The impact of shift-work and organisational climate on health outcomes in nurses

1. The impact of shift-work and organisational climate on health outcomes in nurses Dr Kathryn von Treuer Senior Lecturer and Course Chair, Masters of Industrial and Organisational Psychology, Deakin University & Mr Glenn Little, student researcher, Deakin University 8th QOL conference, Melbourne, November 2006

2. Shift work, organisational climate and health • Poor health outcomes have long been identified in shift workers. • Most studies focus on the causal link between physiological changes in shift workers and poorer health outcomes, particularly in night shift workers. • Few studies have examined organisational climate differences that may occur between different shifts which may also impact upon health outcomes.

3. Shift work, organisational climate and health • The context (of the work environment) in which change and outcomes are measured within organisations have increasingly been recognised to be important. • Some studies suggest that organisational factors may vary between shifts and may therefore effect outcome factors. • This study investigated the variation in organisational climate factors between different types of shiftwork and how these factors may have impacted upon health.

4. Shift work, organisational climate and health- The proposed model Proposed model (von Treuer & Little, 2006) It was hypothesised that changes in shift work would predict differences in the organisational climate between types of shifts, which would then predict health outcomes. Health outcomes Organisational climate Shift work

5. Involvement Co-worker Cohesion Supervisor Support Autonomy Task Orientation Work Pressure Clarity Managerial Control Innovation Physical Comfort Organisational Climate Factors- Work Environment Scale (Moos, 1994)

6. Shift work, organisational climate and health • Participants in the study (n=142) were nursing staff from a large metropolitan hospital who perform shift-work. • Day n=30, Rotating n=74, Night n=26 • Analysis of demographics revealed a representative sample across all variables, except for gender where males were underrepresented, χ2=5.51, 1df, p<0.05 (critical test statistic=3.84).

7. Measures: • Demographic Information Sheet • Work Environment Scale (Moos, 1994) • General Health Questionnaire (Goldberg & Williams, 1991) • Anxiety, Dysfunction, Somatic, Depression

8. Shift work and organisational climate

9. Shift work and organisational climate ANOVA revealed that the organisational climate factors of involvement (p<.044), co-worker cohesion (p<.03) and supervisor support (p<.041) were all found to have significantly lower mean scores for night shift workers compared with rotating and day shift workers.

10. Shift work and organisational climate Tukey’s post hoc tests revealed that the differences were between night shift workers and rotating shift workers. Co-worker cohesion (p<.035) Involvement (p<.035) Supervisor support (p<.043)

11. Regression results: Org climate and GHQ

12. Shift work and Health • Shift type was not found to predict health outcomes as measured by the GHQ • ANOVA revealed no significant differences between shift type and GHQ health outcomes GHQ- Somatic, Anxiety, Dysfunction, Depression, all (p>.05)

13. Research conclusions Type of shift work did not directly predict health outcomes. These findings suggest that differences in health outcomes due to shift-work may be mediated by organisational climate factors which differ between different types of shifts. It was concluded that subsequent changes in the organisational environment with a focus on cohesion and involvement in night shift workers may lessen the negative health outcomes.

14. Shift work, organisational climate and health • Expanding theory: • Cohesion is an important workplace factor • Another study supports the findings that cohesion predicts well-being • Cohesion was the most important predictor of health (GHQ) outcomes • Organisational climates varies between shifts within the same organisation.

15. Shift work, organisational climate and health • Applied knowledge • Increased cohesion and involvement at work may protect employees against negative health outcomes. • Encourage staff to promote initiatives to increase cohesion for night shift workers.