Joanna Yarker

The effects of transformational leadership on followers’ perceived work characteristics and psychological well-being: A longitudinal study

Abstract Transformational leaders employ a visionary and creative style of leadership that inspires employees to broaden their interest in their work and to be innovative and creative. There is some evidence that transformational leadership style is linked to employee psychological well-being. However, it is not clear whether this is due to (1) a direct relationship between leadership behaviour and affective well-being outcomes, or (2) a relationship between leadership behaviour and well-being that is mediated by followers’ perceived work characteristics. (Such characteristics include role clarity, meaningfulness, and opportunities for development.) This study aims to extend previous work by examining the validity of these two mechanisms in a longitudinal questionnaire study. The study was carried out within the elderly care sector in a Danish local governmental department. A theory-driven model of the relationships between leadership, work characteristics, and psychological well-being was tested using Structural Equation Modelling. The results indicated that followers’ perceptions of their work characteristics did mediate the relationship between transformational leadership style and psychological well-being. However, there was only limited evidence of the existence of a direct path between leadership behaviour and employee well-being. These findings have implications for design, implementation, and management of efforts to improve employee well-being.

Women's perceptions of chemotherapy-induced cognitive side affects on work ability: a focus group study.

AIMS AND OBJECTIVES To investigate womens awareness of chemotherapy-induced cognitive changes, their perception of cognitive limitations in carrying out daily tasks and subsequent return to work decisions and perceptions of work ability. BACKGROUND Evidence suggests that women diagnosed with breast cancer experience cognitive changes as a consequence of chemotherapy treatment. Although these changes tend to be subtle deficits in memory, concentration and the ability to organise information, there has been no published research identifying how they can impact patients ability to work and subsequent employment decisions. DESIGN This was a qualitative study. METHOD Data were collected from breast cancer survivors using semi-structured interviews with two focus groups (n = 6, n = 7). Interviews were transcribed verbatim and analysed using template analysis. RESULTS Data were categorised into four main themes: (1) awareness of cognitive changes during and following chemotherapy, (2) cognitive ability and confidence in return to work, (3) impact of cognitive changes on work ability and (4) information on the cognitive side effects of chemotherapy. CONCLUSIONS The views and experiences of breast cancer survivors towards returning to work and subsequent work ability were affected by chemotherapy-induced cognitive impairment. More specifically the appraisal of returning to work and ability to manage work were influenced by three interrelated factors: (1) actual cognitive ability following chemotherapy, (2) awareness of cognitive failures by the women and their families and (3) the subsequent impact on their confidence in carrying out daily tasks including work tasks. RELEVANCE TO CLINICAL PRACTICE More information and support is needed to help patients with cancer to manage chemotherapy-induced cognitive impairments in home and workplace. Nurses are increasingly asked about the impact of cancer and its treatment on work and are therefore well positioned to offer this advice. Subsequently, nurses require additional knowledge and guidance to provide this information and support.

Work Factors Related to Psychological and Health-Related Distress Among Employees with Chronic Illnesses

Objective: This study examined specific psychosocial factors associated with psychological and health-related distress amongst employees reporting different chronic illnesses. Methods: The sample consisted of 1029 employees managing either musculoskeletal pain (n=324), arthritis and rheumatism (n=192), asthma (n=174), depression and anxiety (n=152), heart disease (n=96) or diabetes (n=91). Information on psychological distress, work limitations, illness management, disclosure, absence, presenteeism, support and demographic factors were obtained through self-administered questionnaires. Results: Both low psychological well-being and high health-related distress were associated with an increase in work limitations (β=0.20, SE=.03; and β=0.19, SE=.01, respectively), poorer management of illness symptoms at work (β=−0.17, SE=.12; and β=−0.13, SE=.02), high presentieesm (β=0.19, SE=.25; and β=0.14, SE=.05) and low workplace support (β=−0.05, SE=.22; and β=−0.12, SE=.05). Health-related distress was additionally associated with disclosure of illness at work (β=0.18, SE=.08) and long-term sickness absence (β=0.10, SE=.06). Conclusions: To enable individuals to effectively manage both their illness and their work without serious repercussions, it is important for both healthcare professionals and employers alike, to improve the well-being of workers with chronic illness by supporting and facilitating their efforts to over-come health-related limitations at work.

