Laurenz L. Meier

The chicken or the egg? A meta-analysis of panel studies of the relationship between work–family conflict and strain

Does work-family conflict predict strain, does strain predict work-family conflict, or are they reciprocally related? To answer these questions, we used meta-analytic path analyses on 33 studies that had repeatedly measured work interference with family (WIF) or family interference with work (FIW) and strain. Additionally, this study sheds light on whether relationships between WIF/FIW and work-specific strain support the popular cross-domain perspective or the less popular matching perspective. Results showed reciprocal effects; that is, that WIF predicted strain (β = .08) and strain predicted WIF (β = .08). Similarly, FIW and strain were reciprocally related, such that FIW predicted strain (β = .03) and strain predicted FIW (β = .05). These findings held for both men and women and for different time lags between the 2 measurement waves. WIF had a stronger effect on work-specific strain than did FIW, supporting the matching hypothesis rather than the cross-domain perspective.

Emotional exhaustion and workload predict clinician-rated and objective patient safety

Aims: To investigate the role of clinician burnout, demographic, and organizational characteristics in predicting subjective and objective indicators of patient safety. Background: Maintaining clinician health and ensuring safe patient care are important goals for hospitals. While these goals are not independent from each other, the interplay between clinician psychological health, demographic and organizational variables, and objective patient safety indicators is poorly understood. The present study addresses this gap. Method: Participants were 1425 physicians and nurses working in intensive care. Regression analysis (multilevel) was used to investigate the effect of burnout as an indicator of psychological health, demographic (e.g., professional role and experience) and organizational (e.g., workload, predictability) characteristics on standardized mortality ratios, length of stay and clinician-rated patient safety. Results: Clinician-rated patient safety was associated with burnout, trainee status, and professional role. Mortality was predicted by emotional exhaustion. Length of stay was predicted by workload. Contrary to our expectations, burnout did not predict length of stay, and workload and predictability did not predict standardized mortality ratios. Conclusion: At least in the short-term, clinicians seem to be able to maintain safety despite high workload and low predictability. Nevertheless, burnout poses a safety risk. Subjectively, burnt-out clinicians rated safety lower, and objectively, units with high emotional exhaustion had higher standardized mortality ratios. In summary, our results indicate that clinician psychological health and patient safety could be managed simultaneously. Further research needs to establish causal relationships between these variables and support to the development of managerial guidelines to ensure clinicians’ psychological health and patients’ safety.

Refining the vulnerability model of low self-esteem and depression: Disentangling the effects of genuine self-esteem and narcissism

A growing body of research supports the vulnerability model of low self-esteem and depression, which states that low self-esteem is a risk factor for depression. The goal of the present research was to refine the vulnerability model, by testing whether the self-esteem effect is truly due to a lack of genuine self-esteem or due to a lack of narcissistic self-enhancement. For the analyses, we used data from 6 longitudinal studies consisting of 2,717 individuals. In each study, we tested the prospective effects of self-esteem and narcissism on depression both separately for each construct and mutually controlling the constructs for each other (i.e., a strategy that informs about effects of genuine self-esteem and pure narcissism), and then meta-analytically aggregated the findings. The results indicated that the effect of low self-esteem holds when narcissism is controlled for (uncontrolled effect = -.26, controlled effect = -.27). In contrast, the effect of narcissism was close to zero when self-esteem was controlled for (uncontrolled effect = -.06, controlled effect = .01). Moreover, the analyses suggested that the self-esteem effect is linear across the continuum from low to high self-esteem (i.e., the effect was not weaker at very high levels of self-esteem). Finally, self-esteem and narcissism did not interact in their effect on depression; that is, individuals with high self-esteem have a lower risk for developing depression, regardless of whether or not they are narcissistic. The findings have significant theoretical implications because they strengthen the vulnerability model of low self-esteem and depression.

The interplay between teamwork, clinicians' emotional exhaustion, and clinician-rated patient safety: a longitudinal study

BackgroundEffectively managing patient safety and clinicians’ emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral teamwork.MethodsWe employed a longitudinal study design. Participants were 2100 nurses and physicians working in 55 intensive care units. They answered an online questionnaire on interpersonal and cognitive-behavioral aspects of teamwork, emotional exhaustion, and patient safety at three time points with a 3-month lag. Data were analyzed with cross-lagged structural equation modeling. We controlled for professional role.ResultsAnalyses showed that emotional exhaustion had a lagged effect on interpersonal teamwork. Furthermore, interpersonal and cognitive-behavioral teamwork mutually influenced each other. Finally, cognitive-behavioral teamwork predicted clinician-rated patient safety.ConclusionsThe current study shows that the interrelations between teamwork, clinician burnout, and clinician-rated patient safety unfold over time. Interpersonal and cognitive-behavioral teamwork play specific roles in a process leading from clinician emotional exhaustion to decreased clinician-rated patient safety. Emotionally exhausted clinicians are less able to engage in positive interpersonal teamwork, which might set in motion a vicious cycle: negative interpersonal team interactions negatively affect cognitive-behavioral teamwork and vice versa. Ultimately, ineffective cognitive-behavioral teamwork negatively impacts clinician-rated patient safety. Thus, reducing clinician emotional exhaustion is an important prerequisite of managing teamwork and patient safety. From a practical point of view, team-based interventions targeting patient safety are less likely to be effective when clinicians are emotionally exhausted.

