Intensified job demands in healthcare and their consequences for employee well‐being and patient satisfaction: A multilevel approach
Open accessAbstract
Aims: Intensified job demands (IJDs) and their effects on employee burnout, work engagement and patient satisfaction were investigated across different work units and occupational groups in a healthcare setting. Design: A multilevel study. Methods: One thousand twenty‐four healthcare employees responded to a survey in 2019 and rated their experiences of IJDs, burnout and work engagement. Nine hundred fifty‐one patients rated their satisfaction with care received from healthcare staff. Results: Work units and occupational groups who shared more experiences of increased time pressure and multitasking reported higher exhaustion. Shared perceptions of increased planning and performing one's work autonomously correlated with higher exhaustion and lower patient satisfaction at the work‐unit level. Moreover, work intensification was found to be highest in emergency care and among nurses, while job‐related planning demands were highest in leadership services. Conclusion: IJDs are a shared risk to employee well‐being among heterogeneous healthcare staff and relate negatively to customer‐rated patient satisfaction. We found that high time‐pressure demands increase the shared risk of burnout—especially among nurses and healthcare staff working in emergency care. Furthermore, increased independence and self‐determination in planning and executing work tasks also increase the shared risk of burnout especially among those in leadership services. This can lead to lower customer/care satisfaction among patients. Impact: With the accelerating pace of socio‐economic change, the pace of work is also getting faster. Our findings help understand how IJDs are experienced among heterogeneous healthcare staff. Because different occupational groups and work units had different demands, this research shows that attempts to mitigate the negative effects of IJDs need to be planned and implemented in a context‐specific way. It seems crucial to pay more attention especially to adequate nurse staffing so that the adverse effects of IJDs could be mitigated among them.
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Nursing faces increasing pressure due to changing demographics and a shortage of skilled workers.
“European healthcare, challenged by an aging population and nursing staff shortages, faces increasing demands and work-related stress [9, 10].”
From Nurses’ perceptions, experience and knowledge regarding artificial intelligence: results from a cross-sectional online survey in Germany (2024) · cites this paper as [9]
Nurses anticipate AI to alleviate the increasing burdens in nursing, particularly amidst current staff shortages and escalating workloads.
“Nurses anticipate AI to alleviate the increasing burdens in nursing, particularly amidst current staff shortages and escalating workloads [9, 10].”
From Nurses’ perceptions, experience and knowledge regarding artificial intelligence: results from a cross-sectional online survey in Germany (2024) · cites this paper as [9]
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Cites
The measurement of engagement and burnout: a two sample confirmatory factor analytic approach.
Schaufeli, W. B., Salanova, M., González-romá, V., & Bakker, A. B. (2002) · Journal of Happiness Studies · doi:10.1023/a:1015630930326 · Cited by 10,014 · see citing works
Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study
Schaufeli, W. B., & Bakker, A. B. (2004) · Journal of Organizational Behavior · doi:10.1002/job.248 · Cited by 9,297 · see citing works
(1996) · Consulting Psychologists Press eBooks · Cited by 7,863 · see citing works
Job demands–resources theory: Taking stock and looking forward.
Bakker, A. B., & Demerouti, E. (2017) · Journal of Occupational Health Psychology · doi:10.1037/ocp0000056 · Cited by 6,979 · see citing works
Klein, K. J., & Kozlowski, S. W. J. (2000) · Cited by 4,914 · see citing works
Lepine, J. A., Podsakoff, N. P., & Lepine, M. A. (2005) · Academy of Management Journal · doi:10.5465/amj.2005.18803921 · Cited by 2,438 · see citing works
Schein, E. H. (1990) · American Psychologist · doi:10.1037/0003-066x.45.2.109 · Cited by 2,244 · see citing works
An empirical examination of self-reported work stress among U.S. managers.
Cavanaugh, M. A., Boswell, W. R., Roehling, M. V., & Boudreau, J. W. (2000) · Journal of Applied Psychology · doi:10.1037/0021-9010.85.1.65 · Cited by 2,154 · cited 6× · see citing works
“However, according to the challenge- hindrance approach to work demands (Cavanaugh et al., 2000; LePine et al., 2005), not all demands are solely negative for employee well- being.”
