Hospital-Based Healthcare Workers Victims of Workplace Violence in Italy: A Scoping Review.

The aim of this scoping review is to synthesize the available evidence on the prevalence rates of healthcare workers being victims of violence perpetrated by patients and visitors in Italy. PubMed, Scopus, Web of Science and CINAHL were systematically searched from their inception to April 2021. Two authors independently assessed 1182 studies. All the scientific papers written in English or in Italian reporting primary quantitative and/or qualitative data on the prevalence of aggression or sexual harassment perpetrated by patients or visitors toward healthcare workers in Italy were included. Thirty-two papers were included in the review. The data extracted were summarized in a narrative synthesis organized in the following six thematic domains: (1). Methodology and study design; (2). Description of violent behavior; (3). Characteristics of health care staff involved in workplace violence (WPV); (4). Prevalence and form of WPV; (5). Context of WPV; and (6). Characteristics of violent patients and their relatives and/or visitors. The proportion of studies on WPV differed greatly across Italian regions, wards and professional roles of the healthcare workers. In general, the prevalence of WPV against healthcare workers in Italy is high, especially in psychiatric and emergency departments and among nurses and physicians, but further studies are needed in order to gather systematic evidence of this phenomenon. In Italy, and worldwide, there is an urgent need for governments, policy-makers and health institutions to prevent, monitor and manage WPV towards healthcare professionals.

Risk and Protective Factors of Well-Being among Healthcare Staff. A Thematic Analysis.

The purpose of this study was to identify physical and psychosocial working conditions to improve well-being at work among healthcare staff. This is a potent area of inquiry given the relationship between healthcare staff well-being and service quality and other key organizational characteristics. However, while numerous studies in this area have used a quantitative methodology, very few have applied qualitative methodologies gathering subjective descriptions of the sources of well-being, providing in so doing significant data to explore in depth the factors that influence well-being in healthcare systems. We gathered qualitative data analyzing open-ended questions about risk and protective factors of well-being at work. The sample was made of 795 professionals answering an online questionnaire. Answers were coded and analyzed using the thematic analysis with an inductive approach (data-driven). We identified four themes strongly affecting professional well-being in health-care staff: Interactions, Working Conditions, Emotional Responses to Work, and Competence and Professional Growth. Our findings suggest possible strategies and actions that may be effective in helping to calibrate case-specific support and monitoring interventions to improve health and well-being of healthcare staff. We also discuss the implications of the study and suggest possible avenues for future empirical research.

Psychosocial Risks and Violence Against Teachers. Is It Possible to Promote Well-Being at Work?

Teaching has been reported to be one of the most stressful occupations, with heavy psychological demands, including the need to develop positive relationships with students and their parents; relationships that, in turn, play a significant role in teachers' well-being. It follows that the impact of any violence perpetrated by a student or parent against a teacher is particularly significant and represents a major occupational health concern. The present study examines for the first time the influence of the Job Demands-Control-Support Model on violence directed against teachers. Six hundred and eighty-six teachers working in elementary and high schools in north-east Italy completed an online, self-report questionnaire. Our findings reveal the role played by working conditions in determining teachers' experience of violence: greater job demands are associated with most offense types, whereas the availability of diffused social support at school is associated with lower rates of harassment. Workload should be equally distributed and kept under control, and violence should gain its place in the shared daily monitoring of practices and experiences at school in order to provide a socially supportive work environment for all teachers.

Violence at School and the Well-Being of Teachers. The Importance of Positive Relationships.

