Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study.
Journal
Journal of healthcare management / American College of Healthcare Executives
ISSN: 1096-9012
Titre abrégé: J Healthc Manag
Pays: United States
ID NLM: 9803529
Informations de publication
Date de publication:
01 05 2022
01 05 2022
Historique:
entrez:
16
5
2022
pubmed:
17
5
2022
medline:
20
5
2022
Statut:
epublish
Résumé
Perceived organizational support (POS) may promote healthcare worker mental health, but organizational factors that foster POS during the COVID-19 pandemic are unknown. The goals of this study were to identify actions and policies regarding COVID-19 that healthcare organizations can implement to promote POS and to evaluate the impact of POS on physicians' mental health, burnout, and intention to leave patient care. We conducted a cross-sectional national survey with an online panel of internal medicine physicians from the American College of Physicians in September and October of 2020. POS was measured with a 4-item scale, based on items from Eisenberger's Perceived Organizational Support Scale that were adapted for the pandemic. Mental health outcomes and burnout were measured with short screening scales. The response rate was 37.8% (N = 810). Three healthcare organization actions and policies were independently associated with higher levels of POS in a multiple linear regression model that included all actions and policies as well as potential confounding factors: opportunities to discuss ethical issues related to COVID-19 (β (regression coefficient) = 0.74, p = .001), adequate access to personal protective equipment (β = 1.00, p = .005), and leadership that listens to healthcare worker concerns regarding COVID-19 (β = 3.58, p < .001). Sanctioning workers who speak out on COVID-19 safety issues or refuse pandemic deployment was associated with lower POS (β = -2.06, p < .001). In multivariable logistic regression models, high POS was associated with approximately half the odds of screening positive for generalized anxiety, depression, post-traumatic stress disorder, burnout, and intention to leave patient care within 5 years. Our results suggest that healthcare organizations may be able to increase POS among physicians during the COVID-19 pandemic by guaranteeing adequate personal protective equipment, making sure that leaders listen to concerns about COVID-19, and offering opportunities to discuss ethical concerns related to caring for patients with COVID-19. Other policies and actions such as rapid COVID-19 tests may be implemented for the safety of staff and patients, but the policies and actions associated with POS in multivariable models in this study are likely to have the largest positive impact on POS. Warning or sanctioning workers who refuse pandemic deployment or speak up about worker and patient safety is associated with lower POS and should be avoided. We also found that high degrees of POS are associated with lower rates of adverse outcomes. So, by implementing the tangible support policies positively associated with POS and avoiding punitive ones, healthcare organizations may be able to reduce adverse mental health outcomes and attrition among their physicians.
Identifiants
pubmed: 35576445
doi: 10.1097/JHM-D-21-00208
pii: 00115514-202206000-00007
doi:
Types de publication
Journal Article
Langues
eng
Pagination
192-205Informations de copyright
Copyright © 2022 Foundation of the American College of Healthcare Executives.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
American Medical Association. (2020). Managing mental health during COVID-19 . https://www.ama-assn.org/delivering-care/public-health/managing-mental-health-during-COVID-19
Buselli R., Corsi M., Veltri A., Baldanzi S., Chiumiento M., Del Lupo E., Marino R., Necciari G., Caldi F., Foddis R., Guglielmi G., Cristaudo A. (2021). Mental health of health care workers (HCWs): A review of organizational interventions put in place by local institutions to cope with new psychosocial challenges resulting from COVID-19. Psychiatry Research , 299. Article 113847. https://doi.org/10.1016/j.psychres.2021.113847
doi: 10.1016/j.psychres.2021.113847
Collins L. M., Schafer J. L., Kam C. M. (2001). A comparison of inclusive and restrictive strategies in modern missing-data procedures. Psychological Methods , 6:330–351.
Dal Grande E., Chittleborough C. R., Campostrini S., Tucker G., Taylor A. W. (2015). Health estimates using survey raked-weighting techniques in an Australian Population Health Surveillance System. American Journal of Epidemiology , 182 (6), 544–556. https://doi.org/10.1093/aje/kwv080
doi: 10.1093/aje/kwv080
DeVellis R. (2017). Scale development: theory and applications . Sage Publications.
Eisenberger R., Huntington R., Hutchison S., Sowa D. (1986). Perceived organizational support. Journal of Applied Psychology , 71 (3), 500–507. https://doi.org/10.1037/0021-9010.75.1.51
doi: 10.1037/0021-9010.75.1.51
Eisenberger R., Shanock L. R., Wen X. Q. (2020). Perceived organizational support: Why caring about employees counts. In F. Morgeson (Ed.), Annual Review of Organizational Psychology and Organizational Behavior , 7:101–124. https://doi.org/10.1146/annurev-orgpsych-012119-044917
doi: 10.1146/annurev-orgpsych-012119-044917
Gelman A., Carlin J. B. (2002). Poststratification and weighting adjustments. In: Groves R. M., Dillman D. A., Eltinge J. L., Little R. J. A. (Eds.), Survey nonresponse . John Wiley & Sons.