The role of communication and support in return to work following cancer-related absence

Objective: Many cancer survivors experience difficulties returning to work. However, there have been relatively few attempts to understand why problems with employer support and work adjustment occur. This paper aims to extend previous work in two ways: first, through exploring the way in which communication and support at work effect cancer survivors on their return to work and during the post‐return period; and second, by drawing on a research sample working in the United Kingdom.

Employment and the common cancers: correlates of work ability during or following cancer treatment

AIMS To provide an in-depth review of the impact of cancer and cancer-related issues on work ability for those working during or following cancer treatment. METHODS Of total, 19 papers published between 1999 and 2008 on cancer and work ability were reviewed. RESULTS Studies have shown that most types of cancers result in decreased work ability compared to healthy controls or those with other chronic conditions. Some cancer types have more decreased work ability than other types. Decreased work ability is associated with type of treatment (chemotherapy), treatment-related side-effects (e.g. fatigue) and co-morbidity with other health conditions. For most cancers, work ability improves over time irrespective of age. CONCLUSIONS More longitudinal research is required to fully determine the impact of cancer and its treatment on work ability, occupational health services can help such employees make a full recovery and maintain employment by regularly assessing work ability and working hours so that work adjustment and support can be appropriately tailored.

Sickness absence management: Encouraging attendance or ‘risk-taking’ presenteeism in employees with chronic illness?

Purpose. To investigate the organizational perspectives on the effectiveness of their attendance management policies for chronically ill employees. Methods. A mixed-method approach was employed involving questionnaire survey with employees and in-depth interviews with key stakeholders of the organizational policies. Results. Participants reported that attendance management polices and the point at which systems were triggered, posed problems for employees managing chronic illness. These systems presented risk to health: employees were more likely to turn up for work despite feeling unwell (presenteeism) to avoid a disciplinary situation but absence-related support was only provided once illness progressed to long-term sick leave. Attendance management polices also raised ethical concerns for ‘forced’ illness disclosure and immense pressures on line managers to manage attendance. Conclusions. Participants felt their current attendance management polices were unfavourable toward those managing a chronic illness. The policies heavily focused on attendance despite illness and on providing return to work support following long-term sick leave. Drawing on the results, the authors conclude that attendance management should promote job retention rather than merely prevent absence per se. They outline areas of improvement in the attendance management of employees with chronic illness.

Cognitive intervention for breast cancer patients undergoing adjuvant chemotherapy: a needs analysis.

Background: Evidence suggests women with breast cancer who had received chemotherapy experienced cognitive problems. Although these are largely subtle deficits, they can negatively impact a patients quality of life, ability to work, and subsequent employment decisions. Objective: The present study explored what healthcare information and support are available to help women understand the effects of chemotherapy on daily functioning at home and at work. It also explored what information and support they would find useful as interventions. Methods: Qualitative interviews were carried out with 31 patients attending a breast cancer clinic 4 months after treatment completion (phase 1) and with 5 oncology health professionals (phase 2). Fifteen women who took part in the interviews completed a short questionnaire on suitable interventions (phase 3). Results: Participants reported problems with fatigue, low mood, memory, and attention. Problems with remembering tasks at work were most common. Participants requested more information and support on cognitive difficulties. Oncology health professionals discussed the need for information and support for patients on managing cognitive problems. From the findings, 4 interventions and delivery modes were identified and validated. These were information and activites on cognitive strategies, help with emotional distress associated with cognitive difficulties, and advice for families and employers. Conclusion: Despite mixed evidence for cognitive problems associated with chemotherapy, there is a need for an intervention, and this may be related to managing emotional distress associated with perceived cognitive problems. Implications for Practice: Nurses should include potential cognitive problems when providing information to patients.