BackgroundResultInfluentialThe Truth about Burnout: How Organizations Cause Personal Stress and What to Do about It
Maslach, C., & Leiter, M. P. (1997) · Cited by 2,001 · see citing works
Healthcare staff wellbeing, burnout, and patient safety: a systematic review
Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016) · PLOS ONE · doi:10.1371/journal.pone.0159015 · Cited by 1,683 · see citing works
Rosa, H. (2013) · Columbia University Press eBooks · doi:10.7312/rosa14834 · Cited by 1,584 · see citing works
Workplace stress in nursing: a literature review
McVicar, A. J. (2003) · Journal of Advanced Nursing · doi:10.1046/j.0309-2402.2003.02853.x · Cited by 1,121 · see citing works
Dollard, M. F., & Bakker, A. B. (2009) · Journal of Occupational and Organizational Psychology · doi:10.1348/096317909x470690 · Cited by 1,086 · see citing works
Nurse Burnout and Patient Satisfaction
Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004) · Medical Care · doi:10.1097/01.mlr.0000109126.50398.5a · Cited by 977 · see citing works
The Working Hours Of Hospital Staff Nurses And Patient Safety
Rogers, A. E., Hwang, W.-T., Scott, L. D., Aiken, L. H., & Dinges, D. F. (2004) · Health Affairs · doi:10.1377/hlthaff.23.4.202 · Cited by 952 · cited 1× · see citing works
“Studies have shown that occupational stress and burnout not only have health- hampering consequences for the employees themselves but also negative effects on the quality of care provided to patients (e.g., Argentero et al., 2008; Leiter et al., 1998; Rogers et al., 2004; Vahey et al., 2004).”
BackgroundAn Ultra-Short Measure for Work Engagement
Schaufeli, W. B., Shimazu, A., Hakanen, J., Salanova, M., & Witte, H. D. (2017) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000430 · Cited by 914 · see citing works
Global prevalence of burnout symptoms among nurses: a systematic review and meta-analysis
Woo, T., Ho, R., Tang, A., & Tam, W. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.12.015 · Cited by 866 · see citing works
Social acceleration: a new theory of modernity
(2013) · Choice Reviews Online · doi:10.5860/choice.51-1797 · Cited by 852 · see citing works
Social Acceleration: Ethical and Political Consequences of a Desynchronized High–Speed Society
Rosa, H. (2003) · Constellations · doi:10.1111/1467-8675.00309 · Cited by 773 · see citing works
Klein, K. J., Conn, A. B., Smith, D. B., & Sorra, J. (2001) · Journal of Applied Psychology · doi:10.1037/0021-9010.86.1.3 · Cited by 511 · see citing works
The correspondence of patient satisfaction and nurse burnout
Leiter, M. P., Harvie, P., & Frizzell, C. (1998) · Social Science & Medicine · doi:10.1016/s0277-9536(98)00207-x · Cited by 502 · see citing works
Implementing culture change in health care: theory and practice
SCOTT, T. (2003) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzg021 · Cited by 419 · see citing works
Interventions to improve physicians’ well-being and patient care
Firth‐Cozens, J. (2001) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00221-5 · Cited by 344 · see citing works
The effect of estimation method and sample size in multilevel structural equation modeling
Hox, J. J., Maas, C. J. M., & Brinkhuis, M. J. S. (2009) · Statistica Neerlandica · doi:10.1111/j.1467-9574.2009.00445.x · Cited by 332 · see citing works
An Introduction to Multilevel Modeling Techniques
Heck, R. H., & Thomas, S. L. (2015) · Routledge eBooks · doi:10.4324/9781315746494 · Cited by 312 · see citing works
Fiabane, E., Giorgi, I., Sguazzin, C., & Argentero, P. (2013) · Journal of Clinical Nursing · doi:10.1111/jocn.12084 · Cited by 236 · see citing works
Burnout in healthcare: the case for organisational change
Montgomery, A., Panagopoulou, E., Esmail, A., Richards, T., & Maslach, C. (2019) · BMJ · doi:10.1136/bmj.l4774 · Cited by 231 · see citing works
Bliese, P. D., & Jex, S. M. (2002) · Journal of Occupational Health Psychology · doi:10.1037//1076-8998.7.3.265 · Cited by 228 · see citing works
Burnout in nurses – the relationship between social capital in hospitals and emotional exhaustion
Kowalski, C., Ommen, O., Driller, E., Ernstmann, N., Wirtz, M. A., Köhler, T., & Pfaff, H. (2010) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2009.02989.x · Cited by 222 · see citing works
Kubicek, B., Paškvan, M., & Korunka, C. (2014) · European Journal of Work and Organizational Psychology · doi:10.1080/1359432x.2014.979160 · Cited by 209 · see citing works
WORK INTENSIFICATION, DISCRETION, AND THE DECLINE IN WELL-BEING AT WORK.
