UNASSIGNED: Adverse effects of chronically high levels of stress on physical and mental health are well established. In physicians, the effects of elevated stress levels exceed the individual level and include treatment errors and reduced quality of patient-doctor relationships. Breathing and mindfulness-based exercises have been shown to reduce stress and could serve as an immediate and easy-to-implement anti-stress intervention among physicians. Due to the heterogeneity of their effect on stress, we aim to evaluate the intervention effect of performing a short daily breathwork-based or mindfulness-based intervention on the everyday level of perceived stress in physicians in residence in Germany in a series of N-of-1 trials.
UNASSIGNED: Study participants will choose between two short interventions, box breathing, and one guided more complex mindfulness-based breathing exercise. Each participant subsequently will be randomly allocated to a sequence of 1-week intervention (A) and control (B, everyday life) phases. Each N-of-1 trial consists of two two-week cycles (AB or BA), resulting in a total trial duration of 4 weeks (ABAB or BABA). Perceived levels of stress will be assessed daily via the StudyU App on the participant\'s smartphone. Additionally, participants will be asked to complete a questionnaire at baseline and three months after completion of the study that contains questions about basic participant characteristics, lifestyle factors, individual living situations, and validated psychological questionnaires. Intervention effects will be estimated by Bayesian multi-level random effects models on the individual and population level.
UNASSIGNED: This study contributes to the development of short-term solutions to reduce work-related stress for physicians in residence. This is expected to benefit the individual and increase the quality of overall healthcare due to a reduction in treatment errors and an increase in the quality of doctor-patient relationships.
UNASSIGNED: ClinicalTrials.gov, identifier NCT05745545.

There has been intense focus on improving the quality of animal research in recent times. An emerging concept of a \'culture of care\' has been proposed as another important pillar to enhance scientific quality, with staff well-being being a critical aspect. Professionals working with research animals can face moral and psychological burdens and are at risk of experiencing work-related stress. However, data on the global prevalence of stress in this population is limited. Equally, it is not clear how these stresses manifest, and what impact they might have on an individual\'s workplace performance and research quality. The purpose of this review was to identify work-related stress, its prevalence, and map evidence on strategies to mitigate stresses. We also set out to identify studies assessing the association between work-related stress and research quality. A systematic search was conducted across four databases, in addition to hand searching relevant references. We included peer-reviewed publications describing work-related stress, culture of care and laboratory animal professionals. A total of 49 publications were included for data mapping. Compassion fatigue was the most frequently described work-related stress, and its prevalence across Europe and North America is likely to be widespread. Multiple strategies to mitigate compassion fatigue and work-related stress were put forward, however, limited empirical evidence was available to assess success. Moreover, no studies reported empirical data linking work-related stress with research quality, despite several publications stating the case. Further population-specific research and measured assessments are urgently needed to deliver culture of care programmes to improve human well-being, animal welfare and research quality.

UNASSIGNED: The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW). Factors such as the culture of perfectionism, excessive workloads, and stigma against seeking help exacerbate this issue. This umbrella review synthesizes the existing literature on HCW suicide, exploring the prevalence, causes, and potential preventive strategies.
UNASSIGNED: This study conducted a search of the literature from PubMed/Medline, Scopus, Web of Science, Cochrane Library, PsycINFO, and Google Scholar until April 2, 2024. The non-exhaustive search terms used were \"doctor suicide,\" \"physician suicide,\" \"medical professional suicide,\" \"suicide in healthcare,\" \"healthcare worker suicide prevention,\" and \"causes of healthcare worker suicide.\" Hand-searches were also conducted. Of the 487 studies initially identified, a total of 10 systematic reviews/meta-analyses were included.
UNASSIGNED: This umbrella review collates findings from 400 primary clinical studies conducted between the years 2004 and 2023. With a focus on mental health factors contributing to suicide in HCW, there are regional and specialty-specific variations in stress prevalence in the populace. Further, anesthesiologists and psychiatrics depicted higher rates of burnout compared to other HCW; causative factors such as seeking perfection and challenging work-life balance were key when assessing suicidal behaviors in these groups. Job demand level was found to correlate directly with suicidal thoughts, specifically among psychiatric ward HCW, where access to drugs and sharp instruments is readily available. In specific contexts, female HCWs showed a standardized mortality ratio (SMR), indicating that the rate of suicide was higher among them as compared to the general female population. Interventions such as cognitive behavioral therapy (CBT) and mindfulness were effective in decreasing depression, psychological distress, and anxiety in several included studies. This umbrella review also identified major obstacles to seeking help, including stigma and the fear of professional consequences.
UNASSIGNED: To reduce suicide rates among HCWs, it is the need of the hour to implement evidence-based interventions and create supportive work environments that encourage mutual care for each other\'s emotional health. Further research is necessary to determine the effectiveness of various measures in preventing suicide among HCW.

OBJECTIVE: To prospectively assess (1) the associations of Effort-Reward Imbalance (ERI), its individual components, and over-commitment with (a) the onset of a Major Depressive Episode (MDE) during a 3.6-year follow-up in a population-based cohort in participants with no current Major Depressive Disorder (MDD) in the beginning of the follow-up (n = 959), (b) incidence of MDD in the subsample of participants exempt from lifetime MDD (n = 490), and (c) the onset of a new MDE (i.e. recurrence) in the subsample of participants with remitted but no current MDD (n = 485), and (2) potential effect modification of burnout on these associations.
METHODS: DSM-IV Axis-I disorders were elicited using the semi-structured Diagnostic Instrument for Genetic Studies at each investigation. The ERI Questionnaire was used to measure ERI and overcommitment. Burnout was measured with the Maslach Burnout Inventory General Survey. Serially adjusted logistic regression models were used. The effect of burnout dimensions on these associations was assessed by testing interactions between the ERI and burnout dimensions.
RESULTS: (1) ERI was prospectively associated with the onset of MDE, even after adjustment for burnout [OR (95CI) = 1.22 (1.003-1.49)]. (2) The association between ERI and MDD incidence became non-significant after adjusting for burnout. (3) ERI was not associated with recurrence of pre-existing MDD. (4) burnout did not interact with ERI.
CONCLUSIONS: Our results support a longitudinal association between ERI and the risk of onset of MDE in the community. Burnout did not modify this effect, but it may partially account for the association between ERI and MDD incidence.

The \"Management Competencies to Prevent and Reduce Stress at Work\" (MCPARS) approach focuses on identifying the stress-preventive managers\' competencies able to optimise the employees\' well-being through the management of the psychosocial work environment. Considering leadership as contextualised in complex social dynamics, the self-other agreement (SOA) investigation of the MCPARS may enhance previous findings, as it allows for exploring the manager-team perceptions\' (dis)agreement and its potential implications. However, no studies have tested the MCPARS using the SOA and multisource data. Grounded in Yammarino and Atwater\'s SOA reference theory, we conducted an in-depth investigation on the MCPARS\'s theoretical framework by examining the implications of manager-team (dis)agreement, regarding managers\' competencies, on employees\' psychosocial environment (H1-H2) and affective well-being (H3). Data from 36 managers and 475 employees were analysed by performing several polynomial regressions, response surface, and mediation analyses. The results reveal a significant relationship between SOA on MCPARS and employees\' perceptions of the psychosocial environment (H1). Employees report better perceptions when supervised by in-agreement good or under-estimator managers, while lower ratings occur under over-estimator or in-agreement poor managers (H2). Moreover, the psychosocial environment significantly mediated the relationship between SOA on MCPARS and employees\' well-being (H3). The MCPARS theoretical model\'s soundness is supported, and its implications are discussed.

UNASSIGNED: Decent working time in the health sector is critical to providing quality care, and balancing health workers\' well-being with the requirements of 24/7 healthcare provision. Nursing and midwifery staff, comprising the largest group in the health workforce, play a crucial role. Understanding their experiences and challenges related to duty rosters is essential for improving work conditions, job satisfaction, and ultimately, the quality of care.
UNASSIGNED: This study aims to explore the experiences of nurses and midwives with the hospital duty roster at selected health facilities in Ho, the Volta Region of Ghana.
UNASSIGNED: A qualitative research method with a phenomenological approach was employed to capture the nuanced experiences of nurses and midwives regarding the hospital duty roster. A semistructured interview guide facilitated data collection, ensuring a comprehensive exploration of participants\' experiences. Three selected health facilities in Ho, the Volta Region of Ghana, served as the study\'s location. The study recruited 20 participants (nurses and midwives) to reach data saturation. The collected data were transcribed verbatim and analyzed through thematic content analysis, using a deductive approach. Researchers reviewed the raw data, generating initial codes to capture new concepts of interest.
UNASSIGNED: The duty roster often demonstrated organizational flaws negatively impacting the health, well-being, and job performance of nurses and midwives, consequently affecting patient care quality. The study identified that these healthcare professionals faced significant risks of work-related stress, burnout, and mental health problems due to ineffective coping strategies toward the hospital duty roster. Findings from the study also demonstrated that nurses and midwives prefer day shift because of its short time and the availability of all groups of professionals to help manage cases as compared to a night shift.
UNASSIGNED: The findings underscore factors influencing nurses\' choice of shift patterns, emphasizing the need for further research to explore the extent to which nurses\' preferences are considered when designing hospital duty rosters. Such insights can contribute to improving both the working conditions of healthcare professionals and the overall quality of patient care.

