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Quality of working life, compassion fatigue and burnout among mental
health workers
Findings from a multicentre study in Italy
WPA Congress, Berlin8-12 October 2017
Gaia CetranoResearch AssociateSocial Care Workforce Research UnitKing’s College London
Outline of this presentation
02/09/14 ILPN 2014 Conference 2
➢ Definition of quality of working life
➢ Design of the study (setting and methods)
➢ Characteristics of participants
➢ Factors of quality of working life associated with Compassion Fatigue, Burnout and Compassion Satisfaction
➢ Conclusions and recommendations
What is quality of working life?
Risks for the future
Job complexity
Ergonomics
Participation
Work-life balance
TrustTraining
Salary
Commitment
Autonomy Quality of meetings
Quality of working life• It is defined as the person’s broad job-related experience
• It is a multidimensional concept characterized by two constitutiveareas:
1) the intrinsic quality of work, and
2) the quality of work-life balance
• The intrinsic quality of work derives from the relationships betweenthe worker’s needs and the intrinsic characteristics of the work
• Quality of work-life balance is about reconciling working life and life outside work. This is essential condition both for encouraging entry into the labour market and for enabling people to remain at work.
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A similar approach is used by EUROFOUND in their European WorkingConditions Survey (six waves since 1991 covering 35 EU and neighbouring
countries; 44,000 interviews conducted in 2015)
Indicator Indicator
Opinion of current salary
- Insufficient/Sufficient/Good
Trust
- The manager knows well my tasks
- I am free in the work and little controlled
- The manager helps me when I have problems
- Colleagues help me when I have problems
- The manager trusts me
Impact of work on life
How work influences:
- One’s caregiving role (taking care of children,
parents, etc.)
- One’s home duties (housekeeping, etc.)
- One’s hobbies and interests (friends, sport, etc.)
- One’s political, social and religious activities
Attended training events in the past 24 months
- Yes vs. No
Autonomy
- I can decide to have breaks during work
- I can decide how to do the work
- I have autonomy in solving an organizational
problem
- I can decide the timing of my work
- I can decide the paucity and intensity of my work
- I can choose the tasks to carry out
- I can make weekly or monthly plans
- I can decide the quality level of my work
Impact of life on work
How life influences:
- One’s career opportunities
- One’s professional growth
- One’s opportunity to accept extra duties
- One’s opportunity to change job
Perceived need of training
- Yes vs. No
Participation
In the previous 12 months, participated in meetings to:
- Discuss the service organization
- Define methods, technologies, and techniques
- Plan and verify the activities of the service
- Decide projects and services to be realized
Perceived risks for the future
Perceived risk for the future of:
- Losing job
- Having an inadequate work competence
- Being unable to maintain one’s family
- Being unable to afford a substantial item
- Not receiving an adequate pension
Ergonomic problems
- Hot or cold temperatures
- Excessive or insufficient light levels
- Inappropriate workspace
- Poor hygiene
- Shortage of personal protective equipment
- Lifting, pushing or pulling heavy loads
- Time pressures (work pace and intensity)
- Long periods of time at computer
- Risk of assaults
Perceived quality of meetings
Meetings give me the opportunity to:
- Discuss interesting issues
- Bring my contribution
- Be appreciated for my contribution
- Influence the decisions of the group
- Adequately deal with problems
- Receive emotional support
Job complexity
- Different tasks to be carried out
- Unexpected situations and problems to solve
- Tasks requiring experience
- Tasks with high levels of responsibility
- Job rotation with colleagues
- Coordination of other people’ s work
Organizational commitment
The group:
- Has a clear idea of the mission of the service
- Feels the mission of the service as its own
- Is involved in the achievement of the objectives
- Critically reflects on its work
- Receives support from managers in the
development of its own ideas and projects5
Italian multicentre study on the quality of working life in mental
health staff
Coordinated by the ‘Psychiatric Register, Economics and Geography of Mental Health’ Research Unit at the WHO Collaborating Centre for
Research and Training in Mental Health and Service Evaluation, University of Verona, Italy
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Ergonomic problems
Job complexity
Trust
Autonomy
Participation
Perceived quality of meetings
Organizational commitment
Impact of work on life
Impact of life on work
Attended training
Need for training
Opinion on salary
Perceived risks for the future
COMPASSION FATIGUE
BURNOUT
COMPASSION SATISFACTION
?
Key elements of quality of working life
Setting: 3 Mental Health Departments in Northern Italy1. Lecco Mental Health Department (MHD)2. Legnago MHD3. South Verona Community Mental Health Service (CMHS)
Population (2012)
LECCO MHD 336,127
LEGNAGO MHD 154,015
SOUTH VERONA CMHS 108,421
Instruments
1. Professional Quality of Life Scale III (ProQOL) measuring Compassion Satisfaction, Compassion Fatigue, Burnout (Stamm 2005)
2. Quality of Working Life Questionnaire including 13 indicators developed using the framework of the European Working Conditions Survey designed by EUROFOUND (Gosetti 2013, 2016)
3. Socio-demographic and occupational characteristics
Staff profile (N=400)N %
Gender
Male 95 24.1
Female 299 75.9
Occupational status
Psychiatrist/Psychiatrist in training 79 19.9
Psychologist 27 6.8
Nurse 121 30.5
Social worker/Educator 65 16.4
Rehabilitation therapist 22 5.5
Healthcare support worker 83 20.9
Age
18-29 yrs 35 8.9
30-39 yrs 105 26.8
40-49 yrs 134 34.2
50-59 yrs 102 26.0
Over 60 16 4.1
Organization
Local health authority/Hospital trust 249 62.4
University 40 10.0
Non for profit organization 110 27.6
Type of contract
Open-ended contract 331 82.75
Fixed-term contract 69 17.25
Indicators of Quality of Working Life correlated with Compassion Satisfaction
Levels of CS increase with:
• Trust (coeff. = 0.20) • Autonomy (coeff. = 0.20) • Participation (coeff. = 0.15) • Perceived quality of meetings (coeff. = 0.29) • Organizational commitment (coeff. = 0.28)
Levels of CS decrease with:
• Ergonomic problems (coeff. = - 0.12)
The risk of CF increases with:
• Ergonomic problems (coeff. = 0.23)
• Job complexity (coeff. = 0.13)
• Impact of work on life (coeff. = 0.24)
• Impact of life on work (coeff. = 0.18)
The risk of CF decreases with:
• Perceived quality of meetings (coeff. = -0.13)
Indicators of Quality of Working Life correlated with Compassion Fatigue
The risk of BO increases with:
• Ergonomic problems (coeff. = 0.27)
• Impact of work on life (coeff. = 0.19)
The risk of BO decreases with:
• Perceived quality of meetings (coeff. = -0.31)
• Trust (coeff. = -0.30)
• Autonomy (coeff. = -0.20)
• Participation (coeff. = -0.10)
• Organizational commitment (coeff. = -0.24)
Indicators of Quality of Working Life correlated with Burnout
Perceived risks for the future and levels of CS, CF, BO
Staff that do not perceive risks for the future show significantly higher levelsof CS (**), and significantly lowerlevels of CF (*) and BO (**).
* Significant at the 5% level** Significant at the 1% level
12.714.4 14.7
20.522.7 23.5
36.032.3 32.4
0.0
10.0
20.0
30.0
40.0
No Yes - Some risks Yes - Many risks
Do you perceive risks for the future?Mean values of CS, CF and BO
CS
CF
BO
Training needs and levels of CS, CF, BO
32.928.9
14.4 14.3
22.9 23
0
10
20
30
40
50
60
70
Yes No
Do you perceive the need for training?Mean values of CS, CF and BO
CS CF BO
Members of staff thatdo not perceive the need for training havesignificantly lower CS scores (*).
* Significant at the 5% level** Significant at the 1% level
Opinion on salary and levels of CS, CF, BO
31.3 33 33.3
13.9 14.7 14.2
23.8 23.1 21.6
0
10
20
30
40
50
60
70
Insufficient Sufficient Good
How do you consider your salary?Mean values of CS, CF and BO
CS CF BO
The better the opinion on salary, the lowerthe risk of BO (**).
* Significant at the 5% level** Significant at the 1% level
Factors affecting CF, BO, and CS Results of multiple regressions
• One of the strongest associations of CF and BO was with ergonomic problems, especially time pressures (CF p-value = 0.008, BO p-value = 0.002)
• Increased levels of CF and BO were predicted by higher levels of impact of work on life (CF p-value = 0.009, BO p-value = 0.007)
• Trust predicted lower levels of BO (p-value = 0.004); research demonstrates that support and trust by managers and co-workers are critical in protectingagainst Burnout
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• Need of training (p-value = 0.035), quality of meetings (p-value = 0.007), and perceived risks for the future (p-value = 0.012), affected CS levels
• These factors share similar features in that theyreflect aspects of workers’ motivation and engagement
• Perceived risks for the future were associated with BO too (p-value = 0.001), further suggesting the negative effects of job insecurity on staff well-being
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Factors affecting CF, BO, and CS Results of multiple regressions
Conclusions ➢ In order to provide adequate mental health services,
managers need to provide their employees with adequate ergonomic conditions, paying special attention to time pressures
➢ Building trustful relationships with management and within teams is also crucial
➢ Training and meetings are other important targets for potential improvement, although how meetings and the need for training are perceived might depend on the motivation of members of staff themselves
➢ Additionally, the issue of insecurity for the future should be taken into serious consideration as it can affect both Burnout and Compassion Satisfaction
➢ Lastly, to positively influence their clients’ wellbeing, managers, administrators, and staff themselves need to consider strategies to reduce possible work-life conflicts
Thank you for listening!
02/09/14 ILPN 2014 Conference 20
E-mail address: [email protected]
Website: www.kcl.ac.uk/scwruTwitter: @scwruBlog: blogs.kcl.ac.uk/socialcareworkforce/