Helping Cancer Survivors Return to Work: What Providers Tell Us About the Challenges in Assisting Cancer Patients with Work Questions

Introduction Cancer patients and survivors report receiving little work-related advice from healthcare providers about how to manage their work during treatment or when to return after completing primary treatment. This study explores the extent to which health professionals involved with colorectal cancer patients address work matters during active treatment. Methods Eighteen health professionals from oncology, occupational health and general practice were interviewed. Interviews were transcribed verbatim and analysed using thematic analysis. Results Health professionals provide conflicting and limited information to patients regarding ability to work during treatment, or when to return to work thereafter. Lack of knowledge about impacts of treatment and symptoms on work ability and sustainability, particularly in relation to different occupations and work tasks resulted in providers offering minimal guidance to patients. Current practices relied on providers’ previous experiences with employed patients, rather than a sound evidence-base. Conclusions The type of work-related information given to patients by providers is not systematic. It is necessary to develop a better knowledge base about the impacts of cancer and its treatment on work ability, sustainability and return to work that would help providers to offer more tailored advice to patients, consistently. Therefore, it is appropriate to recommend that formal training for providers is necessary. Enhancing the quality of information and training for health professionals to provide better work-related support to patients during the early stages of treatment could enable individuals to manage their work more effectively and facilitate a successful transition from patient to survivor.

Using a competency-based approach to identify the management behaviours required to manage workplace stress in nursing: A critical incident study

AIM To identify the specific management behaviours associated with the effective management of stress in nursing; and to build a stress management competency framework that can be integrated and compared with nurse management frameworks. BACKGROUND Workplace stress is a significant problem in healthcare, especially within nursing. While there is a reasonable consensus regarding the sources of stress and its impact on health and well-being, little is known about the specific line manager behaviours that are associated with the effective and ineffective management of stress. METHOD Semi-structured interviews using critical incident technique were conducted with 41 employees working within 5 National Health Service (NHS) trusts within the United Kingdom. Data were transcribed and analysed using content analysis. FINDINGS 19 competencies (or sets of behaviour) were identified in the management of stress in employees. The 3 most frequently reported competencies: managing workload and resources, individual consideration and participative approach, are discussed in detail with illustrative quotes. CONCLUSIONS Managers are vital in the reduction and management of stress at work. Importantly, the 2 of the 3 dominant competencies, managing workload and resources and individual consideration, do not feature in the UKs NHS Knowledge and Skills Framework, suggesting there are important skills gaps with regard to managing workplace stress. The implications of this approach for training and development, performance appraisal and assessment are discussed. Interventions to support managers develop effective behaviours are required to help reduce and manage stress at work.

Return-to-work guidance and support for colorectal cancer patients: a feasibility study

Background: Many cancer patients and survivors experience impairments in their ability to work as a result of diagnosis and treatment. Although the literature demonstrates favorable return-to-work rates, there is a lack of intervention studies that have sought to enhance reemployment and return-to-work outcomes. Objective: The purpose of this study was to test the feasibility of an intervention designed to offer brief tailored information on work ability during treatment to colorectal cancer patients. Methods: Thirteen employed colorectal cancer patients were recruited to test the feasibility of the intervention. Participants were provided with an educational leaflet and a face-to-face return-to-work consultation. This included advice and guidance on managing symptoms at work, communication with employer, and information on work ability during and after treatment. This was tailored according to work type (manual/nonmanual). Results: Most participants found key aspects of the intervention useful. In particular, information and advice on the impact of treatment upon work ability were considered most valuable. Although levels of work ability and well-being did not change during the intervention, there were trends of improvement in the data. Conclusions: This study demonstrated that the content of this intervention could aid return to work. Implications for Practice: Most participants felt that specialist cancer nurses and consultants were best placed to deliver return-to-work interventions. Although cancer nurses provide patients with a significant amount of information at diagnosis and treatment, our findings suggest that raising employment matters early on could help identify the most suitable time to deliver a return-to-work intervention.