Organizational Climate and Nurse Health Outcomes in the United States: A Systematic Review

Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Industrial Health (Impact Factor: 1.12). 11/2007; 45(5):622-36. DOI: 10.2486/indhealth.45.622
Source: PubMed

ABSTRACT Increasing interest has been focused on understanding the role working conditions play in terms of the serious issues facing hospitals today, including quality of patient care, nurse shortages, and financial challenges. One particular working condition that has been the subject of recent research, is the impact of organizational climate on nurses' well-being, including occupational health outcomes. To examine evidence-based research on the association between organizational climate and occupational health outcomes among acute-care registered nurses, a systematic review of published studies was conducted. Studies assessing the association between organizational climate variables and three common health outcomes in nurses (blood/body fluid exposures, musculoskeletal disorders, and burnout) were reviewed. Fourteen studies met the inclusion criteria. Although most were cross-sectional in design and variability was noted across studies with respect to operational definitions and assessment measures, all noted significant associations between specific negative aspects of hospital organizational climate and adverse health impacts in registered nurses. While evidence for an association between organizational climate constructs and nurses' health was found, data were limited and some of the relationships were weak. Additional studies are warranted to clarify the nature of these complex relationships.

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Available from: Robyn R M Gershon, Sep 27, 2015
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    • "Burnout has been linked to perceptions of equity at work (van Dierendonck, Schaufeli, & Buunk, 1996) and support from supervisors and coworkers (Halbesleben, 2006; Sundin, Hochwalder, & Lisspers, 2011). Work climate has been associated with work attitudes and burnout in systematic reviews (Gershon et al., 2007; Parker et al., 2003) and found to negatively predict burnout 3 months later in a recent study (Idris, Dollard, & Yulita, 2014). Previous studies (Shirom, 2005) have shown substantial temporal stability of burnout across time. "
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    ABSTRACT: Mental health care workers face heavy emotional demand and are prone to work burnout. Work burnout has been associated with poor mental health and work climate, which refers to individual perceptions about work setting. The purpose of this study was to examine whether intra-individual changes in work climate were associated with intra-individual changes in burnout and depression over two years. The present sample included Chinese mental health care workers (N = 312; mean age = 38.6, SD = 9.9) working in a psychosocial rehabilitation institution. The participants completed questionnaires on work climate, work burnout and depression at seven time points across two years. Parallel process latent growth modeling was used to analyze the associations of change between work climate and burnout and depression. Work climate displayed a logarithmic decreasing trend while burnout and depression displayed logarithmic increasing trends over two years. Baseline levels of work climate were negatively and moderately associated with baseline levels of burnout and depression (r = -.44 to -.60, p < .01). Changes in work climate were negatively and moderately associated with change in burnout (r = -.43, p < .01) and change in depression (r = -.31, p < .05). Change in burnout was positively and strongly associated (r = .58, p < .01) with change in depression. The current results support temporal relationships among changes in work climate, burnout and depression across time. Practical implications for future preventive work in burnout interventions were discussed within this population.
    Psychology Health and Medicine 09/2015; DOI:10.1080/13548506.2015.1080849 · 1.26 Impact Factor
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    • "Clima de segurança, condições e contexto de trabalho e burnout Clima de trabalho como construto geral corresponde as dimensões psicológicas percebidas da organização de trabalho, incluindo avaliações cognitivas e afetivas dos indivíduos sobre diferentes elementos objetivos e subjetivos da organização, como a percepção sobre relação com a chefia, organização do trabalho, normas e procedimentos, satisfação com o trabalho, relacionamento interpessoal com colegas, justiça organizacional, entre outros (Puente-Palacios & Martins, 2013). Clima de segurança, por sua vez, é um conceito mais particular de clima organizacional, abordando os elementos cognitivos e afetivos, além do conjunto de percepções e práticas compartilhadas sobre o risco e a segurança no trabalho (Gershon et al., 2007; Zohar, 1980), sendo este um construto de bastante relevância para atividades ocupacionais onde ocorram exposições a diferentes agentes de risco, como instituições hospitalares, construção civil, entre outros. De acordo com Cohen, Smith e Cohen (1975) e Díaz e Cabrera (1997), o clima de segurança positivo associa-se a ações de investimento em segurança no trabalho, predizendo resultados mais positivos em termos desse conceito. "
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    ABSTRACT: This study presents results from a theoretical- empirical model that assembles aspects of the work context, safety climate, and psychosocial work variables in a hospital setting, and their consequences in the manifestation of burnout syndrome. Burnout is a disorder related to work associated with severe occupational stress. The syndrome is characterized by emotional exhaustion of workers and is established by means of certain associations among individual, environmental, and work characteristics. The goal of this study is to developand test a structural theoretical model linking dimensional variables of work, burnout, and mental health. This is a survey type of design with a convenience sample of 200 health professionals, 174 of whom were female (87%), mean age was 34.4 years, and with a mean of 6.5 years of work in the profession. The instrument for this research was composed of psychological scales for the following constructs: a) work security climate, b) work conditions, c) burnout, and d) socio-demographic aspects. The results indicate the existence of relationships between different aspects of work, safety climate, and health as observed through two integrative theoretical models of psychosocial variables, safety climate, and health for workers in hospital environments. These data help guide policies for worker health protection and prevention taken as a core strategy to ensure the provision of care within the daily routine of the hospital environment.
    • "Questions like whether young people are attracted to this profession and whether the profession can retain the current working nurses are raised by researchers in this field.[123] Dissatisfaction and tending to leave are major worldwide problems in the nursing profession.[45678] Feelings of stress, inadequacy, anxiety, and disempowerment in addition to working long hours are some of the reasons for leaving the profession.[9101112] "
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    ABSTRACT: Background: Dissatisfaction and tending to leave are some of the major nursing problems around the world. Professional commitment is a key factor in attracting and keeping the nurses in their profession. Commitment is a cultural dependent variable. Some organizational and socio-cultural factors are counted as the drivers of professional commitment. This study aimed to explore factors influencing the professional commitment in Iranian nurses. Materials and Methods: A qualitative content analysis was used to obtain rich data. We performed 21 in-depth face-to-face semi-structured interviews. The sampling was based on the maximum variation with the staff nurses and managers in 5 university affiliated hospitals. Constant comparative method used for data analysis Results: Two main categories were emerged: “Challenging with different feelings” and “Managers’ role”. Challenging with different feelings had two subcategories: “Burnout” and “sense of valuing”. The other theme was composed of three subcategories: “Gratitude or punishment climate”, “manager's view of caring” and “knowledge-based vs. routine-based nursing”. Conclusions: Findings revealed the burnout as a common sense in nurses. They also sensed being valued because of having a chance to help others. Impediments in the health care system such as work overload and having more concern in the benefits of organization rather than patient's care and wellbeing lead to a sense of humiliation and frustration. Congruence between the managers and nurses’ perceived values of the profession would be a main driver to the professional commitment. Making a sense of support and gratitude, valuing the care and promoting the knowledge-based practice were among the other important factors for making the professional commitment.
    Iranian journal of nursing and midwifery research 05/2014; 19(3):301-8.
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