Vaccination hesitancy: To be vaccinated, or not to be vaccinated, that is the question in the era of COVID-19.

COVID-19 vaccine hesitancy poses serious challenges in achieving adequate vaccine coverage in the general population. While most studies on vaccine hesitance determinants during the COVID-19 pandemic were quantitative, qualitative research on the reasons for vaccine resistance is still lacking. To fill this gap, this study aims to qualitatively investigate cognitive and emotional factors associated with COVID-19 vaccine hesitancy. This qualitative pilot study was conducted between October and November 2021 in Italy. A total of 40 COVID-19 vaccine-hesitant ("hesitant not vaccinated" or "hesitant but vaccinated") individuals completed anonymous questionnaires with open-ended questions. Data were analysed using the Interpretive Description approach. The central theme that emerged about vaccine hesitancy was the lack of control. This construct included four different sub-categories: distrust of the government, infodemic, influence of family, and general anti-vaccine opinions. The results also showed that the most important emotional and cognitive factors associated with hesitancy were anger related to a perceived sense of oppression; emotional avoidance to minimize risk; anxiety related to potential vaccine side effects. Identifying and understanding factors influencing COVID-19 vaccination hesitancy is crucial to improving communication strategies that will ultimately result in increased confidence and vaccine acceptance.

Investigating the association between patient verbal aggression and emotional exhaustion among Italian health care professionals during the COVID-19 pandemic.

AIMS: To analyze whether patient verbal aggression would be related to emotional exhaustion and whether this relationship would be mediated by work-family conflict and moderated by dehumanization and resilience. BACKGROUND: Although patient verbal aggression has been identified as one of the most experienced forms of aggression, its effects on Italian health care providers during the pandemic are still poorly known. METHODS: A total of 197 Italian health care professionals completed paper-and-pencil questionnaires. Descriptive statistics and moderated mediation analyses were performed. RESULTS: Patient verbal aggression was positively related to health care professionals' emotional exhaustion, both directly and indirectly, as mediated by work-family conflict. Health care providers were more likely to become emotionally exhausted when they had low resilience and, simultaneously, tended to ascribe patients non-uniquely human traits. CONCLUSIONS: Patient verbal aggression may spill over onto health care professionals' family lives. Dehumanization represents an ineffective coping strategy that exacerbates the effects of aggression on work-family conflict, whereas resilience represents a protective resource against emotional exhaustion. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital organisations could benefit from providing their staff with stress management interventions, aggression management, psychological support and psychological resilience training programmes. These programmes should incorporate coping skills on establishing work-home boundaries and balancing empathy with cognitive problem-solving abilities.

A journey through roses and thorns: becoming a physician by learning from patients with life-threatening illnesses. A qualitative study with international medical students.

The medical students' well-being may be threatened by various stressors associated with providing care to different kinds of patients. This study aims to explore students' clinical experiences with patients who suffer from life-threatening illnesses, focusing on potential risk and protective factors. Audio-recorded and face-to-face interviews were conducted and transcribed verbatim. The "Interpretive Description" approach was used to analyse data. Overall, ten medical students with a mean age of 28 years old were interviewed. Well-being promoting factors were the following: therapeutic relationships, work-life balance, social support and communication, perception of improvement in knowledge and availability of advanced directives. Whilst factors that may reduce well-being included death exposure, managing emotions, communication difficulties, internal conflicts and disagreements, lack of knowledge and subjective concerns. These findings shed light on facets that are inherent parts of clinical experience with patients suffering from a life-threatening illness and that may turn in risk or protective factors for the medical students. Understanding the students' subjective experiences may aid in the improvement of the current educational programs, as well as in the development of tailored supportive and preventative interventions to promote well-being and professional competencies among this kind of students.

SMiLE to Life: Meaning in life in healthcare professionals working in palliative care and rehabilitation medicine.

