{"id":"https://openalex.org/W7224195052","doi":"https://doi.org/10.1155/jonm/5209573","title":"Ambidextrous Leadership and Presenteeism Among Clinical Nurses: A Moderated Mediation Model of Self\u2010Efficacy and Leader\u2013Member Exchange","display_name":"Ambidextrous Leadership and Presenteeism Among Clinical Nurses: A Moderated Mediation Model of Self\u2010Efficacy and Leader\u2013Member Exchange","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7224195052","doi":"https://doi.org/10.1155/jonm/5209573","pmid":"https://pubmed.ncbi.nlm.nih.gov/42952151","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13717231"},"language":"en","primary_location":{"id":"doi:10.1155/jonm/5209573","doi":"https://doi.org/10.1155/jonm/5209573","is_oa":true,"landing_page_url":"https://doi.org/10.1155/jonm/5209573","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/jonm/5209573","source":{"id":"https://openalex.org/S172540258","display_name":"Journal of Nursing Management","issn_l":"0966-0429","issn":["0966-0429","1365-2834"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-c","anvur-scientific","cwts-core","dongbi-b","doyens","fnege-4","jufo-3","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Nursing Management","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/jonm/5209573","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5035617698","display_name":"Xiuran Zhou","orcid":"https://orcid.org/0009-0002-2830-3401","observed_orcids":["https://orcid.org/0009-0002-2830-3401"]},"institutions":[{"id":"https://openalex.org/I190242452","display_name":"Guangdong Pharmaceutical University","ror":"https://ror.org/02vg7mz57","country_code":"CN","type":"education","lineage":["https://openalex.org/I190242452"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiuran Zhou","raw_affiliation_strings":["School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn"],"raw_orcid":"https://orcid.org/0009-0002-2830-3401","affiliations":[{"raw_affiliation_string":"School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn","institution_ids":["https://openalex.org/I190242452"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5041463097","display_name":"\u90b9\u58eb\u65b9","orcid":"https://orcid.org/0009-0001-8342-5535","observed_orcids":["https://orcid.org/0009-0001-8342-5535"]},"institutions":[{"id":"https://openalex.org/I190242452","display_name":"Guangdong Pharmaceutical University","ror":"https://ror.org/02vg7mz57","country_code":"CN","type":"education","lineage":["https://openalex.org/I190242452"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Shifang Zou","raw_affiliation_strings":["School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn"],"raw_orcid":"https://orcid.org/0009-0001-8342-5535","affiliations":[{"raw_affiliation_string":"School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn","institution_ids":["https://openalex.org/I190242452"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5044306237","display_name":"Hui Peng","orcid":"https://orcid.org/0000-0003-2512-7190","observed_orcids":["https://orcid.org/0000-0003-2512-7190"]},"institutions":[{"id":"https://openalex.org/I190242452","display_name":"Guangdong Pharmaceutical University","ror":"https://ror.org/02vg7mz57","country_code":"CN","type":"education","lineage":["https://openalex.org/I190242452"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Hui Peng","raw_affiliation_strings":["School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn","institution_ids":["https://openalex.org/I190242452"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160072501","display_name":"Ying Yu","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ying Yu","raw_affiliation_strings":["Guangzhou Municipal Health Commission  Guangzhou Guangdong China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guangzhou Municipal Health Commission  Guangzhou Guangdong China","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5127518204","display_name":"Xiaoying Yan","orcid":"https://orcid.org/0009-0000-9322-4756","observed_orcids":["https://orcid.org/0009-0000-9322-4756","https://orcid.org/0000-0003-1193-9884"]},"institutions":[{"id":"https://openalex.org/I190242452","display_name":"Guangdong Pharmaceutical