Esposizione ad episodi di violenza e burnout nel settore sanitario il ruolo di mediazione della capacità lavorativa
Contenuto principale dell'articolo
Keywords
Abstract
Introduzione. Subire violenza, verbale o fisica, da parte di fruitori dei servizi (pazienti e familiari) costituisce uno dei problemi più importanti per gli operatori sanitari. Obiettivo dello studio. Analizzare l’impatto degli episodi di violenza sul burnout e sulla capacità lavorativa, esplorando la relazione tra esposizione alla violenza, capacità lavorativa e burnout. Metodi. I dati sono stati raccolti attraverso un questionario che indagava l’esposizione alla violenza (tramite il Violent Incident Form-VIF), il burnout (tramite il Maslach Burnout Inventory-MBI-HSS) e la capacità lavorativa (tramite il Work Ability Index-WAI). Al questionario hanno risposto 300 lavoratori. Risultati. Più del 36% degli operatori sanitari ha dichiarato di essere stato vittima di violenza negli ultimi 12 mesi, nella maggior parte dei casi di tipo verbale e perpetrata prevalentemente dai parenti dei pazienti (62.1%). La capacità lavorativa è risultata più bassa tra chi ha vissuto situazioni violente (t=5.2, p=.00), così come esaurimento emotivo e depersonalizzazione risultavano più elevati tra chi aveva sperimentato violenza (esaurimento emotivo: t= -4.2; p=.00; depersonalizzazione: t= -3.1; p=.00). Infine, le analisi hanno evidenziato un effetto di mediazione della capacità lavorativa tra l’esposizione alla violenza, l’esaurimento emotivo (effetto indiretto: b= 2.8, BCa CI [1.43, 4.52]) e la depersonalizzazione (effetto indiretto: b = 1.1, BCa CI [0.50, 1.95]). Discussione. Questo studio è stato uno dei primi a considerare l'effetto di mediazione della capacità lavorativa tra violenza sul luogo di lavoro e burnout nel settore sanitario, segnalando la complessità e la gravità delle conseguenze della violenza sul posto di lavoro, soprattutto nei contesti sanitari
Riferimenti bibliografici
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29. Jeong IY, Kim JS: The relationship between intention to leave the hospital and coping methods of emergency nurses after workplace violence. J Clin Nurs 2018; 27:1692–1701. DOI: 10.1111/jocn.14228
30. Kim H, Kim JS, Choe K, et al: Mediating effects of workplace violence on the relationships between emotional labour and burnout among clinical nurses. J Adv Nurs 2018; 74: 2331–2339. DOI: 10.1111/jan.13731
31. Kvas A and Seljak J: Sources of workplace violence against nurses. Work 2015; 52: 177-184. DOI: 10.3233/WOR-152040
32. Laeeque SH, Bilal A, Babar S, et al: How Patient-Perpetrated Workplace Violence Leads to Turnover Intention Among Nurses: The Mediating Mechanism of Occupational Stress and Burnout. J Aggress Maltreatment Trauma 2018; 27, 1: 96–118. DOI:10.1080/10926771.2017.1410751
33. Loera B, Converso D, Viotti S: Evaluating the Psychometric Properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) Among Italian Nurses: How Many Factors Must a Researcher Consider? PLoS One 2014; 12 9(12): e114987. DOI: 10.1371/journal.pone.0114987
34. Lu L, Lok KI, Zhang L, et al: A Prevalence of verbal and physical workplace violence against nurses in psychiatric hospitals in China. Arch Psychiat Nurs 2019; 33: 68-72. DOI: 10.1016/j.apnu.2019.07.002
35. Magnavita N: Workplace violence and occupational stress in healthcare workers: A chicken-and-egg situation- results of a 6-year follow-up study. J Nurs Scholarsh 2014; 46: 366-376
36. Maslach J, Jackson SE, Leiter MP. Maslach Burnout Inventory (3th edition). Palo Alto CA, Consulting Psychology Press 1996
37. Monteiro I, de Santana P, Chillidab M and Contrera L: Work ability among nursing personnel in public hospitals and health centers in Campinas – Brazil. Work 2012;
41: 316-319. DOI: 10.3233/WOR-2012-0176-31638. OMS, https://www.nurse24.it/images/allegati/rapporto-oms-infermieri.pdf 2020
