Anthony Montgomery

Balancing Work and Home: How Job and Home Demands Are Related to Burnout

Utrecht UniversityThe aim of the present study was to make a clear distinction between workand home domains in the explanation of burnout. First, a 3-factor structureof job and home demands was hypothesized, consisting of quantitativedemands, emotional demands, and mental demands. Next, a model was testedthat delineates how demands in both life domains are related to occupationalburnout through work home interference (WHI) and home work interfer-ence (HWI). In doing so, the partial mediating role of WHI and HWI wasexamined. Consistent with hypotheses, empirical support was found for the3-factor structure of both job and home demands as well as for the partialmediating effects of both WHI and HWI. Job demands and home demandsappeared to have a direct and indirect effect (through WHI and HWI,respectively) on burnout.

Work‐home interference among newspaper managers: Its relationship with burnout and engagement

Managers are increasingly concerned about managing the conflicts experienced in fulfilling the responsibilities of work and family. The problem of balancing these domains arises from work to home interference, which reflects a mutual incompatibility between the demands of the work role and the demands of the home life. The central idea underlying the theoretical model of this study, is that work and home demands lead to work strain and decreased feelings of engagement, while work and home resources lead to increased feelings of engagement and reduced burnout. Work to home interference mediates these relationships. An innovation of the present study was to assess both home demands and positive aspects of work to home interference. Data were collected from 69 newspaper managers. Results indicated that negative interference mediated between demands and outcomes, and positive interference mediated between resources and outcomes. This study highlights the importance of measuring positive concepts in terms of constructing a more balanced picture of work and home interference.

Work‐family interference, emotional labor and burnout

Purpose – The purpose of the current study is to examine the relationship between emotional display rules/job focused labor, work‐family interference (WFI) and burnout among a sample of workers in a Dutch governmental organization.Design/methodology/approach – The research is a cross‐sectional study of 174 workers from a Dutch governmental organization.Findings – Emotional display rules and job‐focused labor were related to burnout and psychosomatic complaints. More specifically, the need to hide negative emotions and engage in surface acting was related to negative outcomes. In addition, WFI partially mediated the relationship between the hiding of negative emotion/surface acting and burnout/psychosomatic complaints.Research limitations/implications – The present study is cross‐sectional and thus the postulated relationships cannot be interpreted causally.Practical implications – In terms of training and/or interventions, there is a need for the worksite to provide structured opportunities for employees ...

Connecting organisational culture and quality of care in the hospital: is job burnout the missing link?

PURPOSE To date, relatively little evidence has been published as to what represents an effective and efficient way to improve quality of care and safety in hospitals. In addition, the initiatives that do exist are rarely designed or developed with regard to the individual and organisational factors that determine the success or failure of such initiatives. One of the challenges in linking organisational culture to quality of care is to identify the focal point at which a deficient hospital culture and inadequate organisational resources are most evident. The accumulated evidence suggests that such a point is physician burnout. This paper sets out to examine this issue. DESIGN/METHODOLOGY/APPROACH The paper reviews the existing literature on organisational culture, burnout and quality of care in the healthcare sector. A new conceptual approach as to how organisational culture and quality of care can be more effectively linked through the physician experience of burnout is proposed. FINDINGS Recommendations are provided with regard to how future research can approach quality of care from a bottom-up organisational change perspective. In addition, the need to widen the debate beyond US and North European experiences is discussed. ORIGINALITY/VALUE The present paper represents an attempt to link organisational culture, job burnout and quality of care in a more meaningful way. A conceptual model has been provided as a way to frame and evaluate future research.

A review of self-medication in physicians and medical students

BACKGROUND There is a culture within medicine that doctors do not expect themselves or their colleagues to be sick. Thus, the associated complexities of self-diagnosis, self-referral and self-treatment among physicians are significant and may have repercussions for both their own health and, by implication, for the quality of care delivered to patients. AIMS To collate what is known about the self-treatment behaviour of physicians and medical students. METHODS The following databases were searched: PubMed, PsychInfo, EBSCO, Medline, BioMed central and Science Direct. Inclusion criteria specified research assessing self-treatment and self-medicating of prescription drugs among physicians and/or medical students. Only peer-reviewed English language empirical studies published between 1990 and 2009 were included. RESULTS Twenty-seven studies were identified that fitted the inclusion criteria. Self-treatment and self-medicating was found to be a significant issue for both physicians and medical students. In 76% of studies, reported self-treatment was >50% (range: 12-99%). Overall, only one of two respondents was registered with a general practitioner or primary care physician (mean = 56%, range = 21-96). Deeper analysis of studies revealed that physicians believed it was appropriate to self-treat both acute and chronic conditions and that informal care paths were common within the medical profession. CONCLUSIONS Self-treatment is strongly embedded within the culture of both physicians and medical students as an accepted way to enhance/buffer work performance. The authors believe that these complex self-directed care behaviours could be regarded as an occupational hazard for the medical profession.

