Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan, Ghent 10 9000, Belgium.
Department of Marketing, Innovation and Organization, Ghent University, Tweekerkenstraat 2, Ghent 9000, Belgium.
Int J Nurs Stud. 2021 Oct;122:104032. doi: 10.1016/j.ijnurstu.2021.104032. Epub 2021 Jul 7.
Nurses have a very stressful and demanding job, which probably affects their health and well-being. This has resulted in a search for an optimal nurse schedule. Self-scheduling is one method to enhance flexibility and give more control to the employee. Literature on self-scheduling is scarce and mainly focused on the implementation process. So far, little is known about the long-term effects of self-scheduling.
The comparison of effects of self-scheduling versus fixed scheduling on three dimensions of organizational justice (distributive, procedural, interactional justice) and three work attitudes (job satisfaction, affective commitment, global empowerment). This total effect is decomposed into direct and indirect effects via hypothesised mediators (leader-member exchange and organizational justice).
A cross-sectional multisite-matched study.
A questionnaire was distributed to nurses and nurse assistants of twelve nursing homes in Flanders (Belgium). Six matched pairs of nursing homes were formed, each containing a nursing home that uses self-scheduling (for at least one year) and one that uses fixed scheduling.
The study sample included 308 nurses and nurse assistants, of which 160 surveys were from nursing homes using fixed scheduling, versus 148 surveys from nursing homes using self-scheduling.
Using a double robust fixed effects regression model adjusted for the propensity score, the total effect of self-scheduling compared to fixed scheduling was analysed on the proposed outcomes. Subsequently, a (multiple) mediation analysis was performed.
If all people would have used self-scheduling instead of fixed scheduling, on average a significant decrease in the mean procedural justice score (estimated mean difference = -0.20, 95% CI -0.36 to -0.05) would be found. There is a significant negative direct effect (estimated mean difference = -0.12, 95% CI -0.21 to -0.03) and indirect effect via the mediator leader-member-exchange (estimated mean difference = -0.08, 95% CI -0.15 to -0.01) on procedural justice. In addition, significant negative indirect effects of self-scheduling were found via the mediator leader-member exchange on all the investigated outcomes.
Drawing up the work schedule is perceived as less fair in the case of self-scheduling. Furthermore, self-scheduling has a negative indirect effect on several work attitudes as a result of the changed relationship between the head nurse and the employees. The increase in task variety and decision-making autonomy for the employees and the altered leadership role of the head nurse can have a major impact on the dynamics of the entire team.
护士的工作压力大且要求高，这可能会影响他们的健康和幸福感。因此，人们一直在寻找一种最佳的护士排班方式。自我排班是一种增强灵活性并赋予员工更多控制权的方法。关于自我排班的文献很少，主要集中在实施过程上。到目前为止，人们对自我排班的长期影响知之甚少。
比较自我排班与固定排班对组织公平（分配公平、程序公平、互动公平）和工作态度（工作满意度、情感承诺、整体授权）三个维度的影响。通过假设的中介变量（领导-成员交换和组织公平），将总效应分解为直接效应和间接效应。
跨截面多地点匹配研究。
在比利时弗拉芒地区的 12 家养老院向护士和护士助理发放问卷。形成了 6 对匹配的养老院，每对包含一家使用自我排班（至少一年）的养老院和一家使用固定排班的养老院。
研究样本包括 308 名护士和护士助理，其中 160 份来自使用固定排班的养老院，148 份来自使用自我排班的养老院。
使用双稳健固定效应回归模型，根据倾向得分调整，分析自我排班与固定排班相比对所提出结果的总效应。随后进行了（多重）中介分析。
如果所有人都使用自我排班而不是固定排班，那么程序公平得分的平均（估计平均差异=-0.20，95%CI -0.36 至 -0.05）将会显著下降。存在显著的负直接效应（估计平均差异=-0.12，95%CI -0.21 至 -0.03）和通过中介领导-成员交换的间接效应（估计平均差异=-0.08，95%CI -0.15 至 -0.01）。此外，通过领导-成员交换，自我排班对所有调查结果都存在显著的负间接效应。
自我排班被认为在制定工作时间表方面不公平。此外，由于护士长与员工之间关系的改变，自我排班对多项工作态度产生了负面影响。员工的任务多样性和决策自主权的增加以及护士长改变的领导角色可能会对整个团队的动态产生重大影响。
