Organizational health and quality of life: survey among ambulance nurses in prehospital emergency care

Background: The workplace plays a central role in causing stress and different kinds of syndromes and diseases. More generally, organizational procedures and practices could have an impact on nurses’ quality of life. Although several studies have investigated this link, none of them considered nurses working in prehospital emergency care. Objectives: To investigate the role of organizational health factors that affect the quality of life and psychosomatic complaints of ambulance nurses.Method: Our sample included 411 ambulance nurses. Workers were administered two questionnaires to assess organizational health and quality of life. Descriptive and correlational analyses were used to test our assumptions. Conclusion: Several organizational health dimensions provided an explanation for the complaints reported by nurses working in prehospital emergency care in terms of quality of life and psychosomatic disorders.The results allowed identification of possible interventions focusing on specific duties and organizational aspects that would improve the quality of nurses’ health

What is Behind Counterproductive Work Behaviors in the Nursing Profession? A Systematic Review

LETTURA CONSIGLIAT

Violare le norme organizzative e sociali nei luoghi di lavoro: Studio correlazionale nel contesto infermieristico

Obiettivi: L’obiettivo principale di questo studio è stato di valutare le relazioni esistenti tra le variabili del contesto organizzativo (per esempio, carichi di lavoro, conflitti interpersonali, vincoli organizzativi), il burnout, il disimpegno morale e i comportamenti controproduttivi (CWB) degli infermieri, negli specifici ambiti clinici in cui lavorano. Metodo: Uno studio descrittivo correlazionale è stato condotto su un campione di 347 infermieri di diverse realtà operative di una grande struttura ospedaliera universitaria del centro Italia. Per l’indagine è stato utilizzato un questionario composto da scale per la misurazione delle variabili di contesto organizzativo, delle dimensioni del burnout, del sovraccarico relazionale, del disimpegno morale e dei comportamenti contro produttivi. Risultati: Gli ambiti clinici influenzavano il benessere organizzativo vissuto dagli infermieri che, a loro volta, influenzavano l’attuazione di CWB. Le aree ambulatoriali e di day hospital risultavano quelle in cui gli infermieri mettevano meno in pratica i CWB, diversamente da quelle di pronto soccorso e di medicina generale in cui i CWB venivano attuati più frequentemente. Conclusioni: I risultati di questo studio sono importanti per chi si occupa del benessere dei lavoratori e per i dirigenti delle professioni infermieristiche perché mettono in luce quanto gli ambiti clinici e le variabili di contesto organizzativo possano spingere gli infermieri ai CWB. Le variabili di contesto organizzativo devono essere tenute in seria considerazione perché si riflettono sulla qualità delle cure offerte ai malati

Modified Moral Distress Scale (MDS-11): Validation Study Among Italian Nurses

Background: Moral distress (MD) has significant implications on individual and organizational health. However there is a lack of an instrument to assess it among Italian nurses. aim: The main aim of this study was to validate a brief instrument to assess MD, developed from the Corley's Moral Distress Scale (MDS).Methods: The modified MDS scale was subjected to content and cultural validity. The scale was administered to 347 nurses. Psychometric analysis were performed to assess construct validity.Results: The scale consists of 11 items, investigating MD in nursing practice in different clinical settings. The dimensionality of the scale was investigated through exploratory factor analysis (EFA), which showed a two-dimensional structure labeled futility and potential damage. The futility refers to feelings of powerlessness and ineffectiveness in some clinical situations; the potential damage dimension captures feelings of powerlessness when nurses are forced to tolerate or perform perceived abusive clinical proceedings. Nurses who experienced higher MD, were more lilely to experience burnout.Conclusions: The modified MDS showed good psychometric properties, and it is valid and reliable for assessing moral distress among Italian nurses. Hence, the modified MDS allows to monitor the distress experienced by nurses and it is an important contribution to the scientific community and all those dealing with well-being of health workers.Keywords: moral distress, professional burnout, medical futility, nursing ethics, clinical ethicsScala sullo Stress Morale Modificata (MDS-11): Studio di Validazione tra gli Infermieri ItalianiIntroduzione: Lo stress morale (DM) ha implicazioni significative sul benessere individuale e sull'organizzazione lavorativa. Tuttavia allo stato attuale non disponiamo di uno strumento per valutare il DM tra gli infermieri italiani. Obiettivo: Lo scopo principale del presente studio è stato quello di validare uno strumento sintetico per la valutazione del MD, sviluppato dalla Scala dello Stress Morale di Corley (MDS).Metodo: La MDS modificata è stata sottoposta a validití  di contenuto e culturale. La scala è stata quindi somministrata a 347 infermieri. Si è eseguita l'analisi psicometrica per valutare la validití  di costrutto.Risultati: La scala consta di 11 items che studiano il moral distress nell'assistenza infermieristica in diversi setting clinici. Le dimensioni della Scala sono state studiate con l'analisi fattoriale esplorativa (EFA), che ha evidenziato che essa consta di due dimensioni chiamate futilití  e danno potenziale. La futilití  si riferisce a sentimenti di impotenza e di inefficacia in alcune situazioni cliniche; a dimensione del danno potenziale cattura invece i sentimenti di impotenza quando si è costretti a tollerare o ad eseguire procedure cliniche ritenute abusive. Gli infermieri che maggiormente sperimentavano MD, erano più probabilmente esposti al burnout.Conclusioni: La MDS modificata ha buone proprietí  psicometriche, ed è uno strumento valido e affidabile per la misurazione dello stress morale tra gli infermieri italiani. Quindi la MDS modificata permette di monitorare lo stress morale vissuto dagli infermieri, e fornisce un importante contributo alla comunití  scientifica e a tutti coloro che si occupano di benessere e salute dei lavoratori.Parole chiave: stress morale, burnout, futilití  medica, etica infermieristica, etica clinic

Nurse moral disengagement

Background: Ethics is a founding component of the nursing profession; however, nurses sometimes find it difficult to constantly adhere to the required ethical standards. There is limited knowledge about the factors that cause a committed nurse to violate standards; moral disengagement, originally developed by Bandura, is an essential variable to consider. Research objectives: This study aimed at developing and validating a nursing moral disengagement scale and investigated how moral disengagement is associated with counterproductive and citizenship behaviour at work. Research design: The research comprised a qualitative study and a quantitative study, combining a crossvalidation approach and a structural equation model. Participants and research context: A total of 60 Italian nurses (63% female) involved in clinical work and enrolled as students in a postgraduate master’s programme took part in the qualitative study. In 2012, the researchers recruited 434 nurses (76% female) from different Italian hospitals using a convenience sampling method to take part in the quantitative study. Ethical considerations: All the organisations involved and the university gave ethical approval; all respondents participated on a voluntary basis and did not receive any form of compensation. Findings: The nursing moral disengagement scale comprised a total of 22 items. Results attested the mono-dimensionality of the scale and its good psychometric properties. In addition, results highlighted a significant association between moral disengagement and both counterproductive and citizenship behaviours

The relationship between nurse managers' leadership style and patients' perception of the quality of the care provided by nurses: Cross sectional survey

Background:  In healthcare systems, human resources play a strategic role that has a significant impact on the whole caring process. When the wellbeing of professionals is low their performance decreases, counterproductive work behaviours may became more likely, and as a result the quality of care is compromised. Studies have shown that leadership style is particularly relevant in relation to the quality of work environments in healthcare organizations. Objective:  The main purpose of this study is to test a model that investigates the relationships between nurse managers’ leadership style and patients’ perception of the quality of the care provided by the nurses, through the mediation of the quality of the working environment (in terms of burnout, interpersonal strain and counterproductive work behaviour). Design:  A multi-centre cross-sectional study was conducted. Setting:  The study was conducted in five hospitals located two in the north, two in the centre and one in the south of Italy. Participants:  Participants were 479 registered nurses (working as staff nurses, while head nurses and nurse managers were excluded) and 829 patients aged 18 years or older, able to read and write Italian and hospitalized for at least 3 days. Severely ill or mentally disabled patients who were not able to fill in the questionnaire were excluded. Methods:  The data were collected through two different questionnaires, one for the nurses and one for the patients. A multilevel analysis was conducted to examine the hypothesized model. Results:  Results confirmed the hypothesis that, when nurses were satisfied with leadership, they felt less burned-out and strained in interpersonal relationships, they engaged less in misbehaviour, and, in turn, patients were more satisfied with the quality of the care provided by the nurses. Conclusions:  The results of this study showed that the characteristics of the organizational context, the leadership, and the behaviours of nurses, influenced patients’ perceptions of nurses’ care. Therefore, managers of healthcare services should take these results into account seriously in order to improve the quality of care provided to patients

