Work environment and related burnout levels: survey among healthcare workers in two hospitals of Southern Italy: Work environment and related burnout levels among healthcare workers

Work environment and related burnout levels: survey among healthcare workers in two hospitals of Southern Italy

Work environment and related burnout levels among healthcare workers


  • Roberto Lupo “San Giuseppe da Copertino” Hospital, ASL (Local Health Authority) Lecce (LE), Italy
  • Alessia Lezzi ANT Italia ONLUS Foundation (National Cancer Association) Lecce (LE), Italy
  • Luana Conte Laboratory of Interdisciplinary Research Applied to Medicine (DReAM), University of Salento and ASL (Local Health Authority) Lecce (LE), Italy; Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics “E. De Giorgi”, University of Salento, Lecce (LE), Italy
  • Pietro Santoro Teacher Lecce (LE), Italy
  • Maicol Carvello Brisighella Community Hospital, ASL (Local Health Authority) of Romagna
  • Giovanna Artioli IRCCS, “Santa Maria Nuova” Hospital, USL (Local Health Authority) - Reggio Emilia, Italy
  • Antonino Calabrò “Nuovo Ospedale degli Infermi” Hospital, ASL (Local Health Authority) Biella (BS) Italy
  • Cosimo Caldararo University of Bari (BA), Italy
  • Stefano Botti IRCCS, “Santa Maria Nuova” Hospital, USL (Local Health Authority) - Reggio Emilia, Italy
  • Maria Chiara Carriero “Santa Chiara” Institute, Rome (RM), Italy


Burnout; Environmental Safety; Evidence-based Design; Healthcare Workers; Stress; Organizational Well-being; Working Environment.


Background and aim of the work. Safety in hospitals is a structural variable on which depends not only on health, but also on physical safety of patients and employees, whom are increasingly exposed to risks as a result of which they may suffer from occupational diseases and/or develop important psycho-physical consequences. The study aimed to evaluate the association between work environment and perceived burnout levels in two hospitals of Southern Italy.

Method.: From March to August 2019 an observational study was carried out through a survey consisting of four sections: sociodemographic data; the Post Occupancy Evaluation (POE) questionnaire; the perception of the environment and possible causes of stress; the burnout levels perceived through the Maslach Burnout Inventory (MBI). A convenience sample of 169 healthcare workers participated in the study. All nurses (including nursing coordinators), clinicians, support staff of the "Vito Fazzi" Hospital of Lecce (Le) and "San Giuseppe da Copertino" Hospital of Copertino (Le) with at least one year of work experience and who signed the informed consent were recruited.

Results. The healthcare workers involved in the survey declared limits in handling and usability of the equipment, both for the patient n=77 (45.6%) and for the healthcare worker n=75 (44.4%), a lack of visual privacy n=89 (52.6%) and acoustic n=128 (75.7%).  The analysis also shows higher scores on the 'depersonalization' scale among the health care workers of San Giuseppe da Copertino” Hospital (LE) (M= 9.36; DS= 9.439) and higher levels on the 'emotional exhaustion' scale in the surgical areas (M= 22.0; DS= 11.86) and in the female gender (M= 23.10; DS=. 12.01).  Conclusions. The study reveals a poor condition of environmental comfort and safety, which generate high levels of stress and burnout in healthcare workers. Such a study can encourage further multicenter studies.


Basar U, Basim N. A cross-sectional survey on consequences of Nurses' Burnout: moderating role of organizational politics. J Adv Nurs 2016; 72: 1838–1850.

Li H, Cheng B, Zhu XP. Quantification of Burnout in emergency Nurses: A systematic review and meta-analysis. Int Emerg Nurs 2018; 39: 46-54.

Monsalve-Reyes CS, San Luis-Costas C, Gómez-Urquiza JL, Albendín-García L, Aguayo R, Cañadas-De la Fuente GA. Burnout syndrome and its prevalence in primary care nursing: a systematic review and meta-analysis. BMC Fam Pract 2018; 19: 59.

Selye H. A syndrome produced by diverse nocuous agents. Nature 1936; 138: 30-32.

Freudenberger, H. Staff Burnout. Journal of Social Issues 1974; 30: 159-165.

Tabolli S, Ianni A, Renzi C, Di Pietro C, Puddu P. Work satisfaction, Burnout and stress of nursing staff: survey in two hospitals in Rome. G Ital Med Lav Ergon 2006; 28: 49-52.

Maslach C, Leiter, MP. The truth about Burnout. Jossey-Bass 1997.

Stefanile C. Cristina Maslach: About "Burnout-syndrome". Bulletin of Applied Psychology 1988; 187: 25-28.

Karasek R, Theorell T. Healthy Work: Stress, Productivity and the the Reconstruction of Working Life. Basic Books 1990.

Wilson B. & Laschinger H.K.S. Staff nurse perception of job empowerment and organizational commitment. Journal of Nursing Administration 1994; 24 (4): 39–47.

Ulrich RS, Simons RF, Losito BD, et al. "Recupero dello stress durante l'esposizione ad ambienti naturali e urbani". Giornale di psicologia ambientale 1991; 11(3): 201–230.

Ulrich, R.P., Quan, X., Zimring, C.P., Joseph, A., Choudhary, R. The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity. The Center for Health Design, September 2004.