The Role of Personality and Job Stressors in Predicting Counterproductive Work Behavior: A three-way interaction

The current study examined interactive effects among personality and job stressors in predicting employees’ engagement in counterproductive work behavior (CWB) defined as behavior that harms organizations or people in organizations. Survey data were collected from 932 employees and results showed significant negative relationships of agreeableness, conscientiousness, and emotional stability with CWB directed at organizations (CWB-O) and people (CWB-P), and significant positive relationships of interpersonal conflict and organizational constraints with CWB-O and CWB-P. Further, it was found that the positive relationships of interpersonal conflict with CWB-O and CWB-P were strongest for people of low emotional stability‐low agreeableness among all emotional stability‐agreeableness combinations, and that the positive relationships of organizational constraints with CWB-O and CWB-P were strongest for people of high emotional stability‐low conscientiousness among all emotional stability‐conscientiousness combinations.

Gender differences in the association of a high quality job and self-esteem over time: A multiwave study

High self-esteem often predicts job-related outcomes, such as high job satisfaction or high status. Theoretically, high quality jobs (HQJs) should be important for self-esteem, as they enable people to use a variety of skills and attribute accomplishments to themselves, but research findings are mixed. We expected reciprocal relationships between self-esteem and HQJ. However, as work often is more important for the status of men, we expected HQJ to have a stronger influence on self-esteem for men as compared to women. Conversely, task-related achievements violate gender stereotypes for women, who may need high self-esteem to obtain HQJs. In a 4-year cross-lagged panel analysis with 325 young workers, self-esteem predicted HQJ; the lagged effect from HQJ on self-esteem was marginally significant. In line with the hypotheses, the multigroup model showed a significant path only from self-esteem to HQJ for women, and from HQJ to self-esteem for men. The reverse effect was not found for women, and only marginally significant for men. Overall, although there were some indications for reciprocal effects, our findings suggest that women need high self-esteem to obtain HQJs to a greater degree than men, and that men base their self-esteem on HQJs to a greater extent than women.

Testing Job Typologies and Identifying At-Risk Subpopulations Using Factor Mixture Models.

Research in occupational health psychology has tended to focus on the effects of single job characteristics or various job characteristics combined into 1 factor. However, such a variable-centered approach does not account for the clustering of job attributes among groups of employees. We addressed this issue by using a person-centered approach to (a) investigate the occurrence of different empirical constellations of perceived job stressors and resources and (b) validate the meaningfulness of profiles by analyzing their association with employee well-being and performance. We applied factor mixture modeling to identify profiles in 4 large samples consisting of employees in Switzerland (Studies 1 and 2) and the United States (Studies 3 and 4). We identified 2 profiles that spanned the 4 samples, with 1 reflecting a combination of relatively low stressors and high resources (P1) and the other relatively high stressors and low resources (P3). The profiles differed mainly in terms of their organizational and social aspects. Employees in P1 reported significantly higher mean levels of job satisfaction, performance, and general health, and lower means in exhaustion compared with P3. Additional analyses showed differential relationships between job attributes and outcomes depending on profile membership. These findings may benefit organizational interventions as they show that perceived work stressors and resources more strongly influence satisfaction and well-being in particular profiles.

Work-privacy conflict and musculoskeletal pain: a population-based test of a stress-sleep-mediation model

ABSTRACT Previous research has shown that work–privacy conflict (WPC) is associated with musculoskeletal pain (MSP), but the processes involved are unclear. This study simultaneously tested strain and sleep problems as mediators in three mediation paths (WPC →strain→MSP; WPC →sleep problems→MSP; and WPC →strain→sleep problems→MSP). Total mediation (including all three mediation paths) was expected to be stronger in older compared to younger participants, in participants doing shift work compared to those with regular work time, and in women compared to men. In a representative sample of the Swiss working population (N = 3438), WPC, strain, sleep problems, and MSP were assessed by self-report. A set of linear regressions and bootstrapping were used to test the indirect path coefficients. All three mediation paths were significant (ps < .001). The total indirect effect was stronger in women compared to men (p = .036) but mediation did not differ based on working schedules or age. However, tests of higher order moderated mediation showed that mediation was significantly higher in women aged 45 or older who did shift work than in all other combinations (p = .036). A process model postulating strain and sleep problems to mediate the association between WPC and MSP was empirically supported. Work redesign should reduce WPC in order to reduce strain, prevent sleeping problems, and reduce work-related MSP.