortisol, heart rate and blood pressure were measured; psychological status was measured using the 42-item Depression Anxiety Stress Scales (DASS-42), Maslach Burnout Inventory and Zung scale. Analyses used Mann–Whitney and Kruskal–Wallis tests, Spearman correlation, hierarchical logistic regression adjusted for age, sex, smoking and thyroid medication use, and receiver operating characteristic (ROC) analysis. Results: Healthcare workers had more favourable glucose, total and low-density lipoprotein (LDL) cholesterol than the older non-healthcare group (all p ≤ 0.003); because the groups differed substantially in age, these unadjusted differences are descriptive only. Metabolic markers correlated only weakly with distress and burnout. Within healthcare workers, elevated stress was discriminated in univariable analysis by low high-density lipoprotein (HDL) cholesterol (area under the curve (AUC) 0.72), raised triglycerides (AUC 0.67) and glucose (AUC 0.66); however, after adjustment for age, sex, smoking and thyroid medication use, none of the markers remained independently associated with elevated stress. Conclusions: In this relatively healthy hospital workforce, routinely available biological markers showed limited value as standalone indicators of occupational stress; they are exploratory rather than validated biomarkers, and require confirmation in larger, prospective, multicentre studies before they can complement—rather than replace—psychological screening in occupational-health practice. Full article

Background: Healthcare professionals are frequently exposed to serious work-related events that may adversely affect their psychological well-being, work ability, and professional retention. Peer support systems have been proposed as a low-threshold organizational approach to providing psychosocial support following such job-inherent events. This study examined the incidence of serious work-related events among healthcare workers, employees’ perceptions of an implemented peer support system, and the potential relevance of psychosocial support for employer attractiveness. Methods: A multicenter cross-sectional survey was conducted following the implementation of peer support structures in three German hospitals in 2022. A total of 295 healthcare workers completed an anonymous questionnaire assessing experiences with serious work-related events, perceptions of the peer support system, preferred support services, and the potential influence of psychosocial support on employer choice. Descriptive statistics and bivariate correlations were performed. Results: Overall, 46.4% of participants reported experiencing at least one serious work-related event within the previous two years. The peer support system was perceived as a valuable resource for supporting staff and managing psychosocial stress. Participants reported benefits not only from direct use of peer support but also from knowing that support was available when needed. Negative perceptions of the peer support system were uncommon. Approximately 27% of respondents indicated that the availability of psychosocial support could influence their choice of employer. Conclusions: Peer support systems are perceived as an acceptable and beneficial approach to addressing psychosocial stress among healthcare professionals. Beyond their supportive function, such systems may be perceived as part of employer attractiveness and a feasible organizational strategy to support workforce well-being and workforce stability in healthcare settings. Full article

Background/Objectives: This study examined the relationships among job satisfaction, affective organizational commitment, career engagement, and quiet quitting in healthcare workers. Specifically, we tested a moderated mediation model in which affective organizational commitment mediated the relationship between job satisfaction and quiet quitting and career engagement moderated this indirect effect. Methods: In this cross-sectional study, data were collected online between April and May 2024 from 373 employees of public and private healthcare institutions in Istanbul, Türkiye. Participants completed validated measures of the four constructs. We tested mediation and moderation with SPSS 26.0 and the Hayes PROCESS macro (Model 14). Results: Job satisfaction correlated positively with affective organizational commitment and strongly and negatively with quiet quitting. Quiet quitting was higher among women (d = 0.42); nurses descriptively showed the lowest job satisfaction and the highest quiet quitting; however, no pairwise difference in quiet quitting was detected. The conditional indirect association between job satisfaction and quiet quitting through affective organizational commitment became stronger as career engagement increased. Conclusions: Job satisfaction and affective organizational commitment emerged as key correlates of lower quiet quitting. Career engagement amplified rather than buffered the role of affective organizational commitment: commitment was most strongly associated with lower quiet quitting among highly career-engaged employees, whereas low commitment in this group was accompanied by higher quiet quitting. Healthcare managers may consider strategies that strengthen employee commitment while supporting career development. Full article

Objectives: The aging population problem caused by low fertility intentions has already emerged worldwide and is expected to become more severe in the future. Despite the gradual implementation of welfare policies, there has been no substantial improvement in individuals’ intentions to have more children. It has therefore become increasingly important to examine the factors that correlate with individuals’ intentions in relation to fertility policy. Methods: The data used in this study were drawn from the 2023 Health Life Satisfaction Survey of the Yangtze River Delta Phase II conducted by Shanghai Jiao Tong University. The primary analysis employed binary logistic regression to examine the association between medical insurance type and fertility intentions, with healthcare accessibility operationalized as a moderating variable. Gender and parity-stratified analyses were conducted as pre-specified exploratory secondary analyses to examine potential heterogeneity in these associations. Results: A total of 8789 citizens were included in the analysis, of whom 18.42 percent reported fertility intentions. Individuals enrolled in the Basic Medical Insurance System for Urban Employees exhibited significantly higher odds of having fertility intentions compared with those enrolled in the Basic Medical Insurance System for Urban and Rural Residents (OR = 1.2154, 95% CI = 1.0626–1.3901, p < 0.001). Moreover, individuals covered by the Basic Medical Insurance System for Urban Employees and residing near secondary hospitals showed significantly higher odds of fertility intentions (OR = 1.6727, 95% CI = 1.1273–2.4821, p < 0.05) than those covered by the Basic Medical Insurance System for Urban and Rural Residents and living near primary hospitals. Conclusions: Medical insurance benefit levels, as well as the quality and accessibility of healthcare resources, are positively associated with individuals’ fertility intentions, suggesting that welfare design and service delivery may jointly shape the institutional context for reproductive decision-making. Full article

