Igor Portoghese

Burnout and workload among health care workers: the moderating role of job control.

Background As health care workers face a wide range of psychosocial stressors, they are at a high risk of developing burnout syndrome, which in turn may affect hospital outcomes such as the quality and safety of provided care. The purpose of the present study was to investigate the moderating effect of job control on the relationship between workload and burnout. Methods A total of 352 hospital workers from five Italian public hospitals completed a self-administered questionnaire that was used to measure exhaustion, cynicism, job control, and workload. Data were collected in 2013. Results In contrast to previous studies, the results of this study supported the moderation effect of job control on the relationship between workload and exhaustion. Furthermore, the results found support for the sequential link from exhaustion to cynicism. Conclusion This study showed the importance for hospital managers to carry out management practices that promote job control and provide employees with job resources, in order to reduce the burnout risk.

Mindsets of Commitment and Motivation: Interrelationships and Contribution to Work Outcomes

ABSTRACT Two studies are reported that investigate the relationships among commitment and motivation mindsets and their contribution to work outcomes. Study 1 involved 487 nurses from a hospital in the center of Italy. Results showed that commitments facets were related to parallel dimensions of work motivation. Study 2 involved 593 nurses from a hospital in the north of Italy. Analyses indicated that commitment and motivation were important antecedents of working attitudes and behaviors. Moreover, self-determined motivation played a critical mediating role in positive behaviors. Findings are discussed in terms of their practical implications for organizations and employees.

Beyond the tradition: test of an integrative conceptual model on nurse turnover

AIM This paper aimed to extend research on nurse turnover by developing and testing a theoretical model of turnover intention that includes two emergent key off-the-job constructs, work-family conflict (WFC) and community embeddedness (CE). BACKGROUND Nurse turnover is considered one of the most significant issues in health care. There is a considerable body of knowledge that has focused on the study of the on-the-job factors of nurse turnover, showing the important role of job attitudes. Recently, WFC and job embeddedness (JE) have been identified as variables that could help explain levels of nurse turnover. METHODS Using structural equation modelling from a cross-sectional survey, the relationships between the variables were explored in a sample of 440 nurses from an Italian public hospital. The questionnaire measures demographic data and psychosocial factors such as job satisfaction, organizational commitment, WFC, CE and turnover intentions. RESULTS The findings supported the importance of non-work dimensions in turnover models. CONCLUSIONS The results suggest that when studying turnover phenomena in health organizations, the extra-work domains (WFC and JE) can contribute to a decrease in the intention to leave, in addition to the more typically emphasized attitude dimension.

How Organizational Support impacts Affective Commitment and Turnover among Italian Nurses: A Multilevel Mediation Model

This study examines multilevel relationships between perceived organizational support (POS), affective commitment and voluntary turnover among nurses. We explored the mediation role of affective commitment between POS and turnover behavior at both individual and work-unit levels. This cross-level study involved 945 Italian nurses from 60 work units. We hypothesized and showed that collective affective commitment fully mediated the impact of climate for POS on individual and collective turnover among nurses. This study helps explain the variance in turnover among nurses in healthcare organizations by analyzing the influence of unit-level climate on individual behavior. Results stress that social environments within wards are important in explaining the processes by which nurses decide to quit their work unit.

Working and Environmental Factors on Job Burnout: A Cross-sectional Study Among Nurses

Background: Burnout is a problem that impacts on the staff management costs and on the patient care quality. Objective: This work aimed to investigate some psychosocial factors related to burnout. Specifically, we explored the sample characteristics for moderate/high emotional exhaustion, cynicism and professional inefficacy, as well as the relationship between both working and environmental variables and burnout. Method: A cross-sectional study involving 307 nurses from one Italian hospital was carried out. A self-reported questionnaire was used to collect data. Data analysis was performed by using SPSS 19.0. Results: The results showed that there was a significant difference between nurses with low and moderate/high burnout in all the three components in almost all the examined organizational variables. In addition, we found that the aspects of working life had a significant impact on the three dimensions of burnout. Conclusions: The findings of this study not only can provide useful basis for future research in the field, but also can offer practical suggestions for improving nursing practice and promote effective workplace, thus reducing the risk burnout among nurses.

