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      Toward a mediation model for nurses’ well-being and psychological distress effects of quality of leadership and social support at work

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          Abstract

          Given the lack of active nurses in industrialized countries throughout the world, in combination with demographic changes, it is of utmost importance to protect nurses’ well-being and to prevent psychological distress, because of their strong association with premature occupational leave. The aim of this study was to investigate the effects of quality of leadership and social support at work on well-being and psychological distress of nurses and to determine whether nurses’ overcommitment mediates the relationship between the abovementioned determinants and the outcomes. A cross-sectional survey design was used to gather our data. This study utilized part of the database of the Nurses’ Early Exit Study. A total of 34,771 nurses (covering all nurse qualifications) working in hospitals, nursing homes, and home-care institutions in 8 European countries filled out a questionnaire (response rate = 51.4%). For all model variables (job satisfaction, satisfaction with salary, positive affectivity, personal burnout, negative affectivity, quality of leadership, social support from immediate supervisor, social support from near colleagues, and overcommitment), psychometrically sound, that is, valid and reliable measures were used. Outcomes from testing a structural equation mediation model indicated that, respectively, positive and negative influences of leadership quality and social support from supervisor and colleagues on nurses’ well-being and psychological distress are partially mediated, that is, reduced, by nurses’ overcommitment. Social work environment is highly important in relation to nurses’ well-being and psychological distress.

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          Most cited references37

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          Adverse health effects of high-effort/low-reward conditions.

          J Siegrist (1996)
          In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
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            Psychological Well-being: Evidence Regarding its Causes and Consequences

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              The Copenhagen Psychosocial Questionnaire--a tool for the assessment and improvement of the psychosocial work environment.

              The aim of this article is to present the Copenhagen Psychosocial Questionnaire (COPSOQ), a questionnaire developed in three different lengths for assessing psychosocial factors at work, stress, and the well-being of employees and some personality factors. The purpose of the COPSOQ concept is to improve and facilitate research, as well as practical interventions at workplaces. The development of the questionnaire was based on a survey of a representative sample of 1858 Danish employees aged 20-59 years. The response rate was 62%; 49% were women. Altogether 145 questions from some international and Danish questionnaires and 20 self-developed questions were tested with factor analyses, analyses of internal reliability, and analyses of response patterns. The analyses resulted in a long research version of the questionnaire with 141 questions and 30 dimensions, a medium-length version for work environment professionals with 95 questions and 26 dimensions, and a short version for workplaces with 44 questions and 8 dimensions. Most of the scales have good reliability, and there seems to be very little overlap between the scales. A novel feature of the COPSOQ is the development of five different scales on demands at work. The COPSOQ concept is a valid and reliable tool for workplace surveys, analytic research, interventions, and international comparisons. The questionnaire seems to be comprehensive and to include most of the relevant dimensions according to several important theories on psychosocial factors at work. The three versions facilitate communication between researchers, work environment professionals, and workplaces.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                April 2017
                14 April 2017
                : 96
                : 15
                : e6505
                Affiliations
                [a ]Institute for Management Research, Radboud University, Nijmegen
                [b ]Open University of the Netherlands, Heerlen, The Netherlands
                [c ]Kingston University, London, UK
                [d ]Institute of Educational Science, University of Regensburg, Regensburg
                [e ]Department of Research Methods in Education, Friedrich Schiller University Jena, Jena, Germany.
                Author notes
                []Correspondence: Beatrice I.J.M. Van der Heijden, Institute for Management Research, Radboud University, PO Box 9108, 6500 HK Nijmegen, The Netherlands; Open University of the Netherlands, Heerlen, The Netherlands; Kingston University, London, UK (e-mail: b.vanderheijden@ 123456fm.ru.nl ).
                Article
                MD-D-16-07721 06505
                10.1097/MD.0000000000006505
                5403076
                28403079
                34180fb3-ded9-49ab-a72c-4a22c2e5e4dd
                Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 25 December 2016
                : 8 March 2017
                : 8 March 2017
                Categories
                5400
                Research Article
                Observational Study
                Custom metadata
                TRUE

                overcommitment,psychological distress,quality of leadership,social support at work,well-being

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