Irritation as defined in this paper is the subjectively perceived emotional and cognitive strain in occupational contexts. The structural equivalence of the Arabic, Dutch, English, French, Italian, Russian, Spanish, Turkish, and Polish adaptations of the German Irritation Scale is examined. The Irritation Scale is recommended for application particularly in occupational contexts. In this field it can be used for evaluating interventions, for research on stress at work, and for individual counseling. Exploratory factor analyses, as well as single group and different multiple-group confirmatory factor analyses, were performed. Structural equivalency in terms of equal factor loadings as well as equal factor covariances across all adaptations can be claimed. However, the single group analyses suggest that the hypothesized factor model should be rejected in the English, Russian, Spanish, and Turkish versions, mainly because of borderline values in the RMSEA index.

Background: Subjective workload in healthcare employees is suspected to be important for the performance and safety of healthcare delivery. This study investigates associations between workflow interruptions and hospital doctors' capability to manage their perceived workload in a safe and efficient manner. Aim: To examine the relationship of observed workflow interruptions with hospital doctors' perceived workload during day clinical shifts. Methods: A prospective study of 43 full shift observations with 29 doctors working in internal medicine and surgical specialties. Workflow interruptions were assessed via observation using a previously validated observation instrument. Doctors assessed their workload twice throughout their day shift using three items of the validated NASA-Task Load Index (NASA-TLX; mental demands, effort, frustration). Results: Hospital doctors were on average disrupted 3.66 times per hour. Most frequent were interruptions by nursing staff, telephone/beeper interruptions and by fellow doctors. Senior doctors reported higher workload than their junior colleagues. Overall workflow interruptions were significantly related to doctors' workload (b¼0.22; p¼0.03). Further analyses revealed that doctors' workload was associated particularly with interruptions by nursing personnel (b¼0.23; p¼0.03). Conclusions: Frequent workflow interruptions may be linked with increased workload in doctors. Healthcare environments need to be better designed to reduce unnecessary interruptions and distractions so that hospital doctors can manage clinical work efficiently and safely.

This study links idiosyncratic deals (i-deals) to job design theory. It investigates the impact of individually negotiated job changes on performance, self-efficacy, and psychological strain through their intervening effects on work design. Based on a sample of 187 health care professionals employed by a hospital in Germany, three types of work designrelated i-deals were investigated: (1) task, (2) career, and (3) flexibility i-deals. Consistent with hypotheses, the three types of i-deal had differential effects on work characteristics, and each in turn related to different outcomes. Specifically, job autonomy mediated the task i-deals-job performance relationship; skill acquisition mediated the career i-deals-occupational self-efficacy relationship; and reduced work overload mediated the flexibility i-dealsemotional and affective irritation relationships. Leader-Member Exchange was confirmed as an antecedent of all three types of i-deals. Task, career, and flexibility i-deals are discussed as ways to make work more intrinsically motivating, ensure one's professional advancement, and balance workplace stressors.

Zusammenfassung. Irritation beschreibt subjektiv wahrgenommene emotionale und kognitive Beanspruchungen im Kontext der Erwerbsarbeit. Anhand von 15 Studien (N = 4 030) werden Skalen- und Itemparameter der Irritations-Skala berichtet. Die Ergebnisse untermauern die branchenübergreifende Validität und Reliabilität der Skala. Erste Hinweise deuten darauf hin, dass Irritation schwerwiegenderen Befindensbeeinträchtigungen, wie depressiven Symptomen, vorgelagert ist. Neben einer Anwendung in der arbeitspsychologischen Stressforschung, kann das Instrument zur Beanspruchungsdiagnostik sowie zur Planung und Evaluation von Präventivmaßnahmen innerhalb der betrieblichen Gesundheitsförderung empfohlen werden.

Background: Interruptions of hospital doctors' workflow are a frequent stressor, eventually jeopardising quality of clinical performance. To enhance the safety of hospital doctors' work, it is necessary to analyse frequency and circumstances of workflow interruptions. Aim: To quantify workflow interruptions among hospital doctors, identify frequent sources and relate sources to doctors' concurrent activities. Methods: Within a typical hospital, 32 participant observations of doctors' full work shifts were carried out. Timeemotion information was collected on types of workflow interruption and doctors' activities and analysed with logitelinear analyses. Results: The frequency of workflow interruptions was high, especially on the intensive care unit and emergency ward. Telephones and bleepers were the most frequently recorded type of work interruption. The combined analysis of doctors' activities and concurrent workflow interruptions revealed that the likelihood of the occurrence of certain types of interruption depended on the tasks being carried out by the doctor. Conclusion: The present method may be useful for quantifying and distinguishing sources of hospital doctors' workflow interruptions and useful in raising awareness of organisational circumstances.