Renato Pisanti

OCCUPATIONAL STRESS AND WELLNESS AMONG ITALIAN SECONDARY SCHOOL TEACHERS

As a part of a larger cross-cultural investigation (Euroteach) which involves 11 European countries and 2 182 secondary school teachers, two were the aims of the present study: (1) to examine the relationship between job conditions and wellness/health outcomes on a group of 169 Italian secondary school teachers, by using the Job Demand-Control-Support (JDCS) Model (Karasek and Theorell, 1990); (2) to analyse the differences with other European countries in the light of specific cultural differences. Controlling for age and gender, results of hierarchical regression indicated that job control and social support combine in different additive patterns with job demands to explain the well-being outcomes (job satisfaction, emotional exhaustion, depersonalisation, somatic complaints). The predictors linearity check indicated that the job demands variable is curvilinearly associated both with emotional exhaustion ( p<0.005) and with somatic symptoms ( p<0.01). As compared to the average of the other European countries, on the positive side, the Italian teachers manifest both a higher degree of personal accomplishment and a lesser degree of depersonalisation; on the other hand, they claim a lesser degree of social support and a higher degree of somatic complaints.

Psychometric properties of the Maslach Burnout Inventory for Human Services among Italian nurses: A test of alternative models

AIM The purpose of this study was to test the factor structure of an Italian version of the Maslach Burnout Inventory for Human Service employees. In addition we examined the reliability and construct validity of the scale. BACKGROUND There is increasing evidence that nurses are at risk of experiencing burnout. Despite the vast international use of the Maslach Burnout Inventory-Human Service Survey, its factor structure and reliability are not beyond question. METHOD In a sample of nurses (N = 1613) six alternative factor models of the instrument were tested using confirmatory factor analysis. Furthermore, we examined the invariance of the pattern of factor loadings of the model that better fitted the data across gender groups. To test construct validity, participants completed four subscales of Symptoms Check List 90-R. Internal consistency was evaluated computing Cronbachs alpha estimates of the scales. The study was conducted in 2007 and 2008 in Italy. RESULTS The factor analysis provided support for a 20-item version identifying the three original dimensions. The model was found to be factorially invariant between men and women. Correlations between the latent MBI-HSS dimensions and distress variables were in line with theoretical predictions. Reliability was supported by acceptable Cronbachs alpha indexes. CONCLUSION The Maslach Burnout Inventory-Human Service Survey has acceptable validity and reliability for measuring burnout among nurses, and can help healthcare managers to offer interventions to reduce burnout among nurses. Limitations of the study and suggestions for further research are highlighted.

Development and validation of a brief Occupational Coping Self-Efficacy Questionnaire for Nurses

AIM This paper is a report of a study to develop and test the psychometric properties of the Occupational Coping Self-Efficacy for Nurses Scale. BACKGROUND Coping self-efficacy beliefs are defined as self-appraisals of capabilities to cope with environmental demands. People with higher levels of coping self-efficacy beliefs tend to approach challenging situations in an active and persistent way, whereas those with lower levels of coping self-efficacy beliefs tend to direct greater energy to managing increasing emotional distress. METHOD In 2006, 1383 nurses completed the following measures: Occupational Coping Self-Efficacy Questionnaire for Nurses, Coping Inventory for Stressful Situations Short Form and Maslach Burnout Inventory. Based on a randomized split of the data, we conducted exploratory factor analysis on group 1 data (n = 691) and confirmatory factor analysis within the framework of structural equation modelling on group 2 data (n = 692). FINDINGS The exploratory results revealed two factors: Coping Self-Efficacy to cope with the occupational burden (Cronbach alpha = 0.77) and Coping Self-Efficacy to cope with the relational burden (alpha = 0.79). In the confirmatory group, the two-factor structure was tested against an alternative one-factor structure and confirmed as the best solution. Correlation patterns between the Occupational Coping Self-Efficacy for Nurses Scales, and both coping and burnout variables, supported the criterion-related validity of the Occupational Coping Self-Efficacy for Nurses dimensions. CONCLUSION Nurses can have two basic and distinct coping self-efficacy beliefs: beliefs about occupational burden and beliefs about relational difficulties in the workplace. Research is needed into how efficacy evaluations shift as a result of specific stress management interventions.

Occupational coping self-efficacy explains distress and well-being in nurses beyond psychosocial job characteristics.

Aim: The main purpose of the present study was to extend the Job Demand Control Support (JDCS) model analyzing the direct and interactive role of occupational coping self-efficacy (OCSE) beliefs. Background: OCSE refers to an individual’s beliefs about their ability to cope with occupational stressors. The interplay between occupational stressors, job resources, and self-efficacy beliefs is poorly investigated. The present research attempts to address this gap. Design: Cross-sectional survey. Method: Questionnaire data from 1479 nurses (65% response) were analyzed. Hierarchical regression analyses were used to test the direct and moderating role of OCSE in conjunction with job demands (i.e., time pressure), and two job resources: job control (i.e., decision latitude and skill discretion) and social support (i.e., supervisor support and coworker support) in predicting psychological distress and well-being. Results: Our findings indicated that high demands, low job control, and low social support additively predicted the distress/well-being outcomes (job satisfaction, emotional exhaustion, depersonalization, psychological distress, and somatic complaints). Beyond the main effects, no significant interactive effects of demands, control, and support were found. OCSE accounted for an additional 1–4% of the variance in the outcomes, after controlling for the JDCS variables. In addition, the results indicate that OCSE buffers the association between low job control and the distress dimensions emotional exhaustion, depersonalization, and psychological distress. Low control was detrimental only for nurses with low OCSE. Conclusion: Our results suggest expanding the JDCS model incorporating individual characteristics such as OCSE beliefs, for predicting psychological distress and well-being. Limitations of the study and practical implications are discussed.

How changes in psychosocial job characteristics impact burnout in nurses : A longitudinal analysis

Aims: The main aim of this longitudinal study was to test the Job Demand-Control-Support (JDCS) model and to analyze whether changes in psychosocial job characteristics are related to (changes in) burnout. Background: Previous studies on the effects of JDCS variables on burnout dimensions have indicated that the iso-strain hypothesis (i.e., high job demands, low control, and low support additively predict high stress reactions) and the buffer hypotheses (i.e., high job control and/or social support is expected to moderate the negative impact of high demands on stress reactions) have hardly been examined concurrently in a longitudinal design; and that the effects of changes of psychosocial job variables on burnout dimensions have hardly been analyzed. Design: This two wave study was carried out over a period of 14 months in a sample of 217 Italian nurses. Method: Hierarchical regression analyses were used to test the cross lagged main and interactive effects of JDCS variables, and to analyse the across-time effects of changes in JDCS dimensions on burnout variables. Results: The Time 1 job characteristics explained 2–8% of the variance in the Time 2 burnout dimensions, but no support for the additive, or the buffer hypothesis of the JDCS model was found. Changes in job characteristics explained an additional 3–20% of variance in the Time 2 burnout dimensions. Specifically, high levels of emotional exhaustion at Time 2 were explained by high levels of social support at Time 1, and unfavorable changes in demands, control, and support over time; high depersonalization at Time 2 was explained by high social support at time 1 and by an increase in demands over time; and high personal accomplishment at Time 2 was predicted by high demands, high control, interactive effect demands × control × social support, at Time 1, and by a decrease in demands over time. No reversed effects of burnout on work characteristics have been found. Conclusion: Our findings suggest that the work environment is subject to changes: the majority of employees experienced considerable changes in all job conditions over time. These changes impacted employee burnout. Limitations and implications of the study are discussed.

The role of transplant-related stressors and social support in the development of anxiety among renal transplant recipients: The direct and buffering effects

Several studies have shown a relevant presence of anxiety feelings among renal transplant patients. This study examines the impact of transplant-related stress and social support on anxiety. Two hypotheses were examined: H1: High transplant-related stressors and low social support are related to high anxiety (additive hypothesis); H2: Social support moderates the detrimental impact of transplant-related stressors on anxiety (buffer hypothesis). One hundred and four kidney transplant recipients (54% male), with a mean age of 50.8 (SD = 12.6), volunteered to participate in a cross-sectional study that included a face-to-face interview and several self-administered scales. Hierarchical regression analyses indicated that higher transplant-related stressors are associated with higher levels of anxiety (F change (2, 92) = 17.4, p < .001, ∆R2 = 24%), but, contrary to our prediction, social support was not directly related with anxiety. However, social support has a moderating effect on the relationship between high transplant-related stressors and anxiety (F change (1, 91) = 5.2, p < .05, ∆R2 = 3%). The results are consistent with the hypothesis that social support has a buffering role on the patients’ distress following renal transplantation and suggest that their psychological well-being could benefit from enhancing the perception of social support in post-operative care.

