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Using an integrated approach to the assessment of the psychosocial work environment: the case of a major hospital in northern Italy.

BACKGROUND
In 2010, Italian regulatory guidelines have been issued consisting of a stepwise procedure for the assessment and management of work-related stress. However, research that empirically examines whether this procedure proves effective in accurately identifying critical psychosocial factors and informing risk management is scarce.


OBJECTIVES
To examine the differential sensitivity of two approaches to risk assessment, the first based on objective instruments only, the second consisting of an integrated approach combining different methods and theoretical perspectives.


METHODS
We examined a sample of 306 healthcare employees in a large-size hospital in northern Italy, using a series of tools, both quantitative (an observational checklist and the HSE-IT and MOHQ questionnaires) and qualitative (Focus Groups). Through instrument-specific reference values, we then compared risk profiles between different homogeneous groups within the institution.


RESULTS
The psychosocial work environment resulted to be far more positive when adopting the first compared to the second approach to risk assessment. The latter approach was also more sensitive in detecting between-groups differences in risk profiles. Furthermore, the Focus Groups returned a more context-specific picture of the psychosocial work environment. Finally, going beyond the emphasis on negative working conditions inherent in the other quantitative instruments, the MOHQ allowed for also identifying health-promoting factors in need for improvement.


CONCLUSIONS
Although more research is needed to confirm our findings, the present study suggests that using an integrated approach to assess the psychosocial work environment may be the most effective way to accurately identify risk factors and support the management process.