Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants
Abstract
:1. Introduction
2. Materials and Methods
2.1. The Study Sample
2.2. Survey Instruments
2.2.1. Psychosocial Working Conditions
2.2.2. Quality of Care
2.3. Statistical Analysis
3. Results
3.1. Sample Characteristics and Descriptive Results
3.2. Primary Statistical Analyses
3.3. Sensitivity Analyses
4. Discussion
4.1. Comparison to Prior Research
4.2. Potential Pathways
4.3. Methodological Considerations
4.4. Recommendations for Practice, Prevention, and Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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(Introductory Text): Please Rate Which Areas of Patient Care Are Affected by Your Work Stress. | |||
---|---|---|---|
Items | Mean (Standard Deviation) | Factor Loading | |
Factor 1: Slips and lapses (Eigenvalue 2.168) | Factor 2: Interaction with patients (Eigenvalue 1.913) | ||
Slips and lapses happen during measurements on patients. | 1.78 (0.73) | 0.78 | |
Slips and lapses happen with patient records (mixing up). | 1.81 (0.68) | 0.88 | |
Slips and lapses happen during documentation. | 1.93 (0.70) | 0.87 | |
I have a hard time being kind to patients. | 2.04 (0.88) | 0.88 | |
I have less patience with patients. | 2.31 (0.91) | 0.88 | |
There is too little time to talk to patients. | 3.53 (0.95) | 0.56 |
Characteristic | |
Age, Mean (M) (Standard Deviation (SD)) | 39.28 (11.43) |
Sex, n (%) | |
Female | 865 (98.41) |
Male | 14 (1.59) |
M (SD) | |
Effort | |
Score range 6–24, cut-off ≥ 21 | 18.56 (3.19) |
Reward | |
Score range 11–44, cut-off ≥ 31 | 28.25 (5.98) |
ERI ratio a | |
(Effort * 11)/(reward * 6) | 1.28 (0.42) |
MA b sub-scale (high) workload | |
Score range 6–24 | 17.36 (4.19) |
MA sub-scale (low) job control | |
Score range 6–24 | 21.11 (2.71) |
MA sub-scale (poor) collaboration | |
Score range 4–16 | 8.41 (2.85) |
MA sub-scale (low) gratification | |
Score range 4–16 | 11.52 (2.66) |
MA sub-scale (poor) practice organization | |
Score range 3–12 | 6.56 (2.08) |
MA sub-scale (lack of) resources | |
Score range 3–12 | 4.63 (1.71) |
MA sub-scale (poor) leadership behavior | |
Score range 3–12 | 8.01 (2.35) |
Slips and lapses c | |
Score range 5–15 | 5.51 (1.79) |
Interaction with patients c | |
Score range 5–15 | 7.88 (2.16) |
n (%) | |
Leadership position (yes) | 421 (48.0) |
Work stress according to ERI (i.e., ratio >1.0) | 616 (73.77) |
Slips and Lapses a | Poor Interaction with Patients a | ||||||||
---|---|---|---|---|---|---|---|---|---|
Characteristic | Model I b | Model II c | Model I b | Model II c | |||||
PR | 95% CI | PR | 95% CI | PR | 95% CI | PR | 95% CI | ||
ERI model | |||||||||
Effort | High vs. low d | 1.34 | 1.03, 1.75 | 1.45 | 1.10, 1.90 | 1.87 | 1.47, 2.38 | 1.88 | 1.47, 2.40 |
Reward | High vs. low | 0.51 | 0.36, 0.71 | 0.53 | 0.38, 0.75 | 0.45 | 0.33, 0.63 | 0.42 | 0.30, 0.59 |
ERI ratio (>1.0 vs. remainder) | High vs. low | 2.46 | 1.60, 3.78 | 2.53 | 1.63, 3.92 | 3.71 | 2.31, 5.96 | 3.62 | 2.25, 5.81 |
MA-specific instrument | |||||||||
