Occupational Demands and Workplace Resources Among Pediatric Hospital Staff During a Health System Crisis

Background/Objectives: The psychosocial and organizational demands of healthcare work intensify during public health crises, with implications for professional functioning. This study aimed to identify the occupational demands and workplace resources associated with professional functioning among pediatric hospital staff, using the Job Demands-Resources (JD-R) framework as the guiding theoretical model. Methods: A cross-sectional, mixed-methods study was conducted among 903 employees of a pediatric emergency hospital in 2024, using a custom questionnaire and thematic analysis of open-ended responses, interpreted through the JD-R framework. Multivariable logistic regression models assessed five occupational functioning outcomes, with workload, age, sex, tenure, occupational category, COVID-sector work, and relocation as predictors. Results: A significant workload increase was the most consistent predictor, associated with four of the five outcomes (aOR 2.04-7.16), and relocation was associated with three outcomes (aOR 1.70-2.49); COVID-sector assignment was not independently associated with the other four outcomes after correction for multiple testing, but was associated with lower odds of difficulty returning to work among infected staff (aOR 0.38). Thematic analysis identified seven themes aligned with the JD-R framework; most were significantly more frequent among COVID-sector staff after FDR correction, although a sensitivity analysis restricted to respondents who answered the open-ended item attenuated this pattern for several themes and reversed it for one. Quantitative-qualitative comparisons showed convergent associations across the constructs examined. Conclusions: Workload and organizational disruption were more consistently associated with impaired occupational functioning than formal sector assignment. These findings support the value of monitoring psychosocial workload indicators in occupational health surveillance and highlight team-level resources as a relevant direction for future prevention efforts.