BACKGROUND:In most Western countries, senior workers have increased their participation in the workforce. However, at the same time, early retirement also increases. The reasons behind this early exit from the workforce are still unclear.

OBJECTIVE:This qualitative study aims to explore the antecedents of and experiences with a voluntary exit from working life before the expected retirement age of 65 in Sweden.

METHODS:Data consist of semi-structured interviews with 18 participants who exited working life between the ages of 61–63. In Sweden, these ages are considered as an early exit from working life since, for many years, the expected retirement age has been 65. Qualitative content analysis with an abductive approach was utilized.

RESULTS:The analysis revealed four sub-themes: 1) Health benefits with an early exit from working life (with the categories: own health status, the possibility for recovery time, and avoidance of strain); 2) Having economic conditions that enable an early exit from working life (with the categories: offers from the employer and financial compromises); 3) Social benefits with an early exit from working life (with the categories: enabling more time with my social network and avoidance of unsatisfying social work environment); 4) Self-fulfillment activities during the senior years (with the categories: enabling time for activities beyond work and avoidance of decreased job satisfaction.

CONCLUSION:This variety of antecedents of and experiences with a voluntary early exit from working life before the expected retirement age highlights that the ongoing increased statutory retirement age also increases the risk for extended inequalities among the aging population.

Objectives: Work stress is a threat to the well-being of nurses in China and also globally, and many studies have been conducted on the risk factors for stress symptoms. However, research on the process and mechanism between work environment risk factors and perceived stress symptoms among nurses remains limited. This study aimed to examine the direct and indirect relationships between nurse-rated structural empowerment, professional competence, thriving and nurses' perceived stress symptoms.

Design: This was a cross-sectional correlational study.

Setting and participants: This study was conducted between April and October 2023, and 2172 nurses at three general hospitals in a Chinese province were recruited.

Method: A questionnaire that included demographic information, the Conditions of Work Effectiveness Questionnaire, the Nurse Professional Competence Scale, the Thriving at Work Scale and one factor from the Psychosomatic Health Aspects Questionnaire that measured perceived stress symptoms was used. The PROCESS macro (model 4) with a parallel mediation model and bootstrapping tests was conducted to examine the direct and indirect relationships of structural empowerment, professional competence and thriving at work on perceived stress symptoms.

Result: The regression analysis showed that structural empowerment, professional competence and thriving at work were negatively related to stress symptoms (β=-0.42, p<0.001; β=-0.06, p=0.009; β=-0.28, p<0.001, respectively), after controlling for marital status (yes/no), clinical experience and night shift (three groups). The results of the bootstrap analysis with a parallel mediator model revealed indirect relationships between structural empowerment and stress symptoms through both professional competence and thriving at work (β=-0.033 (95% CIs -0.059 to -0.009); β=-0.164 (95% CIs -0.204 to -0.126), respectively).

Conclusions: Structural empowerment was related to stress symptoms both directly and indirectly via professional competence and thriving at work. The findings suggest that managers should alleviate nurses' stress symptoms through measures aimed at providing access to empowering structures, strengthening professional competence and promoting thriving at work.

BACKGROUND: Marketisation trends have introduced new elements in residential care homes, potentially related to the psychosocial work environment and well-being of care workers. OBJECTIVE: This study examines differences in job demands and resources across public, outsourced, and private residential care home providers and their associations with care workers’ burnout, job satisfaction, and turnover intentions. METHODS: Data from 253 care workers across 19 residential care homes in three municipalities were analysed using a cross-sectional design, with a 45.3% response rate. We applied the Job Demands-Resources theory and the Copenhagen psychosocial questionnaire, conducting analyses of variance to assess differences and multiple regressions using Generalised Estimating Equations, accounting for the nested structure of the data. RESULTS: Our findings were mixed, with job demands and resources differing across provider types. Outsourced care workers reported higher emotional demands than public sector ones, while private providers offered greater autonomy and supervisor support than public ones. Outsourced workers rated higher levels of burnout than those in public settings, although this difference was non-significant after adding other factors to the model. Statistically significant differences in burnout levels were observed between municipalities. Private care workers reported higher job satisfaction than public ones. About 60% of respondents sometimes or more frequently considered leaving their jobs. Public care workers reported higher turnover intentions than those working for for-profit providers. CONCLUSIONS: This study contributes to understanding how provider type, job demands, and resources relate to care workers' well-being. Further comparative research could help clarify the impact of municipal differences versus provider types.

Background

The outcomes of staff training programs regarding the effect of person-centered care in nursing homes as rated by their residents are limited. This study examines the effects of a nursing home training program by evaluating resident-rated person-centered care, comparing changes over time between an intervention group and a comparison group.

