Introduction: Dealing with chronicity and multimorbity may represent a potential risk factor for healthcare professionals. The increasing request of these professional figures leads to monitor deeply their levels of wellness and distress. Purpose: To describe the level of wellnees, distress and burnout; to measure potential differences within-and-between-group. Method: perspective observational study. Healthcare professionals working in palliative care/oncology and in rehabilitation medicine completed anonymously the following scales: MASI-R (distress and wellness), MDS-R (moral distress), HECS (ethical climate), MBI-GS (burnout), PANAS (positive and negative affects), and CD-RISC (resilience). Results: 317 healthcare professionals completed the study (57.3% nurses and social-health workers, 22% physiotherapists, 20.7% physicians and psychologists). Nurses and social-health workers show higher levels of wellness than physicians and psychologists; whereas physiotherapists reported lower levels of moral distress than physicians and psychologists, and nurses and social-health workers. Physicians and psychologists perceive a better workplace ethical climate than physiotherapists, and more positive affects than nurses and social-health workers. Healthcare professionals reporting no extra-working stressful events in the last year of life show higher levels of wellness (t(310)= 2.97, p=.003) and less negative affects (t(310)= -2.78, p=.006). Furthermore, considering the interaction effect between operating unit and professional figure, physicians and psychologists report higher rates of emotional exhaustion than nurses (F(308,2)=3.00; p=.05) in palliative care unit, whereas lower rates in rehabilitation medicine unit (F(308,2)=7.52; p=.001). Unlike palliative care unit, nurses and social-health workers operating in rehabilitation medicine report higher levels cynicism than physicians and psychologists (F(308,2)=3.34; p=.04). Limitations: not homogeneous sample as for the professional groups, self-report measures. Innovative aspects: mapping potential resources and risk factors, such as moral and ethical aspects that are more always frequently present in present clinical practice, allows to customise interventions supporting healthcare professional’s wellness.
Introduzione: Molteplici sono i potenziali fattori di rischio per i professionisti sanitari che trattano cronicità e multimorbidità. Considerando la crescente richiesta di queste figure professionali, è importante monitorare il loro stato di distress e benessere. Obiettivi: Descrivere livelli di benessere, distress e burnout; rilevare eventuali differenze within-and between- group. Metodo: Studio osservazionale prospettivo. Operatori sanitari italiani in cure palliative/oncologia e in medicina riabilitativa sono stati valutati, anonimamente, attraverso i seguenti test: MASI-R (distress e benessere), MDS-R (moral distress), HECS (ethical climate), MBI-GS (burnout), PANAS (emozioni positive e negative), CD-RISC-10 (resilienza). Risultati: 317 operatori hanno partecipato allo studio (57.3% infermieri e operatori socio sanitari (OSS), 22% fisioterapisti, 20.7% medici e psicologi). Infermieri e OSS riferiscono maggior benessere rispetto a medici e psicologi; mentre i fisioterapisti riportano meno moral distress sia rispetto a medici e psicologi, sia rispetto a infermieri e OSS. Medici e psicologi percepiscono un miglior ethical climate di reparto rispetto ai fisioterapisti, così come maggior emotività positiva rispetto a infermieri e OSS. Coloro che non sono stati esposti a stressor extra-lavorativi riportano maggiori livelli di benessere (t(310)=2.97, p=.003) e meno emotività negativa (t(310)=-2.78, p=.006). Inoltre, considerando gli effetti di interazione fra unità operativa e figura professionale, i medici e gli psicologi riferiscono punteggi più alti di emotional exhaustion rispetto agli infermieri (F(308,2)=3.00; p=.05) in cure palliative, mentre più bassi quando lavorano in un reparto di medicina riabilitativa (F(308,2)=7.52; p=.001). Diversamente delle cure palliative, infermieri e OSS di medicina riabilitativa riportano punteggi più alti di cinismo rispetto a medici e psicologi (F(308,2)=3.34; p=.04). Limiti: Campione non omogeneo per quanto riguarda i gruppi professionali, misure self-report. Aspetti innovativi: Mappare potenziali risorse e fattori di rischio, quali aspetti etici e morali sempre più presenti nella pratica clinica attuale, consente di customizzare interventi di supporto per il benessere del professionista sanitario.
Wellness and distress in healthcare professionals dealing with end-of-life and bioethical issues: a quantitative analysis.
ZANATTA, FRANCESCO
2018/2019
Abstract
Introduction: Dealing with chronicity and multimorbity may represent a potential risk factor for healthcare professionals. The increasing request of these professional figures leads to monitor deeply their levels of wellness and distress. Purpose: To describe the level of wellnees, distress and burnout; to measure potential differences within-and-between-group. Method: perspective observational study. Healthcare professionals working in palliative care/oncology and in rehabilitation medicine completed anonymously the following scales: MASI-R (distress and wellness), MDS-R (moral distress), HECS (ethical climate), MBI-GS (burnout), PANAS (positive and negative affects), and CD-RISC (resilience). Results: 317 healthcare professionals completed the study (57.3% nurses and social-health workers, 22% physiotherapists, 20.7% physicians and psychologists). Nurses and social-health workers show higher levels of wellness than physicians and psychologists; whereas physiotherapists reported lower levels of moral distress than physicians and psychologists, and nurses and social-health workers. Physicians and psychologists perceive a better workplace ethical climate than physiotherapists, and more positive affects than nurses and social-health workers. Healthcare professionals reporting no extra-working stressful events in the last year of life show higher levels of wellness (t(310)= 2.97, p=.003) and less negative affects (t(310)= -2.78, p=.006). Furthermore, considering the interaction effect between operating unit and professional figure, physicians and psychologists report higher rates of emotional exhaustion than nurses (F(308,2)=3.00; p=.05) in palliative care unit, whereas lower rates in rehabilitation medicine unit (F(308,2)=7.52; p=.001). Unlike palliative care unit, nurses and social-health workers operating in rehabilitation medicine report higher levels cynicism than physicians and psychologists (F(308,2)=3.34; p=.04). Limitations: not homogeneous sample as for the professional groups, self-report measures. Innovative aspects: mapping potential resources and risk factors, such as moral and ethical aspects that are more always frequently present in present clinical practice, allows to customise interventions supporting healthcare professional’s wellness.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
Per contatti: unitesi@unipv.it
https://hdl.handle.net/20.500.14239/8062