In the discipline of positive psychology, "well-being" is considered a fundamental aspect of "human flourishing." Inherent to this multidimensional model are emotional, psychological, and social forms of well-being, which can be grounded in positive relationships in the work environment. By adopting an interpretive framework that emphasizes these dynamics, researchers are able to focus on elements that actively help sustain the process of flourishing, rather than on negative environmental features that should be avoided if possible. Within this broader discussion, the specific question of teachers' well-being is one that has global relevance and merits greater academic attention. After all, it has significant consequences for the educational environment and students' ability to learn. The literature suggests that teachers are increasingly exposed to violence on the part of students and/or their parents. Inappropriate and/or aggressive behavior like this can reduce a teacher's occupational well-being and make it more difficult to build positive relationships in the classroom. Ultimately, it is one of the most serious work-related stress factors affecting the profession today. Previous studies have attempted to characterize the contexts in which violence occurs, and its negative impact on both the individuals involved and the broader educational climate. Less attention has been devoted to the capacity of teachers to deal with violence and develop a more resilient mindset. The positive psychology perspective focuses on well-being as a multidimensional construct wherein psychosocial and physical comfort does not simply arise provided there is an absence of suffering and violence. Rather, according to this model, such experiences can be counteracted by a capacity to endure and build positive environments. With these considerations in mind, our study presents data gathered in primary and secondary schools in northern Italy. A total 475 teachers completed an online, self-report questionnaire. The results indicate that teachers can experience occupational well-being even if they are subjected to aggressive behaviors. Supportive leadership and good relationships with colleagues may be considered valuable resources for fostering well-being among teachers.

Addressing Risks of Violence against Healthcare Staff in Emergency Departments: The Effects of Job Satisfaction and Attachment Style.

Violence in the workplace is one of the most serious issues affecting the healthcare sector. The incidence of violent behaviour towards healthcare workers is increasing worldwide. It is difficult to assess the extent of the problem, however, as violent incidents are underreported. In fact, many doctors and nurses see violence-perpetrated primarily by patients and visitors (friends and relatives of patients)-as a part of their job. Several studies indicate that violent behaviour against healthcare workers has serious consequences for the professionals involved, as well as for the wider healthcare system. The purpose of this study was to ascertain the prevalence of patient and visitor violence in a number of emergency departments in northeastern Italy and to explore the relationship between violence and certain psychosocial factors (adult attachment style, age, and job satisfaction). Data were collected using an online questionnaire. Our results demonstrate that patient and visitor violence in emergency departments is a serious risk for nurses and doctors and that it is affected by several factors relating to both patient pathologies and the way the workplace and work patterns are organised. Previous studies indicate that the most common form of violence experienced in these contexts is emotional violence and that nurses are more likely than doctors to suffer emotional and physical violence. Based on multiple regression analysis of the data, it appears that greater age and higher scores in secure attachment are associated with reduced experience of emotional violence from patients and visitors. Furthermore, our results show that the relationship between secure attachment and the amount of patient-and-visitor-perpetrated emotional violence experienced is mediated by levels of job satisfaction. We also discuss the potential implications of these results in terms of using staff training to prevent and manage patient and visitor violence and improve the safety of healthcare professionals.

The Changing Educators' Work Environment in Contemporary Society.

In this paper, we are going to address job satisfaction and perceived self-efficacy withinthe context of residential child-care. A joint report from the European Foundation for the Improvement on Living and Working Conditions and the European Agency for Safety and Health at Work revealed that managers in the field of health and education were the most concerned about the psychosocial risk of their employees, although concern is not automatically translated into tools to face the risk and to manage it. So, measuring and improving employees' job satisfaction and self-efficacy can be an important means for organizations to prevent the outcomes of psychosocial risk, and supporting high quality performance of workers. But profound changes are affecting the nature of work at large, and specifically social educator's in the field of residential care with minors. Globalization, radical technological and communication developments, as well as the pressure to frame care as a commodity, are quickly changing procedures and praxis at work, and even the meaning of job itself. All these changes are highly demanding for this category of professionals, as much as the fact that the organizational setting is vanishing as a resource to sustain their professional attitudes and behaviors. Under these circumstances, job satisfaction and self-efficacy can be hard to experience, and isolating their precursors is essential to develop healthy and effective work environments. This paper means to highlight the process of supporting self-efficacy and job satisfaction in the educational work in residential youth care that is still underrepresented in research. It presents data emerging from two studies, study 1 involving 268 educators and study 2 involving 472 educators belonging to different Italian residential child-care services. Study 1 consists of a quantitative study including the following measures: attachment style, job satisfaction, work-related self-efficacy, and length of service. Study 2 consist of a qualitative exploration deepening the sources of educators' work-satisfaction. Quantitative data support the identification of attachment style and length of service as antecedents of work-related self-efficacy and job satisfaction. Qualitative data show the importance of relational issues in shaping the educators' satisfaction at work.

