Emotional demands as a risk factor for mental distress among nurses.

BACKGROUND: Although it is widely acknowledged that in certain occupations emotional demands may be a critical phenomenon for workers' health, this has been traditionally taken for granted and their role in the stress process has not often been directly assessed. OBJECTIVES: To examine the relationship between emotional demands and mental distress, adjusting for the potential effect of common psychosocial factors (workload, job control, social support, role stressors, and poor relationships) and personal psychological factors (i.e. having been diagnosed with anxiety or depressive disorder). METHODS: A cross-sectional study on a sample of nurses of the National Healthcare Service was carried out (N = 256, 81.3% women). The psychosocial factors considered were assessed by means of widely known and validated scales. The examined health outcome (i.e. mental distress) was operationalized by means of the General Health Questionnaire (12-item version). Covariates: gender, age, tenure and shiftwork. ANALYSES: a series of logistic regressions. RESULTS: Exposure to emotional demands was a risk factor for mental distress. The resulting risk was not altered when adjusting for other psychosocial and personal factors. In the final model emotional demands, workload and role stressors, in addition to having been diagnosed with anxiety or depressive disorder, were significant risk factors for nurses' mental distress. CONCLUSIONS: Emotional demands may substantially impact on nurses mental distress. These results give rise to concern in relation to work-stress prevention in certain professions, given that emotional demands are not included in the most common psychosocial risk assessment tools currently available, which may then miss identifying an important precondition of work stress.

[Social cooperatives in Italy]. / Les entreprises à économie sociale en Italie.

This paper describes the role of social cooperatives in Italy as a type of economic, non-profit organization and their role in contributing to the economic and social growth of the country. The purpose of this paper is to learn more about the experience of the Italian social cooperatives in promoting the work integration process of disadvantaged workers, especially those suffering from mental disorders, from a theoretical and an empirical point of view. Social enterprise is the most popular and consolidated legal and organizational model for social enterprises in Italy, introduced by Law 381/91. Developed during the early 1980s, and formally recognized by law in the early 1990s, social cooperatives aim at pursuing the general interest of the community to promote the human needs and social inclusion of citizens. They are orientated towards aims that go beyond the interest of the business owners, the primary beneficiary of their activities is the community, or groups of disadvantaged people. In Italy, Law 381/91 distinguishes between two categories of social cooperatives, those producing goods of social utility, such as culture, welfare and educational services (A-type), and those providing economic activities for the integration of disadvantaged people into employment (B-type). The main purpose of B-type social cooperatives is to integrate disadvantaged people into the open labour market. This goal is reached after a period of training and working experience inside the firm, during which the staff works to improve both the social and professional abilities of disadvantaged people. During the years, B-type social co-ops acquired a particular relevance in the care of people with mental disorders by offering them with job opportunities. Having a job is central in the recovery process of people suffering from mental diseases, meaning that B-type social co-ops in Italy play an important rehabilitative and integrative role for this vulnerable population of workers. The recent literature has highlighted that difficulties with employment are a feature of mental disorders, with high unemployment rates and short job tenure. Yet, success in employment for this population can be expected when they are provided with adequate support and opportunities. B-type social cooperatives in Italy are found to be very useful in order to help this disadvantaged category of workers find and keep a job. The work environment is more flexible and allows a better integration with less stigma and better work accommodations compared to the open labour market and/or other public/private organizations. Results from B-type Italian social cooperatives studies show that mentally ill workers value the importance of working, are highly satisfied with their job, are motivated to continue working, are engaged in their job and willing to work in the competitive labour market. Also, studies show that environmental characteristics of the social cooperative, such as the implementation of work accommodations and the possibility to work in an environment that is highly supportive, have an impact on increasing the likelihood of being highly satisfied with the job, which in turn is positively related to job tenure. In sum, this article shed light on the historical background that led to the development of social cooperatives in Italy. Furthermore, the features of B-type co-ops that play a central role in facilitating the work integration of people with mental disorders are described in this paper. In general, Italian B-type social cooperatives are found to provide a meaningful work experience to people with mental disorders, that help them increase not only vocational outcomes, but also psycho-social outcomes, and generally to help them better integrate into society.