39. Ramacciati N, Ceccagnoli A, Addey B: Violence towards nurses in the Triage Area. Scenario 2013; 30: 4-10
40. Ramacciati N, Ceccagnoli A, Addey B, Rasero L: Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. Int J Nurs 2018; 81:21-29. DOI: 10.1016/j.ijnurstu.2018.01.017
41. Salvati A: Dati INAIL. 2018, 11
42. Soric M, Golubic R, Milosevic M, et al: Shift work, quality of life and work ability among Croatian hospital nurses. Coll. Antropol. 2013; 37, 2: 379–384
43. Sossai D, Molina FS, Amore M, et al: Analisi degli episodi di violenza in un grande ospedale Italiano. Med Lav 2017; 108, 5: 377-387. DOI: 10.23749/mdl.v108i5.6005
44. Sottimano I, Guidetti G, Converso D, Viotti S: We cannot be “forever young,” but our children are: A multilevel intervention to sustain nursery school teachers’ resources and well-being during their long work life cycle. Plos One 2018; 13(11): e0206627. DOI:10.1371/journal.pone.0206627
45. Tuomi K, Ilmarinen J, Jahkola A, et al: Work Ability Index. 2nd revised edn. Helsinki: Finnish Institute of Occupational Health, 1998
46. UIIPRC Workplace violence. A report to the nation. Iowa City, IA: University of Iowa, 2001
47. Uronen L, Heimonen J, Puukka P, et al: Health check documentation of psychosocial factors using the WA. Occup Med 2017; 67: 151–154. DOI: 10.1093/occmed/kqw117
48. Viotti S, Gilardi S, Guglielmetti C, Converso D: Verbal Aggression From Care Recipients as a Risk Factor Among Nursing Staff: A Study on Burnout in the JD-R Model Perspective. Biomed Res Int 2015; 215-267. DOI: 10.1155/2015/215267
49. Viotti S, Guidetti G, Converso D: Nurses Between the Hammer and the Anvil: Analyzing the Role of the Workplace Prevention Climate in Reducing Internal and External Violence. Violence Vic 2019; 1, 34: 363-375. DOI:10.1891/0886-6708.VV-D-17-00035.i
50. Viotti S, Guidetti G, Sottimano I, Martini M, Converso D: Work ability and burnout: What comes first? A twowave, cross-lagged study among early childhood educators. Safety Science 2019; 118: 898-906
51. Wang PX, Wang MZ, Hu GX, Wang ZM: Study on the relationship between workplace violence and workability among health care professionals in Shangqiu City. Journal of Hygiene Research 2006; 35: 472-474
52. Waschgler K, Ruiz-Hernande JA, Llor-Esteban B, Garcia-Izquierdo M: Patient’s aggressive behaviors towards
nurses: Development and psychometric properties of the hospital aggressive behavior scale-users. J Adv Nurs 2012; 69: 1418–1427. DOI:10.1111/jan.12016
53. WHO (2003). Joint Programme on workplace violence in the health sector. Geneva: Workplace violence in the health sector country case studies research instruments. Survey questionnaire (ultimo accesso 20/05/2020)
54. WHO (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. Disponibile online all’indirizzo https://www.who.int/mental_health/evidence/burn-out/en/, (ultimo accesso 20/05/2020)
55. Yang BX, Stone TE, Petrini MA, Morris DL: Incidence, Type, Related Factors, and Effect of Workplace Violence on Mental Health Nurses: A Cross-sectional Survey. Arch Psychiat Nurs 2018; 32: 31–38. DOI: 10.1016/j.apnu.2017.09.013
56. Yoon HS and Sok S: Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Int J Nurs Pract 2016; 22: 596–604. DOI: 10.1111/ijn.12479
57. Zafar W, Khan UR, Siddiqui SA, et al: Workplace violence and self-reported psychological health: Coping with post-traumatic stress, mental distress and burn out among physicians working in the emergency departments compared to other specialties in Pakistan. Int. J. Emerg Med 2015; 50: 167–177. DOI: 10.1016/j.jemermed.2015.02.049
58. Zhao SH, Shi Y, Sun ZN, et al: Impact of workplace violence against nurses’ thriving at work, job satisfaction and turnover intention: A cross-sectional study. J Clin Nurs. 2018; 27: 2620–2632. DOI: 10.1111/jocn.14311