BACKGROUND: In the healthcare landscape, various protective factors are identified, such as meaning in life (MiL), namely what gives sense to life events. However, little is known about this construct in the healthcare population. OBJECTIVES: To describe MiL among healthcare professionals employed in palliative care and neuro-rehabilitation medicine, unveiling possible differences related to medical specialty and socio-demographic characteristics. METHODS: In this cross-sectional and multicentre study, palliative care and neuro-rehabilitation professionals were recruited. MiL was evaluated with the Schedule for Meaning in Life Evaluation (SMiLE), which provides a list of meaningful areas, as well as related overall indexes of satisfaction (IoS), weighting (IoW), weighted satisfaction (IoWS). Descriptive statistics, t-test, chi-square, linear and binary logistic regressions were performed. RESULTS: Overall, 297healthcare professionals (palliative care=89, neuro-rehabilitation medicine=208, 47% of participants ≤ 40 years old) completed the evaluation. The sample was intra- and inter-groups heterogeneous, in particular concerning age and professional role. Conversely, no significant group differences emerged in MiL indexes comparisons, nor in the number of MiL listed areas. As for MiL areas, the category "family" increased the IoWS index, while terms related to "finances" contributed to decrease it. Comparing specialties, palliative care professionals were more likely to report areas like "partnership", "social commitment", and "satisfaction". Nurses (n=116), nurse aides (n=47), and therapists (n=67) were more likely to mention health-related terms (e.g. health, physical wellbeing) than physicians and psychologists (n=65). CONCLUSION: This study highlighted MiL areas among professionals employed in palliative care and neurorehabilitation specialties, providing informative suggestions for tailored health prevention programs which should pay particular attention to social and family relationships, socio-economic status, and health.

Dealing with ethical issues in rehabilitation medicine: The relationship between managerial support and emotional exhaustion is mediated by moral distress and enhanced by positive affectivity and resilience.

AIMS: To analyse whether managerial support and ethical vision of patient care would be related to emotional exhaustion directly or through moral distress and whether these relationships would be conditional on individual levels of positive affectivity and resilience. BACKGROUND: Although some studies described the effects of ethical climate, moral distress, resilience and positive affectivity on emotional exhaustion, there are no attempts of explicative models containing these variables. METHODS: A total of 222 Italian professionals employed in neuro-rehabilitation medicine units participated in this cross-sectional study. Descriptive statistics, mediation and moderated mediation analyses were conducted using SPSS. RESULTS: Managerial support and ethical vision of patient care were negatively related to emotional exhaustion, directly and through moral distress. Professionals high in resilience and positive affectivity benefited more from the protective effect of managerial support on emotional exhaustion through moral distress. CONCLUSION: Ethical climate represents a protective factor against moral distress and emotional exhaustion. Moreover, individual levels of positive affectivity and resilience may increase the beneficial effects deriving from managerial support in dealing with ethical issues. IMPLICATION FOR NURSING MANAGEMENT: Health organisations may consider developing strategies to improve ethical climate, enhance managers' ability to support team in dealing with ethical issues and foster employees' positive affectivity and resilience.

Measuring Moral Distress Among Critical Care Clinicians: Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised.

OBJECTIVES: Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. DESIGN: Validation study using a survey design. SETTING: Eight medical-surgical ICUs in the north of Italy. SUBJECTS: A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). INTERVENTIONS: The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. MEASUREMENTS AND MAIN RESULTS: The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (α = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was higher for those clinicians considering to give up their position (t = 2.778; p = 0.006). CONCLUSIONS: The Italian Moral Distress Scale-Revised is a valid and reliable instrument to assess moral distress among critical care clinicians and develop tailored interventions addressing its different components. Further research could test the generalizability of its factorial structure in other cultures.

Further Validation of the Persecutory Ideation Questionnaire in the Italian Context: Results From Classical and Modern Test Theory.