Zraati, P. Colour Consideration for Waiting Areas in Hospitals. Conference paper: International Conference on Research into Design. Indian Institute of Technology, Madras, 7-9 January 2013.

Smith, J. Health and Nature: The Influence of Nature on Design of the Environment of Care. The Center for Health Design, Concord, California (USA), 2007: 1-20.

Lankston, L., Cusack, P., Fremantle, C., and Isles, C.) Visual art in hospitals: case studies and review of the evidence. Journal of the Royal Society of Medicine, 2010; 103: 490-499.

Dilani, A. Psychosocially Supportive Design: A Salutogenic Approach to the Design of the Physical Environment. International Hospital Federation Reference Book, 2008/2009: 32-37.

Hamilton DK, Watkins DH. Evidence-based Designe For Multiple Building Types. John Wiley & Sons, Inc 2008.

Jiang S, Verderber S. On the Planning and Design of Hospital Circulation Zones: A Review of the Evidence-Based Literature. HERD 2017; 10: 124-146.

Ulrich RS. View through a window may influence recovery from surgery. Science 1984; 224: 420-1.

Alfonsi E, Capolongo S, Buffoli M. Evidence based design and healthcare: an unconventional approach to hospital design. Ann Ig 2014; 26: 137-43.

Douglas CH, Douglas MR. Patient-centred improvements in health-care built environments: perspectives and design indicators. Health Expect 2005; 8: 264-76.

Avallone F, Paplomatas A. Organisational health, psychology of well-being in work contexts. Raffaello Cortina Editore 2005.

Preiser W. F. E., Rabinowitz H. Z., White T. Post-Occupancy Evaluation. Van Nostrand Reinhold 1988.

Sirigatti, S., Stefanile, C., & Menoni, E. (1988). Per un adattamento italiano del Maslach Burnout Inventory (MBI). Bollettino di Psicologia Applicata, 187-188, 33-39.

Maslach, C., & Jackson, S. E. The measurement of experienced burnout. Journal of Occupational Behavior1981; 2: 99-113. doi:10.1002/job.4030020205

Lahana E, Papadopoulou K, Roumeliotou O, Tsounis A, Sarafis P, Niakas D. Burnout among Nurses working in social welfare centers for the disabled. BMC Nurs 2017; 16.

European Agency for Safety and Health at Work. Musculoskeletal disorders in the healthcare Sector. Discussion paper. 2020.

Inail. Workloads and health worker safety. Well-being of Clinicianss and Nurses, performance and impact on patient safety. 2017.

Fornara F, Bonnes M, Bonaiuto M. Perceived hospital environment quality indicators: A comparison among general surgery units. Psicologia della Salute 2012: 39-60.

Foà C, Guarnieri MC, Bastoni G, Benini B, Giunti OM, Mazzotti M, Rossi C, Savoia A, Sarli L, Artioli G. Soddisfazione sul lavoro, impegno lavorativo e stress/burnout del personale di assistenza agli anziani: una ricerca qualitativa. Acta Biomed. 2020 Nov 30;91(12-S):e2020014. doi: 10.23750/abm.v91i12-S.10918. PMID: 33263342.

ANPA, RTI CTN_AGF 3/2000 Review of the effects of noise exposure.

Cordoza M, Ulrich RS, Manulik BJ, et al. Impact of Nurses Taking Daily Work Breaks in a Hospital Garden on Burnout. Am J Crit Care 2018; 27: 508-512.

Dalke H, Little J, Niemann E, et al. Colour and lighting in hospital design. Optics & Laser Technology 2006; 38: 343-365.

Duzzi B, Giovanardi I, Gradellini C. Burnout syndrome in Nurses. L'infermiere 2014; 5: 29-35.

Prapanjaroensin A, Patrician PA, Vance DE. Conservation of resources theory in Nurse Burnout and patient safety. J Adv Nurs 2017; 73: 2558-2565.

Duarte J, Pinto-Gouveia J. The role of psychological factors in oncology Nurses' Burnout and compassion fatigue symptoms. Eur. J. Oncol. Nurs 2017; 28: 114–121.

Gómez-Urquiza JL, De la Fuente-Solana EI, Albendín-García L, Vargas-Pecino C, OrtegaCampos EM, Cañadas-De la Fuente GA. Prevalence of Burnout Syndrome in Emergency Nurses: A Meta-Analysis. Crit Care Nurse 2017; 37: 1-9.

Zenobi C, Sansoni j. Burnout and intensive care. Nursing professions 2007; 60: 148-54.

DIR. 24 March 2004 on "measures aimed at improving organisational wellbeing in public administrations".

Legislative Decree no. 81 of 9 April 2008, Consolidated Law coordinated with Legislative Decree no. 106 of 3 August 2009 and subsequent supplementary and corrective decrees (updated in the July 2018 edition). Consolidated text on health and safety at work.






Original articles: Health Professions 1/2021

How to Cite

Lupo R, Lezzi A, Conte L, Santoro P, Carvello M, Artioli G, et al. Work environment and related burnout levels: survey among healthcare workers in two hospitals of Southern Italy: Work environment and related burnout levels among healthcare workers . Acta Biomed [Internet]. 2021 Mar. 31 [cited 2024 Jul. 19];92(S2):e2021009. Available from: