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.

Factors influencing refusing of flu vaccination among pregnant women in Italy: Healthcare workers' role.

BACKGROUND: Pregnant women are at increased risk of influenza complications. Influenza vaccine provides them a substantial protection. OBJECTIVE: The aim of this study was to investigate determinants associated with non-adherence to influenza vaccine recommendations in pregnant women in Italy. METHODS: A cross-sectional study has been carried out among pregnant women attending their follow-up visit in some mother and child services in a Region of Italy from October 2016 to January 2017. The study protocol was approved by the local research Ethics. A self-administered close-ended questionnaire has been administered to the pregnant women. Differences in background, socio-demographic characteristics, knowledge and attitudes towards flu vaccine were tested in vaccinated and unvaccinated women. Multivariate analysis was performed to control for confounding factors. RESULTS: Three hundred and sixty-six women answered the survey (97% response rate) and 96.1% (348) declared of being unvaccinated against influenza during the 2016-2017 influenza season. Frequent reasons for refusing vaccination were drugs objection and concerns about vaccines' effects. According to the refusal attitude, influenza knowledge was low in the group. Moreover, analysis showed that low adherence to vaccination is associated to lacking promotion of vaccination to pregnant women carried out by healthcare workers (P < 0.005). CONCLUSIONS: Healthcare workers have a key role in assisting women during the gestational period, so their active involvement in vaccination promotion is essential. It is necessary to improve health care workers' knowledge about vaccine relevance in protecting pregnancy and their communication skills to properly inform pregnant women.

Variations in diagnostic testing utilization in Italy: Secondary analysis of a national survey.

BACKGROUND: According to the principle of horizontal equity, individuals with similar need may have the same possibility of access to health services. The aim of this study is to identify patterns of diagnostic services utilization, in people with, and without chronic disease in Italy. METHODS: Secondary analysis of data from the national survey on Health and use of health care in Italy, carried out in 2013, including 99,497 participants. Multilevel analysis has been used to study the variables associated to diagnostic services utilization. RESULTS: 13.78% of participants have had one diagnostic testing in the four weeks before the interview. In healthy people, utilization of diagnostic testing is reduced in people with low educational level (OR 0.75; 95%CI 0.67-0.84), in housewives (OR 0.66; 95%CI 0.51-0.87), or in those unable to work (OR 0.48; 95%CI 0.26-0.87), while increased in those perceiving a worse health status (up to OR 4.00, 95%CI 2.00-8.01 in very bad health). In people afflicted with chronic disease, access to diagnostic assessment is impaired by educational level (OR 0.69; 95%CI 0.61-0.78) and low household income (OR 0.75; 95%CI 0.58-0.97), while it is increased in the presence of a ticket exemption (OR 1.55, 95%CI 1.42-1.68), and fixed-term occupation (OR2.28, 95%CI 1.31-3.95). Being former-smokers in associated to an increased utilization of services in both groups. CONCLUSIONS: Despite a universal and theoretically egalitarian, public, health care system, variations in diagnostic services utilization are still registered in Italy, both in healthy people and those afflicted by chronic diseases, on socio-economic/occupational basis, and self-perceived health status. Moreover, this significant effect of occupation on healthcare utilization, suggests the need for a comprehensive evaluation of economics in occupational health.