Caroline Biron

At work but ill: psychosocial work environment and well‐being determinants of presenteeism propensity

Many studies have shown that an unfavourable psychosocial environment increases the risk of mental and physical illness, as well as absenteeism, or sickness absence. However, more costly than absenteeism is presenteeism, where a person is present at work even though disabled by a mental or physical illness. We sought to identify factors explaining why workers would come to work even when their health is impaired. In a cross‐sectional design data were collected from 3825 employees of a Canadian organisation. The results show a high occurrence of presenteeism: workers went to work in spite of illness 50% of the time. Presenteeism propensity (the percentage of days worked while ill over total number of sick days) was higher for workers who were ill more often. Heavier workloads, higher skill discretion, harmonious relationships with colleagues, role conflict and precarious job status increased presenteeism, but decision authority did not. Workers reporting high psychological distress and more severe psychosomatic complaints were also more likely to report higher rates of presenteeism. These results suggest that stress research should not only include absenteeism as an outcome indicator, but also consider presenteeism.

The Psychosocial Work Environment, Employee Mental Health and Organizational Interventions: Improving Research and Practice by Taking a Multilevel Approach.

Although there have been several calls for incorporating multiple levels of analysis in employee health and well-being research, studies examining the interplay between individual, workgroup, organizational and broader societal factors in relation to employee mental health outcomes remain an exception rather than the norm. At the same time, organizational intervention research and practice also tends to be limited by a single-level focus, omitting potentially important influences at multiple levels of analysis. The aims of this conceptual paper are to help progress our understanding of work-related determinants of employee mental health by the following: (1) providing a rationale for routine multilevel assessment of the psychosocial work environment; (2) discussing how a multilevel perspective can improve related organizational interventions; and (3) highlighting key theoretical and methodological considerations relevant to these aims. We present five recommendations for future research, relating to using appropriate multilevel research designs, justifying group-level constructs, developing group-level measures, expanding investigations to the organizational level and developing multilevel approaches to intervention design, implementation and evaluation. Copyright

Risk assessment of occupational stress: Extensions of the Clarke and Cooper approach

Abstract For an organization to prevent occupational stress problems, it is necessary to correctly diagnose the characteristics of the work and employment conditions that are perceived as risks by employees and to investigate the consequences of these risks. Clarke and Cooper propose a methodology to assess which organizational factors pose the highest levels of risk to the well-being of employees. A level of risk is calculated based on the exposure level of a hazard and on the level of negative consequences associated with this exposure. The methodology has proven to be useful to prioritize and target specific areas for interventions. The present study introduced significant developments to this methodology by incorporating a coping dimension into the formula in order to better reflect the theoretical stress model. Tested on a sample of employees from a hospital centre (N = 1229), the introduction of coping strategies in the computation of risk level increases the strength of the relationship between risk exposure and outcomes, illustrating that the improved formula constitutes a more precise method to assess risk.

Sickness presenteeism determines job satisfaction via affective-motivational states.

INTRODUCTION Research on the consequences of sickness presenteeism, or the phenomenon of attending work whilst ill, has focused predominantly on identifying its economic, health, and absenteeism outcomes, in the process neglecting important attitudinal-motivational outcomes. PURPOSE A mediation model of sickness presenteeism as a determinant of job satisfaction via affective-motivational states (specifically engagement with work and addiction to work) is proposed. This model adds to the current literature, by focussing on (i) job satisfaction as an outcome of presenteeism, and (ii) the psychological processes associated with this. It posits sickness presenteeism as psychological absence and work engagement and work addiction as motivational states that originate in that. METHODS An online survey on sickness presenteeism, work engagement, work addiction, and job satisfaction was completed by 158 office workers. RESULTS The results of bootstrapped mediation analysis with observable variables supported the model. Sickness presenteeism was negatively associated with job satisfaction. This relationship was fully mediated by both engagement with work and addiction to work, explaining a total of 48.07% of the variance in job satisfaction. Despite the small sample, the data provide preliminary support for the model. CONCLUSIONS Given that there is currently no available research on the attitudinal consequences of sickness presenteeism, these findings offer promise for advancing theorising in this area.

