Support and control of psychosocial OSH demands in psychiatric care

Psychosocial occupational safety and health (OSH) risks pose significant challenges in Swedish psychiatric inpatient care. This study seeks to explore demand, control, and support factors within this context. Utilizing a multi-methodological approach, the researchers analyzed data from the Synergi deviation system (The 736 measure reports that include actions and preventive activities, 463 risk reports) alongside focus-group interviews featuring 67 participants, including 24 registered nurses, 25 psychiatric aides, 9 managers, and 9 physicians. Data were deductively analyzed using the Job Demand-Control-Support (JDCS) model. Synergi Data results included quantitative demands, emotional demands, deficiency demands, emotional support, safety support, organizational support, and conversational strategies to enhance control. Focus-group participants reported experiences of emotional and quantitative demands, organization-based stigmatization, control factors (e.g., participation in decisions, mirroring, therapeutic meetings about aggression [TERMA] training), and emotional support to manage emotional demands. The increased digitalization has led to new forms of emotional demands, such as patient stalking on social media platforms and smartphone filming of employees. The results also indicate that improvements in patient safety, group dynamics, and collaborative efforts have positively influenced wellbeing among the employees. This study highlights identified JDCS factors of importance for practical implications to manage psychosocial OSH in psychiatric inpatient settings, and advocates for further multi- methodological studies to enhance control in psychiatric care.