Effect of autonomy and organizational climate on well-being of dental hygienists

Abstract

While certain dental procedures may cause musculoskeletal problems in dental hygienists, the emotional labor when aiding patients to feel at ease in the dental chair can cause mental problems. Experiencing the physical and mental demands consistently and over time may lead dental hygienists to reduce hours or quit the profession if they do not have autonomy at work or if the organizational climate is unsupportive. The objective of this study was to investigate the association between musculoskeletal disorders, autonomy and organizational climate and the outcomes of likelihood of leaving practice and salutogenic health. Methods: This cross-sectional study was conducted via an online survey of registered Washington State dental hygienists between February and March 2020. Participants answered questions about musculoskeletal disorder symptoms using the Nordic Musculoskeletal Questionnaire and organizational climate using the Work Experience Measurement Scale (WEMS). The main outcomes were the single item on likelihood to leave practice in the next two years and the Salutogenic Health Indicator Scale (SHIS). Adjusted prevalence ratios (PR) and 95% confidence intervals were calculated using robust Poisson multivariable regression models. Results: In the adjusted analysis, the highest quartile of musculoskeletal symptoms (PR= 1.57, 95% CI=1.05-2.36), and low supportive working conditions (PR=1.48, 95% CI= 1.15-1.92) were associated with higher likelihood of leaving practice. Quartiles 2 to 4 of musculoskeletal symptoms (low quartile: PR = 6.14, 95% CI = 2.32-16.29; moderate: PR = 4.32, 95%CI=1.62-11.54; high: PR = 2.97, 95%CI=1.07-8.23), and middle and high tertiles of internal working experience (moderate: PR =5.08, 95% CI = 1.65-15.65; high: PR =6.19, 95% CI = 1.89-20.28) were associated with higher salutogenic health. Conclusion: Our research indicates that organizational climate and autonomy are important factors influencing the well-being and retention of clinical dental hygienists. Appropriate training and education in healthcare management and wellbeing are needed and both dental hygienists and their employers (most often dentists) need to foster supportive working environments. Keywords: Dental hygiene, Burnout, Emotional labor, Musculoskeletal disorders, salutogenic health, Leave practice