Validation of the Italian Version of the Coping Inventory for Stressful Situations—Short Version among Hospital-Based Nurses

The psychometric properties of the Italian version of the Coping Inventory for Stressful Situations–Short Version (CISS-SV-21 items) were tested. In a group of 1,291 hospital-based nurses (77.8% women), four alternative factor models of the CISS–SV were tested using confirmatory factor analysis (CFA). The four models were: M1, the original CISS-SV-21 items three-factor model corresponding to three dimensions (task-oriented, emotion-oriented, and avoidance-oriented coping); M2, the four-factor model corresponding to four dimensions (task-oriented, emotion-oriented, contact a friend-oriented, and treat oneself-oriented) of the CISS–SV (21 items); M3, the three-factor model of the CISS–SV (20 items) made up by the same factor structure of M1 without including Item 1; finally, the four-factor M4 of the CISS–SV (20 items), consisting of the same dimensions of the M2 model without including Item 1. The results of the CFA showed that the M4 factor model was the model that was best able to account for the data (RMSEA=0.06, 90%CI=0.05, −0.06; CFI = 0.90). Reliability was supported by alphas ranging from .72 to .82. The CISS–SV has acceptable validity and reliability for measuring the coping strategies of nurses.

Appraisal of transplant-related stressors, coping strategies, and psychosocial adjustment following kidney transplantation.

This study examined the relations between appraisal of transplant-related stressors, coping, and adjustment dimensions following kidney transplantation (KT). Two models were tested: (1) the main effects model proposing that stress appraisal and coping strategies are directly associated with adjustment dimensions; and (2) the moderating model of stress proposing that each coping strategy interacts with stress appraisal. Importantly, there is a lack of research examining the two models simultaneously among recipients of solid organ transplantation. A total of 174 KT recipients completed the questionnaires. Predictors of post-transplant adjustment included appraisal of transplant-related stressors and coping strategies (task-, emotion-, and avoidance-focused). Adjustment dimensions were psychological distress, worries about the transplant, feelings of guilt, fear of disclosure of transplant, adherence, and responsibility for the functioning of the new organ. The main and moderating effects were tested with regression analyses. Appraisal of transplant-related stressors and emotion-oriented coping were related to all adjustment dimensions, except of adherence and responsibility. Task-oriented coping was positively related to responsibility. Avoidance-oriented coping was negatively correlated with adherence. Only 1 out of 18 hypothesized interactive terms was significant, yielding a synergistic interaction between appraisal of transplant-related stressors and emotion-oriented coping on the sense of guilt. The findings have the potential to inform interventions promoting psychosocial adjustment among KT recipients.

Psychosocial job characteristics and psychological distress / well-being: the mediating role of personal goal facilitation

Psychosocial job characteristics and psychological distress / well‐being: the mediating role of personal goal facilitation: Renato Pisanti, et al. Niccolò Cusano University, Faculty of Psychology, Italy

Stress lavorativo e strategie di coping: effetti sul burnout in un gruppo di insegnanti

L’articolo riporta uno studio condotto su un gruppo di 167 docenti di sei scuole secondarie romane che considera congiuntamente le caratteristiche lavorative e le dimensioni individuali di Coping come predittori delle dimensioni del burnout. Abbiamo esaminato le modalita d’azione delle dimensioni lavorative del modello Domanda-Controllo (D-C) di Karasek (1979) e abbiamo verificato eventuali miglioramenti nel potere esplicativo del modello con l’inclusione di strategie individuali di coping (Compito, Emozione, Evitamento). Sono state condotte una serie di analisi della regressione multipla con strategia gerarchica i cui risultati hanno mostrato che la domanda e il controllo lavorativo interagiscono nel predire solo l’esaurimento emotivo, mentre per quanto riguarda la depersonalizzazione e la realizzazione personale mostrano effetti additivi. Per quanto concerne l’azione delle strategie di coping sono state evidenziate interazioni a tre vie (domanda X controllo X stile di coping) dell’emozione e dell’evitamento nel predire l’esaurimento emotivo, dell’evitamento nello spiegare la depersonalizzazione. Complessivamente i risultati dimostrano l’esigenza di considerare il ruolo delle variabili di personalita nel modello D-C.