Pattern of Hepatitis A Virus Epidemiology in Nursing Students and Adherence to Preventive Measures at Two Training Wards of a University Hospital

Background Nursing students can be exposed to patients with hepatitis A virus (HAV) and can represent a vehicle of transmission both for health personnel, patients and relatives. Objectives The aim of this study was to assess the risk of HAV infection in nursing students during their internship. Patients and Methods A seroprevalence survey on HAV infection was performed on nursing students at the Cagliari university-hospital, together with the assessment of the compliance to preventive measures to decrease the risk of infection during their internship. Blood specimens were obtained from 253 students. All serum samples were tested for anti-HAV antibodies (IgG) by the enzyme-linked immunosorbent assay (ELISA). Compliance to preventive measures was recorded by trained personnel. Results Overall HAV seropositivity in nursing students (mean age 24, range 17 - 45 years) was 3%. Compliance to preventive measures was not uniform (6% - 76%) and extremely low in some specific measures targeted to decrease the oral-fecal transmission. Conclusions The high proportion of susceptible nursing students can contribute to an increase in the risk of nosocomial transmission, especially when specific preventive measures are not completely applied. Nursing education packages, before starting medical internship, should be implemented in order to increase their compliance to preventive measures, especially in wards at higher risk. Vaccination should be considered in wards at higher risk.

Role Stress and Emotional Exhaustion Among Health Care Workers: The Buffering Effect of Supportive Coworker Climate in a Multilevel Perspective

Objective: The aim of the study was to examine the relationship between role stress, emotional exhaustion, and a supportive coworker climate among health care workers, by adopting a multilevel perspective. Methods: Aggregated data of 738 health care workers nested within 67 teams of three Italian hospitals were collected. Multilevel regression analysis with a random intercept model was used. Results: Hierarchical linear modeling showed that a lack of role clarity was significantly linked to emotional exhaustion at the individual level. At the unit level, the cross-level interaction revealed that a supportive coworker climate moderated the relationship between lack of role clarity and emotional exhaustion. Conclusion: This study supports previous results of single-level burnout studies, extending the existing literature with evidence on the multidimensional and cross-level interaction associations of a supportive coworker climate as a key aspect of job resources on burnout.

Factor structure of the straightforward incivility scale in an Italian sample

Workplace incivility is defined as low-intensity deviant behavior with ambiguous intent to harm the target. In this sense, it involves a violation of workplace norms that could damage the quality of working relationships. The aim of this study is to evaluate the factor structure of the adaptation of Straightforward Incivility Scale (SIS; Leiter 2013) in an Italian sample. A sample of 404 healthcare workers completed the SIS. Exploratory and confirmatory factor analyses were conducted. In the first step of analysis, exploratory factor analysis and parallel analysis with 202 participants revealed three factors: supervisor, coworker, and instigated incivility. In the second step, a confirmatory factor analysis with 202 participants supported the 15-item three-factor model in the cross-validation sample. Results provide confirmation of the cross-cultural stability of the facet, factor, and global scale structure of the SIS.

Validazione della scala di motivazione al lavoro (MAWS) nel contesto italiano: evidenza di un modello a tre fattori

In accordo con la Self-Determination Theory (SDT), la scala di motivazione al lavoro (MAWS) e stata sviluppata attraverso l’approccio multidimensionale e validata in lin- gua inglese e francese. Questo lavoro intende esaminare la struttura del MAWS nel contesto organizzativo italiano. Utilizzando due campioni (Studio 1, N = 525; Studio 2, N = 465), i risultati emersi dall’analisi fattoriale esplorativa (Studio 1) indicano una struttura della motivazione suddivisa in tre fattori: motivazione autonoma, introiettata ed esterna, confermata dall’analisi confermativa (Studio 2). E stata anche esaminata la validita discriminante e convergente delle sottoscale. Si e discussa l’importanza della scala per lo sviluppo di future ricerche in ambito organizzativo basate sulla SDT.

Work Related Stress, Well-Being and Cardiovascular Risk among Flight Logistic Workers: An Observational Study

Work-related stress is a known occupational hazard, with a putative role on the development of cardiovascular diseases (CVD). Although several investigations have explored the association in various workplace scenarios, none have focused on the airport flight logistic support personnel, a transportation business of crucial importance, potentially exposed to job stress and consequently to an increase in CVD risk. We explored the relationship between work-related stress and cardiovascular risk in 568 healthy workers of a flight logistic support company using the Health and Safety Executive questionnaire, the Framingham Heart Study General Cardiovascular Disease (CVD) Risk Prediction Score, and the WHO general well-being index (WHO-5). We used univariate and multivariate statistical methods to take account of possible confounders. Our results show that a low job support significantly increases the CVD risk score and decreases the WHO well-being index with reference to subjects reporting high support on the job. In addition, the well-being index of workers with high strain jobs appears lower in respect to workers employed in low strain job. The multivariate analysis confirms a protective effect of job support, and shows a detrimental influence on CVD risk by physical inactivity, regular intake of alcohol, and a low educational level. In addition, job control, job support, low strain, and high demand coupled with high control (active job) showed a beneficial effect on psychological well-being. Our results suggest that a combination of general risk factors and organizational factors contributes to increase CVD risk and well-being, representing a crucial target for intervention strategies to promote health in the workplace.