Background

Nurses have a very stressful and demanding job, which probably affects their health and well-being. This has resulted in a search for an optimal nurse schedule. Self-scheduling is one method to enhance flexibility and give more control to the employee. Literature on self-scheduling is scarce and mainly focused on the implementation process. So far, little is known about the long-term effects of self-scheduling.

Objective

The comparison of effects of self-scheduling versus fixed scheduling on three dimensions of organizational justice (distributive, procedural, interactional justice) and three work attitudes (job satisfaction, affective commitment, global empowerment). This total effect is decomposed into direct and indirect effects via hypothesised mediators (leader-member exchange and organizational justice).

Design

A cross-sectional multisite-matched study.

Setting

A questionnaire was distributed to nurses and nurse assistants of twelve nursing homes in Flanders (Belgium). Six matched pairs of nursing homes were formed, each containing a nursing home that uses self-scheduling (for at least one year) and one that uses fixed scheduling.

Participants

The study sample included 308 nurses and nurse assistants, of which 160 surveys were from nursing homes using fixed scheduling, versus 148 surveys from nursing homes using self-scheduling.

Methods

Using a double robust fixed effects regression model adjusted for the propensity score, the total effect of self-scheduling compared to fixed scheduling was analysed on the proposed outcomes. Subsequently, a (multiple) mediation analysis was performed.

Results

If all people would have used self-scheduling instead of fixed scheduling, on average a significant decrease in the mean procedural justice score (estimated mean difference = -0.20, 95% CI -0.36 to -0.05) would be found. There is a significant negative direct effect (estimated mean difference = -0.12, 95% CI -0.21 to -0.03) and indirect effect via the mediator leader-member-exchange (estimated mean difference = -0.08, 95% CI -0.15 to -0.01) on procedural justice. In addition, significant negative indirect effects of self-scheduling were found via the mediator leader-member exchange on all the investigated outcomes.

Conclusion

Drawing up the work schedule is perceived as less fair in the case of self-scheduling. Furthermore, self-scheduling has a negative indirect effect on several work attitudes as a result of the changed relationship between the head nurse and the employees. The increase in task variety and decision-making autonomy for the employees and the altered leadership role of the head nurse can have a major impact on the dynamics of the entire team.

中文翻译：

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通过领导-成员交换自我安排对组织公正和工作态度的影响：使用倾向得分的横断面研究

背景

护士的工作压力很大，要求很高，这可能会影响他们的健康和福祉。这导致了对最佳护士时间表的搜索。自我安排是一种提高灵活性并给予员工更多控制权的方法。关于自调度的文献很少，主要集中在实施过程。到目前为止，人们对自我调度的长期影响知之甚少。

客观的

自我排班与固定排班对组织公正（分配公正、程序公正、互动公正）和三种工作态度（工作满意度、情感承诺、全球授权）三个维度的影响的比较。这种总效应通过假设的中介因素（领导-成员交换和组织公正）分解为直接和间接效应。

设计

一项横断面多中心匹配研究。

环境

向法兰德斯（比利时）的 12 家疗养院的护士和护士助理分发了一份问卷。形成了六对匹配的疗养院，每对包含一个使用自我调度（至少一年）的疗养院和一个使用固定调度的疗养院。

参与者

研究样本包括 308 名护士和护士助理，其中 160 份调查来自使用固定日程安排的疗养院，而 148 份调查来自使用自我日程安排的疗养院。

方法

使用针对倾向得分调整的双稳健固定效应回归模型，分析了自我调度与固定调度相比对拟议结果的总影响。随后，进行了（多重）中介分析。

结果

如果所有人都使用自我调度而不是固定调度，平均而言，平均程序正义得分会显着降低（估计平均差异 = -0.20，95% CI -0.36 到 -0.05）。存在显着的负面直接影响（估计平均差 = -0.12，95% CI -0.21 到 -0.03）和通过调解员领导-成员交换产生的间接影响（估计平均差 = -0.08，95% CI -0.15 到 - 0.01）关于程序正义。此外，通过调解员领导-成员交换，发现自我调度对所有调查结果都有显着的负面间接影响。

结论

在自我安排的情况下，制定工作时间表被认为不太公平。此外，由于护士长和员工之间关系的改变，自我安排对几种工作态度有负面的间接影响。员工任务多样性和决策自主权的增加以及护士长领导角色的改变会对整个团队的动态产生重大影响。