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采用综合方法评估心理社会工作环境:意大利北部一家大医院的案例。

Using an integrated approach to the assessment of the psychosocial work environment: the case of a major hospital in northern Italy.

出版信息

Med Lav. 2014 Mar-Apr;105(2):139-51.

Abstract

BACKGROUND

In 2010, Italian regulatory guidelines have been issued consisting of a stepwise procedure for the assessment and management of work-related stress. However, research that empirically examines whether this procedure proves effective in accurately identifying critical psychosocial factors and informing risk management is scarce.

OBJECTIVES

To examine the differential sensitivity of two approaches to risk assessment, the first based on objective instruments only, the second consisting of an integrated approach combining different methods and theoretical perspectives.

METHODS

We examined a sample of 306 healthcare employees in a large-size hospital in northern Italy, using a series of tools, both quantitative (an observational checklist and the HSE-IT and MOHQ questionnaires) and qualitative (Focus Groups). Through instrument-specific reference values, we then compared risk profiles between different homogeneous groups within the institution.

RESULTS

The psychosocial work environment resulted to be far more positive when adopting the first compared to the second approach to risk assessment. The latter approach was also more sensitive in detecting between-groups differences in risk profiles. Furthermore, the Focus Groups returned a more context-specific picture of the psychosocial work environment. Finally, going beyond the emphasis on negative working conditions inherent in the other quantitative instruments, the MOHQ allowed for also identifying health-promoting factors in need for improvement.

CONCLUSIONS

Although more research is needed to confirm our findings, the present study suggests that using an integrated approach to assess the psychosocial work environment may be the most effective way to accurately identify risk factors and support the management process.

摘要

背景

2010 年,意大利发布了监管指南,其中包含了逐步评估和管理与工作相关的压力的程序。然而,很少有研究实证检验该程序是否能准确识别关键的心理社会因素并为风险管理提供信息。

目的

检验两种风险评估方法的差异敏感性,第一种方法仅基于客观工具,第二种方法由结合不同方法和理论观点的综合方法组成。

方法

我们使用一系列工具(包括观察检查表、HSE-IT 和 MOHQ 问卷)对意大利北部一家大型医院的 306 名医护人员进行了研究,这些工具既有定量的,也有定性的(焦点小组)。然后,我们通过特定工具的参考值,比较了机构内不同同质群体之间的风险状况。

结果

与第二种风险评估方法相比,第一种方法评估的心理社会工作环境要积极得多。后一种方法在检测风险状况的群体间差异方面也更为敏感。此外,焦点小组提供了更具特定背景的心理社会工作环境画面。最后,MOHQ 超越了其他定量工具中固有的对负面工作条件的强调,还可以识别需要改进的促进健康的因素。

结论

尽管需要更多的研究来证实我们的发现,但本研究表明,使用综合方法评估心理社会工作环境可能是准确识别风险因素并支持管理过程的最有效方法。

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