Improving working conditions and job satisfaction in healthcare. A study concept design on a participatory organizational level intervention in psychosocial risks management

This paper contributes to the literature on organizational interventions on occupational health by presenting a concept study design to test the efficacy of a Participatory Organizational level Intervention to improve working conditions and job satisfaction in Healthcare. The Participatory Organizational-level Intervention is developed using the Italian methodology to assess and manage psychosocial risks tailored to Healthcare. We added an additional step; evaluation, aiming to examine how the intervention works, what worked for whom in which circumstances. This ongoing study is conducted in collaboration with two large Italian Hospitals (more than 7,000 employees). The study design comprises a quasi-experimental approach consisting of five phases and surveys distributed pre- and post-intervention aiming to capture improvements in working conditions and job satisfaction. Moreover, to evaluate the efficacy of the Intervention in terms of process and content, we use a realist evaluation to test Context-Mechanisms-Outcome (CMO) configurations. We collect contextual factors at baseline and during and post-intervention process data on the key principles of line manager support and employees participation. This study is expected to provide insights on methods and strategies to improve working conditions and employees’ job satisfaction and on national policies in the occupational health framework

Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake

Objectives. To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction. Materials and Methods. Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48h after surgery. Results. oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003). Conclusions. This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders

Young workers’ access to and awareness of occupational safety and health services: age-differences and possible drivers in a large survey of employees in Italy

Young workers are in particular need of occupational safety and health (OSH) services, but it is unclear whether they have the necessary access to such services. We compared young with older workers in terms of the access to and awareness of OSH services, and examined if differences in employment conditions accounted for age-differences. We used survey data from Italy (INSuLA 1, 2014), with a sample of 8000 employed men and women aged 19 to 65 years, including 732 young workers aged under 30 years. Six questions measured access to services, and five questions assessed awareness of different OSH issues. Several employment conditions were included. Analyses revealed that young workers had less access and a lower awareness of OSH issues compared with older workers. For instance, odds ratios (OR) suggest that young workers had a 1.44 times higher likelihood [95%—confidence interval 1.21–1.70] of having no access to an occupational physician, and were more likely (2.22 [1.39–3.38]) to be unaware of legal OSH frameworks. Adjustment for selected employment conditions (company size, temporary contract) substantially reduced OR’s, indicating that these conditions contribute to differences between older and younger workers. We conclude that OSH management should pay particular attention to young workers in general and, to young workers in precarious employment, and working in small companies in particular

Self efficacy, perceptions of social context, job satisfaction and their relationship with absences at work. An integrated model rooted in Social Cognitive Theory

Background: Absenteeism is a major concern for organizations and companies since it has negative repercussions on productivity and represents a huge cost due to sick pay and expensive temporary replacement of employees who are obliged to take long-term absences. Objectives: The current study aimed at focussing on absenteeism and its causes through the investigation of a conceptual model founded on social cognitive theory where self-efficacy and Perceptions of Social Context (PoSC, i.e., perceptions of immediate supervisor, colleagues and top management) concur to predict absence from work through the mediating role of job satisfaction. Methods: A group of 361 sales assistants and administrative staff employed by the Italian branch of a retail clothing multinational were administered a self-report questionnaire for measuring self-efficacy, PoSC and job satisfaction. We then matched the self-report answers with objective absence measures. Results: Structural equation modelling lent support to the presumed relationships between variables. We found that: 1) self-efficacy was positively related to the three PoSC; 2) PoSC had a positive relationship with job satisfaction; 3) job satisfaction was negatively related to absence from work; 4) job satisfaction mediated the relationship between PoSC and absence from work. Conclusions: Overall, our contribution offers a theoretical basis for further investigations on the role of individual characteristics and perceptions of social context in absenteeism studies via both observational and intervention studies and cost-effectiveness analysis

An integrated approach to managing wellbeing in the workplace

Mental health presents a major challenge in the modern workplace and the Covid-19 exacerbated this challenge. In this chapter, we propose the Integrated Organizational Mental Health Resilience Framework, a framework that outlines the steps needed for organizations to develop resilience against turbulence. The development of the framework is based on three case studies conducted during the height of the pandemic. The first case study suggests that primary interventions need to contain flexible work policies and practices need to be in place. The second case study suggests that secondary interventions need to be tailored to the emerging needs of workers during turbulent times and the third case study suggests that there is need to review and adapt policies and practices and provide additional support for the walking wounded of turbulent times, in the case of the pandemic, workers suffering from long COVID, to ensure their sustained employment

Gender differences and occupational factors for the risk of obesity in the Italian working population

Background Obesity is a multifactorial condition and a major risk factor associated with several non-communicable diseases, such as cardiovascular disease, and with a higher risk of premature death and disability. Sex-specific factors have key roles and must be taken into consideration in studying occupational factors associated with the risk of obesity. The aim of this study was to investigate gender differences in body mass index (BMI) in a large cohort representative of Italian workers and, correlating this index with several demographic and occupational variables, to verify sex- and work-dependent differences in the risk of obesity. Methods We utilized data from INSuLa, a cross-sectional, nationally representative survey of the Italian worker population conducted in 2013 by the Italian Workers' Compensation Authority to investigate health and safety at work. Analyses were run on a sample of 8000 Italian workers, aged from 16 to 64 years. Logistic regression models were employed to assess gender differences in the relation between occupational characteristics and BMI. We adjusted for age, education, variables related to health protection at work, and chronic conditions and diseases. Results There were several significant differences in the BMI between males and females, linked to some occupational factors. For instance, female shift workers were 1.32 times (95% CI 1.11-1.57) more likely to be overweight or obese than normal-weight workers, and this association was maintained when controlling for confounders. The likelihood of overweight or obesity among women who worked 1-2 night shifts per week was significantly higher - 1.5-1.6 times - than those on day shifts. Conclusions Gender-specific differences in occupational factors associated with the risk of obesity are useful with a view to characterizing this risk and helping identify workplace-targeted intervention strategies

Gender differences and occupational factors for the risk of obesity in the Italian working population

Background Obesity is a multifactorial condition and a major risk factor associated with several non-communicable diseases, such as cardiovascular disease, and with a higher risk of premature death and disability. Sex-specific factors have key roles and must be taken into consideration in studying occupational factors associated with the risk of obesity. The aim of this study was to investigate gender differences in body mass index (BMI) in a large cohort representative of Italian workers and, correlating this index with several demographic and occupational variables, to verify sex- and work-dependent differences in the risk of obesity. Methods We utilized data from INSuLa, a cross-sectional, nationally representative survey of the Italian worker population conducted in 2013 by the Italian Workers’ Compensation Authority to investigate health and safety at work. Analyses were run on a sample of 8000 Italian workers, aged from 16 to 64 years. Logistic regression models were employed to assess gender differences in the relation between occupational characteristics and BMI. We adjusted for age, education, variables related to health protection at work, and chronic conditions and diseases. Results There were several significant differences in the BMI between males and females, linked to some occupational factors. For instance, female shift workers were 1.32 times (95% CI 1.11–1.57) more likely to be overweight or obese than normal-weight workers, and this association was maintained when controlling for confounders. The likelihood of overweight or obesity among women who worked 1–2 night shifts per week was significantly higher – 1.5-1.6 times – than those on day shifts. Conclusions Gender-specific differences in occupational factors associated with the risk of obesity are useful with a view to characterizing this risk and helping identify workplace-targeted intervention strategies