THE RECIPROCITY OF THE QUALITY OF CARE PROVIDERS' OCCUPATIONAL LIFE OF AND THE QUALITY OF CARE: A CYCLE MODEL

Introduction The effects of staff burnout and other aspects of occupational well-being on treatment outcomes, including patient satisfaction, have so far received little research attention (Leiter et al. 1998, Garman & Corrigan, 2002, Argentero et al. 2007). As healthy and resilient organizations (HE.RO., Salanova & Schaufeli, 2009) improve the employees’ health, the organizational performance and the quality of products/services at the same time, the issue then becomes increasingly important in those service contexts where the quality of work may have further effects on the users’ well-being and satisfaction. The construct of patient satisfaction has little standardization, low reliability and uncertain validity. It is often used interchangeably with, and as a proxy for, perceived service quality, although this is a conceptually different and superior construct. Pascoe (1983) defined patient's satisfaction as “a health care recipient’s reaction to salient aspects of the context, process and results of their service experience”. Aim of the study In the perspective of the so called “organizational sustainability”, this study aims at understanding the determinants of well-being of hospital staff and patients, observing the existence of reciprocity relations between working life quality and patients’ satisfaction. The relationship between antecedent of quality of occupational life (such as social support, organizational justice, commitment), staff well-being (burnout was the initial research focus), and patient satisfaction have been investigated in this study. We expect that units with higher level of burnout will report lower level of patient satisfaction. Methods 172 staff members from 8 hospital facilities completed the COPSOQ (Kristensen et al., 2003), the JCQ (Karasek et al. 2008), and the Maslach Burnout Inventory; 163 of the clients/patients they cared for were interviewed about their satisfaction with care using the Questionnaire on the Evaluation of Perceived Quality of Home Care [Questionario sulla valutazione della qualità percepita nell’ADI, Franci & Corsi, 1999)]. Cronbach’s alphas were calculated for each of the subscales used in the study and will be reported. All appeared to be acceptable, with many reaching .80 or higher. Results Data collection and analysis (Regression analysis) are still in progress and the results and conclusion will be reported in order to explore the existence of significant relationships between antecedent and effects of workers' well-being and patients' satisfaction. We conducted a first exploratory cross-sectional survey of nurses (N = 94) and patients (N = 93) from 4 units in a urban hospital in Turin, which confirmed the existence of a significant relationships between well-being and patient satisfaction: regression analysis (R²=,229; X²=13,774; sig=0,003) confirmed the existence of a significant inverse relationship between antecedents and effects of the team's emotional exhaustion (OR=,901 sig=0,006) and patient satisfaction. Final results will be available for the conference. Discussion Patients cared for on units that nurses described as having adequate staff, good administrative support for nursing care and good relationships between doctors and nurses were likely to report high satisfaction levels with their care, and their nurses reported significantly lower burnout. The overall level of nurses' burnout on hospital units also affected patient satisfaction. Improvements in nurses' work environments in hospitals have the potential to reduce nurses' high levels of job burnout and increase patients’ satisfaction with their care. Although this study has explored some aspects of the nature of the relationship between organizational features of the nurse's practice environment, nurse's burnout, patient's satisfaction, and the link between nurse's burnout and patient satisfaction, future research will be needed to increasingly understand the causal mechanisms that link organizational features and outcomes. More research is needed on how organizational features affect the process of nursing care, and the interrelationships between nursing care processes and outcomes. Conclusions The most important finding of this study is that a higher level of staff emotional exhaustion in the workplace seems to be associated with a lower level of patient satisfaction. Final results and conclusions will be available for the conference.