The relationship with patients in healthcare: which workplace resources can lessen the impact of social stressor?

Journal title PSICOLOGIA DELLA SALUTE
Author/s Chiara Guglielmetti, Silvia Gilardi, Lucia Accorsi, Daniela Converso
Publishing Year 2014 Issue 2014/2 Language Italian
Pages 17 P. 121-137 File size 265 KB
DOI 10.3280/PDS2014-002008
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

National and international studies have highlighted that healthcare workers are increasingly facing episodes of verbal and physical violence. Empirical evidence supports the hypothesis that aggressive behaviors by patients can generate burnout processes. However few studies have investigated the workplace resources that can lessen the impact of such social stressor on the well-being of healthcare workers. We analyzed if and under what circumstances different types of resources, emotional (colleagues’ support, managers’ support) and cognitive ones (decision authority and job meaning), lessen the negative impact of verbal aggression on burnout and emotional well-being. This exploratory cross-sectional study was conducted on the healthcare workers of a surgery department (133 workers with a 67% response rate). Data was collected via a self-report questionnaire. A moderated hierarchical regressions analysis highlighted that aggressive behaviors are important predictors of burnout and affective wellbeing. The support of colleagues and managers and, to a lesser extent, the attribution of meaning to one’s work moderate the negative impact on emotional exhaustion. Affective well-being is shown to be moderated by colleagues’ support, and by the perception of decision authority. In addition we found that the attribution of meaning to one’s work positively influences well-being in cases of highly aggressive patient behavior. The study highlights some socio-organizational factors that protect against social stressor tied to the interaction with patients in healthcare contexts.

Keywords: Workplace violence, patients, nursing, burnout, occupational health, Demand Induced Strain Compensation Model.