Giorgi G., Lecca L. I., Alessio F., Finstad G. L., Bondanini G., Lulli L. G., Arcangeli G., Mucci N. (2020). COVID-19-related mental health effects in the workplace: A narrative review. International Journal of Environmental Research and Public Health , 17 (21). Article 7857. https://doi.org/10.3390/ijerph17217857
doi: 10.3390/ijerph17217857
Groenewold M. R., Burrer S. L., Ahmed F., Uzicanin A., Free H., Luckhaupt S. E. (2020). Increases in health-elated workplace absenteeism among workers in essential critical infrastructure occupations during the COVID-19 pandemic—United States, March-April 2020. MMWR Morbidity and Mortality Weekly Report , 69 (27), 853–858. https://doi.org/10.15585/mmwr.mm6927a1
doi: 10.15585/mmwr.mm6927a1
The Hastings Center. (2020). Ethics Guidance and Resources on COVID-19. https://www.thehastingscenter.org/publications-resources/ethics-resources-on-the-coronavirus/
Khajuria A., Tomaszewski W., Liu Z. C., Chen J. H., Mehdian R., Fleming S., Vig S., Crawford M. J. (2021). Workplace factors associated with mental health of healthcare workers during the COVID-19 pandemic: an international cross-sectional study. BMC Health Services Research , 21 (1), 11 Article 262. https://doi.org/10.1186/s12913-021-06279-6
doi: 10.1186/s12913-021-06279-6
Kisely S., Warren N., McMahon L., Dalais C., Henry I., Siskind D. (2020). Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ , 369, m1642. https://doi.org/10.1136/bmj.m1642
doi: 10.1136/bmj.m1642
Kroenke K., Spitzer R. L., Williams J. B. (2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care , 41 (11), 1284–1292. https://doi.org/10.1097/01.Mlr.0000093487.78664.3c
doi: 10.1097/01.Mlr.0000093487.78664.3c
Kroenke K., Spitzer R. L., Williams J. B., Monahan P. O., Löwe B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine , 146 (5), 317–325. https://doi.org/10.7326/0003-4819-146-5-200703060-00004
doi: 10.7326/0003-4819-146-5-200703060-00004
Kurtessis J. N., Eisenberger R., Ford M. T., Buffardi L. C., Stewart K. A., Adis C. S. (2017). Perceived organizational support: A meta-analytic evaluation of organizational support theory. Journal of Management , 43 (6), 1854–1884. https://doi.org/10.1177/0149206315575554
doi: 10.1177/0149206315575554
Labrague L. J., De los Santos J. A.A. (2020). COVID-19 anxiety among front-line nurses: Predictive role of organisational support, personal resilience and social support. Journal of Nursing Management , 28 (7), 1653–1661. https://doi.org/10.1111/jonm.13121
doi: 10.1111/jonm.13121
Li Y., Scherer N., Felix L., Kuper H. (2021). Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS ONE , 16 (3), e0246454. https://doi.org/10.1371/journal.pone.0246454
doi: 10.1371/journal.pone.0246454
Maunder R. (2004). The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned. Philosophical Transactions of the Royal Society B Biological Sciences , 359 (1447), 1117–1125. https://doi.org/10.1098/rstb.2004.1483
doi: 10.1098/rstb.2004.1483
Meese K. A., Colon-Lopez A., Singh J. A., Burkholder G. A., Rogers D. A. (2021). Healthcare is a team sport: Stress, resilience, and correlates of well-being among health system employees in a crisis. Journal of Healthcare Management , 66 (4), 304–322. https://doi.org/https://doi.org/10.1097/JHM-D-20-00288
doi: 10.1097/JHM-D-20-00288
Muller A. E., Hafstad E. V., Himmels J. P. W., Smedslund G., Flottorp S., Stensland S. Ø., Stroobants S., Van de Velde S., Vist G. E. (2020). The mental health impact of the COVID-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review. Psychiatry Research , 293, 113441. https://doi.org/10.1016/j.psychres.2020.113441
doi: 10.1016/j.psychres.2020.113441
Muthén, L. K., & Muthén, B. O. Mplus User’s Guide .(1998–2017). (8 th ed.) . Muthén & Muthén.