University","ror":"https://ror.org/02vg7mz57","country_code":"CN","type":"education","lineage":["https://openalex.org/I190242452"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Xiaoying Yan","raw_affiliation_strings":["School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn"],"raw_orcid":"https://orcid.org/0009-0000-9322-4756","affiliations":[{"raw_affiliation_string":"School of Nursing Guangdong Pharmaceutical University  Guangzhou Guangdong China  gdpu.edu.cn","institution_ids":["https://openalex.org/I190242452"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5127518204"],"corresponding_institution_ids":["https://openalex.org/I190242452"],"apc_list":{"value":2700,"currency":"USD","value_usd":2700},"apc_paid":{"value":2700,"currency":"USD","value_usd":2700},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.85295256,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"2026","issue":"1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11084","display_name":"Workplace Health and Well-being","score":0.8574000000953674,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11084","display_name":"Workplace Health and Well-being","score":0.8574000000953674,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10186","display_name":"Nursing education and management","score":0.07129999995231628,"subfield":{"id":"https://openalex.org/subfields/2922","display_name":"Research and Theory"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10006","display_name":"Job Satisfaction and Organizational Behavior","score":0.03229999914765358,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/ambidextrous-leadership","display_name":"ambidextrous leadership","score":1.0},{"id":"https://openalex.org/keywords/presenteeism","display_name":"presenteeism","score":0.9850000143051147},{"id":"https://openalex.org/keywords/clinical-nurses","display_name":"clinical nurses","score":0.7839999794960022},{"id":"https://openalex.org/keywords/self-efficacy","display_name":"self-efficacy","score":0.9800000190734863},{"id":"https://openalex.org/keywords/leader-member-exchange","display_name":"leader-member exchange","score":0.9990000128746033},{"id":"https://openalex.org/keywords/moderated-mediation","display_name":"moderated mediation","score":0.890999972820282},{"id":"https://openalex.org/keywords/nursing-management","display_name":"nursing management","score":0.6489999890327454},{"id":"https://openalex.org/keywords/sick-leave","display_name":"sick leave","score":0.3440000116825104},{"id":"https://openalex.org/keywords/workload-adjustment","display_name":"workload adjustment","score":0.5600000023841858},{"id":"https://openalex.org/keywords/occupational-health-support","display_name":"occupational health support","score":0.8029999732971191}],"concepts":[{"id":"https://openalex.org/C24614281","wikidata":"https://www.wikidata.org/wiki/Q17086331","display_name":"Moderated mediation","level":2,"score":0.8317999839782715},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.777400016784668},{"id":"https://openalex.org/C2779382274","wikidata":"https://www.wikidata.org/wiki/Q1756074","display_name":"Presenteeism","level":3,"score":0.7161999940872192},{"id":"https://openalex.org/C179420905","wikidata":"https://www.wikidata.org/wiki/Q223871","display_name":"Mediation","level":2,"score":0.545199990272522},{"id":"https://openalex.org/C142853389","wikidata":"https://www.wikidata.org/wiki/Q744778","display_name":"Association (psychology)","level":2,"score":0.46549999713897705},{"id":"https://openalex.org/C53059260","wikidata":"https://www.wikidata.org/wiki/Q374758","display_name":"Multilevel model","level":2,"score":0.400299996137619},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.3880000114440918},{"id":"https://openalex.org/C93225998","wikidata":"https://www.wikidata.org/wiki/Q1941972","display_name":"Moderation","level":2,"score":0.3847000002861023},{"id":"https://openalex.org/C2780344248","wikidata":"https://www.wikidata.org/wiki/Q2084130","display_name":"Nursing management","level":2,"score":0.37220001220703125},{"id":"https://openalex.org/C71104824","wikidata":"https://www.wikidata.org/wiki/Q1476639","display_name":"Structural equation