2. Al-Shiyab AA, Ababneh RI: Consequences of workplace violence behaviors in Jordanian public hospitals. Empl Relat 2018; 40, 3: 515-528. DOI: 10.1108/ER-02-2017-0043
3. Arnetz JE: The Violent Incident Form (VIF): A practical instrument for the registration of violent incidents in the health care workplace. Work and Stress 1998; 12: 17-28
4. Arnetz JE, Hamblin L, Russel J, et al: Preventing Patient to-Worker Violence in Hospitals: Outcome of a Randomized Controlled Intervention. J Occup Environ Med 2017; 59: 18-27. DOI: 10.1097/JOM.0000000000000909
5. Azami M, Moslemirad M, MektaKooshali MH, et al: Workplace Violence Against Iranian Nurses: A Systematic Review and Meta-Analysis. Violence Vict 2018; 33,6: 1148-1175. DOI: 10. 1891/ 0886- 6708. VV- D- 17-00079
6. Balducci C, Fraccaroli F: Stress lavoro-correlato: Questioniaperte e direzioni future (Work-related stress: Open issues and future directions). G Ital di Psicol 2019; 46:39-65
7. Camerino D, Conway PM, Van der Heijden BIJM, et al: Low‐perceived work ability, ageing and intention to leave nursing: a comparison among 10 European countries. JAN 2006; 56: 542-552. DOI:10.1111/j.1365-2648.2006.04046.x
8. Cannav. M, Fusaro N, Colaiuda F, et al: Studio preliminare sulla presenza e la rilevanza della violenza nei confronti del personale sanitario dell’emergenza. Clin ter 2017; 168: 99-112. DOI: 107417/CT.2017.1990
9. Cashmore AW, Indig D, Hampton SE, et al: Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records. BMC Health Serv Res 2012; 12: 1-10
10. Chen S, Lin S, Ruan Q, et al: Workplace violence and its effect on burnout and turnover attempt among Chinese medical staff. Arch Environ Occup Health 2016; 71:330–337. DOI: 10.1080/19338244.2015.1128874
11. Choi SH and Lee H: Workplace violence against nurses in Korea and its impact on professional quality of life and turnover intention. Nurs Manag 2017; 25 : 508–518. DOI:10.1111/jonm. 12488
12. CIIP, Consulta interassociativa italiana per la prevenzione (2017). Libro d’argento Ciip sull’invecchiamento al lavoro. Disponibile online all’indirizzo: https://www.ciip-consulta.it/index.php?option=com_phocadownload&view=file&id=1:aging-ebook&Itemid=609 (ultimo accesso 20/05/2020)
13. Costa G, Sartori S, Bertoldo B, et al: Work ability in health care workers. Int. Congr. Ser. 2005; 1280:264-269
14. D’Alterio N, Fantinelli S, Galanti T, Cortini M: The mediator role of the job related stress in the relation between learning climate and job performance. Evidences from the health sector. Recenti Prog Med 2019; 110:251-254
15. Elliott P: Violence in health care: What nurse managers need to know. Nurs Manage 1997; 28: 38-41
16. Erdur B, Ergin A, Yuksel A, et al: Assessment of the relation of violence and burnout among physicians working in the emergency departments in Turkey. Ulus Travma Acil Cerrahi Derg 2015; 21: 175–181. DOI: 10.5505/tjtes.2015.91298
17. Esmaeilpour M, Salsali M, Ahmadi F: Workplace violence against Iranian nurses working in emergency departments. Int Nurs Rev 2011; 58: 130–137
18. Fafliora E, Bampalis VG, Zarlas G, et al: Workplace violence against nurses in three different Greek healthcare settings. Work 2016; 53: 551–560. DOI: 10.3233/WOR-152225
19. Ferri P, Reggiani F, Di Lorenzo R: I comportamenti aggressivi nei confronti dello staff infermieristico in tre differenti
aree sanitarie. Professioni Infermieristiche 2011; 64: 143-150
20. Field A: Discovering statistics using IBM SPSS Statistics (4th edition). Sage Publications Ltd, London 2000
21. Fischer FM, Da Silva Borges FN, Rotenberg L, et al: Work Ability of Health Care Shift Workers: What Matters? Chronobiol Int 2006; 23:1165-79
22. Fischer FM, Martinez MC: Individual features, working conditions and work injuries are associated with work ability among nursing professionals. Work 2013; 45: 509-517. DOI: 10.3233/WOR-131637
