Reducing job insecurity and increasing performance ratings: Does impression management matter?

Prior research on job insecurity has demonstrated its detrimental effects on both employees and the organization, yet no research has detailed how people actively deal with it. Drawing from proactivity research, this article argues that job insecurity prompts a proactive use of impression management tactics in the workplace. The effectiveness of these tactics depends on the level of supervisory liking for the employee and the attributions supervisors make regarding the employee's motives for the impression management behaviors (i.e., for the good of the organization or for self-interest). A 3-wave survey study of 271 Chinese employees and their supervisors showed that employees experiencing job insecurity in Time 1 reported using a variety of tactics to impress their supervisors at Time 2 and that these tactics curbed the affect associated with job insecurity and enhanced supervisor rated performance, through supervisor's liking and attributed motives. The relationship between impression management and increased supervisor-rated performance was moderated by supervisor attributions; the relationship between impression management and reduced affective job insecurity depended on supervisor liking. © 2013 American Psychological Association.postprin

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely