Stress among medical students: factor structure of the University Stress Scale among Italian students

OBJECTIVES: The main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study. OUTCOME MEASURES: We measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10). RESULTS: Results showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from -0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range. CONCLUSION: Finally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S

Current preventive policies and practices against Vaccine-Preventable Diseases and tuberculosis targeted for workers from hospitals of the Sardinia Region, Italy

Introduction. Health care Workers are exposed to infectious diseases more than the general population. Many of these infections are preventable by vaccination. The objective in this study is to investigate whether, how, and which vaccination underwent Sardinia Health Care Workers (HCWs) and the variability of policies in different Hospital Health Managements of the whole region. Methods. In March 2013, we enrolled the Hospital Health Management of all the 32 Sardinia hospitals. We investigate on immunity against vaccine-preventable diseases and education campaigns about recommended vaccinations for HCWs. Flu, hepatitis B, measles-mumps-rubella, varicella and tuberculosis were the objects of our research. Results. In most of the hospitals, influenza vaccination coverage among HCWs is less than 6%. Hepatitis B antibody assay was performed in all the respondent hospitals but only 14 had available data as collected electronically. Most of the hospitals did not perform serological tests for the evaluation of antibodies against Varicella, Measles, Mumps and Rubella in their HCWs. In 30 hospitals Mantoux test was replaced or integrated by "in vitro" test for health surveillance protocols. Conclusions. This method produced a large amount of data in small time and at a low cost. Sending back data to respective Hospital Health Management (HHM) we took a step towards greater awareness of the issue of biological risks of HCWs and of vaccine coverage

Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire

BACKGROUND: In the last decade academic stress and its mental health implications amongst university students has become a global topic. The use of valid and theoretically-grounded measures of academic stress in university settings is crucial. The aim of this study was to examine the factorial structure, reliability and measurement invariance of the short student version of the effort-reward imbalance questionnaire (ERI-SQ). METHODS: A total of 6448 Italian university students participated in an online cross-sectional survey. The factorial structure was investigated using exploratory factor analysis and confirmatory factor analysis. Finally, the measurement invariance of the ERI-SQ was investigated. RESULTS: Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the ERI-SQ. A modified version of 12 items showed the best fit to the data confirming the 3-factor model. Moreover, multigroup analyses showed metric invariance across gender and university course (health vs other courses). CONCLUSIONS: In sum, our results suggest that the ERI-SQ is a valid, reliable and robust instrument for the measurement of stress among Italian university students

The roles of unit leadership and nurse-physician collaboration on nursing turnover intention

Aim: To report a study of the relationship between variables at the group and individual level with nurses' intention to leave their unit. Background: Workplaces are collective environments where workers constantly interact with each other. The quality of working relationship employees develop at the unit-level influences both employee outcomes and unit performance by shaping employee attitudes. Design: The study was a cross-sectional design with self-administered questionnaires. Methods: A questionnaire including measures of leader-member exchange and nurse-physician collaboration analysed at group-level and affective commitment and turnover intention analysed at individual level, was administered individually to 1018 nurses in five Italian hospitals. Data were collected in 2009. Results: A total of 832 nurses (81·7% response rate) completed questionnaires. The results showed that affective commitment at individual level completely mediated the relationship between leader-member exchange at group-level and nursing turnover intention. Furthermore, the cross-level interaction was significant: at individual level, the nurses with high levels of individual affective commitment towards their unit showed low levels of turnover intention and this relationship was stronger when the nurse-physician collaboration at group-level was high. Conclusion: This study showed the importance for organizations to implement management practices that promote both high-quality nurse-supervisor and nurse-physician relationships, because they increase nurses' identification with their units. Individual affective commitment is an important quality for retaining a workforce and good nurses' relationship at group-level relationships with both supervisors and physicians are instrumental in developing identification with the work unit. Thus, the quality of relationship among staff members is an important factor in nurses' decision to leave

Pilot study for the assessment of perceived critical organizational aspects in a hospital of local health authority of Cagliari, Italy

Introduction: In italy, the effectiveness of public health services must be assessed trhoug the assessment of efficency of employees. Objective. To acquire from this activity useful infomrmation to assess and promote the well being at work. Methods: During the assessment activities, a questionnaire was administered to assess the efficency of the management in manage perceived critical organizational aspects. Results: The 44-58% consider not sufficient the management efficency in manage perceived critical organizational aspects, expecially for quality of services, communication, vocational training and risks for worker's health and safety. Conclusions: The study provide useful suggestions to better assess and manage the risk of work-related stress and exploit the key consultant role of occupational physician in the organizational context.Introduction: In italy, the effectiveness of public health services must be assessed trhoug the assessment of efficency of employees. Objective. To acquire from this activity useful infomrmation to assess and promote the well being at work. Methods: During the assessment activities, a questionnaire was administered to assess the efficency of the management in manage perceived critical organizational aspects. Results: The 44-58% consider not sufficient the management efficency in manage perceived critical organizational aspects, expecially for quality of services, communication, vocational training and risks for worker's health and safety. Conclusions: The study provide useful suggestions to better assess and manage the risk of work-related stress and exploit the key consultant role of occupational physician in the organizational context

International validation of the “Revised Motivation at Work Scale”: Validation evidence in five different languages (French, English, Italian, Spanish, & Dutch)

Results of a cross-cultural validation study of the Revised Motivation at Work Scale is presented in five languages. This scale attempts to improve over previous scales in several ways. Firstly, previously published scales of work motivation using SDT overemphasized an approach orientation for extrinsic motivation items and an avoidance orientation for introjected motivation items. To overcome this problem, we distinguished between introjection-approach and introjection-avoidance and also between extrinsic-material (approach and avoidance) and extrinsic-social (approach and avoidance). Factorial analyses confirm that this theoretical differentiation can be statistically detected. Moreover, alpha coefficients are higher for external regulation than in previous scales. Secondly, strict differentiation of the autonomous items into identified regulation and intrinsic motivation was used when developing items. Previous scales sometimes combine identification and intrinsic motivation into the same items. This increases the face validity of the scales. Thirdly, previously published scales were only available in French or English (or were translations of these measures), without empirical evidence showing equivalence across languages, which limits cross-cultural generalization. This revised scale is translated in 12 languages - Chinese, Arabic, Norwegian, Swedish, Danish, Greek, German, Dutch, Spanish, English, Italian and French - with data collected and analyzed for the latter five languages. The present study conducted with 1910 participants shows empirical evidences of validity, reliability and structural invariance in five different languages (French, English, Italian, Spanish, and Dutch). We also show that the MAWS subscales are predictably related to organizational behavior constructs. Implications for research and practice involving SDT in organizations are discussed