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

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.

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.

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.

Shift workOrganisational

climateHealth outcomes

Organisational Climate Factors- Work Environment Scale (Moos, 1994)

• Involvement• Co-worker Cohesion• Supervisor Support• Autonomy• Task Orientation

• Work Pressure• Clarity• Managerial Control• Innovation• Physical Comfort

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).

Measures:

• Demographic Information Sheet• Work Environment Scale (Moos, 1994)• General Health Questionnaire (Goldberg &

Williams, 1991) – Anxiety, Dysfunction, Somatic, Depression

Shift work and organisational climate

WES scale scores

30

40

50

60

70

Invo

lvem

ent

Coworker

Cohes

ion

Supervi

sor S

upport

Autonom

y

Task

Orienta

tion

Work

Pre

ssure

Clarit

y

Man

ager

ial C

ontrol

Innova

tion

Physic

al C

omfo

rt

WES Scale Item

WE

S S

cale

Sco

re

Day

Night

Rotating

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.

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)

Regression results: Org climate and GHQ

GHQ scale Organisational climate subscale

GHQ – Anxiety

F (11,119)=3.19, p<.001, R2=.24

Work pressure (p<.004)

Co-worker cohesion (p<.015)

Involvement (p<.039)

GHQ – Somatic

F (11,119)=2.573, p<.006, R2=.19

Co-worker cohesion (p<.006*)

Involvement (p<.017)

Work pressure (p<.025)

GHQ – Dysfunction

F (11,119)=2.176, p<.020, R2 =.17

Co-worker cohesion (p<.001)

Involvement (p<.017)

GHQ – Depression

F (11,119)=.97, p>.05, R2=.8

-

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)

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.

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.

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.