Kevin R. H. Teoh, PhD, is Lecturer in Organizational Psychology, Department of Organizational Psychology, Birkbeck University of London, United Kingdom. E-mail:
Health Care Manage Rev. 2020 Apr/Jun;45(2):162-172. doi: 10.1097/HMR.0000000000000207.
The high prevalence of burnout and depression among doctors highlights the need to understand the psychosocial antecedents to their work-related well-being. However, much of the existing research has been atheoretical, operationalized a narrow measurement of well-being, and predominantly examined such relationships at the individual level.
This study uses a multilevel perspective to examine individual (i.e., job demands and resources) and organizational-level psychosocial predictors of three measures of work-related well-being: perceived stress, presenteeism, and work engagement. The job demands-resources theory underpins the postulated relationships.
The 2014 National Health Service Staff Survey was analyzed using multilevel modeling in MPlus. The data set involved 14,066 hospital-based doctors grouped into 157 English hospital organizations (i.e., Trusts).
Congruent with job demands-resources theory, job demands (workplace aggression and insufficient work resources) were stronger predictors of perceived stress and presenteeism than job resources. Equally, job resources (job control and manager support) were generally stronger predictors of work engagement than job demands. At the organizational level, bed occupancy rates and number of emergency admissions predicted work engagement. No hypothesized individual or multilevel interactions were observed between any of the job demands and resources.
The findings emphasize that a broader perspective of work-related well-being among hospital doctors should be employed and the empirical value of examining such relationships from a multilevel perspective. Successful health intervention should target the appropriate antecedent pathway and recognize the role of organizational-level factors when trying to manage hospital doctors' work-related well-being.
医生群体中 burnout 和 depression 的高发率突显了理解影响其工作相关幸福感的心理社会因素的必要性。然而，现有的大部分研究都缺乏理论基础，对幸福感的测量维度较窄，且主要在个体层面上检验这些关系。
本研究采用多水平视角，检验个体（即工作需求和资源）和组织层面的心理社会因素对三种工作相关幸福感衡量指标的预测作用：感知压力、出勤主义和工作投入。工作需求-资源理论为所提出的关系提供了理论基础。
本研究使用 MPlus 中的多层次模型分析了 2014 年国家卫生服务人员调查的数据。该数据集包含了 14066 名基于医院的医生，他们被分为 157 个英国医院组织（即信托）。
与工作需求-资源理论一致，工作需求（工作场所侵犯和工作资源不足）比工作资源更能预测感知压力和出勤主义。同样，工作资源（工作控制和经理支持）通常比工作需求更能预测工作投入。在组织层面上，床位占用率和急诊入院人数预测了工作投入。在任何工作需求和资源之间，都没有观察到假设的个体或多层次交互作用。
研究结果强调，应该采用更广泛的视角来研究医院医生的工作相关幸福感，从多水平视角检验这些关系具有实证价值。成功的健康干预应该针对适当的前因路径，并在试图管理医院医生的工作相关幸福感时，认识到组织层面因素的作用。
