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Percezione delle liste e dei tempi d'attesa nei servizi sanitari. Variabili antecedenti alla customer satisfaction
Full text linkThe issue of waiting lists and waiting times characterizes most of the health systems of developed nations and whose purpose is to ensure universal coverage of health services in a broader perspective of fundamental human rights protection. So, apart from being a critical success factor for the health facility in terms of improving the quality of service and customer satisfaction, this issue taps a series of rights considered to be fundamental and inalienable by citizens/users such as the right to health, equality in access to the performances and care appropriateness. The issue acquires also more relevance because of higher expectations, the desire for greater involvement and participation by health services users and the link between satisfaction and patient adherence to treatments.
The research aims to explore the issue of the waiting lists and waiting times by a dual point of view, that of health professionals (through focus group) and users (through quantitative survey). With regard to users, a further objective consists in confirming the main relationships between the variables that emerge from the literature and reference models as well as designing and suggesting possible new relationships between them. These variables primarily pertain to the discrepancy between expectations and perceptions according to the confirmation/disconfirmation approach (Oliver, 1980), the perceived value associated with the service (Woodruff, 1997), the emotional and affective reactions (Pruyn & Smidts, 1998), the attribution of responsibility for internal-user causal locus vs. external-operators/external-system (Taylor, 1994; Weiner, 2000).
The overall results for the two phases of research can help to analyse deeper the issue of waiting lists and waiting times in the health service, and to provide ideas and operative suggestions aimed at improving specific user satisfaction about waiting times and, in general, the health service.La problematica delle liste e dei tempi d’attesa caratterizza la maggior parte dei sistemi sanitari delle nazioni sviluppate il cui fine consiste nell’assicurare la copertura universale delle prestazioni sanitarie in una più ampia prospettiva di tutela di diritti fondamentali della persona. Quindi, oltre a rappresentare un fattore critico di successo per la struttura sanitaria in termini di miglioramento della qualità del servizio e della customer satisfaction, essa va a toccare una serie di diritti ritenuti ormai fondamentali e irrinunciabili da parte dei cittadini/utenti quali il diritto alla salute, l’eguaglianza nell’acceso alle prestazioni e l’appropriatezza delle cure. La questione acquista, inoltre, maggiore rilevanza in virtù delle aspettative più elevate, del maggior desiderio di coinvolgimento e di partecipazione espressi dall’utente dei servizi sanitari e del legame esistente tra soddisfazione e adesione del paziente alle cure e ai trattamenti medici.
La ricerca si propone di esplorare la problematica delle liste e dei tempi d’attesa da un duplice punto di vista, quello degli operatori sanitari (mediante focus group) e quello degli utenti (mediante questionario). Relativamente agli utenti, un ulteriore obiettivo consta nel confermare le principali relazioni tra le variabili emerse dalla letteratura e nei modelli di riferimento nonché nel delineare e suggerire possibili e nuove relazioni tra le stesse. Tali variabili concernono innanzitutto la discrepanza tra le aspettative e le percezioni dell’utente secondo l’approccio della conferma/smentita (Oliver, 1980), il valore percepito associato al servizio (Woodruff, 1997), le reazioni emotive e affettive (Pruyn & Smidts, 1998), le attribuzioni di responsabilità in termini di locus causale interno-utente vs esterno-operatori/esterno-sistema (Taylor, 1994; Weiner, 2000). I risultati complessivi relativi alle due fasi della ricerca consentono di contribuire all’analisi e all’approfondimento della tematica delle liste e dei tempi d’attesa nel servizio sanitario e di fornire spunti e suggerimenti operativi volti a migliorare la soddisfazione degli utenti specifica per i tempi d’attesa e, in generale per il servizio sanitario
Presenteismo e salute dei lavoratori: effetti di mediazione sullo strain psico-fisico in un'indagine longitudinale
No full textIl presente lavoro si propone di approfondire
il fenomeno del presenteismo, costrutto ancora poco indagato,
soprattutto in Italia, nelle sue implicazioni mediche,
psicologiche, sociali ed economiche. Nella prima parte viene
proposta una rassegna della letteratura internazione, dei
significati, delle cause e conseguenze del fenomeno per la
salute individuale e organizzativa. Nella seconda parte,
viene presentato uno studio che ha coinvolto, per un periodo
di circa un anno, 326 lavoratori appartenenti ad un’azienda
operante nel settore metalmeccanico.
Tale studio costituisce, a conoscenza di chi scrive, la prima
indagine – caratterizzata da un disegno longitudinale e da un
approccio multi-metodo, entrambi poco presenti anche nella
letteratura internazionale – effettuata nel nostro Paese sul
fenomeno del presenteismo.
