Stress at work: development of the Stress Perception Questionnaire of Rome (SPQR), an ad hoc questionnaire for multidimensional assessment of work related stress.

Stress is an emotional condition, mostly experienced as negative, initially identified and defined by Selye in the mid-thirties of the last Century. Since the first definition, stress concerns the adaptation pro- cess mostly related to environmental changes. An application of stress focuses on the evaluation of its interference on work conditions, and the scientific evidence on work related stress is very ample and rich. We are proposing a new ad hoc questionnaire for the multidimensional assessment of work related stress, called Stress Perception Question- naire of Rome (SPQR) composed of 50 items. The development of this questionnaire is based on a multi-step process: a) Identification of all the relevant topics to work related stress and areas in the scientific evidence and their transformation on specific contents of 60 tentative items; b) Exploratory factor analysis aimed to identify the best items (50) which could guarantee the maximum convergence on single scales (8), and the minimum redundancy between scales; c) Validation of the 8 scales' structure by a confirmatory factor analysis (fully achieved); d) Factor analysis for a second level factor resulting in a single factor identified as the questionnaire total score (Stress Score); d) Reliability analysis of the questionnaire total score and the single scale scores (at optimum level); e) Validation by external criteria of work related stress identified in the presence of personal violence episodes experienced by a group of health workers with different professional profiles and from two different hospitals in Rome. Our results show that the SPQR is a useful and sensitive tool for assessing the presence of emotional stress related problems identifiable in a work environment. The advantage of this questionnaire is that it allows for a multidimensional description of the different components of this problematic area besides its ability to quantify the overall stress level of those who have been administered the SPQR.

[Evidence based medicine and mobbing]. / Evidence based medicine e mobbing.

The phenomenon of the physical, moral or psychical violence in the working environment, variously indicated as "mobbing", "workplace bullying" or "workplace harassment", is to date object of numerous studies, mostly of epidemiological type, which are yet to clear, in a sufficient way, the aspects of that phenomenon, the possible causes, risk factors, constituent characteristics and consequences. Our search, a systematic review of the existing studies in literature and a meta-analysis of the jobs chosen to such scope, has shown that only a small percentage of the researches conducted on the topic is represented from studies that collected original information on the subject. The results of the meta-analysis show that in the category of the mobbed workers the psychosomatic disturbs, stress, and anxiety are greater than in the group of controls and that the perception of the surrounding environment is more negative in the victims of mobbing compared with the not mobbed workers. The value of such results is reduced by the characteristics and the heterogeneity of the studies.

[Attention, repetitive works, fatigue and stress]. / Attenzione, lavori ripetitivi, fatica e stress.

Repetitive work in occupational settings often requires a combination of mental and physical demands, but few studies were conducted concerning the relationship between attention and repetitive work. In attentive and cognitive tasks, it is common to observe effort and fatigue without the presence of those neuromuscular modifications that would justify the use of these terms. Therefore, we can talk about mental fatigue in those cases in which it is observed the exhaustion of the necessary resources for the execution of a job that doesn't demand the employment of neuromuscular apparatus. Scientific literature about this argument consists of experimental studies which aim to estimate at what extent attentive demands exspecially cognitive demands can interact with physical ones which are peculiarities of repetitive tasks. Work characterized by the maintenance of high levels of performance for a long time, produce cognitive effort with high level of vigilance, selective attention, decisional ability, automated control mechanisms, such as "eye-hand", and may contribute to the fatigue. Indeed, fatigue plays a important role in a working context since, it may interfere with the work itself by reducing the worker's efficiency and performance and if excessive and extended, it may alter the subject's psycho-physical condition and induce different pathologies. Repetitive work can contribute to the increasing of muscular fatigue by inducing mental fatigue: for example tasks which require high vigilance but low neuromuscular work, may induce a sense of effort and fatigue and cognitive factors and mental stress may cause muscular fatigue. Several intrinsic job factors, including repetitive works, may act as stressors and they can cause mental and physical symptoms such as anxiety, depression and somatic diseases. The European Community has often emphasized the pathogenic value of stress and fatigue with their high social and individual costs. For this purpose, it is opportune to consider the norm UNI EN ISO 10075, which points out the necessity to consider the human component, in term of mental load which implies not only the cognitive component but also the whole psychical sphere of the subject. Training intended like a sort of learning of specific modalities, supplies workers with the necessary instruments for a correct and more aware management of the peculiarities of working activity, contributing to the reduction of fatigue and stress deriving from the job.

[Scientific evidence in occupational medicine: meta-analysis of the data regarding the effects of working with video terminals on the psycho-physical well-being]. / L'evidenza scientifica in medicina del lavoro: meta-analisi dei dati degli effetti sul benessere psico-fisico del lavoro con videoterminale.

Psycho-physical well-being of video display terminal (VDT) workers is often neglected. The aim of this study is to evaluate, through the comparison of controlled studies published in scientific literature, the psycho-physical well-being of VDT workers and, in particular way, the phenomena of strain and mental fatigue with their neuro-physiological, behavioural and subjective components. Seven-hundreds articles have been found from which we have selected twenty-one articles on the basis of the following inclusion criteria: controlled studies and evaluation of variables about mental fatigue; finally, only fifteen articles were utilized in the analysis due to the variability of data needed in the computation of effect size. For continuous variables we have performed two different types of elaboration methods; in case of variables showing no significant heterogeneity among studies, we have used the Weighted Mean Difference method, according to the Fixed Effect Model, while for variables showing significant heterogeneity among studies, we have used the Standardized Mean Difference method according to the Random Effects Model. Categorical variables have been analyzed trough the calculation of Odds Ratio according to the Fixed Effect Model or to the Random Effects Model respectively in case of heterogeneity's absence or presence among studies. Variables obtained by the studies were classified in four groups: biological assessment, strain assessment, subjective well-being assessment, and psycho-somatic symptoms. Statistically significant outcomes have been found for urinary adrenalin, sleep disturbances and for all the evaluated categorical parameters except headache. These outcomes allow for the following observations: 1) psycho-physical well-being of VDT workers, and especially mental fatigue, remain an object of uncertain identification and they are often neglected by Occupational Health doctors even though their evaluation is required by the Italian legislation (D.Lgs 626/94); 2) even though there is a huge interest on the argument, the amount of controlled studies on VDT workers is still insufficient. Furthermore, studies are often weak in power heterogeneous and discordant on potential problematic issues and consequently there is a difficulty in both the reproduction and overlapping of the studies; 3) Occupational Health doctor should be more careful toward this specific argument and, in his clinical practice, he should use only evidence-based parameters with high level of reproduction suggested by studied which can be considered homogeneous and overlapping for case studies and control groups. This meta-analysis suggests which evaluations to use as statistically significant parameters for the health protection of VDT workers.