modeling","level":2,"score":0.3675000071525574},{"id":"https://openalex.org/C2778173179","wikidata":"https://www.wikidata.org/wiki/Q25339289","display_name":"Attendance","level":2,"score":0.3483000099658966},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.3276999890804291},{"id":"https://openalex.org/C85973986","wikidata":"https://www.wikidata.org/wiki/Q1091731","display_name":"Exploratory research","level":2,"score":0.31700000166893005},{"id":"https://openalex.org/C65067816","wikidata":"https://www.wikidata.org/wiki/Q2295139","display_name":"Computer-assisted web interviewing","level":2,"score":0.27720001339912415},{"id":"https://openalex.org/C2718322","wikidata":"https://www.wikidata.org/wiki/Q629463","display_name":"Job satisfaction","level":2,"score":0.2761000096797943},{"id":"https://openalex.org/C2777146004","wikidata":"https://www.wikidata.org/wiki/Q14949826","display_name":"CLARITY","level":2,"score":0.2752000093460083},{"id":"https://openalex.org/C2778476105","wikidata":"https://www.wikidata.org/wiki/Q628539","display_name":"Workload","level":2,"score":0.2621999979019165},{"id":"https://openalex.org/C27400517","wikidata":"https://www.wikidata.org/wiki/Q332278","display_name":"Absenteeism","level":2,"score":0.25119999051094055}],"mesh":[{"descriptor_ui":"D000069597","descriptor_name":"Presenteeism","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D000069597","descriptor_name":"Presenteeism","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002681","descriptor_name":"China","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003430","descriptor_name":"Cross-Sectional Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007857","descriptor_name":"Leadership","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009726","descriptor_name":"Nurses","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D009726","descriptor_name":"Nurses","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D011795","descriptor_name":"Surveys and Questionnaires","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D020377","descriptor_name":"Self Efficacy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1155/jonm/5209573","doi":"https://doi.org/10.1155/jonm/5209573","is_oa":true,"landing_page_url":"https://doi.org/10.1155/jonm/5209573","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/jonm/5209573","source":{"id":"https://openalex.org/S172540258","display_name":"Journal of Nursing Management","issn_l":"0966-0429","issn":["0966-0429","1365-2834"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-c","anvur-scientific","cwts-core","dongbi-b","doyens","fnege-4","jufo-3","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Nursing Management","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13717231","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13717231/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13717231/pdf/JONM-2026-5209573.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Nurs Manag","raw_type":"Text"},{"id":"pmid:42952151","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42952151","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of nursing management","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1155/jonm/5209573","doi":"https://doi.org/10.1155/jonm/5209573","is_oa":true,"landing_page_url":"https://doi.org/10.1155/jonm/5209573","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/jonm/5209573","source":{"id":"https://openalex.org/S172540258","display_name":"Journal of Nursing Management","issn_l":"0966-0429","issn":["0966-0429","1365-2834"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["abdc-c","anvur-scientific","cwts-core","dongbi-b","doyens","fnege-4","jufo-3","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Nursing Management","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":0.9391000270843506,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7224195052.pdf","grobid_xml":"https://content.openalex.org/works/W7224195052.grobid-xml"},"referenced_works_count":27,"referenced_works":["https://openalex.org/W1988930537","https://openalex.org/W2066690727","https://openalex.org/W2099808856","https://openalex.org/W2103750534","https://openalex.org/W2129558137","https://openalex.org/W2134816404","https://openalex.org/W2922446281","https://openalex.org/W2947325851","https://openalex.org/W2961239316","https://openalex.org/W3013333266","https://openalex.org/W3033318737","https://openalex.org/W3035316601","https://openalex