title: Associations of chronic embitterment among NHS staff.
abstract: BACKGROUND
  Chronic embitterment is commonly recognized among people seen by occupational health professionals, but its associations remain unclear.
  
  
  OBJECTIVE
  To investigate the associations of chronic embitterment with procedural justice, the psychological work contract, depression and the Health & Safety Executive's Management Standards Indicator Tool as well as selected employment variables.
  
  
  METHODS
  A sample of consecutive attendees at occupational health in a single NHS Trust were asked to complete a set of validated questionnaires and give further information about sickness absence and their work.
  
  
  RESULTS
  The sample (n = 236) was representative of those attending this occupational health department. Staff showing embitterment rated procedural justice and organizational support lower than other staff and were significantly more likely to have taken sickness absence, uncertified as well as certified. Uncertified sickness absence was almost universal in embittered staff. Although depression was significantly more prevalent among embittered staff, the majority of embittered staff were not depressed. Of those who scored as embittered and depressed or anxious, 93% had had certified sickness absence in the previous 12 months. On the Management Standards Indicator Tool, embittered individuals had significantly lower scores than others on Manager and Peer Support, Role, and Change subscales.
  
  
  CONCLUSIONS
  Although the data are cross-sectional and self-reported, they provide evidence of the burden on organizations of chronic embitterment among their staff, particularly in terms of sickness absence. Staff who are embittered perceive their organization as unsupportive of them, and as showing low levels of procedural justice.
authors.affiliation: Health at Work Service, West London Mental Health NHS Trust, Canal Mews, Uxbridge Road, Southall, Middlesex UB1 3EU, UK, Centre for Mental Health, Department of Medicine, Imperial College, Hammersmith Campus, Du Cane Road, London W12 0NN, UK. t.sensky@imperial.ac.uk.
authors.forename: T
authors.initials: T
authors.lastname: Sensky
authors.affiliation: Health at Work Service, West London Mental Health NHS Trust, Canal Mews, Uxbridge Road, Southall, Middlesex UB1 3EU, UK.
authors.forename: R
authors.initials: R
authors.lastname: Salimu
authors.affiliation: Health at Work Service, West London Mental Health NHS Trust, Canal Mews, Uxbridge Road, Southall, Middlesex UB1 3EU, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ballard
authors.affiliation: Health at Work Service, West London Mental Health NHS Trust, Canal Mews, Uxbridge Road, Southall, Middlesex UB1 3EU, UK.
authors.forename: D
authors.initials: D
authors.lastname: Pereira
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D016272:Occupational Health; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D018582:Sick Leave / Q000706:statistics & numerical data*; D013192:Staff Development; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D016526:Workload / Q000523:psychology*
keywords: Chronic embitterment; depression; organizational justice; sickness absence.