Green, F. (2004) · RePEc: Research Papers in Economics · Cited by 187 · see citing works
From employee to ‘entreployee’
Pongratz, H. J., & Voß, G. G. (2003) · Concepts and Transformation · doi:10.1075/cat.8.3.04pon · Cited by 186 · see citing works
An introduction to multilevel modeling techniques : MLM and SEM approaches using Mplus
Heck, R. H., & Thomas, S. L. (2015) · Cited by 186 · see citing works
Occupational stress in nursing: a review of the literature
Clegg, A. P. (2001) · Journal of Nursing Management · doi:10.1046/j.1365-2834.2001.00216.x · Cited by 181 · see citing works
Bliese, P. D., & Jex, S. M. (2002) · Journal of Occupational Health Psychology · doi:10.1037/1076-8998.7.3.265 · Cited by 170 · see citing works
Bergen Burnout Inventory: reliability and validity among Finnish and Estonian managers
Salmela‐Aro, K., Rantanen, J., Hyvönen, K., Tillemann, K., & Feldt, T. (2010) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-010-0594-3 · Cited by 163 · see citing works
Self-citationMartin, A. J., Karanika‐Murray, M., Biron, C., & Sanderson, K. A. (2014) · Stress and Health · doi:10.1002/smi.2593 · Cited by 149 · see citing works
Staff Burnout and Patient Satisfaction With the Quality of Dialysis Care
Argentero, P., Dell’Olivo, B., & Ferretti, M. S. (2008) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2007.09.011 · Cited by 125 · see citing works
Caregiver Well-being and Patient Outcomes in Heart Failure
Bidwell, J. T., Lyons, K. S., & Lee, C. S. (2016) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000350 · Cited by 123 · see citing works
Thun, S., Halsteinli, V., & Løvseth, L. T. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3229-0 · Cited by 95 · see citing works
Feldt, T., Rantanen, J., Hyvönen, K., Mäkikangas, A., Huhtala, M., Pihlajasaari, P., & Kinnunen, U. M. (2013) · Industrial Health · doi:10.2486/indhealth.2013-0059 · Cited by 92 · see citing works
Self-citationIs Work Intensification Extra Stress?
Franke, F. (2015) · Journal of Personnel Psychology · doi:10.1027/1866-5888/a000120 · Cited by 88 · see citing works
Changes in work intensification and intensified learning: challenge or hindrance demands?
Korunka, C., Kubicek, B., Paškvan, M., & Ulferts, H. (2015) · Journal of Managerial Psychology · doi:10.1108/jmp-02-2013-0065 · Cited by 87 · see citing works
Zeytinoglu, I. U., Denton, M. A., Davies, S., Baumann, A. O., Blythe, J., & Boos, L. (2006) · Health Policy · doi:10.1016/j.healthpol.2005.12.004 · Cited by 87 · see citing works
Systematic Review of Burnout Risk Factors among European Healthcare Professionals
Bria, M., Băban, A., & Dumitrascu, D. L. (2012) · Cognitie, Creier, Comportament · Cited by 85 · see citing works
Associations between Work Intensification, Stress and Job Satisfaction
Zeytinoglu, I. U., Denton, M. A., Davies, S., et al. (2007) · Relations industrielles · doi:10.7202/016086ar · Cited by 81 · see citing works
Organizational culture, work organization conditions, and mental health: A proposed integration.