23. Hayes AF. Introduction to mediation, moderation, and conditional process analysis. A regression based approach (2nd edition). The Guilford Press, NY, London 2018
24. Hegney D, Tuckett A, Parker D, Eley RM: Workplace violence: Differences in perceptions of nursing work between those exposed and those not exposed: A cross sector analysis. Int J Nurs Pract 2010; 16: 188–202. DOI:
10.1111/j.1440-172X.2010.01829.x
25. Ilmarinen J, Tuomi K, Seitsamo J: New dimensions of work ability. Int.Congr Ser 2005; 1280: 3-7
26. Ilmarinen V, Ilmarinen J, Huuhtanen P, et al: Examining the factorial structure, measurement invariance and convergent and discriminant validity of a novel self-report measure of work ability: work ability – personal radar. Ergonomics 2015; 58: 1445-1460. DOI:10.1080/00140139.2015.1005167
27. International Labour Office: International Council of Nurses, World Health Organization, Public Services International: Framework Guidelines for Addressing Workplace Violence in the Health Sector. Geneva: International Labour Office; 2002
28. Itzhaki M, Bluvstein I, Bortz AP, et al: Mental health nurse’s exposure to Workplace Violence leads to Job stress, Which leads to reduced Professional Quality of life. Front Psychol 2018; DOI: 10.3389/fpsyt.2018.00059
29. Jeong IY, Kim JS: The relationship between intention to leave the hospital and coping methods of emergency nurses after workplace violence. J Clin Nurs 2018; 27:1692–1701. DOI: 10.1111/jocn.14228
30. Kim H, Kim JS, Choe K, et al: Mediating effects of workplace violence on the relationships between emotional labour and burnout among clinical nurses. J Adv Nurs 2018; 74: 2331–2339. DOI: 10.1111/jan.13731
31. Kvas A and Seljak J: Sources of workplace violence against nurses. Work 2015; 52: 177-184. DOI: 10.3233/WOR-152040
32. Laeeque SH, Bilal A, Babar S, et al: How Patient-Perpetrated Workplace Violence Leads to Turnover Intention Among Nurses: The Mediating Mechanism of Occupational Stress and Burnout. J Aggress Maltreatment Trauma 2018; 27, 1: 96–118. DOI:10.1080/10926771.2017.1410751
33. Loera B, Converso D, Viotti S: Evaluating the Psychometric Properties of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) Among Italian Nurses: How Many Factors Must a Researcher Consider? PLoS One 2014; 12 9(12): e114987. DOI: 10.1371/journal.pone.0114987
34. Lu L, Lok KI, Zhang L, et al: A Prevalence of verbal and physical workplace violence against nurses in psychiatric hospitals in China. Arch Psychiat Nurs 2019; 33: 68-72. DOI: 10.1016/j.apnu.2019.07.002
35. Magnavita N: Workplace violence and occupational stress in healthcare workers: A chicken-and-egg situation- results of a 6-year follow-up study. J Nurs Scholarsh 2014; 46: 366-376
36. Maslach J, Jackson SE, Leiter MP. Maslach Burnout Inventory (3th edition). Palo Alto CA, Consulting Psychology Press 1996
37. Monteiro I, de Santana P, Chillidab M and Contrera L: Work ability among nursing personnel in public hospitals and health centers in Campinas – Brazil. Work 2012;
41: 316-319. DOI: 10.3233/WOR-2012-0176-31638. OMS, https://www.nurse24.it/images/allegati/rapporto-oms-infermieri.pdf 2020
39. Ramacciati N, Ceccagnoli A, Addey B: Violence towards nurses in the Triage Area. Scenario 2013; 30: 4-10
40. Ramacciati N, Ceccagnoli A, Addey B, Rasero L: Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. Int J Nurs 2018; 81:21-29. DOI: 10.1016/j.ijnurstu.2018.01.017
41. Salvati A: Dati INAIL. 2018, 11
42. Soric M, Golubic R, Milosevic M, et al: Shift work, quality of life and work ability among Croatian hospital nurses. Coll. Antropol. 2013; 37, 2: 379–384
43. Sossai D, Molina FS, Amore M, et al: Analisi degli episodi di violenza in un grande ospedale Italiano. Med Lav 2017; 108, 5: 377-387. DOI: 10.23749/mdl.v108i5.6005