Home care rehabilitation professionals (hcRPs) provide health services for clients with a broad range of medical conditions. During the COVID-19 pandemic, home care rehabilitation professionals experienced exacerbations of pre-existing work-related stressors, increased risk of transmission of the COVID-19 virus, reduced resource availability, greater workloads, and staffing shortages. The primary aim of this study was to examine the experience and impact of occupational and mental stress on hcRPs working during the COVID-19 pandemic. Semi-structured interviews were conducted with 24 hcRPs working in Ontario, Canada during the COVID-19 pandemic. Inductive thematic analysis was used to interpret and organize the data into conceptualized themes. Interview data was organized into three themes: (a) unique challenges of a home care rehabilitation professional, (b) COVID-19 exacerbations of home care occupational and mental stress, and (c) personal and workplace coping strategies. Many participants reported reducing their hours or taking on adjunctive roles in different clinical settings outside of home care due to work-related stress exacerbated by the COVID-19 pandemic. With a focus on the effects of COVID-19 on the practice of home care, this study provides a unique perspective on the challenges experienced by hcRPs during an emergent and evolving global public health concern. The exploratory nature of this research works towards providing a framework of factors to be addressed when creating sustainable healthcare interventions, as well as recommendations to support hcRPs to benefit both the community and health-care providers.

UNASSIGNED: To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women.
UNASSIGNED: The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline.
UNASSIGNED: A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure.
UNASSIGNED: We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity.
UNASSIGNED: Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment.
UNASSIGNED: Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.
About 75% of around 500 middle-aged women reported mental stress in 2016/17. Low decision latitude and conflicts at work predicted incident sick leave independent of general mental stress and previous periods of sick leave. Efforts to improve the work environment may be essential for interventions aiming to reduce absenteeism among working women.

UNASSIGNED: Nursing is pivotal to healthcare delivery but is often associated with high levels of organizational stress. In this cross-sectional study, we aimed to investigate the associations between exposure to organizational stressors, measured using the Health and Safety Executive Management Standards Indicator Tool, and psychosomatic complaints among nurses in a medium-sized city hospital in northeastern Italy.
UNASSIGNED: A total of 215 nurses participated in the study, completing self-report questionnaires assessing organizational stressors and the prevalence of psychosomatic complaints experienced over the preceding six months.
UNASSIGNED: Significant associations were observed between various organizational stressors and psychosomatic complaints among nurses. Specifically, the Relationships factor emerged as a significant predictor of palpitations, irritability, anxiety, physical and mental tiredness, and headache. Additionally, Demands and Managers\' support were identified as significant predictors of specific psychosomatic complaints.
UNASSIGNED: This study highlights the critical role of addressing organizational stressors, particularly those related to interpersonal relationships, in promoting nurse well-being and optimizing patient care delivery. Despite its strengths, including the use of a well-established measurement tool and a comprehensive assessment of psychosomatic complaints, limitations such as the cross-sectional design and self-report measures warrant consideration. By prioritizing supportive work environments and implementing targeted interventions, healthcare organizations can cultivate a culture of well-being among nurses, ultimately enhancing the quality and safety of healthcare delivery.

In recent years, there has been a noticeable increase in attention towards promoting well-being within academic settings. In the specific context of academia, a critical issue is understanding whether the current practices for assessing and managing well-being can bridge the implementation gap and increase opportunities for creating healthy academic conditions. The paper explores the practices adopted for assessing and managing work-related stress (WRS) risks in Italian academia by referring to data from a group of Italian universities of the QoL@Work network (Quality of Life at Work in academia). The aim is to improve understanding of the factors that influence the realization of a WRS risk assessment-management pathway and how they may facilitate or hinder the transition from assessment to the implementation of interventions in the academic context. The results suggest that the assessment-management pathway should prioritize the creation of organizational scaffolding to support participatory processes in order to prevent the data collected from failing to stimulate organizational change in working conditions.