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Prevention and Research

Well-being at work in a center for rehabilitation

Original Article, 59 - 65
doi: 10.11138/PER/2013.2.2.059
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Background: the quality of the work environment of nurses is a subject of increasing interest since there is a close link between the quality of care and patient satisfaction. Surveys on the characteristics of hospitals in Europe, United States and Asia demonstrated that the quality of organizational behaviour influenced emotional exhaustion and the intention to change jobs in nurses. With regard to this, we performed a survey on the health service staff, at risk of occupational stress, in a center for rehabilitation located in Abruzzo (Italy).
Methods: the first step of the investigation was to identify homogenous groups of workers considering their duties in relation to job stress. We investigated all the health service staff, the office-workers and the blue collar workers (117 women and 58 men); 85% of them were in a stable job. We used anonymous questionnaires to evaluate the perception of anxiety, job stress and symptoms. State trait anxiety inventory (STAI) was used in scale 1, to measure state-anxiety as a temporary and varying condition, and in scale 2, to monitor trait-anxiety, as a relatively fixed tendency of the personality. Occupational stress was determined by the Italian version of the Karasek Job Content Questionnaire, composed of 49 items, determining decision latitude (DL), job demand (JD) job strain (JD/DL), social support and job insecurity. The perception of symptoms was also evaluated by a 10 item questionnaire. Statistical analyses were performed using SPSS® software 11.0 (SPSS Inc, Chicago, IL, USA). The “multiple comparisons/post hoc tests” (into the ANOVA) for the analysis of significant differences among groups was utilized, while the Spearman rho correlation coefficient was applied to evaluate the correlation between quantitative variables such as STAI 1 and STAI 2, DL, JD, JI, SS.
Results: the levels of anxiety and job insecurity of all the groups of workers were within the normal range. Physiotherapists and professional nurses showed rather higher anxiety, elevated job demand (JD), rather lower decision latitude and higher job strain (“job strain” = JD/DL). The health care assistants showed lower JD and DL similar to that of the professional nurses. The social assistants, teachers and logopedics showed rather low JD and rather elevated DL. Physicians had low values of anxiety, job demand and job strain, high DL and low perception of symptoms. The job stress of the blue collar workers of the hospital was similar to that of the professional nurses and physiotherapists.
The perception of symptoms in all the sanitary staff was highly correlated with levels of anxiety and job strain.
Conclusions: the low levels of anxiety and job insecurity of the health service staff show that, in this center, the work environment was of good quality. However, this study also indicates that in centers for rehabilitation and treatment of chronic diseases, the levels of occupational stress of physiotherapists and professional nurses are higher than those of the other groups of health service staff (social assistants, teachers and logopedics).
This investigation thus demonstrates that it necessary to improve the work environment of physiotherapists and professional nurses (fewer than the number required for the health care of the increasingly ageing population), also in order to avoid them leaving their jobs and therefore maintaining workforce stability.

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    doi: 10.11138/PER/2013.2.2.059