Feedback im Arbeitsleben - eine Selbstwert-Perspektive

Zusammenfassung: Feedback ist unerlässlich und allgegenwärtig. Konstruktives Feedback ist ein wichtiges Führungsinstrument. Gutes Feedback zu geben, ist jedoch alles andere als einfach, und nicht selten fühlen sich Mitarbeitende durch Feedback verletzt und demotiviert. Ein zentraler Aspekt guten Feedbacks bezieht sich auf Aufrechterhaltung, Förderung oder Schädigung des Selbstwerts; der vorliegende Artikel beleuchtet Feedback vor allem unter diesem Aspekt. Diskutiert werden die Bedeutung des Feedbacks für den Selbstwert, Kriterien für optimales Feedback sowie die Schwierigkeiten, optimales Feedback zu geben wie auch Feedback anzunehmen, wobei negatives Feedback im Vordergrund steht. Abschließend wird auf Feedback im Rahmen betrieblicher Leistungsbewertung eingegange

Battery Discharge from Monday to Friday: Background Social Stress at Work is Associated with more Rapid Accumulation of Fatigue

Purpose: This field study investigated the effects of background social stress at work on the weekly course of evening fatigue. Methods: Male employees of a Swiss organisation reported their fatigue after work and at 9 pm in the evening over three weeks. A total of 482 evening fatigue measurements from 34 male participants were subjected to multilevel analysis. Results: Sleep quality in the previous night and fatigue after work predicted evening fatigue. Evening fatigue was not associated with the time spent on daily housework or child care. There was a linear increase in evening fatigue across weekdays and a main effect of workplace social stressors on evening fatigue. Sleep quality during the previous night mediated the link between background social stressors and evening fatigue. Moreover, an interaction between workplace social stressors and working days indicated that fatigue accumulated faster during the working week in those reporting a high level of social stress at work. Conclusion: Social stress at work seems to accelerate the loss of resources over consecutive workdays. The analysis of workplace social stressors and other potential moderators of resource dynamics contributes to our understanding of work-related stress, including the role of background stressors and the temporal dynamics of resource loss

Effects of team leaders' position in cardiopulmonary resuscitation teams on leadership behavior and team performance: A prospective randomized interventional cross-over simulation-based trial.

BACKGROUND Leadership is an important performance factor in resuscitation teams. Medical guidelines for cardiopulmonary resuscitation (CPR) advise team leaders to keep hands off patients. There is little evidence for this recommendation that is based purely on observational data. Accordingly, the aim of this trial was to investigate the effect of leaders' position during CPR on leadership behavior and team performance. METHOD This is a prospective randomized interventional crossover simulation-based single center trial. Teams of 3 to 4 physicians each, representing a rapid response team, were confronted with a simulated cardiac arrest. Team leaders were randomly assigned and assigned team leaders were 1:1 randomized to 2 leadership positions: position at the patient's head; and hands-off position. Data analysis was performed from video-recordings. All utterances during the first 4 minutes of CPR were transcribed and coded based on a modified "Leadership Description Questionnaire." The primary endpoint was the number of leadership statements. Secondary outcomes included CPR related performance markers like hands-on time and chest compression rate, and the behavioral related endpoints Decision Making, Error Detection, and Situational Awareness. RESULTS Data from 40 teams (143 participants) was analyzed. Leaders in hands-off position made more leadership statements (28 ± 8 vs 23 ± 8; P <.01) and contributed more to their team's leadership (59 ± 13% vs 50 ± 17%; P = .01) than leaders in the head position. Leaders' position had no significant effect on their teams' CPR performance, Decision Making, and Error Detection. Increased numbers of leadership statements lead to improved hands-on time ( R = 0.28; 95% confidence interval 0.05-0.48; P = .02). CONCLUSIONS Team leaders in a hands-off position made more leadership statements and contributed more to their teams' leadership during CPR than team leaders actively involved in the head position. However, team leaders' position had no effect on their teams' CPR performance

Social stress in human-machine systems: opportunities and challenges of an experimental research approach

This article presents some deliberations on methodological approaches to researching the effects of work-related social stress on performance, with particular consideration being given to machine-induced social stress. The article proposes a broad methodological approach to examine such effects. A particular focus is placed on performance after-effects (e.g. unscheduled probe tasks), extra-role behaviour, and task management behaviour because of conventional performance measures (i.e. scheduled tasks) often being unimpaired by social stressors. The role of the ‘performance protection mode’ as an important concept is discussed. A distinction is made between three facets of after-effects: performance-related, behavioural, and emotional. Unscheduled probe tasks and voluntary tasks are proposed to measure performance-related and behavioural after-effects. Propositions for specific experimental scenarios are made, allowing for sufficiently realistic simulations of social stress at work. The availability of such lab-based simulations of work environments offers good opportunities for this line of experimental research, which is expected to gain in importance since highly automated systems may modify the impact of human-induced social stress or may even represent a social stressor themselves. Finally, the considerations presented in this article are not only of relevance to the domain of social stress but to experimental stress research in general