The Persecutory Ideation Questionnaire (PIQ) is a valuable instrument to measure persecutory ideation. The aim of this study is to validate the scale in the Italian context and to extend the study of its psychometric properties using approaches from both classical and modern test theories. The results of the study, involving 700 individuals, confirmed the one-factor structure and the good validity and reliability of the scale. Full metric invariance and partial scalar and strict invariance were also supported across gender, age, and education level groups. Rasch analysis indicated that the 5-point response scale is well-functioning and that the PIQ is most appropriate to measure high levels of persecutory ideation. The results contribute to a better understanding of the measurement properties of the PIQ. The paper discusses the advantages and contributions of each method used to explore the measurement properties of the scale.

How Is Job Insecurity Related to Workers' Work-Family Conflict during the Pandemic? The Mediating Role of Working Excessively and Techno-Overload.

The current labor market is characterized by drastic changes linked to the use of information and communication technologies (ICT) and post-COVID-19 transformations, which have decreased job security and job stability. As a result, the feeling of losing one's job has become even more common among European workers. In this study, we aimed to investigate whether and how job insecurity would be related to work-family conflict during the pandemic. Online self-report questionnaires assessing job insecurity, working excessively, techno-overload, and work-to-family conflict were completed by 266 workers from Italy. Descriptive analyses, confirmatory factor analyses, and structural equation mediation models were conducted. Job insecurity was positively associated with work-to-family conflict, both directly and indirectly, as mediated by techno-overload and a tendency to work excessively. This study advances the literature, as it is the first to identify techno-overload and working excessively as parallel psychological mechanisms linking job insecurity to work-family conflict among Italian workers during the pandemic. Workers could benefit from technological workload monitoring programs, techno effectiveness, and time management training programs. Companies could also consider implementing family-friendly and digital disconnection practices.

[Occupational stress in municipal police officers: contribution to the Italian adaptation of a questionnaire for the assessment of the operational and organizational stressors]. / Lo stress negli operatori di polizia locale: contributo all'adattamento italiano di uno strumento per la misura di stressor operativi e organizzativi.

INTRODUCTION: The study of occupational stress in police has received growing interest because of the potential negative effects that it may produce both on an individual and on an organizational level. The aim of the present research is to give a first contribution to the Italian adaptation of two questionnaires used in order to assess operational and organizational stressors in police: the Operational Police Stress Questionnaire (PSQ-Op) and the Organizational Police Stress Questionnaire (PSQ-Org). METHODS; The PSQ-Op-It and the PSQ-Org-It have been administered to all the municipal police officers serving the population of a small town in Northern Italy (N = 88). An explorative factor analysis has been carried out to verify the internal structure; in order to assess the concurrent validity, correlations with psycho-physical malaise (GHQ-12) and burnout (MBI-GS) have been calculated. RESULTS: The factor analysis (rotation method oblimin) confirmed the original structure of the two questionnaires: two factors, corresponding to organizational and operational stressors, have been extracted. The Cronbach's alphas of the two questionnaires, 0.95 and 0.94 respectively, have pointed out good internal consistency. The two instruments are related to the subscales of the GHQ-12 and the MBI-GS, with the exception of the professional inefficacy dimension. CONCLUSIONS: The PSQ-Org-It and the PSQ-Op-It have shown good psychometric properties, so they could be used in order to assess police-specific stressors. Nevertheless we suggest to deepen the obtained results by confirmative factor analyses to carry out through the administration of the instrument to more numerous samples, in different and more structured urban contexts.

The influence of operational and organizational stressors on the well-being of municipal police officers.

BACKGROUND: Helping professions are at a high risk of developing occupational stress that can cause negative effects at individual and organizational levels. OBJECTIVES: This article attempts to examine the presence of operational and organizational stressors as potential predictors of burnout and psychosomatic symptoms among municipal police officers. METHODS: A cross-sectional study of municipal police officers working in a town in Northern Italy was conducted. A self-report questionnaire was administered to all the officers serving the population of this town (N = 88). RESULTS: Regression analyses revealed that organizational stressors affected emotional exhaustion and cynicism, whereas operational stressors were associated with psychosomatic symptoms. CONCLUSIONS: These findings suggest that operational and organizational stressors can affect the level of psychosomatic well-being of municipal police officers, but at the same time reveal the existence of their specific effects on the outcome variables. In this perspective, individual psychological support and group interventions should be carried out not only to deal with traumatic events but also to manage chronic stressors. This is one of the first studies in Italy investigating municipal police officers' well-being as potentially related to specific job stressors. Nevertheless, our results are based on police officers employed by the municipality of a single town; it would be therefore useful to extend the research to larger samples.

