Data_Sheet_1_Reducing Psychosocial Risk Factors and Improving Employee Well-Being in Emergency Departments: A Realist Evaluation.PDF

This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, the study aims to assess potential moderators including the level of intervening (organization-directed or multilevel), process variables (the number and fit of actions to risk factors, communication and employee participation) and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity (based on the number of actions implemented) and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions (including professional support for employees with stress-related complaints) seem essential to also improve well-being.

本研究报告了在荷兰15个急诊科进行的为期2.5年的干预项目的研究成果，旨在降低心理社会风险并提升员工福祉。该项目采用了“PRIMA”心理社会风险管理方法，该方法包括风险评估周期、设计并实施变革、评估变革以及在必要时调整方法。此外，项目还运用了参与式行动研究的原则，以赋能部门在项目期间设计和实施自身的行动。除确定总体效果外，研究旨在评估潜在调节因素，包括干预水平（组织导向或多层次）、过程变量（行动与风险因素的数量和适配度、沟通与员工参与）以及参与项目后半段提供的心理社会安全氛围干预。线性混合模型分析结果显示，除自主性因素外，所有工作因素均有所改善，尽管自主性因素在项目中途有所提升，但在整个时间范围内并未显著变化。此外，工作投入度有所下降，而职业倦怠症状保持稳定。实施更适配行动、沟通更佳并更广泛地让员工参与过程的急诊科，在职业因素和福祉方面均显示出更为积极的改变。基于实施行动数量的活动增加以及关于压力管理的多层次方法并未导致更大改善。心理社会安全氛围干预在改善心理社会安全氛围方面效果显著，但似乎需要更长的追踪期以评估其对职业因素和福祉的影响。总体而言，该项目在多数工作因素上带来了积极的变化，其研究结果强调了过程变量在压力管理干预中的重要性。更长时间的追踪以及高质量的多层次干预（包括对有压力相关投诉的员工提供专业支持）似乎对于提升福祉至关重要。