Adding insult to injury:Illegitimate stressors and their association with situational well-being, social self-esteem, and desire for revenge

Implying an offense to self, appraising a stressor as indicating a lack of consideration by others should have effects beyond its stressfulness per se. In Stress-as-Offense-to-Self theory (SOS), such stressors are called “illegitimate stressors.” We assessed situations appraised as stressful in two diary studies (N 1 = 117, N 2 = 137). Outcome variables were feelings of resentment in both studies, plus nervousness, anxiety, and sadness in Study 1 and depressive mood, threat to social self-esteem, and desire for revenge in Study 2. Controlling for stressfulness, perceived illegitimacy predicted affective reactions that are outward-directed (feelings of resentment [Studies 1 and 2], threat to social self-esteem and desire for revenge [Study 2]); it also predicted sadness in Study 1 but not depressive mood in Study 2, nor nervousness (Study 1). Thus, not all hypotheses were confirmed but the pattern was as expected, in that results were consistent regarding outcomes typically associated with the attribution of blame. The independent contribution of perceived illegitimacy aligns well with the underlying Stress-as-Offense-to-Self theory. Practical implications refer to efforts to avoid illegitimate stressors, for instance by perspective-taking, by showing appreciation and support, and by supporting such behaviours through keeping stressors in general at a manageable level

Outcome assessment in low back pain: how low can you go?

The present study examined the psychometric characteristics of a "core-set” of six individual questions (on pain, function, symptom-specific well-being, work disability, social disability and satisfaction) for use in low back pain (LBP) outcome assessment. A questionnaire booklet was administered to 277 German-speaking LBP patients with a range of common diagnoses, before and 6months after surgical (N=187) or conservative (N=90) treatment. The core-set items were embedded in the booklet alongside validated ‘reference' questionnaires: Likert scales for back/leg pain; Roland and Morris disability scale; WHO Quality of Life scale; Psychological General Well-Being Index. A further 45 patients with chronic LBP completed the booklet twice in 1-2weeks. The minimal reliability (similar to Cronbach's alpha) for each core item was 0.42-0.78, increasing to 0.84 for a composite index score comprising all items plus an additional question on general well-being (‘quality of life'). Floor or ceiling effects of 20-50% were observed for some items before surgery (function, symptom-specific well-being) and some items after it (disability, function). The intraclass correlation coefficient (ICC) ("test-retest reliability”) was moderate to excellent (ICC, 0.67-0.95) for the individual core items and excellent (ICC, 0.91) for the composite index score. With the exception of "symptom-specific well-being”, the correlations between each core item and its corresponding reference questionnaire ("validity”) were between 0.61 and 0.79. Both the composite index and the individual items differentiated (P<0.001) between the severity of the back problem in surgical and conservative patients (validity). The composite index score had an effect size (sensitivity to change) of 0.95, which was larger than most of the reference questionnaires (0.47-1.01); for individual core items, the effect sizes were 0.52-0.87. The core items provide a simple, practical, reliable, valid and sensitive assessment of outcome in LBP patients. We recommend the widespread and consistent use of the core-set items and their composite score index to promote standardisation of outcome measurements in clinical trials, multicentre studies, routine quality management and surgical registry system

Perceived stress and team performance during a simulated resuscitation

Purpose: Barriers to optimal performance of cardiopulmonary resuscitation may partly relate to human factors, such as stress and specific emotions. The aim of this study was to investigate whether mental stress and different perceived emotions have a negative impact on the performance of rescuers. Methods: This prospective, observational study was conducted at the Simulator Center of the University Hospital Basel, Switzerland. A total of 120 medical students (70% female) participated in teams of three. They reported levels of perceived stress, feeling overwhelmed, motivation and specific emotions before, during, and after a simulated resuscitation. The association of stress/overload (index of stress and feeling overwhelmed), motivation, and specific emotions with resuscitation performance defined as hands-on time during the first 180s after cardiac arrest was investigated. Results: During resuscitation, levels of stress/overload, motivation, and negative emotions were significantly higher as compared to the periods before and after resuscitation. In contrast, positive emotions were highest before and after resuscitation and significantly lower during resuscitation. In general, females reported higher stress/overload and negative emotions, whereas males reported more positive emotions. A multivariate linear regression model showed negative associations of stress/overload (regression coefficient −18.12, 95% CI −30.73, −5.51, p=0.006) and positive associations of motivation (regression coefficient 13.45, 95% CI 0.95, 25.95, p=0.036) with resuscitation performance. Conclusion: A simulated cardiac arrest caused substantial perceived stress/overload and negative emotions, particularly in female students, which adversely impacted resuscitation performance. Further studies are required to expand our findings to more experienced medical professionals and investigate whether stress coping strategies improve resuscitation performanc

StOP? II trial: cluster randomized clinical trial to test the implementation of a toolbox for structured communication in the operating room-study protocol.

