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Dipartimento Medicina del Lavoro International Conference Psychosocial Risk Management at Work: The European Framework Dipartimento Medicina del Lavoro International Conference Psychosocial Risk Management at Work: The European Framework Rome 5 November 2008 “Developing a Model for Assessing Work Organization Well-being, Job burnout and Mobbing among Health Workers” P. Deitinger, R. Bentivenga, M. Ghelli

Dipartimento Medicina del Lavoro The research During the activity plan 2005 -2007, ISPESL promoted Dipartimento Medicina del Lavoro The research 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. 2

Contest • The “Territorial Area” consists of 14 social health districts parceled out in 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. 3

Objective The Objective is to perform an integrated psychosocial risks assessment, consistent with the 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 wellbeing of the Health Unit workers. Three tools, adapted to health context and with a proven reliability have been used. 4

Methods and tools 1) “Multidimensional Organizational Health Questionnaire” (MOHQ, F. Avallone & A. Paplomatas, 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; 5

Methods and tools 3) “Val. Mob” (A. Aiello, P. Deitinger, C. Nardella e M. Methods and tools 3) “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. 6

Sample and structural data The study sample comprised 474 people aged between 20 and 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 7

MOHQ: Results Graph 1: General profile of the Unit M = 2. 59 A= MOHQ: Results Graph 1: General profile of the Unit M = 2. 59 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 8

OCS: Results Graph 2: Organizational Checkup 9 OCS: Results Graph 2: Organizational Checkup 9

Val. Mob. : Scores Mobbing Scale Low Middle high High Relationship ≤ 27 28 Val. Mob. : Scores Mobbing Scale Low Middle high 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 10

Val. Mob: Results 1 RELATIONSHIP INTRUSION DISQUALIFICATION SYMPTOMATOLOGICAL 11 Val. Mob: Results 1 RELATIONSHIP INTRUSION DISQUALIFICATION SYMPTOMATOLOGICAL 11

Val. Mob: Results 2 Cross – validation • 380 subjects affirm that they are 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. 12

Conclusions 1 • This organization as a whole appears to function well, especially considering 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 health and organizational well-being: the - Psychophysical Stress, - Tolerable tasks - Absence of Fairness. 13

Conclusions 2 • Issues about mobbing, as Disqualification and Intrusion, are confirmed by the Conclusions 2 • 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. 14

Interventions Possible interventions should involve: • Redistribution of workloads and rotation of some of 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. 15

Thank you for your attention! patrizia. deitinger@ispesl. it 16 Thank you for your attention! patrizia. [email protected] it 16