VALIDATION OF THE ITALIAN VERSION OF THE COPING INVENTORY FOR STRESSFUL SITUATIONS-SHORT VERSION AMONG HOSPITAL-BASED NURSES.

The psychometric properties of the Italian version of the Coping Inventory for Stressful Situations-Short Version (CISS-SV-21 items) were tested. In a group of 1,291 hospital-based nurses (77.8% women), four alternative factor models of the CISS-SV were tested using confirmatory factor analysis (CFA). The four models were: M1, the original CISS-SV-21 items three-factor model corresponding to three dimensions (task-oriented, emotion-oriented, and avoidance-oriented coping); M2, the four-factor model corresponding to four dimensions (task-oriented, emotion-oriented, contact a friend-oriented, and treat oneself-oriented) of the CISS-SV (21 items); M3, the three-factor model of the CISS-SV (20 items) made up by the same factor structure of M1 without including Item 1; finally, the four-factor M4 of the CISS-SV (20 items), consisting of the same dimensions of the M2 model without including Item 1. The results of the CFA showed that the M4 factor model was the model that was best able to account for the data (RMSEA = 0.06, 90%CI = 0.05, -0.06; CFI = 0.90). Reliability was supported by alphas ranging from .72 to .82. The CISS-SV has acceptable validity and reliability for measuring the coping strategies of nurses.

Psychometric properties of the Maslach Burnout Inventory for Human Services among Italian nurses: a test of alternative models.

AIM: The purpose of this study was to test the factor structure of an Italian version of the Maslach Burnout Inventory for Human Service employees. In addition we examined the reliability and construct validity of the scale. BACKGROUND: There is increasing evidence that nurses are at risk of experiencing burnout. Despite the vast international use of the Maslach Burnout Inventory-Human Service Survey, its factor structure and reliability are not beyond question. METHOD: In a sample of nurses (N = 1613) six alternative factor models of the instrument were tested using confirmatory factor analysis. Furthermore, we examined the invariance of the pattern of factor loadings of the model that better fitted the data across gender groups. To test construct validity, participants completed four subscales of Symptoms Check List 90-R. Internal consistency was evaluated computing Cronbach's alpha estimates of the scales. The study was conducted in 2007 and 2008 in Italy. RESULTS: The factor analysis provided support for a 20-item version identifying the three original dimensions. The model was found to be factorially invariant between men and women. Correlations between the latent MBI-HSS dimensions and distress variables were in line with theoretical predictions. Reliability was supported by acceptable Cronbach's alpha indexes. CONCLUSION: The Maslach Burnout Inventory-Human Service Survey has acceptable validity and reliability for measuring burnout among nurses, and can help healthcare managers to offer interventions to reduce burnout among nurses. Limitations of the study and suggestions for further research are highlighted.

Impact of Work Motivation on Occupational Health in Healthcare Workers.

OBJECTIVES: The present cross-sectional study investigated, in a group of Italian healthcare workers (HCWs), the association between work motivation and occupational health and the impact of socio-demographic and job-related variables on this association. METHODS: A total of 656 subjects (nurses, technicians, midwives and physiotherapists) completed the survey. Linear regression models were used to correlate motivation types (by Scale of Motivation At Work) with health indicators (general health, depression, professional exhaustion, satisfaction and turnover intention) and burnout's subscales (emotional exhaustion, depersonalization and reduced professional achievement). FINDINGS: Autonomous motivation correlated positively with general health and work satisfaction and negatively with depression, exhaustion and turnover intention. Scoring high on intrinsic/integrated regulation was associated with better health and job satisfaction and with turnover intention, depression and emotional exhaustion. Controlled motivation, demotivation and external regulation nourished burnout's indicators, while autonomous motivation was protective. Operating in intensive care or surgical areas negatively affected general health; working as a nurse manager or midwife increased one's depressive risk and reduced satisfaction; being older than 60 increased emotional exhaustion and turnover intention; having a master's degree protected from exhaustion and depression. IMPLICATIONS: Collectively, our findings extend evidence on the role of work motivation in shaping occupational health and underline the importance for healthcare organizations of promoting actions to reinforce autonomous motivation at work.

