| Studies conducted in Ontario health-care agencies, mostly in hospital and community nursing practice settings have shown that the psychosocial work environment (PWE) has a powerful influence on how nurses experience their work. Unfortunately, minimal research is available in the published literature on the PWE of Nurse Case Managers (Reimanis, Cohen, & Redman, 2001). For the most part, Nurse Case Managers (NCMs) studies have been conducted within traditional hospital and community-based health-care settings. In Ontario, NCM jobs have expanded into insurance settings. In nursing position in Ontario NCM positions ranked fourth (College of Nurses of Ontario, 2007). Despite the popularity of the job, little is known about the PWE of NCM jobs. Since 1998 NCMs have been hired at a large-workplace disability management insurer in Ontario (Irvine, 2001). A NCM provides case management services to injured workers. A descriptive correlational study was used to examine the PWE of NCMs employed in a large insurance setting in Ontario in order to explore the relationship between PWE factors and the NCMs' demographic characteristics; and to describe the relationship between NCMs PWE and their clients' return-to-work (RTW) outcome. The Demand-Control Model served as the theoretical framework for this study.;One third of the participants reported high psychological demands while experiencing low job control associated with high-strain jobs. Strong positive correlations were identified between job control and nurses' skill (rho = .88, p < .01) and decision-making authority (rho = .89, p < .01). A moderate positive correlation was identified between nurses' skill and decision-making authority (rho = .60, p < .01). Number of years of nursing experience was positively related to nurses' skill (rho = .27, p < .05), job control (rho = .24, p < .05), and age (rho = .72, p < .01). Inverse correlations were found between type of client and nurse's skill (rho = -.34, p < .01), decision-making authority (rho = -.44, p < .01); and job control (rho = -.44, p < .01). Statistically significant positive correlations were found between type of client case managed and number of clients RTW per one month (rho = .58, p < .01). The highest number of clients RTW was reported by NCMs in the high-strain quadrant. Statistically significant positive correlation were reported between number of clients RTW with job demand (rho = .29, p < .05). Inverse correlation was reported between number of clients RTW with job control (rho = -.31, p < .01). NCMs at this agency reported facing challenges especially related to meeting clients' RTW outcome. Implications for practice, research, education, leadership and policy are discussed. |
