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  • 1
    In: Trials, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: Perceived high chronic stress is twice as prevalent among German general practitioners (GPs) and non-physician medical staff compared to the general population. The reasons are multi-factorial and include patient, practice, healthcare system and societal factors, such as multi-morbidity, the diversity of populations and innovations in medical care. Also, practice-related factors, like stressful patient-staff interactions, poor process management of waiting times and lack of leadership, play a role. This publicly funded study evaluates the effectiveness of the newly developed participatory, interdisciplinary, and multimodal IMPROVE job intervention on improving job satisfaction among general practice personnel. The intervention aims at structural stress prevention with regard to working conditions and behavioural stress prevention for leaders and other practice personnel. Methods In this cluster-randomised controlled trial, a total of 56 general practices will be assigned to either (1) participation in the IMPROVE job intervention or (2) the waiting-list control group. The IMPROVE job intervention consists of the following elements: three workshops, a toolbox with supplemental material and an implementation period with regular contact to so-called IMPROVE job facilitators. The first workshop, addressing leadership issues, is designed for physicians with leadership responsibilities only. The two subsequent workshops target all GP and non-physician personnel; they address issues of communication (with patients and within the team), self-care and team-care and practice organisation. During the 9-month implementation period, practices will be contacted by IMPROVE job facilitators to enhance motivation. Additionally, the practices will have access to the toolbox materials online. All participants will complete questionnaires at baseline and follow up. The primary outcome is the change in job satisfaction as measured by the respective scale of the validated German version of the Copenhagen Psychosocial Questionnaire (COPSOQ, version 2018). Secondary outcomes obtained by questionnaires and - qualitatively - by facilitators comprise psychosocial working conditions including leadership aspects, expectations and experiences of the workshops, team and individual efforts and organisational changes. Discussion It is hypothesised that participation in the IMPROVE job intervention will improve job satisfaction and thus constitute a structural and behavioural prevention strategy for the promotion of psychological wellbeing of personnel in general practices and prospectively in other small and medium sized enterprises. Trial registration German Clinical Trials Register: DRKS00012677 . Registered on 16 October 2019. Retrospectively, https://www.drks.de/drks_web/navigate.do?navigationId=trial . HTML & TRIAL_ID = DRKS00012677.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2040523-6
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  • 2
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-10-25)
    Abstract: Leadership has become an increasingly important issue in medicine as leadership skills, job satisfaction and patient outcomes correlate positively. Various leadership training and physician psychological well-being programmes have been developed internationally, yet no standard is established in primary care. The IMPROVE job leadership program was developed to improve job satisfaction among German general practitioners and practice personnel. Its acceptance and effectiveness were evaluated. The IMPROVE job intervention is a participatory, interdisciplinary and multimodal leadership intervention that targets leadership, workflows and communication in general practices using three elements: (1) two leadership workshops with skills training; (2) a toolbox with printed and online material, and (3) a 9-month implementation phase supported by facilitators. A cluster-randomised trial with a waiting-list control evaluated the effectiveness on the primary outcome job satisfaction assessed by the Copenhagen Psychosocial Questionnaire (range 0–100). A mixed-methods approach with questionnaires and participant interviews evaluated the acceptance of the intervention and factors influencing the implementation of intervention content. Statistical analyses respected the clustered data structure. The COVID-19 pandemic necessitated intervention adjustments: online instead of on-site workshops, online material instead of facilitator practice visits. Overall, 52 of 60 practices completed the study, with altogether 70 practice leaders, 16 employed physicians, and 182 practice assistants. According to an intention-to-treat analysis, job satisfaction decreased between baseline and follow-up (not significantly) in the total study population and in both study arms, while the subgroup of practice leaders showed a non-significant increase. A mixed multilevel regression model showed no effect of the intervention on job satisfaction ( b  = − 0.36, p   〉  0.86), which was influenced significantly by a greater sense of community ( b  = 0.14, p   〈  0.05). The acceptance of the IMPROVE job workshops was high, especially among practice leaders compared to assistants (1 = best to 5 = worst): skills training 1.78 vs. 2.46, discussions within the practice team 1.87 vs. 2.28, group discussions 1.96 vs. 2.21. The process evaluation revealed that the COVID-19 pandemic complicated change processes and delayed the implementation of intervention content in practice routines. The workshops within the participatory IMPROVE job intervention were rated very positively but the multimodal intervention did not improve job satisfaction 9 months into the pandemic. Qualitative data showed an impairment of implementation processes by the unforeseeable COVID pandemic. Trial registration Registration number: DRKS00012677 on 16/10/2019.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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  • 3
