Ángela Asensio-Martínez

A factor confirmation and convergent validity of the "areas of worklife scale" (AWS) to Spanish translation

BackgroundPerceived incongruity between the individual and the job on work-life areas such as workload, control, reward, fairness, community and values have implications for the dimensions of burnout syndrome. The “Areas of Work-life Scale” (AWS) is a practical instrument to measure employees´ perceptions of their work environments.AIMS: Validate a Spanish translation of the AWS, and it relationship with Masclach Burnout Inventory dimensions.MethodsThe study was conducted in three medium-sized hospitals and seven rural and urban Primary Care centres (N = 871) in Spain. The “Maslach Burnout Inventory General Survey” (MBI-GS) and AWS were applied. We developed a complete psychometric analysis of its reliability, and validity.ResultsData on the reliability supported a good internal consistency (Cronbach α between .71, and .85). Construct validity was confirmed by a six factor model of the AWS as a good measure of work environments (χ2(352) = 806.21, p < 0.001; χ2/df = 2.29; CFI = 0.935, RMSEA = 0.039); concurrent validity was analysed for its relationship with other measures (opposing dimensions to burnout, and MBI), and each correlation between dimensions and sub-dimensions were statistically significant; as well, predictive validity, by a series of Multiple Regression Analysis examined the resulting patterns of the Confirmatory Factor Analysis (CFA) confirms the relationship between the work-life areas and burnout dimensions.ConclusionsLeiter and Maslach’s AWS has been an important instrument in exploring several work-life factors that contribute to burnout. This scale can now be used to assess the quality of work-life in order to design and assess the need for intervention programs in Spanish-speaking countries.

Causes of discomfort in the academic workplace and their associations with the different burnout types: a mixed-methodology study.

BackgroundBurnout is the result of prolonged workplace exposure to chronic stress factors and may present itself in one of the following subtypes: “frenetic”, “under-challenged” and “worn-out”. The aims of the present study were to identify the causes of workplace discomfort that affect employees in large organizations and to determine the predictive power of these causes with regard to the burnout subtypes.MethodWe employed a qualitative and quantitative analysis (QQA), using a cross-sectional design with an online survey administered to a randomly selected sample of University workers (n = 409). To determine the causes of discomfort, we raised the following open question: “What aspects of your work generate discomfort for you?”. The responses were subjected to content analysis and categorized by three independent referees. The concordance between the responses was estimated with the kappa coefficient (k). Subtype classification was assessed according to the “Burnout Clinical Subtype Questionnaire” (BCSQ-36). The degree of association between the motives for the complaint and the burnout profiles was evaluated using adjusted odds ratio (OR), which was based on multivariate logistic regression models.ResultsThe causes of discomfort included: physical environment (setting aspects, material conditions, journey/access), organization (schedules, structure, functions, interpersonal relations) and individual conditions (workload, powerlessness, rewards, negligence). The concordance index between the referees was k = 0.80. Employees who were upset with the hierarchical structure were more likely to be classified as frenetic (OR = 4.32; 95% CI = 1.43-13.06; p = 0.010); those who complained of routine duties were more likely to be classified as under-challenged (OR = 5.33; 95% CI = 1.84-15.40; p = 0.002); those whose discomfort was caused by structure control systems were more likely to be classified as worn-out (OR = 6.13; 95% CI = 1.57-23.91; p = 0.009).ConclusionsThe causes of discomfort among the different burnout subtypes are primarily attributable to the organization itself, in response to the structure and functions. The associations observed between the different subtypes and motives for complaint are consistent with the clinical profile-based syndrome definition, which suggests that interventions should be case-specific.

Beyond the consultation room: Proposals to approach health promotion in primary care according to health-care users, key community informants and primary care centre workers

Primary health care (PHC) is the ideal setting to provide integrated services centred on the person and to implement health promotion (HP) activities.

Value congruence, control, sense of community and demands as determinants of burnout syndrome among hospitality workers

Employees working in the hospitality industry are constantly exposed to occupational stressors that may lead employees into experiencing burnout syndrome. Research addressing the interactive effects of control, community and value congruence to alleviate the impact of workplace demands on experiencing burnout is relatively limited. The present study examined relationships among control, community and value congruence, workplace demands and the three components of burnout. A sample of 418 employees working in a variety of hospitality associations including restaurants and hotels in Spain were recruited. Moderation analyses and linear regressions analyzed the predictive power of control, community and value congruence as moderating variables. Results indicate that control, community and value congruence were successful buffers in the relationships between workplace demands and the burnout dimensions. The present findings offer suggestions for future research on potential moderating variables, as well as implications for reducing burnout among hospitality employees.

Health-care users, key community informants and primary health care workers'' views on health, health promotion, health assets and deficits: Qualitative study in seven Spanish regions

BackgroundAlthough some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention.MethodsA descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out.ResultsHealth-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants’ profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having implemented some change to promote their health. The most powerful motivators to change lifestyles are having a disease, fear of becoming ill and taking care of oneself to maintain health. Health-care users believe that the main difficulties are associated with the physical, social, working and family environment, as well as lack of determination and motivation. They also highlight the need for more information. In relation to the assets and deficits of the neighbourhood, each group identifies those closer to their role.ConclusionsGenerally, participants showed a holistic and positive concept of health and a more traditional, individual approach to health promotion. We consider therefore crucial to depart from the model of health services that focuses on the individual and the disease toward a socio-ecological health model that substantially increases the participation of health-care users and emphasizes health promotion, wellbeing and community participation.

Transcultural adaptation and validation of the Celiac Dietary Adherence Test. A simple questionnaire to measure adherence to a gluten-free diet.

BACKGROUND AND AIMS A gluten-free diet is to date the only treatment available to celiac disease sufferers. However, systematic reviews indicate that, depending on the method of evaluation used, only 42% to 91% of patients adhere to the diet strictly. Transculturally adapted tools that evaluate adherence beyond simple self-informed questions or invasive analyses are, therefore, of importance. The aim is to obtain a Spanish transcultural adaption and validation of Lefflers Celiac Dietary Adherence Test. METHODS A two-stage observational transversal study: translation and back translation by four qualified translators followed by a validation stage in which the questionnaire was administered to 306 celiac disease patients aged between 12 and 72 years and resident in Aragon. Factorial structure, criteria validity and internal consistency were evaluated. RESULTS The Spanish version maintained the 7 items in a 3-factor structure. Reliability was very high in all the questions answered and the floor and ceiling effects were very low (4.3% and 1%, respectively). The Spearman correlation with the self-efficacy and life quality scales and the self-informed question were statistically significant (p < 0.01). According to the questionnaire criteria, adherence was 72.3%. CONCLUSION The Spanish version of the Celiac Dietary Adherence Test shows appropriate psychometric properties and is, therefore, suitable for studying adherence to a gluten-free diet in clinical and research environments.