Methods

This quasi-experimental study was conducted in 25 nursing homes. A total of 124 residents in the intervention group and 65 in the comparison group were enrolled between August 2021 and June 2023. Data were collected using the ‘Person-centered Climate-Questionnaire-Patient version’ (twice, pre- and post-intervention). The two-year training program comprised knowledge and skills in quality of care through lectures, seminars, and skill practice among 15 managers and frontline staff members in nursing homes. These staff members were expected to implement what they had learned and diffuse their knowledge to their coworkers at their nursing homes. An ANCOVA analysis was performed with a significance level of p ≤ 0.05.

Results

Among the residents, the person-centered scores were statistically significant (p < 0.001). The intervention group scores improved over time (mean = 13.6, SD = 20.0), whereas the comparison group declined (mean=-5.9, SD = 24.6).

Conclusion

The program was associated with improvements in person-centered climate as rated by residents. These findings highlight the clinical importance of training programs, including knowledge and skills in person-centered care, dementia care, teamwork, staff empowerment, and psychological nursing care, is central for improving person-centered care for nursing home residents.

Trial registrationChictr.org.cnChiCTR2100048628. Registered July 12, 2021.

Purpose

The purpose of this paper is to describe first-line managers’ (FLMs’) experiences and reflections on structural conditions for management practice within hospital settings using Kanter’s theory of structural empowerment.

Design/methodology/approach

A qualitative deductive approach with a descriptive design was used. Interviews were conducted with 11 FLMs in charge of medical or surgical hospital units spread across Sweden. Data were analyzed using a directed content analysis, based on Kanter’s theory of structural empowerment, encompassing such as access to necessary and sufficient resources, information, support and opportunities to learn and develop.

Findings

Findings of this study from the FLMs’ descriptions and reflections shed light on the impact of power dynamics on the structural conditions for management practice. The availability of nursing staff was a fundamental resource in the FLMs’ work performance, ensuring delivery of care to patients and a sound work environment for staff. Additionally, the other structural elements outlined in Kanter’s theory were evident in the findings, as the FLMs wished for structured information flow, identified potential and challenged opportunities for development and emphasized the importance of receiving support from people with a genuine understanding of their work situation.

Originality/valueThe results of this study contribute to the understanding of FLMs’ structural conditions for management practice in hospital settings. The paper’s originality stems from the use of a deductive approach, providing a structured lens with the potential to inform future research and practice in the field of health-care management.

Background

Mental health problems are prevalent among university students, underscoring the need to improve access to effective interventions. Mental healthcare utilization is influenced by general and country-specific factors. This study aimed to identify and compare preferences and barriers to help-seeking for mental health problems among university students in three European countries.

Methods

A cross-sectional, web-based survey was conducted with a sample of 4960 university students from Portugal (n = 3399), Germany (n = 680), and Sweden (n = 881). Depressive symptoms (9-item Patient Health Questionnaire) and overall mental health (5-item Mental Health Index) were assessed. Students responded to questions regarding help-seeking preferences for and barriers to mental health problems.

Results

Rates of moderate to severe depressive symptoms ranged from 37.5 to 51.0 % and were highest among German students. A majority (76.3–89.3 %) of students indicated they would talk to a friend in case of mental health problems. Readiness to seek help was particularly high among Portuguese students. Readiness to use internet-based interventions was low among all students. Up to 51 % of students reported uncertainty regarding where they could seek help. Students with depressive symptoms versus those without were less likely to speak with a friend about emotional problems but were more likely to consider taking medications. Students with depressive symptoms were also more likely to endorse several help-seeking barriers.

Conclusion

Reducing structural barriers, improving awareness of treatment options and increasing acceptance of help-seeking for emotional problems may improve uptake of mental health services among students in these European countries.

Background

The work-related empowerment of nurses is essential for enhancing person-centered care and climate. However, research on more complex relationships that consider mediation remains sparse.

Objective

This study aimed to investigate the relationship between nurse-rated structural empowerment and a person-centered climate, as well as the mediating role of nurse professional competence.DesignA cross-sectional survey study.

Settings and Participants

This study was conducted among 2172 nurses, at three general hospitals in China, between April 2023 and October 2023.

Methods

The Conditions of Work Effectiveness Questionnaire, which measured structural empowerment, the Nurse Professional Competence Scale, and the Person-Centered Climate Questionnaire-Staff Version were employed to collect data. The PROCESS macro (Model 4) and bootstrapping tests were used to examine the relationships and mediation effects.