L’indagine prende in esame il ruolo di mediazione del
presenteismo nella relazione tra specifici fattori di rischio
di contesto e di contenuto del lavoro – crescita lavorativa,
conflitto con i colleghi, ricompense sociali – e lo strain
psico-fisico. I fattori di rischio sono stati rilevati tramite
uno strumento self-report all’inizio dell’anno. I lavoratori,
alla fine dello stesso anno, sono stati sottoposti alla visita
di sorveglianza sanitaria, in cui il medico competente
ha rilevato lo strain psico-fisico.
Le relazioni ipotizzate sono state testate stimando un modello
di equazioni strutturali con variabili osservate. È emersa
un’associazione negativa fra ricompense sociali e presenteismo
e positiva fra conflitto con i colleghi e presenteismo.
Non è invece emersa alcuna associazione tra crescita
e presenteismo. Il presenteismo, a sua volta, predice lo strain
psico-fisico. Complessivamente, il presenteismo media
la relazione tra ricompense sociali e strain, nonché quella
tra conflitto interpersonale e strain, ma non quella tra
crescita e strain.
Il presente lavoro è caratterizzato da alcuni aspetti innovativi
rispetto ai precedenti studi condotti sul tema, sia a livello
teorico che metodologico. Da un punto di vista teorico
il modello ipotizzato si propone di cogliere specifici fattori
di rischio del processo che porta alla formazione dello stress
lavorativo, attraverso il ruolo del presenteismo. Da un punto
di vista metodologico l’adozione di un disegno di ricerca
longitudinale e multi-metodo consente una migliore
comprensione delle relazioni tra le variabili indagate,
spesso limitata dall’utilizzo esclusivo di strumenti self-report
in disegni cross-sectional.
Vengono discussi, infine, i possibili interventi finalizzati a
prevenire il presenteismo e a minimizzare le sue conseguenze
negative sulla salut
Risky riding behavior on two wheels: The role of cognitive, social, and personality variables among young adolescents
No full textObjective
The main objective of this study was to analyze and estimate the relations between risky riding behaviors and some personality and sociocognitive variables through structural equation modeling. We focused on two-wheel riding behavior among a sample of 1,028 Italian adolescents at their first driving experience.
Conclusions
The main findings confirmed the role of personality in influencing riding behavior directly as well as indirectly through risk perception. In particular, risk perception was a significant mediator between personality, social norm, and riding behavior. The significant relations that emerged in the general sample were further confirmed in the two specific sub-samples of males and females. In terms of social marketing and educational communication, it may consequently be advisable to proceed in an integrated and coordinated manner at both the cognitive and social level, taking into account some "dispositions to risk" related to personality.
Impact on industry
The integrated and coordinated action on different levels - cognitive, social, and personality - may therefore allow more effective and significant results in reducing those risky riding behaviors that often underlie young two-wheel riders' higher involvement in traffic accidents
“To be, rather than to seem”: The impact of supervisor’s and personal responsibility on work engagement, job performance, and job satisfaction in a positive healthcare organization
No full textMoving from a definition of positive organization, in this study the relationship among job resources (i.e., supervisor’s responsibility, job autonomy, and perceived organizational support), personal resources (i.e., responsibility toward the task and toward colleagues and collaborators), work engagement, and its positive outcomes (i.e., job performance and job satisfaction) were investigated in an Italian public healthcare organization. Data were collected from 224 healthcare employees who completed a questionnaire to express their evaluations. The aims of the study were: a) to explore the issue of responsibility — a construct still little investigated in the literature — with particular reference to the supervisor’s role; b) to evaluate the psychometric properties of the Positive Organization Questionnaire (POQ) and of the other instruments adopted through confirmatory factor analyses; c) to verify the hypothesized relations through a structural equation model with observed variables. Results showed that the scales adopted had satisfactory psychometric properties. Furthermore, according to the JD-R model, job autonomy and perceived organizational support were positively associated with work engagement, which, in turn, was positively associated with job performance and job satisfaction. In this study, supervisor’s responsibility is seen as a job resource, however it wasn’t directly related with the considered outcomes, but employee responsibility toward the task mediated the relationship between supervisor’s responsibility and job performance, like responsibility toward colleagues and collaborators mediated the relationship with work engagement. Finally, job autonomy showed a positive direct effect on job satisfaction. Some limitations and future developments are discussed
The role of negative affectivity in the evaluation of work stress: An empirical survey
No full textThe evaluation of work stress is very often conducted using self-report measures in order to detect both the risk factors and their consequences in terms of strain. However, some authors criticize the exclusive use of self-report measurements in
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the evaluation of work stress. In particular, many objections are related to the role, as yet unclear, played by affectivity in the process of work stress (Cox, Griffiths & Rial-Gonzalez, 2000; Semmer, Grebner, & Elfering, 2004).
This study was conducted in one Italian organization (n = 670) in order to examine the role of negative affectivity (NA) in the formation process of perceived work stress among its workers. An adaptation of the Strain Free Negative Affectivity Scale created for the Italian context was used in this organization in order to assess psycho-physical strain, perceived conflict and negative affectivity.