Dextras-Gauthier, J., Marchand, A., & Haines, V. Y. (2012) · International Journal of Stress Management · doi:10.1037/a0028164 · Cited by 71 · see citing works
Antecedents of intensified job demands: evidence from Austria
Mauno, S., Kubicek, B., Minkkinen, J., & Korunka, C. (2019) · Employee Relations · doi:10.1108/er-04-2018-0094 · Cited by 60 · see citing works
Self-citationPaškvan, M., & Kubicek, B. (2017) · Springer eBooks · doi:10.1007/978-3-319-54678-0_3 · Cited by 57 · see citing works
Kubicek, B., Korunka, C., & Ulferts, H. (2012) · Journal of Advanced Nursing · doi:10.1111/jan.12011 · Cited by 55 · see citing works
Stress in nurses: The 100 top‐cited papers published in nursing journals
del Río, B. M., Puchol, Á. S., Martínez‐Zaragoza, F., & Gil, G. B. (2018) · Journal of Advanced Nursing · doi:10.1111/jan.13566 · Cited by 51 · see citing works
Healthcare professionals’ work engagement in Finnish university hospitals
Lepistö, S., Alanen, S., Aalto, P., Järvinen, P., Leino, K., Mattila, E., & Kaunonen, M. (2017) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12538 · Cited by 42 · see citing works
Shared time pressure at work and its health-related outcomes: Job satisfaction as a mediator
Silla, I., & Gamero, N. (2013) · European Journal of Work and Organizational Psychology · doi:10.1080/1359432x.2012.752898 · Cited by 41 · see citing works
Janssen, E., Strydonck, I. V., Decuypere, A., Decramer, A., & Audenaert, M. (2020) · Journal of Advanced Nursing · doi:10.1111/jan.14563 · Cited by 40 · see citing works
Hart, S., & Warren, A. M. (2013) · Economic and Industrial Democracy · doi:10.1177/0143831x13505119 · Cited by 37 · see citing works
Holland, P. J., Tham, T. L., & Gill, F. J. (2018) · International Journal of Nursing Practice · doi:10.1111/ijn.12630 · Cited by 32 · see citing works
Choi, D., Noh, Y., & Rha, J. S. (2018) · Service Business · doi:10.1007/s11628-018-00390-1 · Cited by 12 · see citing works
The real business of health care
Leggat, S. G. (2008) · Australian Health Review · doi:10.1071/ah080203 · Cited by 1 · see citing works
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Sommer, D., Schmidbauer, L., & Wahl, F. (2024) · BMC Nursing · doi:10.1186/s12912-024-01884-2 · Cited by 91 · see citing works
- Authors
- Huhtala, M., Geurts, S., Mauno, S., & Feldt, T.
- Affiliations
- JAMK University of Applied Sciences (FI)
- Radboud University Nijmegen (NL)
- Tampere University (FI)
- University of Jyväskylä (FI)
- Corresponding author
- Huhtala, Mari
- Venue
- Journal of Advanced Nursing
- Publisher
- Wiley
- Published
- 2021-05-28
- Volume
- 77
- Issue
- 9
- Pages
- 3718-3732
- ISSN
- 0309-2402 (ISSN-L)
- 1365-2648
- OpenAlex
- W3165159017
- Cited by
- 98
- References
- 58
- Citations by year
- 2026: 20 · 2025: 23 · 2024: 22 · 2023: 23 · 2022: 8 · 2021: 1 · 2018: 1
- FWCI
- 13.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Advanced Nursing (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Jyväskylä University Digital Archive (University of Jyväskylä) (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- Tampere University Institutional Repository (Tampere University) (submittedVersion, cc-by)
- Theseus (Ammattikorkeakoulujen) (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- Academy of Finland (308334, 308336)
- Topics
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Keywords
- healthcare workers, burnout, work engagement, patient satisfaction, time pressure, multitasking, employee autonomy, occupational groups, emergency care, nurses, nurse staffing, employee well-being
- MeSH terms
- Work Engagement, Burnout, Professional, Cross-Sectional Studies, Delivery of Health Care, Humans, Job Satisfaction, Leadership, Occupations, Surveys and Questionnaires
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