The nature of change in organizational health interventions: some observations and propositions

Despite an accumulation of knowledge on organizational health interventions, theoretical integration and progress in the area still seems to be slow. This chapter is premised on the need to understand the nature and mechanisms of change in organizational health interventions, which can offer predictions on when change interventions will succeed or fail. To proactively manage change it is important to understand its properties and mechanisms. Indeed, latest research points to the pivotal role of process issues, or the ‘how’ and ‘why’ that need to be taken into account when implementing interventions. Here, we expand on this line of work by harvesting current knowledge and harnessing possible properties of change. Specifically, we examine the nature of change in organizational health interventions and the forces, at the fundamental level of the individual, that can facilitate the transition between before and after an intervention, and make some propositions on the possible mechanisms of change in organizational health interventions (i.e. relating to the dimensions, direction, levels, stakeholders, psychosocial mechanisms, and temporal patterns of change). In terms of mechanisms, we suggest a few (including diffusing, sharing, identifying, comparing, influencing, learning), based on well-established psychological theory. Summarizing and building on this knowledge, we offer six propositions on the nature of change in organizational health interventions. As such, we hope to stir discussion and theoretical progress in the area of organizational health interventions.

Capturing the Active Ingredients of Multicomponent Participatory Organizational Stress Interventions Using an Adapted Study Design

Adapted study designs use process evaluation to incorporate a measure of intervention exposure and create an artificial control and intervention groups. Taking into account exposure levels to interventions combines process and outcome evaluation and strengthens the design of the study when exposure levels cannot be controlled. This study includes longitudinal data (two assessments) with added process measures at time 2 gathered from three complex participatory intervention projects in Canada in a hospital and a university. Structural equation modelling was used to explore the specific working mechanisms of particular interventions on stress outcomes. Results showed that higher exposure to interventions aiming to modify tasks and working conditions reduced demands and improved social support, but not job control, which in turn, reduced psychological distress. Exposure to interventions aiming to improve relationships was not related to psychosocial risks. Most studies cannot explain how interventions produce their effects on outcomes, especially when there are multiple concurrent interventions delivered in several contexts. This study advances knowledge on process evaluation by using an adapted study design to capture the active ingredients of multicomponent interventions and suggesting some mechanisms by which the interventions produce their effects on stress outcomes. It provides an illustration of how to conduct process evaluation and relate exposure levels to observed outcomes. Copyright

From Black and White to Colours: Moving the Science of Organizational Interventions for Stress and Well-Being Forward

This last chapter reflects on the lessons learned, the insights offered, and the solutions generated by all the contributors to this book. Starting with the principle that we learn from failure as much as we learn from success, we aimed to organise these insights into a framework that reflects the four elements of organizational interventions: context, content, process, and criterion or outcome. This framework is not revolutionary; it comes from the fields of organizational change and programme evaluation. New here, however, is perhaps the move away from stages models that describe an interventions as going through concrete stages in a linear manner and towards a more functional and dynamic view of interventions. The chapters in this volume have illustrated with vivid examples how complex and unpredictable organizational interventions for stress and well-being can be in practice. They have also indicated the directions in which the science of interventions can progress, and we have outlined these here, together with our reflection on how we can move from black and white to all colour.

Introduction – Why Do Some Interventions Derail? Deconstructing the Elements of Organizational Interventions for Stress and Well-Being

In this introductory chapter we suggest that we can extract invaluable lessons about the active ingredients of organizational interventions for stress and well-being can be extracted from interventions that have failed or derailed. We then present the four pillars of organizational interventions for stress and well-being (context, content, process, and outcome) as a way to organise the lessons presented in this book and to guide intervention design and evaluation more broadly. Finally, we outline the chapters presented in this edited volume.