BACKGROUND Surgical care, which is performed by intensely interacting multidisciplinary teams of surgeons, anesthetists, and nurses, remains associated with significant morbidity and mortality. Intraoperative communication has been shown to be associated with surgical outcomes, but tools ensuring efficient intraoperative communication are lacking. In a previous study, we developed the StOP?-protocol that fosters structured intraoperative communication. Before the critical phases of the operation, the responsible surgeon initiates and leads one or several StOP?s. During a StOP?, the surgeon informs about the progress of the operation (status), next steps and proximal goals (objectives), and possible problems (problems) and encourages all team members to voice their observations and ask questions (?). In a before-after study performed mainly in visceral surgery, we found effects of the StOP?-protocol on mortality, length of hospital stay, and reoperation. We intend to assess the impact of the StOP?-protocol in a cluster randomized trial, in a wider variety of surgical specialties (i.e., general, visceral, thoracic, vascular surgery, surgical urology, and gynecology). The primary hypothesis is that the consistent use of the StOP?-protocol by the main surgeon reduces patient mortality within 30 days after the operation. The secondary hypothesis is that the consistent use of the StOP?-protocol by the main surgeon reduces unplanned reoperations, length of hospital stay, and unplanned hospital readmissions. METHODS This study is designed as a multicenter, cluster-randomized parallel-group trial. Board-certified surgeons of participating clinical departments will be randomized 1:1 to the StOP? intervention group or to the standard of care (control) group. The intervention group will undergo a training to use the StOP?-protocol and receive regular feedback on their compliance with the protocol. The surgeons in the control group will communicate as usual during their operations. The unit of observation will be operations performed by cluster surgeons. Consecutive patients will be enrolled over 4 months per cluster. A total of 400 surgeons will be recruited, and we expect to collect patient outcome data for 14,000 surgical procedures. DISCUSSION The StOP?-protocol was designed as a tool to structure communication during surgical procedures. Testing its effects on patient outcomes will contribute to implementing evidenced-based interventions to reduce surgical complications. TRIAL REGISTRATION ClinicalTrials.gov NCT05356962. Registered on May 2, 2022

Beneficial effects of a cognitive-behavioral occupational stress management group training: the mediating role of changing cognitions.

INTRODUCTION While the effectiveness of cognitive-behavioral stress management trainings (SMTs) is well-documented, the underlying mechanisms, especially in an occupational context, are not fully understood. We tested whether SMT-induced improvements in stress management skills, particularly in the mastery of changing cognitions, may explain beneficial SMT effects. METHODS Our non-randomized controlled trial comprised 108 employees of a German health insurance company, with 65 of them participating in a cognitive-behavioral SMT and 43 participating in an alternative control training (AT). As outcome variables, we repeatedly assessed stress-related (functional stress management skills, relaxation, stress reactivity, exhaustion), work-related (job dissatisfaction), and specific-context-related (social support, trait anger) measures at baseline, 2 weeks, and 3 months after the trainings. Functional stress management skills and, in particular, a subscale assessing perceived mastery of changing cognitions ("cognitive-strategies-and-problem-solving") were tested as mediators of change. RESULTS Repeated measures (M)AN(C)OVAs and complementary multigroup latent difference models confirmed improvements in all outcomes in the SMT-group compared to the AT-group (p's ≤ 0.015). Multivariate mediation path analyses revealed that, regarding mechanisms of change, the subscale cognitive-strategies-and-problem-solving was identified as the most important mediator for all outcomes (95% CIs for expected increases in SMT- vs. AT-group = [lower limits (LLs) ≥ 0.004]; 95% CIs for expected decreases in the SMT- vs. AT-group = [upper limits(ULs) ≤ -0.078]) except for job dissatisfaction. DISCUSSION Our findings confirm that employees can effectively learn to master stress reduction techniques and consequently lower the resulting burden. Moreover, beneficial SMT effects seem to result from improvements in functional stress management skills, particularly in the ability to change cognitions. This points to the importance of training cognitive techniques