  1. European Agency for Safety and Health at Work (EU-OSHA) (2010). Workplace violence and harassment: a European picture. Luxembourg: Publications Office of the European Union.
  2. Ayranci U. (2005). Violence toward health care workers in emergency departments in west Turkey. The Journal of Emergency Medicine, 28 (3): 361-365. DOI: 10.1016/j.jemermed.2004.11.01
  3. Bakker A.B., Demerouti E. and Euwema M.C. (2005). Job resources buffer the impact of job demands on burnout. Journal of Occupational Health Psychology, 10 (2): 170. DOI: 10.1037/1076-8998.10.2.17
  4. Bakker A.B., Demerouti E. and Shaufeli W.B. (2005). The crossover of burnout and work engagement among working couples. Human Relations, 58: 661-689. DOI: 10.1177/001872670505596
  5. Bakker A. B., Hakanen J.J., Demerouti E. and Xanthopoulou D. (2007). Job resources boost work engagement, particularly when job demands are high. Journal of Educational Psychology, 99: 274-284. DOI: 10.1037/0022-0663.99.2.27
  6. Baldasseroni A., Camerino D., Cenni P., Cesana G. C., Fattorini E., Ferrario M. e Tartaglia, R. (2001).
  7. La valutazione dei fattori psicosociali. Proposta della versione italiana del Job Content Questionnaire di RA Karasek. [The assessment of psychosocial factors. Italian version of Job Content Questionnaire by RA Karasek]. Fogli di Informazione ISPESL, 14 (3): 20-32.
  8. Bauer D.J. and Curran P.J. (2005). Probing interactions in fixed and multilevel regression: Inferential and graphical techniques. Multivariate Behavioral Research, 40: 373-400.
  9. 10.1207/s15327906mbr4003_5
  10. Carmi-Iluz T., Peleg R., Freud T. and Shvartzman P. (2005). Verbal and physical violence towards hospital-and community-based physicians in the Negev: an observational study. BMC Health services research, 5 (1): 54. DOI: 10.1186/1472-6963-5-5
  11. Cordes C.L. and Dougherty T.W. (1993). A review and an integration of research on job burnout. Academy of Management Review, 18 (4): 621-656 De Jonge J. and Dormann C. (2003). The DISC Model: Demand-Induced Strain Compensation Mechanism in Job Stress. In: M. Dollard, A.H. Winefield and H.R. Winefield, editors, Occupational stress in the service professions, Taylor b& Francis, London, pp. 73-74.
  12. De Jonge J., Le Blanc P.M., Peeters M.C.W., Noordam H. (2008) Emotional job demands and the role of matching job resources: a cross sectional study among health care workers. International Journal of Nursing Studies, 45 (10): 1460-1469. DOI: 10.1016/j.ijnurstu.2007.11.00
  13. Demerouti E., Bakker A.B., Nachreiner F. and Schaufeli W.B. (2000) A model of burnout and life satisfaction amongst nurses. Journal of Advanced Nursing, 32 (2): 454-464. DOI: 10.1046/j.1365-2648.2000.01496.
  14. Dollard M.F., Dormann C., Boyd C.M., Winefield H.R. and Winefield A.H. (2003). Unique aspects of stress in human service work. Australian Psychologist, 38 (2): 84-91. DOI: 10.1080/1533296090340847
  15. Dormann C. and Zapf D. (2004). Customer-related social stressor and burnout. Journal of Occupational Health Psychology, 9 (1): 61-82. DOI: 10.1037/1076-8998.9.1.6
  16. Estryn-Behar M., Van Der Heijden B., Camerino D., Fry C., Le Nezet O., Conway P.M. and Hasselhorn
  17. H.M. (2008). Violence risks in nursing – results from the European ‘NEXT’ Study. Occupational Medicine, 58 (2): 107-114. DOI: 10.1093/occmed/kqm14
  18. Genovese U. (2012). Effetti della medicina difensiva sulla pratica medica e sul processo di cura. M.D. Medicinae Doctor, XIX, 10.
  19. Hackman J.R. and Oldham G.R. (1980). Work redesign. Reading, MA: Addison-Wesley.
  20. Hakanen J.J., Bakker A.B. and Demerouti E. (2005). How dentists cope with their job demands and stay engaged: The moderating role of job resources. European Journal of Oral Sciences, 113: 479-487. DOI: 10.1111/j.1600-0722.2005.00250.
  21. Hansen N., Sverke M. and Näswall K. (2009). Predicting nurse burnout from demands and resources in three acute care hospitals under different forms of ownership: A cross-sectional questionnaire survey. International Journal of Nursing Studies, 46 (1): 96-107. DOI: 10.1016/j.ijnurstu.2008.08.00
  22. Kahn W.A. (1990). Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33: 692-724. DOI: 10.2307/25628
  23. Karasek R., Brisson C., Kawakami N., Houtman I., Bongers P. and Amick B. (1998). The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. Journal of Occupational Health Psychology, 3 (4): 322. DOI: 10.1037/1076-8998.3.4.32
  24. Kowalenko T., Cunningham R., Sachs C.J., Gore R., Barata I.A., Gates D. and McClain A. (2012).
  25. Workplace Violence in Emergency Medicine: Current Knowledge and Future Directions. The Journal of Emergency Medicine, 43 (3): 523-531. DOI: 10.1016/j.jemermed.2012.0
  26. Kristensen T.S., Hannerz H., Høgh A. and Borg V. (2005). The Copenhagen Psychosocial Questionnaire-a tool for the assessment and improvement of the psychosocial work environment. Scandinavian Journal of Work, Environment & Health, 31 (6): 438-449. DOI: 10.5271/sjweh.94
  27. Lazarus R.S. and Folkman S. (1984). Stress, appraisal, and coping. New York: Springer.
  28. Lee J.S. and Akhtar S. (2011). Effects of the workplace social context and job content on nurse burnout. Human Resource Management, 50 (2): 227-245. DOI: 10.1002/hrm.2042
  29. Magnavita N. and Heponiemi T. (2012). Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study. BMC Health Services Research, 12 (1): 108. DOI: 10.1186/1472-6963-12-10
  30. Magnavita N. (2013). The Exploding Spark: Workplace Violence in an Infectious Disease Hospital – A Longitudinal Study. BioMed Research International. DOI: 10.1155/2013/31635
  31. Martini M. e Converso D. (2012). Lo studio del burnout in sanità: rapporto coi pazienti e relazione lavoro-famiglia come richieste e risorse. Giornale Italiano Medicina del Lavoro ed Ergonomia, XXIV N. 1/supplemento A Psicologia Gennaio/Marzo 2012: A41-A50.
  32. Maslach C. and Jackson S.E. (1986). The Maslach Burnout Inventory (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.
  33. Maslach C., Schaufeli W.B. and Leiter M.P. (2001). Job burnout. Annual Review of Psychology, 52: 397-422. DOI: 10.1146/annurev.psych.52.1.397
  34. McKinnon B. and Cross W. (2008). Occupational violence and assault in mental health nursing: a scop- ing project for a Victorian Mental Health Service. International Journal of Mental Health Nursing, 17 (1): 9-17. DOI: 10.1111/j.1447-0349.2007.00499.
  35. Podsakoff P.M., MacKenzie S.B. and Podsakoff N.P. (2012). Sources of method bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63: 539-569. DOI: 10.1146/annurev-psych-120710-10045
  36. Siemsen E., Roth A. and Oliveira P. (2010). Common method bias in regression models with linear, quadratic, and interaction effects. Organizational Research Methods, 13 (3): 456-476. DOI: 10.1177/109442810935124
  37. Simbula S. e Benedetti E. (2013). La scuola tra passato e presente: come gli insegnanti fanno fronte alle richieste lavorative e si sentono engaged [School between past and present: how teachers cope with their job demands and stay engaged]. Psicologia della Salute, 2: 71-94. DOI: 10.3280/PDS2013-00200
  38. Sirigatti S. e Stefanile C. (1993). The Maslach Burnout Inventory: adattamento e taratura per l’Italia. [The Maslach Burnout Inventory: Adaptation and calibration for Italy]. Firenze: Organizzazioni Speciali.
  39. Taddei S. e Vanni D. (2008). Customer-related social stress and burnout. A contribution to the Italian adaptation of the Customer-related Social Stress scale. Bollettino di Psicologia Applicata, 256: 29-39.
  40. Thomas W. and Cook R.D. (1989). Assessing influence on regression coefficients in generalized linear models. Biometrika, 76 (4): 741-749. DOI: 10.1093/biomet/76.4.74
  41. Toderi S., Sarchielli G. e Giani L. (2013). Autonomia lavorativa e benessere nella professione infermieristica: l’influenza del contesto di lavoro e del percorso formativo [Job autonomy and well-being in the nurse profession: the influence of the workplace and the training course]. Psicologia della Salute, 1: 89-110. DOI: 10.3280/PDS2013-00100
  42. Van de Ven B. and Vlerick P. (2013). Testing the triple-match principle among technology employees. European Journal of Work and Organizational Psychology, 22 (6): 658-669. DOI: 10.10801359432X.2012.682359
  43. Viotti S., Converso D. e Loera B. (2012). Soddisfazione lavorativa e burnout in relazione alle caratteristiche del lavoro e alla tipologia dell’utenza: un confronto tra servizi di cura intensivi (ICU) e non intensivi (non-ICU) [Job satisfaction, job burnout and their relationships with work’ and patients’ characteristics: a comparison between intensive care units (ICU) and not-intensive care units (NOT-ICU)]. Giornale Italiano di Medicina del Lavoro ed Ergonomia, XXIV N. 2/supplemento B Psicologia Aprile/Giugno 2012 B52-B60.
  44. Warr P. (1990). The measurement of well‐being and other aspects of mental health. Journal of Occupational Psychology, 63 (3): 193-210. DOI: 10.1111/j.2044-8325.1990.tb00521.
  45. Warr P. (2012). How to Think About and Measure Psychological Well-being. In: M. Wang, R.R. Sinclair and L.E. Tetrick, editors, Research Methods in Occupational Health Psychology. New York: Psychology Press/Routledge.
  46. Winstanley S. and Whittington R. (2004). Aggression towards health care staff in a UK general hospital: variation among professions and departments. Journal of Clinical Nursing, 13 (1): 3-10. DOI: 10.1111/j.1365-2702.2004.0080

  • Users’ Support as a Social Resource in Educational Services: Construct Validity and Measurement Invariance of the User-Initiated Support Scale (UISS) Barbara Loera, Mara Martini, Sara Viotti, Daniela Converso, in Frontiers in Psychology /2016
    DOI: 10.3389/fpsyg.2016.01248
  • Who Cares for Those Who Take Care? Risks and Resources of Work in Care Homes Caterina Gozzoli, Diletta Gazzaroli, Chiara D’Angelo, in Frontiers in Psychology 314/2018
    DOI: 10.3389/fpsyg.2018.00314
  • Le dinamiche di interazione nella complessità del sistema sanitario: ruoli e responsabilità Giovanna Fanci, in SICUREZZA E SCIENZE SOCIALI 3/2019 pp.19
    DOI: 10.3280/SISS2018-003003
  • Customer Orientation and Leadership in the Health Service Sector: The Role of Workplace Social Support Andreina Bruno, Giuseppina Dell’Aversana, Anna Zunino, in Frontiers in Psychology 1920/2017
    DOI: 10.3389/fpsyg.2017.01920
  • Verbal Aggression from Care Recipients as a Risk Factor among Nursing Staff: A Study on Burnout in the JD-R Model Perspective Sara Viotti, Silvia Gilardi, Chiara Guglielmetti, Daniela Converso, in BioMed Research International /2015 pp.1
    DOI: 10.1155/2015/215267
  • Aging and Work Ability: The Moderating Role of Job and Personal Resources Daniela Converso, Ilaria Sottimano, Gloria Guidetti, Barbara Loera, Michela Cortini, Sara Viotti, in Frontiers in Psychology 2262/2018
    DOI: 10.3389/fpsyg.2017.02262
  • Stress-Preventive Management Competencies, Psychosocial Work Environments, and Affective Well-Being: A Multilevel, Multisource Investigation Stefano Toderi, Cristian Balducci, in International Journal of Environmental Research and Public Health /2018 pp.397
    DOI: 10.3390/ijerph15030397
  • Comportamenti aggressivi e episodi di violenza a danno degli operatori sanitari: intervento di prevenzione e contrasto Maria Cristina Florini, Caryn Vallesi, Carla Baldassarri, in PSICOLOGIA DELLA SALUTE 2/2019 pp.143
    DOI: 10.3280/PDS2019-002007

Chiara Guglielmetti, Silvia Gilardi, Lucia Accorsi, Daniela Converso, La relazione con i pazienti in sanità: quali risorse lavorative per attenuare l’impatto degli stressor sociali? in "PSICOLOGIA DELLA SALUTE" 2/2014, pp 121-137, DOI: 10.3280/PDS2014-002008