.org/W3047424683","https://openalex.org/W3112787345","https://openalex.org/W3168472281","https://openalex.org/W4206008093","https://openalex.org/W4280513862","https://openalex.org/W4286492061","https://openalex.org/W4383107120","https://openalex.org/W4386687714","https://openalex.org/W4389752961","https://openalex.org/W4391386947","https://openalex.org/W4391821276","https://openalex.org/W4392806915","https://openalex.org/W4402513965","https://openalex.org/W4404293609","https://openalex.org/W4404646229"],"related_works":["https://openalex.org/W7132852194","https://openalex.org/W4283823941","https://openalex.org/W6901451016","https://openalex.org/W7152645539","https://openalex.org/W4205307714","https://openalex.org/W2961239316","https://openalex.org/W3208947312","https://openalex.org/W4392131140","https://openalex.org/W4409973884","https://openalex.org/W4409378497"],"abstract_inverted_index":{"AIM:":[0],"This":[1],"study":[2],"aimed":[3],"to":[4,12,54,121,128,283,287],"examine":[5,129],"the":[6,20,26,63,130,168,175,181,188,194,212,222,234,241,273],"pathways":[7,134],"linking":[8],"ambidextrous":[9],"leadership":[10,64],"(AL)":[11],"nurses'":[13,144,227,288],"presenteeism,":[14,173,228],"with":[15,47,52,143,149,157,174],"a":[16],"particular":[17],"focus":[18],"on":[19],"mediating":[21,131],"role":[22,28],"of":[23,29,73,180,191,237,276],"self-efficacy":[24,152,164,200,219,289],"and":[25,44,51,66,75,97,132,146,172,199,226,229,249,268,279,286],"moderating":[27,133],"leader-member":[30],"exchange":[31],"(LMX)":[32],"in":[33,82,117,154,217,230],"this":[34,83,86,192],"process.":[35],"BACKGROUND:":[36],"Presenteeism":[37],"among":[38,135,203],"clinical":[39,107],"nurses":[40,108,204],"remains":[41],"persistently":[42],"high":[43],"is":[45],"associated":[46,142,148,156],"reduced":[48],"individual":[49],"productivity":[50],"risks":[53],"patient":[55],"safety.":[56],"Previous":[57],"research":[58],"has":[59],"examined":[60],"associations":[61,246],"between":[62,170,197,224],"style":[65],"attendance":[67],"behavior;":[68],"however,":[69],"AL-the":[70],"flexible":[71],"combination":[72],"exploratory":[74],"exploitative":[76],"behaviors-has":[77],"received":[78],"limited":[79],"empirical":[80],"attention":[81,282],"context.":[84],"Examining":[85],"pathway":[87,177],"may":[88,291],"inform":[89],"nursing":[90,277],"management":[91,278],"practice.":[92],"METHODS:":[93],"A":[94],"cross-sectional,":[95,244],"descriptive,":[96],"correlational":[98,122,248],"design":[99,242],"was":[100,140,201,243],"adopted.":[101],"Data":[102],"were":[103,126],"collected":[104],"from":[105],"394":[106],"recruited":[109],"through":[110],"convenience":[111],"sampling":[112],"at":[113],"three":[114],"tertiary":[115],"hospitals":[116],"Guangzhou.":[118],"In":[119,184],"addition":[120],"analyses,":[123],"regression":[124],"models":[125],"constructed":[127],"these":[136,245],"variables.":[137],"RESULTS:":[138],"AL":[139,171,198,225],"negatively":[141],"presenteeism":[145],"positively":[147],"self-efficacy;":[150],"higher":[151,206],"was,":[153],"turn,":[155],"lower":[158],"presenteeism.":[159],"Mediation":[160],"analysis":[161],"indicated":[162],"that":[163,238,257,280],"partially":[165,220],"accounted":[166],"for":[167],"association":[169,196,223],"indirect":[176],"representing":[178],"33.3%":[179],"total":[182],"effect.":[183],"addition,":[185],"LMX":[186,232],"moderated":[187,214],"first":[189,235],"stage":[190,236],"pathway:":[193],"positive":[195],"stronger":[202],"reporting":[205],"LMX.":[207],"CONCLUSION:":[208],"The":[209,254],"findings":[210,255],"support":[211,271],"hypothesized":[213],"mediation":[215],"model,":[216],"which":[218,231],"mediates":[221],"conditions":[233],"pathway.":[239],"Because":[240],"are":[247],"cannot":[250,294],"establish":[251],"causal":[252],"direction.":[253],"suggest":[256],"structural":[258],"measures":[259],"such":[260],"as":[261],"reasonable":[262],"scheduling,":[263],"sick-leave":[264],"protection,":[265],"workload":[266],"adjustment,":[267],"occupational":[269],"health":[270],"remain":[272],"primary":[274],"responsibility":[275],"managerial":[281],"relational":[284],"quality":[285],"beliefs":[290],"complement,":[292],"but":[293],"replace,":[295],"them.":[296]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-30T00:00:00"}