    In: BMJ Open, BMJ, Vol. 13, No. 7 ( 2023-07), p. e066298-
    Abstract: Strong primary care leaders are needed to assure high quality services for patient populations. This study analysed general practitioners’ (GP) leadership skills comparing practice-level self and staff assessments based on the full range of leadership model and the leader-member exchange (LMX). Setting The questionnaire survey was conducted among German general practice leaders and their staff participating in the IMPROVE job trial. Participants The study population comprised 60 German general practices with 366 participants: 84 GP practice leaders and 282 employees (28 physicians and 254 practice assistants). Primary and secondary outcome measures Leadership skills of the practice leaders were measured using the Integrative Leadership Questionnaire (German Fragebogen für integrative Führung) and the LMX-7 questionnaire. Leaders rated themselves and practice staff rated their leaders. The data was analysed by paired mean comparisons on the practice level. Results For most leadership dimensions, practice leaders rated themselves higher than their employees rated them. Differences were found for transformational leadership (p 〈 0.001, d=0.41), especially for the dimensions ‘innovation’ (p 〈 0.001, d=0.69) and ‘individuality focus’ (p 〈 0.001, d=0.50). For transactional leadership, the dimension ‘goal setting’ differed significantly (p 〈 0.01, d=0.30) but not the other dimensions. Scores for negative leadership were low and showed no differences between leaders and employees. Interestingly, employed physicians’ rated their practice leaders higher on the two transformational (‘performance development’, ‘providing a vision’) and all transactional dimensions. The LMX-7 scale showed high quality relationships between leaders and employees. Conclusions This 180° analysis of GPs’ leadership skills with self and employee ratings indicated good relationships. There is a potential to improve leadership regarding goal-setting, innovation and focusing on individual team members. These results allow for the development of targeted interventions. Trial registration number German Clinical Trials Register, DRKS00012677. Registered 16 October 2019.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2023
    detail.hit.zdb_id: 2599832-8
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  • 4
    In: Trials, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: An amendment to this paper has been published and can be accessed via the original article.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2040523-6
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  • 5
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 5 ( 2022-02-24), p. 2618-
    Abstract: Background: Work-privacy conflict (WPC) has become an important issue for medical professionals. The cluster-randomized controlled IMPROVEjob study aimed at improving job satisfaction (primary outcome), with additional outcomes such as examining the work-privacy conflict in German general practice personnel. Using baseline data of this study, the relationship between work-privacy conflict and job satisfaction (JS) was analyzed. In addition, factors associated with higher WPC were identified. Methods: At baseline, 366 participants (general practitioners (GPs) in leadership positions, employed general practitioners, and practice assistants) from 60 German practices completed a questionnaire addressing socio-demographic data and job characteristics. Standardized scales from the German version of the COPSOQ III requested data concerning job satisfaction and work-privacy conflict. Both scores range from 0 (lowest) to 100 (highest). Multilevel analysis accounted for the clustered data. Statistical analyses were performed using IBM SPSS and RStudio software, with a significance level set at p 〈 0.05. Results: Job satisfaction was 77.16 (mean value; SD = 14.30) among GPs in leadership positions (n = 84), 79.61 (SD = 12.85) in employed GPs (n = 28), and 72.58 (SD = 14.42) in practice assistants (n = 254). Mean values for the WPC-scale were higher for professionals with more responsibilities: GPs in leadership positions scored highest with 64.03 (SD = 29.96), followed by employed physicians (M = 45.54, SD =30.28), and practice assistants (M = 32.67, SD = 27.41). General practitioners and practice assistants working full-time reported significantly higher work-privacy conflict than those working part-time (p 〈 0.05). In a multilevel analysis, work-privacy conflict was significantly associated with job satisfaction (p 〈 0.001). A multiple regression analysis identified working hours, as well as and being a practice owner or an employed physician as factors significantly influencing WPC. Discussion: WPC was high among general practice leaders and practice personnel working full-time. Future interventions to support practice personnel should focus on reducing WPC, as there is good evidence of its effects on job satisfaction.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 6
    In: Public Health Forum, Walter de Gruyter GmbH, Vol. 28, No. 2 ( 2020-06-25), p. 143-146
    Abstract: In dem vom BMBF geförderten transdisziplinären Forschungsverbund IMPROVE job beschäftigen sich MitarbeiterInnen medizinischer, sozial- und wirtschaftswissenschaftlicher Disziplinen mit dem Thema „Psychische Gesundheit von Beschäftigten in kleinen und mittleren Unternehmen“. Im Zentrum steht die transdisziplinäre Entwicklung und Evaluation einer partizipativen Intervention zur Verhältnis- und Verhaltensprävention psychischer Belastungen am Arbeitsplatz. Das Vorhaben wird modellhaft in Hausarztpraxen durchgeführt.
    Type of Medium: Online Resource
    ISSN: 1876-4851 , 0944-5587
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2020
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