Rafi M. A., Hasan M. T., Azad D. T., Alam S. F., Podder V., Hossain S., Akther S. M.Q., Ashraf F., Hossain M. G. (2021). Willingness to work during initial lockdown due to COVID-19 pandemic: Study based on an online survey among physicians of Bangladesh. PLOS ONE , 16 (2), e0245885 . https://doi.org/10.1371/journal.pone.0245885
doi: 10.1371/journal.pone.0245885
Rangachari P., Woods J. L. (2020). Preserving organizational resilience, patient safety, and staff retention during COVID-19 requires a holistic consideration of the psychological safety of healthcare workers. International Journal of Environmental Research and Public Health , 17 (12), 4267. https://doi.org/doi:10.3390/ijerph17124267
doi: 10.3390/ijerph17124267
Scheiber, N., & Rosenthal, B. M. (2020, April 27). Nurses and doctors speaking out on safety now risk their job . https://www.nytimes.com/2020/04/09/business/coronavirus-health-workers-speak-out.html
Shanafelt T., Ripp J., Trockel M. (2020). Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA , 323 (21), 2133–2134. https://doi.org/10.1001/jama.2020.5893
doi: 10.1001/jama.2020.5893
Shanock L. R., Eisenberger R., Heggestad E. D., Malone G., Clark L., Dunn A. M., Kirkland J., Woznyj H. (2019). Treating employees well: The value of organizational support theory in human resource management. Psychologist-Manager Journal , 22 (3–4), 168–191. https://doi.org/10.1037/mgr0000088
doi: 10.1037/mgr0000088
Sonis J., Pathman D. E., Read S., Gaynes B. N., Canter C., Curran P., Miller T. (2021). Generalized anxiety, depression and posttraumatic stress disorder in a national sample of U.S. internal medicine physicians during the COVID-19 pandemic. General Hospital Psychiatry , 71:142–144. https://doi:10.1016/j.genhosppsych.2021.05.004
doi: 10.1016/j.genhosppsych.2021.05.004
Spetz, J. (2020, June 13). There are not nearly enough nurses to handle the surge of coronavirus patients: Here’s how to close the gap quickly. Health Affairs.https://www.healthaffairs.org/do/10.1377/hblog20200327.714037/full/
Sun H., Wang S., Wang W., Han G., Liu Z., Wu Q., Pang X. (2021). Correlation between emotional intelligence and negative emotions of front-line nurses during the COVID-19 epidemic: A cross-sectional study. Journal of Clinical Nursing , 30 (3–4), 385–396. https://doi.org/10.1111/jocn.15548
doi: 10.1111/jocn.15548
West C. P., Dyrbye L. N., Satele D. V., Sloan J. A., Shanafelt T. D. (2012). Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. Journal of General Internal Medicine , 27 (11), 1445–1452. https://doi.org/10.1007/s11606-012-2015-7
doi: 10.1007/s11606-012-2015-7
Williams E. S., Konrad T. R., Scheckler W. E., Pathman D. E., Linzer M., McMurray J. E., Gerrity M., Schwartz M. (2001). Understanding physicians’ intentions to withdraw from practice: The role of job satisfaction, job stress, mental and physical health. Health Care Management Review , 26 (1), 7–19. https://doi.org/10.1097/00004010-200101000-00002
doi: 10.1097/00004010-200101000-00002
Zandi G., Shahzad I., Farrukh M., Kot S. (2020). Supporting role of society and firms to COVID-19 management among medical practitioners. International Journal of Environmental Research and Public Health , 17 (21). Article 7961. https://doi.org/10.3390/ijerph17217961
doi: 10.3390/ijerph17217961
Zhang S. X., Sun S., Afshar Jahanshahi A., Alvarez-Risco A., Ibarra V. G., Li J., Patty-Tito R. M. (2020). Developing and testing a measure of COVID-19 organizational support of healthcare workers—Results from Peru, Ecuador, and Bolivia. Psychiatry Research , 291, 113174. https://doi.org/10.1016/j.psychres.2020.113174
doi: 10.1016/j.psychres.2020.113174
Zhou T., Guan R. Y., Sun L. Q. (2021). Perceived organizational support and PTSD symptoms of frontline healthcare workers in the outbreak of COVID-19 in Wuhan: The mediating effects of self-efficacy and coping strategies. Applied Psychology-Health and Well Being , 13 (4), 745–760. https://doi.org/10.1111/aphw.12267
doi: 10.1111/aphw.12267
Zuromski K. L., Ustun B., Hwang I., Keane T. M., Marx B. P., Stein M. B., Ursano R. J., Kessler R. C. (2019). Developing an optimal short-form of the PTSD checklist for DSM-5 (PCL-5). Depression and Anxiety , 36 (9), 790–800. https://doi.org/10.1002/da.22942
doi: 10.1002/da.22942