44. Sottimano I, Guidetti G, Converso D, Viotti S: We cannot be “forever young,” but our children are: A multilevel intervention to sustain nursery school teachers’ resources and well-being during their long work life cycle. Plos One 2018; 13(11): e0206627. DOI:10.1371/journal.pone.0206627
45. Tuomi K, Ilmarinen J, Jahkola A, et al: Work Ability Index. 2nd revised edn. Helsinki: Finnish Institute of Occupational Health, 1998
46. UIIPRC Workplace violence. A report to the nation. Iowa City, IA: University of Iowa, 2001
47. Uronen L, Heimonen J, Puukka P, et al: Health check documentation of psychosocial factors using the WA. Occup Med 2017; 67: 151–154. DOI: 10.1093/occmed/kqw117
48. Viotti S, Gilardi S, Guglielmetti C, Converso D: Verbal Aggression From Care Recipients as a Risk Factor Among Nursing Staff: A Study on Burnout in the JD-R Model Perspective. Biomed Res Int 2015; 215-267. DOI: 10.1155/2015/215267
49. Viotti S, Guidetti G, Converso D: Nurses Between the Hammer and the Anvil: Analyzing the Role of the Workplace Prevention Climate in Reducing Internal and External Violence. Violence Vic 2019; 1, 34: 363-375. DOI:10.1891/0886-6708.VV-D-17-00035.i
50. Viotti S, Guidetti G, Sottimano I, Martini M, Converso D: Work ability and burnout: What comes first? A twowave, cross-lagged study among early childhood educators. Safety Science 2019; 118: 898-906
51. Wang PX, Wang MZ, Hu GX, Wang ZM: Study on the relationship between workplace violence and workability among health care professionals in Shangqiu City. Journal of Hygiene Research 2006; 35: 472-474
52. Waschgler K, Ruiz-Hernande JA, Llor-Esteban B, Garcia-Izquierdo M: Patient’s aggressive behaviors towards
nurses: Development and psychometric properties of the hospital aggressive behavior scale-users. J Adv Nurs 2012; 69: 1418–1427. DOI:10.1111/jan.12016
53. WHO (2003). Joint Programme on workplace violence in the health sector. Geneva: Workplace violence in the health sector country case studies research instruments. Survey questionnaire (ultimo accesso 20/05/2020)
54. WHO (2019). Burn-out an “occupational phenomenon”: International Classification of Diseases. Disponibile online all’indirizzo https://www.who.int/mental_health/evidence/burn-out/en/, (ultimo accesso 20/05/2020)
55. Yang BX, Stone TE, Petrini MA, Morris DL: Incidence, Type, Related Factors, and Effect of Workplace Violence on Mental Health Nurses: A Cross-sectional Survey. Arch Psychiat Nurs 2018; 32: 31–38. DOI: 10.1016/j.apnu.2017.09.013
56. Yoon HS and Sok S: Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Int J Nurs Pract 2016; 22: 596–604. DOI: 10.1111/ijn.12479
57. Zafar W, Khan UR, Siddiqui SA, et al: Workplace violence and self-reported psychological health: Coping with post-traumatic stress, mental distress and burn out among physicians working in the emergency departments compared to other specialties in Pakistan. Int. J. Emerg Med 2015; 50: 167–177. DOI: 10.1016/j.jemermed.2015.02.049
58. Zhao SH, Shi Y, Sun ZN, et al: Impact of workplace violence against nurses’ thriving at work, job satisfaction and turnover intention: A cross-sectional study. J Clin Nurs. 2018; 27: 2620–2632. DOI: 10.1111/jocn.14311
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Converso D, Sottimano I, Balducci C. Esposizione ad episodi di violenza e burnout nel settore sanitario: il ruolo di mediazione della capacità lavorativa. Med Lav [Internet]. 2021 Feb. 23 [cited 2024 Aug. 17];112(1):58-67. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/9906
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Come citare
1.
Converso D, Sottimano I, Balducci C. Esposizione ad episodi di violenza e burnout nel settore sanitario: il ruolo di mediazione della capacità lavorativa. Med Lav [Internet]. 2021 Feb. 23 [cited 2024 Aug. 17];112(1):58-67. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/9906
