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Dipartimento Medicina del Lavoro
International ConferenceInternational ConferencePsychosocial Risk Management at Work:Psychosocial Risk Management at Work:
The European FrameworkThe European FrameworkRome 5 November 2008Rome 5 November 2008
““Developing a Model for Assessing Work Organization Developing a Model for Assessing Work Organization Well-being, Job burnout and Mobbing among Health Workers”Well-being, Job burnout and Mobbing among Health Workers”
P. Deitinger, R. Bentivenga, M. Ghelli
2
The research
Dip
art
imento
Medic
ina d
el La
voro
During the activity plan 2005-2007, ISPESL promoted an
action research about psychosocial risk factors in
collaboration with the Service of Prevention and
Protection of a national health service Unit in central
Italy .
3
Contest
•The “Territorial Area” consists of 14 social health
districts parceled out in 14 municipalities.
•The 1058 employees of Unit are in the health,
technical and administrative staff.
•The Unit consists of 12 Departments divided in
Operative Units, Services, Districts and Hospital Centers.
4
Objective
The Objective is to perform an integrated
psychosocial risks assessment, consistent with
the European Framework for Psychosocial Risk
Management, in order to identify preventive
measures that could improve the health and well-
being of the Health Unit workers.
Three tools, adapted to health context and with a
proven reliability have been used.
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Methods and tools
1) “Multidimensional Organizational Health Questionnaire” (MOHQ, F. Avallone & A. Paplomatas, 2005) for the assessment of organizational health and wellbeing, widely employed by about 200 Italian public administration agencies of 34.000 people, and subsequently adapted for assessing health care environments. It has been chosen for the completeness and the full coverage of the organizational dimensions investigated.
2) Italian adaptation (by L.Borgogni) of the Organizational Check up System, (OCS, C. Maslach e M.P. Leiter, 2005), for the assessment of the job burnout/job engagement. The questionnaire has been standardized on a sample comprised of 945 people. It evaluates 4 issues:
• Work Relation;• Work Life Areas;• Change; • Management Processes;
6
Methods and tools3) “Val.Mob” (A. Aiello, P. Deitinger, C. Nardella e M.
Bonafede, 2008), a scale for assessing mobbing in workplaces.
The scale has been standardized on a sample comprised of 441 people, subdivided in 2 groups (A), Experimental group, and (B), Control group.
The tool is subdivided in 3 parts: • Mobbing Scale, which investigate 3 factors:
Relationships, Intrusion/Meddling, Disqualification; • Symptomatological Scale, which concern main
categories of diagnosis which are currently in effect in the forensic medicine in order to determine mobbing;
• Demographics and organizational data.
7
Sample and structural data
The study sample comprised 474 people aged between 20 and 64 years whose mean is 44.6, and Standard Deviation 8.33; 63.9% were women and 32.7% were men.
•Most of them had a middle-school education, with 54.2% of the sample holding the obligatory high-school leaving certificate.
•The most frequent qualification was professional nurse (48.1%) and mean time on the job was 10 years (SD 9).
•The working week was 36 hours
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MOHQ: Results Graph 1: General profile of the Unit
2,06 2,08
2,322,44 2,48 2,51
2,59 2,62 2,66 2,66 2,66 2,67 2,72,83
2,9 2,95 2,96
1,00
1,50
2,00
2,50
3,00
A B C D H G I F O E M L N P S Q R
A= Stress factors L= Clear goals
B= Tolerable tasks M= Indicators of well-being
C= Fairness N= Effectiveness
D= Indicators of malaise O=Psychosomatic Disorders
E= Conflict P= Information
F= Safety Q= Interpersonal relations
G= Enhancement R= Listening
H=Openness to innovation S= Social utility
I= Comfort
M = 2.59
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OCS: Results Graph 2: Organizational Checkup
52
51
51
49
54
48
0 10 20 30 40 50 60 70 80 90 100
Recognition
Control
Social inclusion
Fairness
Values
Workload
Discrepancy Tuning
Working life areas
40
31
52
0 10 20 30 40 50 60 70 80 90 100
Exhaustion Energy
Occupationalefficacy
Involvement
Occupational inefficacy
Occupational Disaffection
Burnout Engagement
Work relation
55
52
51
53
0 10 20 30 40 50 60 70 80 90 100
Cohesion
Competence
Leadership
Change
Negative Positive
Management processes
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Val.Mob.: Scores
Mobbing Scale LowMiddle
Low
Middlehigh High
Relationship ≤ 27 28-71 72-120 ≥ 121
Intrusion / Meddling
≤ 10 11-12 13-26 ≥ 27
Disqualification ≤20 21-42 43-57 ≥ 58
Symptomatological Scale
≤ 30 31-55 56-88 ≥ 89
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Val.Mob: Results 1
1%
12%
62%
17%
0 10 20 30 40 50 60 70
LOW
MIDDLE LOW
MIDDLE HIGH
HIGH 12%
45%
38%
0 10 20 30 40 50
MIDDLE LOW
MIDDLE HIGH
HIGH
1%
11%
58%
23%
0 10 20 30 40 50 60
LOW
MIDDLE LOW
MIDDLE HIGH
HIGH
RELATIONSHIP
SYMPTOMATOLOGICAL
DISQUALIFICATION
INTRUSION
1%
19%
53%
15%
0 10 20 30 40 50 60
LOW
MIDDLE LOW
MIDDLE HIGH
HIGH
12
Val.Mob: Results 2
Cross – validation
•380 subjects affirm that they are not vexed at work, but 20 of them could appear mobbed or in an mobbing process.
•76 subjects affirm that they are vexed at work, but the data show that only 31 of them are mobbed.
13
Conclusions 1 •This organization as a whole appears to function well,
especially considering the excellent Relationships in the
workplace.
•There are however main negative features for the
health and organizational well-being:
- Psychophysical Stress,
- Tolerable tasks
- Absence of Fairness.
14
•Issues about mobbing, as Disqualification and Intrusion, are confirmed by the Val.Mob. Scale results.
•This phenomenon is so complex that it requires a deepening at individual level.
•Other dimensions need attention: Safety, Enhancement, Recognition and Occupational Disaffection.
Conclusions 2
15
Interventions
Possible interventions should involve:
•Redistribution of workloads and rotation of some of the heavier tasks.
•Managerial training with focus on the leadership styles and workers’ enhancement.
•Introduction of incentives in order to enhance the job engagement.