The adversity-activated development reflection tool (AART) has been used therapeutically to capture personal growth arising during adversity. Our mixed-methods study used this tool to assess adversity-activated growth in 854 mental and community healthcare workers during the COVID-19 pandemic. Participants used the tool to describe the positive and negative effects of the COVID-19 pandemic in different life domains (self, family, work, and community). Through an ideal-type analysis of 133 purposively subsampled AARTs, we derived three levels of adversity-activated development (AAD): none, minimal, and deep. Higher levels of AAD were associated with spending more time connecting with friends and family (OR = 1.83, 95% CI 1.23 to 2.75, p < 0.01) and skill development in mental health care (OR = 1.63, 95% CI 1.16 to 2.28, p < 0.01). Deep development was characterised by changes in life priorities, changes in coping, realising strengths and capabilities, and making stronger connections with others. The AART can usefully assess both positive and negative growth, enabling respondents to convey the complexities of their experiences in their own words, whilst allowing the levels of overall self-development to be distilled. Our findings reinforce the value of promoting social connectedness and skill development to facilitate employee growth during collective occupational stress. Full article

The present study evaluated the association between morning serum cortisol levels and burnout syndrome among healthcare workers in the department of Boyacá, Colombia. An observational, analytical, cross-sectional, and quantitative study was conducted on 69 employees. Total serum cortisol was measured via chemiluminescence in fasting morning samples (reference: 110–692 nmol/L). Burnout was assessed using the Maslach Burnout Inventory–General Survey (MBI-GS). A total of 96.6% of participants fell within the normal range for serum cortisol. MBI-GS dimensions reported mean scores of: exhaustion 1.54 ± 1.17, cynicism 0.93 ± 0.89, and professional efficacy 5.60 ± 0.60. High exhaustion prevalence was 16.9%, high cynicism 6.8%, and low efficacy 3.4%. Profile classification showed 67.8% “engaged,” 13.6% “overextended/worn-out,” and 5.1% with “burnout.” No significant association was found between cortisol and burnout dimensions: exhaustion (r = 0.069, p = 0.605), cynicism (r = −0.135, p = 0.309), and professional efficacy (r = 0.044, p = 0.742). Mean cortisol comparisons between high and low dimension groups showed no statistically significant differences (p > 0.05). The study documented a low prevalence of established burnout and an absence of significant association between morning serum cortisol and MBI-GS dimensions, suggesting a relatively healthy work environment; however, the prevalence of high emotional exhaustion warrants preventive interventions. Multilevel organizational strategies like workload management, job stability, role clarity, and psychosocial support are recommended for worker mental health protection. Full article

Occupational burnout has become a major topic in occupational health psychology because of its implications for employee well-being, mental health, and organizational functioning. Although the scientific literature has grown steadily, the field still requires an integrated picture of its development, collaboration patterns, and thematic structure. This study examined the evolution, collaboration patterns and thematic structure of occupational burnout research through a bibliometric analysis of publications indexed in the Web of Science Core Collection between 2000 and 2025. A total of 3227 publications were retrieved using a topic-based search focused specifically on occupational burnout terminology. Bibliometric analyses used VOSviewer to map and visualize trends in scientific production, co-authorship networks, country/region collaboration, keyword co-occurrence, and journal citation patterns. The findings indicate an accelerating increase in publication output, from 17 publications in 2000 to 454 in 2025. The period 2020–2025 alone accounted for 2142 publications, representing 66.4% of the corpus. Collaboration analyses revealed an increasingly international field involving 122 countries/regions, with the United States occupying a highly connected position and collaboration clusters emerging in Europe and Asia. Spain also appeared to connect European and Latin American research communities. Thematic mapping showed that burnout is closely associated with organizational variables, psychological distress, healthcare settings, and measurement-related issues. Overall, occupational burnout research has become an internationalized and multidisciplinary field, shaped by the growing relevance of psychosocial risks, mental health, and work-related well-being. Full article

The present study aims to examine the effect of transformational and transactional leadership styles on the effectiveness of talent management in the Jordanian Ministry of Health, where the mediating variable is employee engagement while the moderating variable is organizational culture. The current study fills an important void in the literature because few studies have integrated all these relationships within the public healthcare sector in a Middle East context. A cross-sectional quantitative study was performed using stratified random sampling over 154 departmental units within the Ministry of Health. A structured questionnaire was used to gather data from 379 healthcare professionals, which were then analyzed by applying Structural Equation Modeling (SmartPLS 4). The results show that transformative leadership (β = 0.238; p = 0.043) as well as transactional leadership are significant to the success of talent management. Leadership styles also positively affect employee engagement (β = 0.66; p = 0.001), and employee engagement in turn has a positive influence on the effectiveness of talent management (β = 0.309; p = 0.001). Organizational culture is shown to have a moderating effect (β = 0.102; p = 0.012), which strengthens the relationship between leadership and talent management. The findings underscore the need for culturally appropriate leadership development and engagement strategies in public healthcare systems. Based on the findings, policy-makers in the Ministry of Health might consider investing in leadership competency building and develop supportive organizational cultures as strategic approaches to strengthen talent management and organizational performance. Full article