Workload (high) | High vs. low | 1.58 | 1.22, 2.05 | 1.65 | 1.27, 2.15 | 2.32 | 1.83, 2.96 | 2.33 | 1.83, 2.98 |
Job control (low) | High vs. low | 1.28 | 0.99, 1.66 | 1.48 | 1.12, 1.94 | 2.09 | 1.63, 2.67 | 2.12 | 1.65, 2.73 |
Collaboration (poor) | High vs. low | 1.70 | 1.32, 2.20 | 1.69 | 1.30, 2.19 | 2.02 | 1.59, 2.57 | 2.04 | 1.60, 2.61 |
Gratification (low) | High vs. low | 1.49 | 1.15, 1.93 | 1.46 | 1.12, 1.90 | 1.33 | 1.05, 1.70 | 1.38 | 1.08, 1.77 |
Practice organization (poor) | High vs. low | 2.28 | 1.77, 2.93 | 2.24 | 1.73, 2.90 | 1.70 | 1.34, 2.17 | 1.74 | 1.36, 2.23 |
Resources (lack of) | High vs. low | 1.37 | 1.05, 1.78 | 1.39 | 1.07, 1.82 | e | e | ||
Leadership (poor behavior) | High vs. low | 1.24 | 0.94, 1.63 | 1.22 | 0.92, 1.61 | 1.87 | 1.47, 1.37 | 1.94 | 1.53, 2.48 |
Slips and Lapses a | Poor Interaction with Patients a | ||||||||
---|---|---|---|---|---|---|---|---|---|
Characteristic | Model I b | Model II c | Model I b | Model II c | |||||
PR | 95% CI | PR | 95% CI | PR | 95% CI | PR | 95% CI | ||
ERI model | |||||||||
Effort | z-score | 1.28 | 1.11, 1.47 | 1.33 | 1.15, 1.53 | 1.47 | 1.35, 1.62 | 1.48 | 1.35, 1.63 |
Reward | z-score | 0.75 | 0.66, 0.85 | 0.75 | 0.66, 0.86 | 0.67 | 0.59, 0.76 | 0.65 | 0.57, 0.74 |
ERI ratio | z-score | 1.28 | 1.16, 1.42 | 1.28 | 1.16, 1.42 | 1.47 | 1.35, 1.62 | 1.48 | 1.35, 1.63 |
MA-specific instrument | |||||||||
Workload | z-score | 1.37 | 1.18, 1.58 | 1.40 | 1.20, 1.62 | 1.95 | 1.69, 2.24 | 1.95 | 1.69, 2.25 |
Job control | z-score | 1.20 | 1.03, 1.40 | 1.33 | 1.13, 1.57 | 1.85 | 1.56, 2.19 | 1.89 | 1.58, 2.26 |
Collaboration | z-score | 1.31 | 1.16, 1.48 | 1.30 | 1.15, 1.47 | 1.49 | 1.34, 1.66 | 1.49 | 1.34, 1.66 |
Gratification | z-score | 1.32 | 1.15, 1.50 | 1.30 | 1.13, 1.49 | 1.27 | 1.13, 1.44 | 1.32 | 1.16, 1.49 |
Practice organization | z-score | 1.52 | 1.36, 1.70 | 1.50 | 1.34, 1.68 | 1.32 | 1.17, 1.48 | 1.32 | 1.17, 1.49 |
Resources | z-score | 1.14 | 1.01, 1.28 | 1.13 | 1.00, 1.28 | d | d | ||
Leadership | z-score | 1.26 | 1.11, 1.44 | 1.27 | 1.11, 1.44 | 1.50 | 1.33, 1.69 | 1.52 | 1.34, 1.73 |
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Mambrey, V.; Vu-Eickmann, P.; Angerer, P.; Loerbroks, A. Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants. Int. J. Environ. Res. Public Health 2021, 18, 9693. https://doi.org/10.3390/ijerph18189693
Mambrey V, Vu-Eickmann P, Angerer P, Loerbroks A. Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants. International Journal of Environmental Research and Public Health. 2021; 18(18):9693. https://doi.org/10.3390/ijerph18189693
Chicago/Turabian StyleMambrey, Viola, Patricia Vu-Eickmann, Peter Angerer, and Adrian Loerbroks. 2021. "Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants" International Journal of Environmental Research and Public Health 18, no. 18: 9693. https://doi.org/10.3390/ijerph18189693
APA StyleMambrey, V., Vu-Eickmann, P., Angerer, P., & Loerbroks, A. (2021). Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants. International Journal of Environmental Research and Public Health, 18(18), 9693. https://doi.org/10.3390/ijerph18189693