Attitude towards Intranasal Vaccines and Psychological Determinants: Effects on the General Population in Northern Italy.

Little is known about the use of intranasal vaccines, but some studies have shown that this innovative way of administration is preferred over needle injection as it is considered both less painful and intrusive to the body, equally effective, and associated with fewer side effects. This study aimed to investigate specific psychological determinants (intolerance of uncertainty, persecutory ideation, perceived control, vaccine hesitancy) of attitude toward nasal vaccine delivery. A convenience sample including 700 Italian participants took part in this cross-sectional study and completed an online questionnaire. A structural equation model with a latent variable was performed to study the relationship between psychological variables, vaccine hesitancy, and attitude toward nasal vaccine delivery. The results indicate that both a hesitant attitude toward vaccination (ß = 0.20, p = 0.000) and low perceived control (ß = -0.20, p = 0.005) may directly increase preference for nasal administration; furthermore, high levels of persecutory ideation may indirectly influence the propensity for intranasal vaccine. These findings suggest that pharmaceutical companies could implement nasal vaccines and provide detailed information on these vaccines through informational campaigns. Hesitant individuals with low levels of perceived control could more easily comply with these types of vaccines.

Perceptions of COVID-19 Vaccines: Protective Shields or Threatening Risks? A Descriptive Exploratory Study among the Italian Population.

Although several quantitative studies have explored vaccine hesitancy, qualitative research on the factors underlying attitudes toward vaccination is still lacking. To fill this gap, this study aimed to investigate the general perceptions of COVID-19 vaccines among the Italian population with a qualitative approach. The sample included 700 Italian participants who completed an online survey. Open questions underwent a descriptive analysis for unveiling meaning categories, while differences in the prevalence of categories were calculated using chi-square or Fisher's exact tests. Vaccination was associated with the following seven main themes: 'safety', 'healthcare', 'vaccine delivery', 'progress', 'ambivalence', 'mistrust', and 'ethics'. Vaccinated individuals more frequently reported words related to the safety theme (χ2 = 46.7, p < 0.001), while unvaccinated individuals more frequently reported words related to mistrust (χ2 = 123, p < 0.001) and ambivalence (χ2 = 48.3, p < 0.001) themes. Working in the healthcare sector and being younger than 40 years affected the general perceptions of vaccination in terms of pro-vaccine attitudes. Unvaccinated individuals were more affected by the negative experiences of their acquaintances and manifested more distrust of scientific researchers, doctors, and pharmaceutical companies than vaccinated individuals. These findings suggest promoting collaborative efforts of governments, health policymakers, and media sources, including social media companies, in order to deal with cognitions and emotions supporting vaccine hesitancy.

How and When May Technostress Impact Workers' Psycho-Physical Health and Work-Family Interface? A Study during the COVID-19 Pandemic in Italy.

Although a growing body of research has analyzed the determinants and effects of technostress, it is still unclear how and when technostress would impact workers' psycho-physical health and work-family interface during the pandemic. To fill this gap, this study tests the mediating mechanisms and the boundary conditions associated with the impact of technostress on workers' psycho-physical well-being and work-family conflict. A total of 266 Italian workers completed online questionnaires measuring (traditional vs. remote) working modalities, technostress, fear of COVID-19, working excessively, psycho-physical distress, work-family conflict, loss of a loved one due to COVID-19, and resilience. Structural equation models were performed. Results indicated that technostress was positively related to psycho-physical distress and work-family conflict, as mediated by fear of COVID-19 and working excessively, respectively. The loss of a loved one exacerbated the effects of fear of COVID-19 on psycho-physical health, while resilience buffered the effects of working excessively on work-family conflict. Since numerous organizations intend to maintain remote working also after the COVID-19 emergency, it is crucial to study this phenomenon during its peaks of adoption, to prevent its potential negative outcomes. The implications of these findings for theory and practice are discussed.