PsyCARE study: assessing impact, cost-effectiveness, and transdiagnostic factors of the Italian ministry of health's "psychological bonus" policy.

BACKGROUND: The prevalence of anxiety and depression disorders is surging worldwide, prompting a pressing demand for psychological interventions, especially in less severe cases. Responding to this need, the Italian government implemented the "Psychological Bonus" (PB) policy, allotting 25 million euros for mental health support. This policy entitles individuals to a minimum of four to twelve psychological sessions. In collaboration with the National Board of Italian Psychologists, our study assesses this policy's effectiveness. Indeed, the PsyCARE study aims to examine the utilization of the Psychological Bonus, evaluate its impact on adult and adolescent participants' psychological well-being through pre- and post-intervention assessments and six-month follow-up, and conduct a longitudinal cost-effectiveness analysis of this policy. A secondary aim is to investigate the influence of these interventions on transdiagnostic factors, including emotion regulation and epistemic trust. METHODS: The study involves licensed psychotherapists and their patients, both adults and adolescents, benefiting from the Psychological Bonus. Data collection is underway and set to conclude in December 2023. Psychotherapists will provide diagnostic information and assess patient functioning. In addition, patients will be evaluated on mental health aspects such as clinical symptoms, emotion regulation, epistemic trust, and quality of life. We will employ linear mixed-effects models to analyze the outcomes, accounting for both fixed and random effects to capture the hierarchical structure of the data. DISCUSSION: We anticipate the study's findings will highlight reduced psychological distress and improved quality of life for participants and demonstrate the Psychological Bonus policy's cost-effectiveness. The study will gather data on the role of specific versus nonspecific therapeutic factors in psychotherapy while adopting a patient-tailored approach to identify effective therapeutic elements and examine transdiagnostic factors. Overall, this study's findings will guide future measures within the Italian healthcare system, fostering a psychological health culture and providing valuable insights to the broader public. STUDY REGISTRATION: https://osf.io/6zk2j.

Adjustment Processes After the First Wave of the COVID-19 Pandemic: A Grounded Theory Study Based on Clinical Psychologists' Experience.

Background: Anxiety, depression, and post-traumatic stress have been reported among the general population during the first wave of the COVID-19 pandemic. However, the adjustment after the emergency phase remains under-investigated. This study aims to understand the adjustment processes of the population after the emergency phase of the pandemic. Methods: We conducted a grounded theory based on the experience of 24 clinical psychologists who provided extensive support to the population during the pandemic in different Italian regions. Three online focus groups were conducted. The transcripts of the focus groups were analyzed through a process of open, axial, and selective coding. Data collection terminated once thematic saturation was reached. Results: Repositioning emerged as the evolutionary task people were confronted with in the face of a New Reality. Repositioning meant dealing with and integrating unpleasant Emotional Experiences deriving from the lockdown and reopening (i.e., unsafety, emotional exhaustion, loneliness, uncertainty, loss, and disconnection) through different Coping Strategies. Repositioning was facilitated or hindered by contextual and individual Intervening Conditions and led to two Adjustment Outcomes: growth or block. Conclusion: Results suggest that repositioning was the core task people had to face after the emergency phase of COVID-19. Proactive psychological interventions may support the population in repositioning in order to prevent maladjustment and encourage post-traumatic growth.

Promoting the Resilience of the Italian Population Against SARS-CoV-2.

The COVID-19 pandemic, due to its exceptional level of impact on the populations of the richest and most technologically advanced nations-which are experiencing unprecedented widespread mortality, fear, and social isolation-and due to the considerable difficulties faced by health services in coping with the emergency and the uncertainty regarding the evolution of the pandemic and its foreseeable heavy economic repercussions on a global scale, requires a change in the approach to the prevention and treatment of the infection based on the integration of biomedical and psychological sciences and professions. A survey of the Italian pandemic population, the results of which we report here, shows a widespread state of psychological distress, which, based on decades of scientific and clinical evidence on the relationship between mental states and immune system efficiency that we summarize in this paper, plausibly weakens the resistance of individuals and the population to SARS-CoV-2 infection. Italy can deploy a great force, represented by tens of thousands of psychologists and psychotherapists, who, as health workers, could be employed, alongside local and hospital medicine, in primary care and in promoting the resilience of citizens and health workers themselves, who are subject to a deadly work stress that also includes a widespread threat to their lives.

Development and validation of a brief Occupational Coping Self-Efficacy Questionnaire for Nurses.

AIM: This paper is a report of a study to develop and test the psychometric properties of the Occupational Coping Self-Efficacy for Nurses Scale. BACKGROUND: Coping self-efficacy beliefs are defined as self-appraisals of capabilities to cope with environmental demands. People with higher levels of coping self-efficacy beliefs tend to approach challenging situations in an active and persistent way, whereas those with lower levels of coping self-efficacy beliefs tend to direct greater energy to managing increasing emotional distress. METHOD: In 2006, 1383 nurses completed the following measures: Occupational Coping Self-Efficacy Questionnaire for Nurses, Coping Inventory for Stressful Situations Short Form and Maslach Burnout Inventory. Based on a randomized split of the data, we conducted exploratory factor analysis on group 1 data (n = 691) and confirmatory factor analysis within the framework of structural equation modelling on group 2 data (n = 692). FINDINGS: The exploratory results revealed two factors: Coping Self-Efficacy to cope with the occupational burden (Cronbach alpha = 0.77) and Coping Self-Efficacy to cope with the relational burden (alpha = 0.79). In the confirmatory group, the two-factor structure was tested against an alternative one-factor structure and confirmed as the best solution. Correlation patterns between the Occupational Coping Self-Efficacy for Nurses Scales, and both coping and burnout variables, supported the criterion-related validity of the Occupational Coping Self-Efficacy for Nurses dimensions. CONCLUSION: Nurses can have two basic and distinct coping self-efficacy beliefs: beliefs about occupational burden and beliefs about relational difficulties in the workplace. Research is needed into how efficacy evaluations shift as a result of specific stress management interventions.

Psychosocial job characteristics and psychological distress / well-being: the mediating role of personal goal facilitation.

OBJECTIVE: This study examined the mediating role of personal goal facilitation through work (PGFW), defined as perceptions of the extent to which one's job facilitates the attainment of one's personal goals, in the association between psychosocial job characteristics and psychological distress and job-related well-being. MATERIAL AND METHODS: Questionnaire data from 217 nurses (84% female, with a mean age of 42.7 years, SD=7.2) were analyzed. Participants completed the following measures: the Leiden Quality of Work Questionnaire for Nurses, Workplace Goal Facilitation Inventory, Maslach Burnout Inventory-Human Services Survey, and Utrecht Work Engagement Scale (short version). A cross-sectional study design was applied. Hierarchical multiple regression analyses were conducted. RESULTS: The results indicated that unfavorable psychosocial job characteristics (high demands, low control, and low social support) were associated with lower PGFW. Furthermore, personal goal facilitation through work explained significant additional variance (from 2 to 11%) in psychological distress (somatic complaints and emotional exhaustion) and job-related well-being (personal accomplishment, job satisfaction, and work engagement), controlling for demographic indicators and psychosocial job characteristics. Finally, the results provided support for the mediating effects of PGFW between all psychosocial job characteristics and all outcomes, except in the case of depersonalization. CONCLUSIONS: This study suggests that hindered personal goal facilitation may be a mechanism through which psychosocial job characteristics have a negative impact on employees' well-being.

How Changes in Psychosocial Job Characteristics Impact Burnout in Nurses: A Longitudinal Analysis.

AIMS: The main aim of this longitudinal study was to test the Job Demand-Control-Support (JDCS) model and to analyze whether changes in psychosocial job characteristics are related to (changes in) burnout. BACKGROUND: Previous studies on the effects of JDCS variables on burnout dimensions have indicated that the iso-strain hypothesis (i.e., high job demands, low control, and low support additively predict high stress reactions) and the buffer hypotheses (i.e., high job control and/or social support is expected to moderate the negative impact of high demands on stress reactions) have hardly been examined concurrently in a longitudinal design; and that the effects of changes of psychosocial job variables on burnout dimensions have hardly been analyzed. DESIGN: This two wave study was carried out over a period of 14 months in a sample of 217 Italian nurses. METHOD: Hierarchical regression analyses were used to test the cross lagged main and interactive effects of JDCS variables, and to analyse the across-time effects of changes in JDCS dimensions on burnout variables. RESULTS: The Time 1 job characteristics explained 2-8% of the variance in the Time 2 burnout dimensions, but no support for the additive, or the buffer hypothesis of the JDCS model was found. Changes in job characteristics explained an additional 3-20% of variance in the Time 2 burnout dimensions. Specifically, high levels of emotional exhaustion at Time 2 were explained by high levels of social support at Time 1, and unfavorable changes in demands, control, and support over time; high depersonalization at Time 2 was explained by high social support at time 1 and by an increase in demands over time; and high personal accomplishment at Time 2 was predicted by high demands, high control, interactive effect demands × control × social support, at Time 1, and by a decrease in demands over time. No reversed effects of burnout on work characteristics have been found. CONCLUSION: Our findings suggest that the work environment is subject to changes: the majority of employees experienced considerable changes in all job conditions over time. These changes impacted employee burnout. Limitations and implications of the study are discussed.

Occupational coping self-efficacy explains distress and well-being in nurses beyond psychosocial job characteristics.

AIM: The main purpose of the present study was to extend the Job Demand Control Support (JDCS) model analyzing the direct and interactive role of occupational coping self-efficacy (OCSE) beliefs. BACKGROUND: OCSE refers to an individual's beliefs about their ability to cope with occupational stressors. The interplay between occupational stressors, job resources, and self-efficacy beliefs is poorly investigated. The present research attempts to address this gap. DESIGN: Cross-sectional survey. METHOD: Questionnaire data from 1479 nurses (65% response) were analyzed. Hierarchical regression analyses were used to test the direct and moderating role of OCSE in conjunction with job demands (i.e., time pressure), and two job resources: job control (i.e., decision latitude and skill discretion) and social support (i.e., supervisor support and coworker support) in predicting psychological distress and well-being. RESULTS: Our findings indicated that high demands, low job control, and low social support additively predicted the distress/well-being outcomes (job satisfaction, emotional exhaustion, depersonalization, psychological distress, and somatic complaints). Beyond the main effects, no significant interactive effects of demands, control, and support were found. OCSE accounted for an additional 1-4% of the variance in the outcomes, after controlling for the JDCS variables. In addition, the results indicate that OCSE buffers the association between low job control and the distress dimensions emotional exhaustion, depersonalization, and psychological distress. Low control was detrimental only for nurses with low OCSE. CONCLUSION: Our results suggest expanding the JDCS model incorporating individual characteristics such as OCSE beliefs, for predicting psychological distress and well-being. Limitations of the study and practical implications are discussed.

Job characteristics, organizational conditions, and distress/well-being among Italian and Dutch nurses: a cross-national comparison.

BACKGROUND: Among health care workers, nursing has been identified as particularly stressful. Several studies have shown cross-national differences in nurses' levels of occupational stress and burnout. OBJECTIVES: The purpose of the study was to compare job characteristics, organizational conditions, and strain reactions in Italian (N = 609) and Dutch (N = 873) nurses. It was also examined how and to what extent various job characteristics and organizational conditions explain occupational and general strain. DESIGN: The study was a cross-sectional questionnaire survey. METHOD: Based on the Job Demand-Control-Support Model and the Tripod accident causation model, respectively job characteristics and organizational conditions were assessed as independent variables. Strain was operationalized in terms of job satisfaction, burnout, and psychosomatic complaints. RESULTS: Italian nurses perceived their job characteristics, organizational conditions, and well-being as more unfavourable than their Dutch colleagues. Hierarchical regression analyses showed that high job demands, low skill discretion, and low social support from supervisor were the most consistent predictors of occupational and general strain across samples. Organizational conditions added significantly to the prediction of job satisfaction and burnout. Furthermore, lack of personnel was a stronger predictor of burnout in the Italian nurses than in the Dutch nurses. CONCLUSIONS: The study provides cross-national confirmation of the impact of job characteristics and organizational conditions on nurses' well-being. Differences in job characteristics partially explain the observed cross-national differences in distress/well-being. Furthermore, some evidence for crossnational differential effects of job characteristics and organizational conditions on well-being was found.