Prior research on organizational trust has not rigorously examined the context specificity of trust nor distinguished between the potentially varying dimensions along which different stakeholders base their trust. As a result, dominant conceptualizations of organizational trust are overly generalized. Building on existing research on organizational trust and stakeholder theory, we introduce a more nuanced perspective on the nature of organizational trust. We develop a framework that distinguishes between organizational stakeholders along two dimensions: depth of the relationship (deep or shallow) and locus (internal or external). The framework identifies which of six dimensions of trustworthiness (benevolence, integrity, managerial competence, technical competence, transparency, and identification) will be relevant to which stakeholder type. We test the predictions of our framework using original survey data from 1,298 respondents across four stakeholder groups from four different organizations. The results reveal that the relevant dimensions of trustworthiness vary systematically across different stakeholder types and provide strong support for the validity of the depth and locus dimensions.

humanism, economism, management paradigms, sustainability, management theory, business strategy,

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Objective: Burnout is a global work-related phenomenon. Intensive care unit (ICU) nurses are at risk of burnout and the COVID-19 pandemic may increase this risk. The objectives of this study were to assess the prevalence of burnout risk and identify risk factors among ICU nurses during the COVID-19 pandemic. Research methodology: Web-based survey performed during the first wave of the COVID-19 pandemic in French speaking Belgium. Main outcome measures: Risk of burnout was assessed with the Maslach Burnout Inventory scale. Results: A total of 1135 ICU nurses responded to the questionnaire. The overall prevalence of burnout risk was 68%. A total of 29% of ICU nurses were at risk of depersonalisation (DP), 31% of reduced personal accomplishment (PA), and 38% of emotional exhaustion (EE). A 1:3 nurse-to-patient ratio increased the risk of EE (OR = 1.77, 95% CI: 1.07-2.95) and DP (OR = 1.38, 95% CI: 1.09-2.40). Those who reported having a higher perceived workload during the COVID-19 pandemic were at higher risk for all dimensions of burnout. Shortage of personal protective equipment increased the risk of EE (OR = 1.78, 95% CI: 1.35-3.34) and nurses who reported having symptoms of COVID-19 without being tested were at higher risk of EE (OR = 1.40, 95% CI: 1.68-1.87). Conclusions: Two-thirds of ICU nurses were at risk of burnout and this risk was associated with their working conditions during the first wave of the COVID-19 pandemic. We recommend monitoring the risk of burnout and implementing interventions to prevent and manage it, taking into account the factors identified in this study.

Introduction The COVID-19 pandemic has had a significant impact on nursing practice in intensive care unit (ICU) and, consequently, on workload. Objective To assess the nurse-patient (N:P) ratio required by COVID-19 patients and to identify the factors that influence nursing in this context. Design This study was a retrospective observational study that evaluated the N:P ratio using the Nursing Activities Score (NAS). Setting Three Belgian French-speaking hospitals, including five ICUs. Patients included COVID-19 and non-COVID-19 patients in the ICU. Measurements and Main Results The study included 95 COVID-19 patients and 1,604 non-COVID-19 patients (control group) resulting in 905 and 5,453 NAS measures, respectively. The NAS was significantly higher among the COVID-19 patients than in the control group (p=<0.0001). In the COVID-19 group, these higher scores were also observed per shift and uniformly across the three hospitals. COVID-19 patients required more time in the activities of monitoring and titration (χ2= 457.60, p=<0.0001), mobilisation (χ2= 161.21, p=<0.0001), and hygiene (χ2= 557.77, p=<0.0001). Factors influencing nursing time measured by NAS in the COVID-19 patients were age < 65 years old (p=0.23), the use of continuous venovenous hemofiltration (p=0.002), a high APACHE II score (p=0.006), and patient death (p=0.002). A COVID-19 diagnosis was independently associated with an increase in nursing time (OR=4.8, 95% CI:3.6-6.4). Conclusions Patients hospitalised in the ICU due to COVID-19 require significantly more nursing time and need an average N:P ratio of almost 1:1.