A 10 year (2000–2010) systematic review of interventions to improve quality of care in hospitals

BackgroundAgainst a backdrop of rising healthcare costs, variability in care provision and an increased emphasis on patient satisfaction, the need for effective interventions to improve quality of care has come to the fore. This is the first ten year (2000–2010) systematic review of interventions which sought to improve quality of care in a hospital setting. This review moves beyond a broad assessment of outcome significance levels and makes recommendations for future effective and accessible interventions.MethodsTwo researchers independently screened a total of 13,195 English language articles from the databases PsychInfo, Medline, PubMed, EmBase and CinNahl. There were 120 potentially relevant full text articles examined and 20 of those articles met the inclusion criteria.ResultsIncluded studies were heterogeneous in terms of approach and scientific rigour and varied in scope from small scale improvements for specific patient groups to large scale quality improvement programmes across multiple settings. Interventions were broadly categorised as either technical (n = 11) or interpersonal (n = 9). Technical interventions were in the main implemented by physicians and concentrated on improving care for patients with heart disease or pneumonia. Interpersonal interventions focused on patient satisfaction and tended to be implemented by nursing staff. Technical interventions had a tendency to achieve more substantial improvements in quality of care.ConclusionsThe rigorous application of inclusion criteria to studies established that despite the very large volume of literature on quality of care improvements, there is a paucity of hospital interventions with a theoretically based design or implementation. The screening process established that intervention studies to date have largely failed to identify their position along the quality of care spectrum. It is suggested that this lack of theoretical grounding may partly explain the minimal transfer of health research to date into policy. It is recommended that future interventions are established within a theoretical framework and that selected quality of care outcomes are assessed using this framework. Future interventions to improve quality of care will be most effective when they use a collaborative approach, involve multidisciplinary teams, utilise available resources, involve physicians and recognise the unique requirements of each patient group.

Emotional labour at work and at home among Greek health‐care professionals

– The emotionally taxing nature of health‐care work has been increasingly recognized. In parallel, the field of work and family has been searching for more specific antecedents of both work interference with family (WFI) and family interference with work (FWI). The current study aims to examine the relationship between surface acting and hiding negative emotions with WFI and FWI among Greek health‐care professionals., – The research is a cross‐sectional study of 180 Greek doctors and 84 nurses using self‐report measures., – Results indicated that, for doctors, surface acting at work was positively related to WFI and, for nurses, surface acting at home was positively related to FWI., – The respondents were sampled on a convenience basis and the non‐random procedure may have introduced unmeasured selection effects. The present study is cross‐sectional and thus the postulated relationships cannot be interpreted causally., – Emotional management training and opportunities for emotional decompression for Greek health‐care professionals should be explored. In terms of medical education, the need to train students to understand and cope with emotional demands is an important first step. This research highlights the need for communication‐skills training courses facilitating emotional awareness and emotional management., – These findings position emotional labour as an important antecedent of both WFI and FWI.

Job burnout and cognitive functioning: A systematic review

Although it is generally accepted that burnout has an effect on cognitive functioning, very few studies have so far examined the link between cognitive functioning and job burnout. The purpose of this systematic review was to explore the reported association between burnout and cognitive functioning, as assessed objectively (that is, using psychometric tests rather than self-reports). The review identified 15 English-language articles published between 2005 and 2013. The results suggest that burnout is connected to specific cognitive deficits. In particular, burnout has been found to be associated with a decline in three main cognitive functions: executive functions, attention and memory. These results have clear implications, in particular for professions that are characterized by high levels of both work pressure and cognitive demands. Due to the scarcity and heterogeneity of available articles, future longitudinal prospective studies are needed, in order to determine the cognitive functions predominantly impaired as a result of burnout, and to establish causal relationships.

Concealment of Information in Clinical Practice: Is Lying Less Stressful Than Telling the Truth?

From the Lab of Hygiene; Lab of Physi-ology, Medical School, Aristotle Univer-sity, Thessaloniki, Greece.Submitted May 31, 2007; acceptedJune 21, 2007.The first and second author haveconducted the same amount of workand share first authorship.Authors’ disclosures of potential con-flicts of interest and author contribu-tions are found at the end of thisarticle.Corresponding author: E. Panagopoulou,Lab of Hygiene, 54124, Medical School,Aristotle University, Thessaloniki, Greece;e-mail: efharis@the.forthnet.gr.© 2008 by American Society of ClinicalOncology0732-183X/08/2607-1175/

Vulnerable older people in the community: relationship between the Vulnerable Elders Survey and health service use.

20.00DOI: 10.1200/JCO.2007.12.8751