“We All Held Our Own”: Job Demands and Resources at Individual, Leader, Group, and Organizational Levels During COVID-19 Outbreak in Health Care. A Multi-Source Qualitative Study

Abstract

Background: Interventions tackling COVID-19 impact on health care workers’ mental health would benefit from being informed by validated and integrated assessment frameworks. This study aimed to explore the fitness of integrating the Job Demands-Resources (JD-R) model and the Individual-Group-Leader-Organization (IGLO) framework to investigate the pandemic’s impact on health care workers’ mental health. Methods: Qualitative data were collected via 21 semi-structured interviews with senior and middle managers and four focus groups with employees (doctors, nurses, health care assistants) from three areas (Department of Emergency, Department of Medicine, Research Institute of Neuroscience) of a large health care institution facing the first wave of COVID-19. NVivo deductive content analysis of text data was performed. Findings: Several COVID-19-related job demands and resources were found at IGLO levels. Individual-level demands included emotional load, while resources included resilience and motivation. Group-level demands included social distancing, while resources included team support and cohesion. Leader-level demands included managers’ workload, while resources included leader support. Organizational-level demands included work reorganization, while resources included mental health initiatives. Conclusions/Application to Practice: Integrating JD-R and IGLO proved feasible, as job demands and resources could be categorized according to the individual, group, leader, and organization framework. The findings expand previous studies by filling the lack of knowledge on how job demands and resources might unfold at different workplace levels during a pandemic. Results provide unit-level evidence for designing and implementing multilevel interventions to manage health care workers’ mental health during COVID-19 and future pandemics. Our findings offer occupational health practitioners a suitable approach to perform workplace mental health assessment activities.

Return to Work during the COVID-19 Outbreak: A Study on the Role of Job Demands, Job Resources, and Personal Resources upon the Administrative Staff of Italian Public Universities

“…We can identify the proactivity behavior toward safety and health at work as a form of engagement with the organization that in turn may limit the risk of exhaustion, especially in times of crisis and uncertainties that, on the contrary, may expose to a greater risk of stress and burnout. This is in accordance with recent qualitative studies conducted in the healthcare sector [ 34 ] that reported how proactivity, motivation, and personal initiatives were recognized as personal resources functional to sustain a better adaptation in the difficult times of the COVID-19 pandemic. However, future studies can evaluate more complex relationships between safety participation behaviors and stress reactions.…”

“…On the other side, quantitative job demand overload emerged as a significant job demand in the relationship with emotional exhaustion for both WPs and WBs. Consistent with existing evidence from different occupations [ 31 , 33 , 34 , 35 ], we can confirm that employees of the public administrative sector that continued, or suddenly returned to work, since the first phases of the pandemic had to significantly bear an increase in job-related demands. This has probably been affected by new work procedures and schedules, as well as the need to manage work with remote colleagues and at the same time having to maintain and comply with the procedures for the prevention of contagion that involved work organization of both WPs and WBs.…”

“…A range of words that connotes high quantitative job demands includes work intensity, work pressure, or work overload; in turn, all of these expressions specifically imply sustained cognitive effort that, according to the JD-R model [ 20 ], are associated with higher levels of exhaustion. Although an increase in the workload has been recorded in both the healthcare sector and among those who shifted to remote working practices due to the pandemic emergency (e.g., [ 33 , 34 , 35 ]), this element can also be traced back to workers who, by returning to work, have had to readjust their job according to new procedures for managing the “new” or “next normal” [ 36 ] situation. Indeed, new routines and behaviors, such as wearing masks and social distancing, along with frequent messages about handwashing and cleaning, as well as new ways of working with physically distant colleagues, may have affected changes in work schedules; furthermore, these changes have been shown to increase stress, anxiety, and fatigue in general [ 31 , 37 ].…”

Burnout among Health Care Professionals during COVID-19

“…Given predicted shortages of nurses in the future [ 8 ] and Generation Y nurses’ (i.e., born between 1980 and 1994) strong desire for work–life balance [ 43 ], any action that can balance the needs for service delivery with the needs of staff is highly recommended. Giusino et al’s findings [ 44 ] suggests that HCP’s mental health should be addressed on multiple levels (individual, the group, the leader, and the organization) as COVID-19 related job demands and resources are found at all levels [ 45 ].…”

The Cost-Effectiveness Analysis of the Productivity Measurement and Enhancement System Intervention to Reduce Employee Work-Related Stress and Enhance Work Performance

“…Therefore, a health and safety culture is needed, especially mental health interventions at the individual, group, and organizational level among healthcare workers. The interventions need to address the impact of COVID-19 on the mental health of healthcare workers by identifying the job demands and resources and understanding the barriers to achieving effective outcomes in terms of health and well-being within their work environment [51].…”