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van de prof uit de les.
HOOFDSTUK 1
VERDIEPING : MEANINGFUL ACTIVITIES DURING COVID-19 LOCKDOWN AND ASSOCIATION WITH
MENTAL HEALTH IN BELGIAN ADULTS
- Duiding prof: Volwassen mensen werden bevraagd welke activiteiten men deed tijdens de lockdown
en als je de activiteit doet, hoe betekenis vol ervaart u deze activiteit? (n = 2000)
o General Health Questionnaire (meet de mate van mentale gezondheid bij mensen)
o Kernresultaten: (tabel 7 kennen voor het examen!)
Mensen doen minder sociale activiteiten (buiten), minder vrijwilligerswerk,
studentenjobs
Mensen doen meer aan: self-care, vrijetijdsbestedingen binnen, huishoudelijke
taken,…
Hiërarchische regressie analyse: stapsgewijs te werk gaan (controlevariabelen in
rekening houden: leefomgeving, burgerlijke staat, veerkracht,…)
Model 1: Controlevariabelen verklaren in totaal 33.5% van de variantie
(33.5% van de verschillen tussen mensen vallen te verklaren door de
controle variabelen)
Model 2: EMAS-schaal invoeren die meet in welke mate de activiteit die
men deed betekenisvol was voor hem/haar
Er is een heel sterk negatief verband: moe heer betekenisvol men een activiteit
ervaart, hoe minder mentaal ongelukkig men voelt
Hoofdstuk 2: geen artikels te kennen
HOOFDSTUK 3
BASIS: IMPACT OF THE EFFORT-REWARD IMBALANCE MODEL ON INTENT TO LEAVE AMONG
BELGIAN HEALTHCARE WORKERS: A PROSPRECTIVE STUDY
1. INTRODUCTION
- Hedendaagse problemen binnen de healthcare:
o Recruitment problemen
Stijging aan nood aan verpleegsters
Ageing populatie
Stijging consumer behavior/higher patient expectations
Medische technologische ontwikkelingen
Daling aan instromers in het werkveld van verpleging
Lagere sociale waarde van de job ‘verpleging’
Negatief stereotype over de werkomstandigheden van verpleegsters
o Retention problemen
Hoge turnover: organizational turnover, professional turnover,… (zowel organisatie
als de sector zelf!)
High early retirement intention (Boumans et al, 2008)
, o Turnover bij verplegers
Consequenties:
Financiële kosten
Negatieve patient outcomes
Personeel uitkomsten
o General problem: antecedenten turnover bij verplegers??
Antwoord belangrijk voor
Retentie van verpleging
Preventie bij turnover
Vorig onderzoek: intentie om te vertrekken is een predictor voor ‘actual turnover
behavior’ (Hayes et al, 2006)
European NEXT study en Belgische WOQUAL study
- Turnover cognitions and actual turnover
- Intentie om te vertrekken
o 2 condities van turnover
Intentie om de huidige organisatie te verlaten (organizational turnover intention)
Intentie om de positie van verpleging te verlaten (professional turnover intention)
o Intentie om te vertrekken: withdrawal behavior, passive/active coping with unhealthy work
environment
- JDCS-model (Karasek en Theorell, 1990)
o Gezondheidswerkers die werkzaam zijn in jobs die worden gekenmerkt door de combinatie
van hoge taakeisen, lage beslissingsruimte en lage sociale steun, hebben een verhoogd risico
op spanning (vb de intentie om te vertrekken)
- Effort-reward imbalance model (Siegrist, 1996)
- ERI model: 3 onderzoekshypotheses
o H1: extrinsic hypothese: an imbalance between efforts and
rewards increases the risk of developing
A high intent to leave the current organization one year
later
A high intent to leave the nursing profession one year
later
o H2: intrinsic hypothesis: a high level of overcommitment increases
the risk of developing
A high intent to leave the current organization one year
later
A high intent to leave the nursing profession one year later
o H3: interaction hypothesis: an effort-reward imbalance in combination with a high level of
overcommitment increases the risk of developing
A high intent to leave the current organization one year later
A high intent to leave the nursing profession one year later
,2. METHODS
- Sample:
o Nurses’ early exit study (NEXT)
Inquiry into the cause of premature withdrawal from Health-care work
Subject: to find out why health care personnel withdraw from their occupations long
before they have reached the pension age
Aim: to promote retention of health care personnel in their respective work areas
o Study design NEXT
o Total Belgian sample at baseline
N = 4257 (all nurses and
nursing aids who responded
the Q0 self-report
questionnaire)
Brussels: 793
(52.9%)
Flanders: 1966
(69.6%)
Wallonia: 1498 (56.5%)
Overall response rate: 61.3%
92.5% women, mean age: 38.4 years
Respondents in hospitals: n = 2303 (54%)
Respondents in ROB/RVT: n = 303 (7%)
Respondents in home care: n = 1651 (39%)
o 2 subsamples in Belgian sample
Stayers: (n = 1531): used in this paper
Stayed in the organization during 1 year follow-up
Completed both Q0 and Q12
Leavers: (n = 110)
Left the organization during the year follow up
Completed both Q0 and Qex
- ERI questionnaire: 23 items
o Effort: 6 items
Quantitative work load (work pressure, time pressure, working overtime,…)
High score = high effort
o Reward: 11 items
3 aspects: financial reward, esteem and career opportunities
High score = high reward
o Overcommitment: 6 items
Inability to withdraw from work obligations
High score = high overcommitment
o ERI model:
Effort-reward ratio:
(effort/reward) x correction factor
Ratio > 1 efforts > reward = imbalance
(Q0) mean ERI ratio = .57 (.257)
ERI < 1: n = 3825, 94.1%
ERI >= 1: n = 238, 5.9%
(Q0) mean overcommitment = 13.96 (3.24)
, o Intent to leave current organization
Measured by 1 item: “how often do you think about leaving the current
organization?”
6 answer categories ranging from ‘never’ to ‘every day’
High intent to leave: … ?????
o Intent to leave the nursing professions
Measure by 3 items: “ how often do you think about: (1) further qualification outside
nursing, (2) giving up nursing, (3) giving up nursing and starting a different kind of job
Each item: six answer categories, ranging from ‘never’ to ‘every day’
High intent to leave: …????
- Design and statistical analyses
o Study sample: 1531 stayers who completed both Q0 and Q12
o Longitudinal design:
Intent to leave was measure 2 times (at Q0 and Q12)
Participants having a high intent to leave at baseline excluded from further
analyses
o Multivariate logistic regression:
To test all three hypotheses of the ERI model
Use of quartiles: only 4.4% of the participants was experiencing an imbalance (ratio >
1) at baseline
Adjustments were made for: age, gender, type of organization (hospital, nursing,
home or home care), number of working hours a week, work schedule (day work
versus shift work), family situation and education
3. RESULTS
- Study sample: 1531 stayers
o Mean age: 38.4 (8.8)
o Mean ERI: .54
ERI < 1: N = 1424: 95.6%
ERI > 1: N = 65: 4.4%
- H1: extrinsic hypothesis
o Mensen die een hoge onbalans ervaren (Q4)
zullen in vergelijking zitten met mensen in
balans (Q1) hebben 1,8 keer zo veel kans op
professionele turnover (zwaar significant)
o Rapporteren 5 keer zo veel meer dat ze hun
organisatie willen verlaten
o Hypothese is bevestigd!
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