Results

The results showed that nurse-rated structural empowerment was significantly positively related to the person-centered climate and professional competence of nurses. Nurse professional competence, in turn, was significantly positively related to person-centered climate. Furthermore, the nurse professional competence significantly mediated the relationship between structural empowerment and a person-centered climate. The model explained 49.9% of the variance in person-centered climates.

Conclusions

Structural empowerment and nurses professional competence are both essential for fostering a person-centered climate in hospital wards. Professional competence mediates the relationship between structural empowerment and a person-centered climate.

Background

The mental health of university students is a global concern, with high rates of depression and anxiety that need to be addressed.AimWe aimed to compare the mental health of Portuguese, Swedish and German university students in the health and social sciences following the Covid-19 pandemic and to analyze the factors associated with depressive and anxious symptoms in each country.

Methods

A cross-sectional study with a sample of students from Portugal, Germany and Sweden was conducted. Data from online questionnaires, including a sociodemographic and clinical questionnaire, the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder (GAD-7) and the MHI-5 (Mental Health Inventory) was collected from October to December 2022.

Results

The sample was composed of 1670 university students. The prevalence of mild to severe depressive symptoms was 72.7 % in Germany, 62.9 % in Sweden, and 60.3 % in Portugal and the prevalence of mild to severe anxiety symptoms was 78.6 % in Portugal, 73.7 % in Germany, and 66.9 % in Sweden. Being a female student, having a previous mental health disorder diagnosis, and poor academic performance were associated with higher severity of depression and anxiety symptoms in all three countries. Country-specific factors associated with more depressive and/or anxiety symptoms were younger age, smoking, low socioeconomic level and living away from home. Swedish students who do not consume alcohol had more anxiety symptoms and German students who do not consume alcohol had more depressive symptoms.

Conclusion

The high prevalence of depressive and anxiety symptoms among students in the three countries highlights the need to address modifiable factors that contribute to this mental health burden. Our results, which are in line with international trends, underline the need for policy reforms that target the main determinants of mental health, in particular by improving socio-economic conditions. Addressing these factors could play a crucial role in improving mental health outcomes in this population.

Background

Nurses work in a knowledge-intensive sector with high demands for lifelong learning. Thriving is a positive psychological state, including a sense of mutual learning and vitality at work. Research on thriving, its antecedents and outcomes is called for. The study aim was to examine thriving as a mediator in the relationships between telephone nurses’ structural empowerment and the outcomes work-personal life benefits, job performance, work-related stress symptoms and turnover intentions, as well as to psychometrically test the Thriving Scale (Swedish version).

Methods

Questionnaire data, a national sample of 409 Swedish telephone nurses, were collected, and relationships were examined using multiple regression analyses with PROCESS macro. Factorial validity of the Thriving Scale was tested using confirmative factor analyses.

Results

There were statistically significant relationships between structural empowerment and the outcomes (work-personal life benefits, job performance, stress symptoms, turnover intentions), and these relationships were mediated by thriving. The Thriving Scale showed good internal consistency, and an acceptable to borderline mediocre fit for factorial validity. Thirty-two percent reported turnover intentions.

Conclusions

Good access to structural empowerment increases nurses’ thriving, which in turn improves work-personal life benefits, job performance, and decreases stress symptoms and turnover intentions. Managers should strive to improve nurses’ thriving at work, emphasizing good access to empowering structures.

Purpose: Cancer affects a great number of people during working life, and tailored interventions targeting this population are important. The present study, focused on the developmental phase of a work-oriented intervention, aimed to describe work-related experiences and needs among people undergoing curative cancer therapy.

Methods: People (n = 22, age md 55 years, range 39-64, purposive sampling) undergoing adjuvant or neo-adjuvant chemo-/radiotherapy for breast (n = 12), prostate (n = 5), or colorectal (n = 5) cancer were individually interviewed using a semi-structured interview guide covering their ability to work and work-related facilitators, barriers, and needs. Qualitative content analysis with an inductive approach was applied.

Results: When undergoing curative cancer treatment, striving for work-life balance and a normal life is challenging, but necessary for wellbeing, according to the participants. Five subthemes described their experiences and needs: "Cancer is not my identity, and working helps me experience a sense of self," "I mostly have confidence in my future ability to work," "I need to find a new balance between work, private life, and my changed health needs," "Having flexible working conditions helps me work, and both strengthens and limits my wellbeing," and "Having access to individual support, in which others and I participate, affects my ability to work."

Conclusion: While undergoing curative cancer therapy, striving for work-life balance and a normal life is challenging but necessary for wellbeing. Our study findings suggest that a work-oriented intervention tailored to individual needs, flexibility in working conditions, and cooperation between the employee and various stakeholders are warranted during the early stage of cancer therapy.