The role of resilience in the work-life interface: A systematic review.

BACKGROUND: In an increasingly competitive marketplace, workers struggle to find a good balance between work and personal life. Difficulties in fulfilling the demands arising from these different domains may undermine employees' well-being and job-related outcomes, thereby, impairing organizational productivity. OBJECTIVE: Does resilience play a relevant role in relation to work-life interface? And, if so, how is resilience related to its three facets (i.e., work-life conflict, enrichment, and balance)? To answer these questions, the current paper systematically reviews studies analysing the role of resilience in the work-life interface. METHODS: A key terms literature search was performed using multiple electronic databases (i.e., Scopus, PsycINFO, Web of Science, PubMed) without setting any publication date limitation. The review process followed the international PRISMA statement guidelines. A quality assessment was conducted using the Mixed Methods Appraisal Tool. RESULTS: A total of 26 eligible papers published between 2009 and 2020 were included. Among these, 6 employed a qualitative design, while 20 studies adopted a quantitative design mostly examining resilience as antecedent. Data were predominantly collected in the healthcare sector. Resilience was mainly analysed in relation to work-life conflict. The most commonly used theoretical framework was Conservation of Resources theory. CONCLUSIONS: Overall, resilience was negatively associated with work-life conflict and positively related to both work-life balance and enrichment. A positive work-life balance can promote resilience, but resilience can also help workers to balance work and life. Additionally, resilience can protect from the negative effects of both work-life imbalance and work-life conflict on workers' health and job-related outcomes.

Well-Being and Professional Efficacy Among Health Care Professionals: The Role of Resilience Through the Mediation of Ethical Vision of Patient Care and the Moderation of Managerial Support.

Drawing on the Conservation of Resources theory, this study analyzes whether resilience could be related to healthcare providers' wellbeing and professional self-efficacy, both directly and indirectly, as mediated by ethical vision of patient care and moderated by managerial support in dealing with ethical issues. Overall, 315 Italian healthcare professionals employed in neuro-rehabilitation medicine or palliative care specialties participated in this multi-centered cross-sectional study. The following variables were investigated: resilience (Connor-Davidson Resilience Scale), wellbeing (Maugeri Stress Index-Reduced), professional self-efficacy (Maslach Burnout Inventory-General Survey), ethical vision of patient care and managerial support in dealing with ethical issues (Italian version of the Hospital Ethical Climate Survey). Overall, resilience was positively associated with healthcare providers' wellbeing and professional self-efficacy, directly and indirectly, as mediated by ethical vision of patient care. Highly resilient healthcare professionals who perceived the presence of a positive ethical vision of patient care in their workplace were more likely to experience greater wellbeing when managerial support in dealing with ethical issues was high (vs. low). Thus, these findings provide suggestions for tailored interventions sustaining healthcare professionals along their daily activity characterized by high-demanding and challenging situations.

How Supportive Ethical Relationships Are Negatively Related to Palliative Care Professionals' Negative Affectivity and Moral Distress: A Portuguese Sample.

In the modern healthcare landscape, moral distress has become an increasingly common phenomenon among healthcare professionals. This condition is particularly prevalent among palliative care professionals who are confronted with bioethical issues in their daily practice. Although some studies described the effects of poor ethical climate and negative affectivity on moral distress, how these variables could be incorporated into a single model is still unclear. Thus, this study aims to investigate whether ethical relationships with the hospital could be related to the intensity and frequency of moral distress, both directly and as mediated by professionals' negative affectivity. Sixty-one Portuguese palliative care professionals completed web-based self-report questionnaires. After exploring descriptive statistics, mediation analyses were performed using the partial least squares method. The results indicated that the presence of positive relationships with the hospital reduced the professionals' negative affectivity levels. This, in turn, led palliative care professionals to experience a lower frequency and intensity of moral distress. Being a physician was positively associated with negative affectivity but not with the frequency of moral distress. Considering the protective role of ethical relationships with hospitals, health organizations could consider implementing interventions to improve hospitals' ethical climate and provide staff with ethics training programs.