Four popular models, widely present in the literature on work stress, were tested within the observed organization: partial mediation model, common cause model, regression model, total mediation model. These models are characterized by a specific role, different in each of them, played by NA.
The results show both a direct and an indirect – through perceived conflict – effect of NA on strain. There is also evidence of a relevant role of NA in the formation process of perceived work stress. These results highlight the seasonableness of adding hetero-evaluations or objective indicators of stress to self-evaluations in order to obtain a broader and integrated knowledge of the work stress in the observed context
Perfectionism and presenteeism among managers of a service organization: The mediating role of workhaholism.
No full textThis article examines the negative consequences of perfectionism in the workplace, in terms of both workaholism and presenteeism. Specifically, we propose a theoretical model in which self-oriented perfectionism is both directly and indirectly associated with presenteeism, through workaholism. The study was conducted on a sample of 413 workers with leadership and responsibility roles within an Italian service organization. The results showed a positive association between self-oriented perfectionism and workaholism, which, in turn, was positively associated with presenteeism. Self-oriented perfectionism, however, was not associated with presenteeism, after controlling for the effect of workaholism. Workaholism, therefore, completely mediated the relationship between self-oriented perfectionism and presenteeism. Moreover, the mediating effect of workaholism was supported only for male participants. Altogether, these results help to expand the literature on the role of perfectionism in the workplace. Practical implications are discussed for managers and human resource professionals
“The best or nothing": the mediating role of workaholism in the relationship between perfectionism and burnout.
No full textThe study involved 225 workers operating in an Italian public organization. The first aim was to evaluate the psychometric properties of the short version of the Multidimensional Perfectionism Scale in the Italian context. Confirmatory factor analysis supported the 3-factor model of perfectionism and evidenced satisfactory psychometric properties of the scale. The study also aimed to test a theoretical model in which the three dimensions of perfectionism — self-oriented, other-oriented, socially prescribed perfectionism — have both a direct and an indirect effect, through workaholism, on emotional exhaustion and professional inefficacy. Results showed that self-oriented and other-oriented perfectionism were positively associated with workaholism, which, in turn, was positively associated with emotional exhaustion. Furthermore, workaholism mediated the relationship between self-oriented and other-oriented perfectionism and emotional exhaustion. Additionally, self-oriented perfectionism had a negative direct effect on emotional exhaustion, whereas socially prescribed perfectionism showed a positive direct effect on both emotional exhaustion and professional inefficacy. Possible implications are discussed for managers and human resources professionals
Il ruolo di mediazione dell’interferenza lavoro-casa nella relazione tra stressors e malessere psico-fisico: un approccio multi-metodo
No full textIntroduzione. Lo studio integra l’interferenza lavoro-casa (Work-Home Interference, WHI) all’interno del modello teorico Effort-Recovery, secondo il quale lo svolgimento del proprio lavoro richiede degli sforzi, ai quali deve far seguito un adeguato recupero. Se si verifica un’interferenza tra sfera lavorativa e vita privata dell’individuo diminuiscono la qualità e la quantità del recupero, il che si ripercuote sulla salute del lavoratore.
Obiettivi e Metodi. Si ipotizza che il carico lavorativo (richieste lavorative) sia associato positivamente al WHI (Ipotesi 1) e che l’autonomia lavorativa (risorse lavorative) sia associata negativamente al WHI (Ipotesi 2). Ci si aspetta inoltre un’associazione positiva tra WHI e strain psico-fisico (ipotesi 3) il quale, a propria volta, predice le assenze per malattia (Sickness Absences, SA) (ipotesi 4). Lo studio ha coinvolto un campione di lavoratori di una pubblica amministrazione. Carico, autonomia e WHI sono stati misurati tramite un questionario. Lo strain psico-fisico è stato rilevato dal medico competente, mentre le SA sono state rilevate attingendo al database aziendale. Le relazioni sono stato testate stimando un modello di equazioni strutturali.
Risultati. Il carico lavorativo è associato positivamente al WHI, mentre non è emersa alcuna associazione tra autonomia e WHI. Il WHI è associato positivamente allo strain psico-fisico, il quale predice le SA. Nel complesso, il WHI media la relazione tra carico e strain. Lo strain media inoltre la relazione tra WHI e SA.
Conclusioni. Un elevato carico lavorativo, in linea con il modello E-R, interferisce con la vita privata del lavoratore, inficiando il processo di recupero. Ciò comporta la comparsa di sintomi psico-fisici, i quali possono indurre il lavoratore ad assentarsi dal lavoro. Da un punto di vista applicativo, sono discussi possibili interventi finalizzati a contenere l’effetto del carico lavorativo sul WHI e, indirettamente, sullo strain psico-fisico
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