Walking on new paths. Solutions for family farming facing climate change

Como resultado de la experiencia del Programa INNOVA AF se logró constatar que es posible desencadenar procesos más amplios de transformación rural a partir de la implementación de prácticas y conocimientos para la adaptación al cambio climático. Estos cambios, los cuales se presentan y se analizan en esta publicación brindan insumos para proyectar a la agricultura familiar como una piedra angular para la adaptación de los territorios al cambio climático. Este libro explora el potencial de la agricultura familiar en América Latina en la producción de alimentos, manejo y conservación de recursos es un hecho irrefutable, ampliamente reconocido, desde la posición de la agricultura familiar como eje transformador en el territorio al implementar prácticas y conocimientos que le ayuden a sus sistemas productivos a adaptarse a los cambios del clima. Esta capacidad de resiliencia fue evidente durante la pandemia, que contra todo pronóstico se mantuvo produciendo alimentos, pero sacrificando sus medios de vida.The experience of conducting the INNOVA AF Program made it evident that it was possible to trigger broader rural transformation processes by implementing practices and knowledge for climate change adaptation. These changes, presented and analyzed in this book, provide inputs to position family farming as a cornerstone for adapting territories to climate change. This book explores tha potential of The leading role played by family farming in Latin America in food production, resource management, and conservation is an irrefutable fact that is widely recognized, but it does so from the point of view of family farming as a transforming axis in the territory due to implementing practices and knowledge that help their production systems adapt to climate variations. This resilience capacity was evident during the pandemic because, against all odds, farmers kept producing food while sacrificing their livelihoods

The ethical leadership of the nursing ward managers as a key determinant of nurses' organisational behaviours in the healthcare settings

AIM: the main aim of this study is to examine the influence of the coordinator’s ethical leadership on nurses’ emotions (i.e., positive and negative) and work behaviours. method: a questionnaire was administered in paper format, including well-validated scales reported in literature, to a sample of 347 nurses working in a university hospital. a structural equation model has been tested after examining pearson’s correlations among study variables. results: the coordinator’s ethical leadership is strongly related to the implementation of nurses’ organisational citizenship behaviour and counterproductive work behaviour, which are influenced by their emotions. positive emotions fully mediate the relationship between ethical leadership and organisational citizenship behaviour, while negative emotions partially mediate the relationship between ethical leadership and counterproductive work behaviour. conclusions: ethical leadership acts on nurses’ organisational behaviour, as described in the modelling process. the nurses’ organisational behaviour is crucial to the outcome of the health care service. therefore, the ethical leadership indirectly affects the quality of the care and the cure offered to the patients

La salute degli infermieri in area critica: studio comparativo nell'ambito dell'emergenza sanitaria

Introduzione: è stato ampiamente riconosciuto che l'ambiente di lavoro è fondamentale nella genesi di stress e nell'insorgere di sindromi e disturbi di vario genere, che possono influenzare la salute lavorativa degli infermieri. Lo specifico contesto lavorativo e le diverse funzioni svolte dal personale infermieristico, sono inoltre considerati predittori positivi o negativi di salute organizzativa, tanto da indurre gli autori della presente ricerca a studiare il fenomeno in tre gruppi di infermieri dell’area dell’emergenza: le Camere Operatorie, i Pronto Soccorso e le Terapie Intensive. Metodi: per la conduzione dello studio è stato seguito un disegno descrittivo comparativo (ANOVA e test post-hoc di Duncan) e per l’indagine è stato utilizzato il Questionario Infermieristico sulla Salute Organizzativa (QISO). Sono stati coinvolti 953 infermieri delle Camere Operatorie, dei Pronto Soccorso e delle Terapie Intensive di dodici aziende sanitarie. Risultati: i risultati hanno dimostrato che per quanto riguarda la soddisfazione generale, sia il personale delle Camere Operatorie sia quello dei Pronto Soccorso hanno riportato i medesimi punteggi ma entrambe più bassi rispetto alle Terapie Intensive. In merito alla fatica lavorativa e alla soddisfazione per la propria unità operativa, i colleghi delle Terapie Intensive risultano avere punteggi più alti nelle due dimensioni indagate rispetto ai colleghi delle Camere Operatoria che a loro volta hanno punteggi superiori a quelli dei Pronto Soccorso. Discussioni: la presente ricerca ha dimostrato che tra gli infermieri di Pronto Soccorso sono stati individuati punteggi più bassi rispetto ai colleghi delle Camere Operatorie e delle Terapie Intensive, riguardo alcune dimensioni di salute organizzativa. Ciò è dovuto presumibilmente al tipo di lavoro svolto dagli infermieri nei diversi contesti operativi esaminati Conclusioni: in conclusione risulta fondamentale porre l’attenzione alle politiche che promuovono la Salute Organizzativa specialmente all’interno dei Pronto Soccorso dove la peculiarità del lavoro condiziona la percezione che gli infermieri hanno della propria salute organizzativa