Variables of Individual Difference and the Experience of Touch in Nursing.

We aim to investigate nurses' feelings of comfort or discomfort with three different types of touch: task-oriented contact, touch promoting physical comfort, and touch providing emotional containment. A questionnaire was administered to a sample of 198 nurses. We present results of multiple regression analysis identifying some antecedents of nurses' feelings of comfort with touch, namely, attachment style, worry, gender, and length of service. Worry is negatively associated with task-oriented contact and touch promoting physical comfort. Attachment security and length of service are associated with comfort with touch aimed at emotional containment; female nurses feel more comfortable than male nurses in performing this type of touch. Practical implications of findings are discussed in relation to the promotion of focused training courses for practitioners who are willing to improve the quality of care services.

Dissatisfaction in Child Welfare and Its Role in Predicting Self-Efficacy and Satisfaction at Work: A Mixed-Method Research.

Child welfare organizations are increasingly concerned with challenges emerging from the assessment of social workers' dissatisfaction. This type of service represents the work area where social workers are at greater risk of burnout. Although several studies account for high social workers' burnout scores, they do not systematically dwell upon its sources and roots. In addition, scholars point out that a considerable number of work related issues may be perceived both as a source of dissatisfaction and satisfaction. We assume that there is a need to deepen the understanding of how dissatisfaction's sources may exert an impact on both personal job satisfaction and professional self-efficacy, which are positively associated with well-being at work. The present mixed-method research has two aims: (1) the extensive exploration, applying qualitative methodology, of the perceived sources of dissatisfaction; (2) the attempt to identify the extent to which those sources predict job satisfaction and professional self-efficacy. It is our purpose to further explore which differences emerge by age. The research involved child welfare workers, that is, SWs employed in public child welfare agencies in the North East of Italy. Results show the predominant role of interpersonal trust and mutual respect, as main predictors of both professional self-efficacy and job satisfaction. Practical implications of findings are discussed.

Burnout Disrupts Anxiety Buffer Functioning Among Nurses: A Three-Way Interaction Model.

Over the last 40 years, job burnout has attracted a great deal of attention among researchers and practitioners and, after decades of research and interventions, it is still regarded as an important issue. With the aim of extending the Anxiety Buffer Disruption Theory (ABDT), in this paper we argue that high levels of burnout may disrupt the anxiety buffer functioning that protects people from death concerns. ABDT was developed from Terror Management Theory (TMT). According to TMT, reminders of one's mortality are an essential part of humans' daily experience and have the potential to awake paralyzing fear and anxiety. In order to cope with death concerns, people typically activate an anxiety-buffering system centered on their cultural worldview and self-esteem. Recent ABDT research shows that individuals with post-traumatic stress disorder are unable to activate such anxiety buffering defenses. In line with these results, we hypothesized that the burnout syndrome may have similar effects, and that individuals with higher levels of burnout will be less likely to activate an anxiety buffering response when their mortality is made salient. Participants were 418 nurses, who completed a questionnaire including: a mortality salience (MS) manipulation, a delay manipulation, and measures of burnout, work-related self-efficacy, and representation of oneself as a valuable caregiver. Nurses are daily exposed both to the risk of burnout and to mortality reminders, and thus constituted an ideal population for this study. In line with an anxiety buffer disruption hypothesis, we found a significant three-way interaction between burnout, MS and delay. Participants with lower levels of burnout reported higher levels of self-efficacy and a more positive representation as caregivers in the MS condition compared to the control condition, when there was a delay between MS manipulation and the assessment of the dependent measures. The difference was non-significant for participants with higher levels of burnout. Theoretical and practical implications of findings are discussed.

Exploring Physicians' Dissatisfaction and Work-Related Stress: Development of the PhyDis Scale.

Research, all over the world, is starting to recognize the potential impact of physicians' dissatisfaction and burnout on their productivity, that is, on their intent to leave the job, on their work ability, on the amount of sick leave days, on their intent to continue practicing, and last but not least, on the quality of the services provided, which is an essential part of the general medical care system. It was interest of the provincial medical board's ethical committee to acquire information about physician's work-related stress and dissatisfaction. The research group was committed to define the indicators of dissatisfaction and work-related stressors. Focus groups were carried out, 21 stressful experience's indicators were identified; we developed an online questionnaire to assess the amount of perceived stress relating to each indicator at work (3070 physicians were contacted by e-mail); quantitative and qualitative data analysis were carried out. The grounded theory perspective was applied in order to assure the most reliable procedure to investigate the concepts' structure of "work-related stress." We tested the five dimensions' model of the stressful experience with a confirmatory factor analysis: Personal Costs; Decline in Public Image and Role Uncertainty; Physician's Responsibility toward hopelessly ill Patients; Relationship with Staff and Colleagues; Bureaucracy. We split the sample according to attachment style (secure and insecure -anxious and avoidant-). Results show the complex representation of physicians' dissatisfaction at work also with references to the variable of individual difference of attachment security/insecurity. The discriminant validity of the scale was tested. The original contribution of this paper lies on the one hand in the qualitative in depth inductive analysis of physicians' dissatisfaction starting from physicians' perception, on the other hand, it represents the first attempt to analyze the physicians' dissatisfaction with reference to attachment styles, which is recognized as being a central variable of individual difference supporting caregiving practices. This study represents an original and innovative attempt to address physicians' dissatisfaction and job satisfaction. The PhyDis scale has been developed and, in line with international findings, our results indicate that role uncertainty and loss of social esteem are the most dissatisfying factors.

Development and Initial Validation of the Nurses' Comfort With Touch Scale.

BACKGROUND AND PURPOSE: The extent to which nurses feel comfortable about the use of touch may affect the frequency and quality of nursing touch-based interventions. No valid instrument exists to assess nurses' feelings of comfort with touch. In this study, the nurses' scale was developed and preliminary validated. METHODS: Items were generated through semistructured interviews. After testing the content validity with a team of experts, the psychometric properties were tested with a sample of 451 nurses. RESULTS: Explorative factor analysis yielded a five-factor solution, which was supported by confirmatory factor analysis. Examination of concurrent validity revealed that comfort with touch was correlated with positive affective states and emotional self-efficacy. CONCLUSION: Future directions and implications for nursing research, education, and practice are discussed.

Nurses' comfort with touch and workplace well-being.

Touch is an essential part of caregiving and has been proved to be useful to reduce pain. Nevertheless, little attention has been paid to nurses' perceptions of touch. The aim of this article was to examine the relationship between nurses' feelings of comfort with touch and their well-being at work. A sample of 241 nurses attending a pain management training course completed a questionnaire, including the following measures: Comfort with Touch (CT) scale (task-oriented contact, touch promoting physical comfort, touch providing emotional containment), Maslach Burnout Inventory (MBI; emotional exhaustion, cynicism), and Job Satisfaction. Results of structural equation models showed that touch providing emotional containment was the main predictor of emotional exhaustion. Emotional exhaustion, in turn, was positively related to cynicism and negatively related to job satisfaction. In addition, the direct path from touch providing emotional containment to cynicism was significant. Practical implications of the findings are discussed.