Moral Distress among Frontline Physicians and Nurses in the Early Phase of COVID-19 Pandemic in Italy.

During the COVID-19 health emergency, healthcare professionals faced several ethical demanding job stressors, becoming at particular risk of moral distress. To date, only a few scales have been developed to evaluate moral distress among frontline professionals working in contact with COVID-19 patients. Moreover, although many healthcare professionals from various disciplines were converted to COVID-19 patient care, no study has yet analyzed whether the resulting change in duties might represent a risk factor for moral distress. Thus, this study aimed to investigate how and when the change in duties during the emergency would be related to healthcare professionals' psycho-physical malaise. To this aim, a first Italian adaptation of the Stress of Conscience Questionnaire (SCQ) was provided. In total, 272 Italian healthcare professionals participated in this cross-sectional study. Healthcare professionals who had to perform tasks outside their usual clinical duties were more likely to experience moral distress and then psycho-physical malaise. This was particularly likely for those who were extremely concerned about becoming infected with the virus. The results also indicated that the Italian adaptation of the SCQ had a one-factor solution composed of six items. This study provides the first Italian adaptation of SCQ and practical suggestions on how supporting professionals' well-being during emergencies.

Engagement and Vicarious Traumatization in rescue workers.

PURPOSE: The aims of this study are (1) to investigate the incidence of the symptoms of Vicarious Traumatization in a group of rescue workers; (2) to explore some of the main predictors of Engagement and Vicarious Traumatization; and (3) to identify the individual and organizational factors able to improve the state of well-being of those working in the helping professions. METHODS: A total of 782 rescue workers, involved in critical operations of various kinds in constant contact with traumatized subjects, were investigated applying the Maslach Burnout Inventory-General Scale (MBI-GS) and the Secondary Traumatic Stress Scale (STSS). RESULTS: The post-traumatic symptoms most frequently reported were those of an intrusive nature. A partial overlap emerged between the predictors of Vicarious Traumatization and Engagement: if compared with social and demographic characteristics and with the degree of commitment required by the work, organizational variables would appear to have the greatest influence over the two constructs. A supportive working environment in particular favors Engagement, reducing the probability of developing Burnout. CONCLUSIONS: The results confirm the hypotheses that Engagement and Vicarious Traumatization are primarily determined by organizational variables, and, particularly, by the level of job support.

Organizational features of workplace and job engagement among Swiss healthcare workers.

The aim of this study was to determine the engagement level among healthcare workers in a Swiss hospital, identifying organizational predictors that could affect it. A four-part survey (a demographic questionnaire, Maslach Burnout Inventory-General Survey, Areas of Worklife Scale, and the General Health Questionnaire) was completed by 206 nurses and physicians. With regards to organizational predictors of job engagement, energy was primarily influenced by workload, involvement by values, and efficacy by reward. Moreover, we found that engagement might affect psychophysical health conditions: better health generally corresponds to higher levels of engagement. These results confirm that engagement is influenced by organizational variables and that engaged employees are generally more healthy and efficient. Therefore, interventions to minimize the impact of work stressors and to improve engagement are needed. Effective management of excessive workload, higher levels of autonomy, and greater job support are vital to limit psychological problems of healthcare workers.

The moderating effect of exposure to robbery on the relationship between post-traumatic stress and job satisfaction.

Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs. isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. To test our predictions, we conducted a two-wave study-with a lag of two months between measurements-on 140 employees from a national bank in Italy. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the "isolated exposure" group the job satisfaction score was higher among less symptomatic victims, within the "shared exposure" group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice.