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

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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 .

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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.

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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;

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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.

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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

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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.

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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.

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•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

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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.

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Thank you

for your attention!

patrizia.deitinger@ispesl.it