Reducing Psychosocial Risk Factors and Improving Employee Well-Being in Emergency Departments: A Realist Evaluation

Abstract

This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, the study aims to assess potential moderators including the level of intervening (organization-directed or multilevel), process variables (the number and fit of actions to risk factors, communication and employee participation) and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity (based on the number of actions implemented) and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions (including professional support for employees with stress-related complaints) seem essential to also improve well-being.

Emergency department workforces’ experiences and perceptions of well-being from an international perspective: a scoping review

“…Other notable interventions which reported positive findings included: a video debriefing programme to support well-being 70 ; tactile massage and hypnosis 71 ; and Pups Assisting Wellness for Staff. In contrast, de Wijn and van der Doef 44 found less positive findings in their PRIMA intervention (psychosocial risk management approach) which decreased levels of work engagement and showed no change in burnout levels. Despite this, they also reported that in EDs where employees were more involved in the process, more positive changes in job factors and well-being were seen.…”

“…The job demands-control model 41 was used as a framework for a quantitative survey study 42 while the job demands-resources model 43 was used in both of de Wijn et al ’s quantitative studies. 44 45 Both models were developed within the field of occupational psychology.…”

“…Out of the 14 interventions reviewed, only two studies were underpinned by a well-being definition or theory. 44 48 Arnold et al 48 defined well-being using a blog definition to which there is no clearly stated evidential support but instead, appeared to be developed through experience as a medic. 49 de Wijn and van der Doef 44 used the widely known and evidence-based job demands-resources model to support their intervention.…”

Assessment of Psychosocial Risks in Workers in the Health Sector: Evidence in the Peruvian Population

“…This study aimed to identify the prevalence of psychosocial risks in health providers, as well as to identify if some of the sociodemographic factors are linked to them. To this end, and considering that workers constantly face intense work pressure, it is essential to effectively address the experiences and situations to which they are exposed, even more so knowing that these can have a significant impact on their emotions, giving rise to psychosocial risks that they affect both their personal wellbeing and their performance at work, with organizations being the main protagonists that generate psychosocial risks (De Wijn & Van, 2022;Wu et al, 2022); this is how this study becomes relevant, since making a diagnosis regarding the prevalence of psychosocial risks is a concern in all organizations; in this regard, Talavera-Velasco et al (2018) establishes that the constant concern of leaders to obtain high quality standards is causing overwhelming working conditions that, independently of affecting the attitude of the worker, they face adverse situations at work that affect their well-being, which has a negative impact their job performance (Di Tecco et al, 2020;Madrid et al, 2020).…”

SOphrology Intervention to Improve WELL-Being in Hospital Staff (SO-WELL): Protocol for a Randomized Controlled Trial Study

“…Moreover, NHCW staff of hospitals can also be at risk [11,12], with working environment described as the main risk factor [13]. Indeed, the medical staff, especially those working in emergency departments are exposed to psychosocial risk factors because of the type of work they do [58,59]. Moreover, the COVID-19 pandemic has worsened the situation all around the world [60][61][62].…”