Table of Contents
JHSS 2024;9(3):312-333
ORIGINAL ARTICLE IN OCCUPATIONAL HEALTH PSYCHOLOGY
The relationship between discriminatory work environment and psychological distress in Italian organizations: Are lack of supervisor support and economic stress mediating factors?
Authors: Giorgia BONDANINI1, Gabriele GIORGI2, Francesco CHIRICO3, Amelia RIZZO4, Hicham KHABBACHE5, Francesca ROMANA TESTA6, Giulia FOTI7*, Federico ALESSIO8, Valerio VINCIARELLI9, Georgia Libera FINSTAD10
1 Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: giorgia.bondanini@unier.it ORCID: https://orcid.org/0000-0002-2421-3217.
2 Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: gabriele.giorgi@unier.it ORCID: https://orcid.org/0000-0002-7340-356X
3 Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Roma, Italy. Email: medlavchirico@gmail.com. ORCID: https://orcid.org/0000-0002-8737-4368.
4 Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy. E-mail: amrizzo@unime.it. ORCID: https://orcid.org/0000-0002-6229-6463.
5 Laboratory of «Morocco: history, Theology and languages», Department of Psychology, Faculty of Arts and Human Sciences Fès-Saïss, Sidi Mohamed Ben Abdellah University, Fez- Morocco Email: hicham.khabbache@usmba.ac.ma. ORCID: https://orcid.org/0000-0001-9587-2829.
6Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: fromana98@gmail.com.
7Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: giulia.foti@unier.it ORCID: https://orcid.org/0000-0002-1496-2054.
8Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: federico.alessio@unier.it ORCID: https://orcid.org/0000-0002-0769-0783.
9Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: valerio.vinciarelli@unier.it.
10Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: georgialibera.finstad@unier.it ORCID: https://orcid.org/0000-0003-3234-9197.
*Corresponding Author: Psychologist, Business@Health Laboratory, European University of Rome, 00163 Rome, Italy. Department of Human Sciences, European University of Rome, 00163 Rome, Italy. E-mail: giulia.foti@unier.it
Abstract
Introduction:The construct of a discriminatory work environment is becoming increasingly significant in organizations due to its potential impact on corporate, health, and economic stress. Economic stress, in particular, can be viewed as a potential stressor, comprising both objective and subjective components. This research aims to demonstrate how the perception of a discriminatory work environment can affect workers’ perceived well-being, considering supervisor support and economic stress as potential mediators.
Methods:A parallel mediation analysis was conducted on 170 managers to examine the associations between a discriminatory work environment, psychological distress, supervisor support, and economic stress. Subsequently, a simple mediation model was tested on a second sample of 358 employees to explore the relationships between a discriminatory work environment, supervisor support, and psychological distress.
Results:The findings indicate that the total effect of a discriminatory work environment on employees’ psychological well-being is significant. Additionally, there is a direct positive effect of a discriminatory work environment on employees’ psychological distress, supervisor support, and economic stress. In the second sample, the results demonstrate that a discriminatory work environment significantly affects the lack of supervisor support, which, in turn, significantly impacts psychological distress.
Discussion:This research highlights the importance of promoting a non-discriminatory work environment to ensure greater psychological well-being and foster a positive organizational climate. Assessing and training managers to provide effective support may also be promising strategies for enhancing well-being and performance in the workplace.
Keywords: discriminatory work; economic stress; psychological distress; supervisor support; wellbeing.
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JHSS 2024;9(3):334-351
ORIGINAL ARTICLE IN OCCUPATIONAL HEALTH PSYCHOLOGY
Stress management and psychological resilience of healthcare workers: The role of job satisfaction, job performance, and continuance commitment
Authors: Hazal Koray ALAY1*, Emine OZTURK2, Meri TAKSI DEVECIYAN3
1 Batman University, Batman, Turkiye. E-mail: hazalkoray.alay@batman.edu.tr. ORCID:https://orcid.org/0000-0002-6638-3089.
2 University of Healthy Science, Istanbul, Turkiye. E-mail: emineozt77@gmail.com ORCID: https://orcid.org/0009-0003-5941-0936.
3 Istanbul Kultur University, Istanbul, Turkiye. E-mail: m.taksideveciyan@iku.edu.tr ORCID: https://orcid.org/0000-0001-9206-0315.
*Corresponding Author: Associate Professor Hazal Koray Alay, Batman University, Batman Turkiye. E-mail: hazalkoray.alay@batman.edu.tr
Abstract
Introduction: The purpose of this study is to examine the role of job satisfaction, job performance, and continuance commitment in the relationship between psychological resilience and stress management among healthcare workers at İstanbul province public hospitals, in Turkey.
Methods: As the data collection and analysis method in this research, a cross-sectional study design was used on a sample of 848 healthcare workers. A simple random sampling method was used to collect data. Data were evaluated using IBM’s statistical program SPSS Statistics 26.0 and Hayes Process Macro statistical program. In the research, data were examined using frequency analysis, explanatory factor analysis, reliability analysis, Pearson correlation analysis, and multiple regression analysis.
Result: The research’s findings indicate that stress management, psychological resilience, job satisfaction, and job performance are significantly correlated. There is no statistically significant correlation between continuance commitment and other variables.
Discussion: The psychological resilience of health workers is effective on job performance. It is emphasized that the job performance of health workers can help them to have a better level of psychological resilience both personally and professionally. Healthcare workers with high job performance tend to have a more positive relationship with their jobs, which may increase their capacity to cope with stress. Stress management is very important, as healthcare professionals do not accept mistakes and have high risks while providing services. For this reason, stress management practices can be developed to alleviate the difficulties of working conditions in institutions and increase psychological resilience.
Keywords: Continuance commitment; healthcare worker; job satisfaction; job performance; psychological resilience; stress management.
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JHSS 2024;9(3):352-366
ORIGINAL ARTICLE IN PSYCHOLOGY
Psychometric properties and gender invariance of the Work-related Acceptance and Action Questionnaire (WAAQ) in the Italian context
Authors: Angela RUSSO1*, Andrea ZAMMITTI2, Giuseppe SANTISI3, Paola MAGNANO4
1 Department of Psychology, University of Bologna, Cesena. Italy. Email: angela.russo@phd.unict.it. ORCID: https://orcid.org/0000-0003-0688-7864
2 Department of Educational Sciences, University of Catania, Catania, Italy. Email: andrea.zammitti@unict.it. ORCID: https://orcid.org/0000-0002-1666-638X
3 Department of Educational Sciences, University of Catania, Catania, Italy. Email: gsantisi@unict.it. ORCID: https://orcid.org/0000-0001-9750-7673
4 Department of Human and Social Sciences, Kore University of Enna, Enna, Italy. Email: paola.magnano@unikore.it. ORCID: https://orcid.org/0000-0002-2706-5221
*Corresponding Author: Angela Russo, Department of Educational Sciences, Via Biblioteca n. 4, Catania, Italy (affiliation when the research was conducted). Department of Psychology, University of Bologna, Cesena, Italy (current affiliation). E-mail: angela.russo@phd.unict.it
Abstract
Introduction: This research paper aims to validate the Work-related Acceptance and Action Questionnaire (WAAQ, Bond et al., 2013) in the Italian context, demonstrating gender invariance. This measure was developed to address the need for a brief contextual measure of psychological flexibility in professional domains.
Methods: Five studies were conducted. In Study 1, the scale was culturally adapted; parallel analysis and Exploratory Factor Analysis were conducted. Study 2 tested the structure, and the model fit of the 7-item scale through confirmatory factor analysis and internal consistency indices. Study 3 examined concurrent validity. Study 4 verified the temporal reliability using the test-retest method. Study 5 analyzed gender invariance.
Results: In Study 1, the scale confirmed its one-factorial structure, accounting for 59.73% of the variance. Study 2 demonstrated a good model fit of the 7-item scale in the Italian context. Study 3 showed negative correlations with psychological inflexibility and positive correlations with life satisfaction, flourishing, and work engagement. Study 4 verified the temporal stability of the scale. Study 5 confirmed configural, metric, scalar, and residual invariance regarding gender.
Discussion: Overall, the results support the WAAQ’s validity and reliability for assessing work-related psychological flexibility, making it a valuable tool for researchers and practitioners.
Keywords: psychological flexibility; work-related psychological flexibility; assessment; ACT; WAAQ.
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JHSS 2024;9(3):367-378
ORIGINAL ARTICLE IN PSYCHOLOGY
The effects of mindful self-care on medical resident wellness, depression, and burnout
Authors: Wendy M. GUYKER1, Evette A. ADDAI2, Catherine P. COOK-COTTONE3*, Susan M. ORRANGE4, Sofie SCALETTA5
1 Department of Counseling, School, and Educational Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA. E-mail: wmguyker@buffalo.edu ORCID: https://orcid.org/0000-0003-2874-2439.
2 Mountain of Change Counseling and Psychological Services, Chicago, USA. E-mail: evetteaddai@mountainofchange.org ORCID: https://orcid.org/0000-0001-6036-762X.
3 Department of Counseling, School, and Educational Psychology University at Buffalo, The State University of New York, Buffalo, NY, USA. E-mail: cpcook@buffalo.edu ORCID: https://orcid.org/0000-0001-7-7146-066X.
4 Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA. E-mail: sorrange@buffalo.edu ORCID: https://orcid.org/0009-0000-8722-1153.
5 Department of Counseling, School, and Educational Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA. E-mail: smscalet@buffalo.edu ORCID: https://orcid.org/0009-0000-6585-9834.
*Corresponding Author: Catherine P. Cook-Cottone, Professor of Counseling, School, and Educational Psychology, University at Buffalo, Buffalo, NY, USA. E-mail: cpcook@buffalo.edu.
Abstract
Introduction: The Accreditation Council for Graduate Medical Education (ACGME), a U.S. nonprofit organization setting educational standards for safe and high-quality medical care, recently expanded its requirements for resident well-being, emphasizing self-care. However, little research exists on this topic. This study aimed to assess the types and frequency of mindful self-care behaviors, defined as intentional practices that promote awareness of internal needs and external demands. It also examined the relationship between self-care, well-being, burnout, distress, and depression, and whether self-care can protect residents from depression linked to burnout and distress.
Methods: A cross-sectional survey was conducted with medical residents at a Northeastern U.S. medical school over three months. Residents in their first four years of surgical and non-surgical specialties received an email with a survey link and informed consent. Mindful self-care was assessed using the Mindful Self-Care Scale (MSCS), distress with the Physician Well-Being Index (PWBI), depression with the Patient Health Questionnaire-9 (PHQ-9), and wellness with the Brief Resident Wellness Profile (BRWP). Data were analyzed using SPSS, with moderation analyses performed to explore self-care’s role in mitigating depression linked to distress.
Results: A total of 104 residents participated (15.95% response rate). Self-care positively correlated with resident well-being (r = .62, p < .0001) and negatively correlated with resident distress (r = -.50, p < .0001) and resident depression (r = -.56, p < .0001). Burned-out residents had significantly less self-care than those not burned out (F (1,97) = 15.69, p < .0001). Moderation analyses evidenced that mindful self-care is protective for residents against developing depression related to burnout and distress.
Discussion: This research shows that resident self-care is strongly linked to well-being and is associated with lower distress, depression, and burnout. It highlights that self-care can protect against poor health outcomes during residency and emphasizes that self-care can involve changing one’s approach rather than requiring additional resources like time or money.
Keywords: Burnout; depression; mental health; mindfulness; self-care.
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JHSS 2024;9(3):379-398
ORIGINAL ARTICLE IN OCCUPATIONAL HEALTH PSYCHOLOGY
Prevalence and factors associated with burnout syndrome in resident physicians: A cross-sectional study in Italy
Authors: Luca DI GIAMPAOLO1*, Andrea ROSSETTI2, Teresa GALANTI3, Simone DE SIO4, Luca COPPETA5, Hector NIETO6, Hiroo WADA7, Niu QUIAO8, Younes RAMI9, Hicham KHABBACHE10 , Driss AIT ALI11, Amelia RIZZO12, Kavita BATRA13, Murat YILDIRIM14, Mahmood BAHRAMIZADEH15, Francesco CHIRICO16
1 Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio”, Chieti-Pescara, Italy. E-mail: luca.digiampaolo@unich.it ORCID: https://orcid.org/0000-0003-3315-7197.
2 Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio”, Chieti-Pescara, Italy. E-mail: catena93go@gmail.com.
3 Department of Psychological, Health and Territorial Sciences, University “G. d’Annunzio”, Chieti-Pescara, Italy. E-mail: teresa.galanti@unich.it ORCID: https://orcid.org/0000-0003-1926-4877.
4 Research Unit of Occupational Medicine, University “La Sapienza”, Roma, Italy. E-mail: simone.desio@uniroma1.it ORCID: https://orcid.org/0000-0003-4538-3941.
5 Department of Biomedicine and Prevention, University “Tor Vergata”, Roma, Italy. E-mail: luca.coppeta@uniroma2.it ORCID: https://orcid.org/0000-0003-2470-6107.
6Occupational Medicine School, University of Business and Social Sciences, Buenos Aires C1061 ABA, Argentina. E-mail: hnieto@live.com.ar ORCID: https://orcid.org/0009-0007-9325-8404.
7Department of Public Health & Division of Medical Education, Juntendo University Graduate School of Medicine, Tokyo, Japan. E-mail: h-wada@iuntendo.ac.jp ORCID: https://orcid.org/0000-0002-0752-3790.
8School of Public Health, Shanxi Medical University, China. E-mail: niuquiao55@sxmu.edu.cn ORCID: https://orcid.org/0000-0003-0015-3341.
9Biodiversity, Ecology and Genome Laboratory, 4 Avenue Ibn Battouta, Faculty of Sciences, Mohammed V University in Rabat, B.P. 1014 Morocco. Email: younesrami01@gmail.com ORCID: https://orcid.org/0000-0003-2313-8734.
10Laboratory of «Morocco: History, Theology and languages, » Department of Psychology, Faculty of Arts and Human Sciences Fès-Saïss, Sidi Mohamed Ben Abdellah University, Fez-Morocco. Director of Lifelong Learning Observatory (UNESCO/ USMBA). Email: hicham.khabbache@usmba.ac.ma ORCID: https://orcid.org/0000-0001-9587-2829.
11Laboratory of «Morocco: History, Theology and languages, » Department of Psychology, Faculty of Arts and Human Sciences Fès-Saïss, Sidi Mohamed Ben Abdellah University, Fez-Morocco. Email: driss.aitali@usmba.ac.ma ORCID: https://orcid.org/0000-0001-5043-9677.
12Department of Clinical and Experimental Medicine and Department of Cognitive Sciences, Psychological, Educational, and Cultural Studies, University of Messina, Messina, Italy. E-mail: amrizzo@unime.it ORCID: https://orcid.org/0000-0002-6229-6463.
13Department of Medical Education and Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, United States of America. E-mail: kavita.batra@unlv.edu ORCID: https://orcid.org/0000-0002-0722-0191.
14Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University, Ağrı, Turkey. E-mail: muratyildirim@agri.edu.tr ORCID: https://orcid.org/0000-0003-1089-1380.
15Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. E-mail: mbzoandp@gmail.com ORCID: 0000-0003-4719-938x
16Post-Graduate School of Occupational Health, Catholic University of the Sacred Heart, Rome, Italy. Department of Health Service, Italian State Police, Ministry of the Interior, Milan, Italy. E-mail: medlavchirico@gmail.com ORCID: https://orcid.org/0000-0002-8737-4368.
*Corresponding Author: Prof Luca Di Giampaolo, School of Specialization in Occupational Medicine – Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio” of Chieti and Pescara, Italy. E-mail: luca.digiampaolo@unich.it
Abstract
Introduction: Burnout syndrome is a psychological condition marked by emotional exhaustion, depersonalization, and diminished personal accomplishment due to chronic workplace stress. Despite its significance, few studies have specifically documented burnout levels among resident physicians. This study aims to assess the prevalence of burnout and its associated factors within this population.
Methods: We conducted a cross-sectional survey involving 160 resident physicians in Italy. To evaluate levels of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA), we utilized the Maslach Burnout Inventory. Additionally, we assessed work-life balance using questions related to Free-time satisfaction (FTS), Free-Time Satisfaction Reduction (FTRS), and Work-problems pervasiveness (WPP).
Results: The analysis revealed that 30% of residents had high levels of emotional exhaustion, with an equal percentage reporting low levels. For depersonalization, 26.88% of participants reported high levels. In contrast, only 3.75% of residents report high levels of personal accomplishment. Furthermore, our findings indicate that only work-related factors influence burnout levels in our sample.
Discussion: Consistent with previous research, our results demonstrate higher levels of emotional exhaustion and depersonalization, and lower levels of personal accomplishment among resident physicians. These findings support existing studies that burnout is strongly associated with work-related factors over individual-level demographic factors. Furthermore, residents who maintain a good work-life balance report lower burnout levels compared to those who struggle to achieve this balance.
Keywords: Burnout; prevalence; occupational health; work-life balance.
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JHSS 2024;9(3):399-415
ORIGINAL ARTICLE IN OCCUPATIONAL HEALTH AND COVID-19
The work-related well-being of social service workers post COVID-19 pandemic: The psychosocial impact of remote vs in-person work
Authors: Venusia COVELLI1*, Morena TAFFARELLO2, Marina Angela VISCO3, Francesco CHIRICO4, Pietro CRESCENZO5, Luca COPPETA6,Kavita BATRA7, Alessandra MARELLI8
1 Department of Theoretical and Applied Sciences, eCampus University, Italy. E-mail: venusia.covelli@uniecampus.it ORCID: https://orcid.org/0000-0002-5965-2658.
2 Department of Theoretical and Applied Sciences, eCampus University, Italy. E-mail: morenataffarello78@gmail.com
3 Department of Theoretical and Applied Sciences, eCampus University, Italy. E-mail: marina.visco@uniecampus.it ORCID: https://orcid.org/0009-0009-7593-1292.
4 Post-Graduate School of Occupational Health, Catholic University of the Sacred Heart, Rome, Italy. E-mail: francesco.chirico@unicatt.it ORCID: https://orcid.org/0000-0002-8737-4368.
5 Department of Theoretical and Applied Sciences, eCampus University, Italy. E-mail: pietro.crescenzo@uniecampus.it ORCID: https://orcid.org/0000-0001-5240-315X.
6Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. E-mail luca.coppeta@uniroma2.it ORCID: https://orcid.org/0000-0003-2470-6107.
7Department of Medical Education and Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, USA. Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, USA. E-mail: kavita.batra@unlv.edu ORCID: https://orcid.org/0000-0002-0722-0191.
8Department of Theoretical and Applied Sciences, eCampus University, Italy. E-mail: alessandra.marelli@uniecampus.it ORCID: https://orcid.org/0009-0009-7593-1292.
*Corresponding Author: Venusia Covelli, Associate Professor, eCampus University, Isimbardi 10 street, Novedrate (Co), Italy. E-mail: venusia.covelli@uniecampus.it
Abstract
Introduction: The COVID-19 emergency and the subsequent restrictive measures forced an internal reorganization of social services, including a remote working model. These changes forced Social Service Workers (SSW) to change their work using new technologies, which might have affected their job satisfaction and general well-being. Therefore, the current research aims to compare the remote working situation during the pandemic with the return to in-person work to evaluate how these two models affected the SSW’s job satisfaction and well-being.
Methods: SSW working in social service delivery organizations were recruited to participate in an online semi-structured survey comprising the Job Satisfaction Scale, Psychological General Well-Being Index-S, Work-Related Stress Indicator Tool, Organizational Identification Scale, and Positive and Negative Affect Schedule. The survey tool had several open-ended questions to examine participants’ views about the existing interventions in their workplace and what could be improved and implemented on a permanent basis to enhance their well-being at work.
Results: A total of 119 social workers accepted to complete the survey. 77 experienced both in-person and remote working. Comparing working in-person with remote working, the quality of life and satisfaction with one’s health do not change. Whereas the perception of the risk of contracting COVID-19 increases when working in-person (M=3.88) than in remote working (M=1.96; p<.05), and the levels of anxiety increase in remote conditions (M=4.51) if compared to in-person working (M=4.06; p<.05). Job satisfaction about the relationship with the superior is better when working in-person than in remote working (M=4.87 vs 4.61; p<.05) and job satisfaction about the relations between the service and the workers is better when working in-person than in remote working (M=4.87 vs M=4.61; p<.05). Significant differences emerge also from the “in-person vs. remote working” comparison regarding all the dimensions of work-related stress. Discussion: Results lead to useful reflections regarding the management of relations with users and colleagues, the psycho-physical well-being of operators, and, more generally, the quality of the services provided about the mode of service delivery and whether they work in-person vs. remote working.
Keywords: COVID-19 pandemic; job satisfaction; psychological well-being; remote work; social service workers; work-related stress.
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JHSS 2024;9(3):416-431
ORIGINAL ARTICLE IN SOCIOLOGY OF HEALTH
Longitudinal association of individual and household social capital with suicidal ideation: A multilevel analysis in South Korea
Authors: Sehee HAN1*
1 Institute of Social Sciences, Kookmin University, 77 Jeongneung-Ro, Seongbuk-Gu, Seoul, South Korea. E-mail: shkingdom@gmail.com ORCID: https://orcid.org/0000-0003-2547-8986.
*Corresponding Author: Dr. Sehee Han, Institute of Social Sciences, Kookmin University, 77 Jeongneung-Ro, Seongbuk-Gu, Seoul, South Korea
Abstract
Introduction: Social capital has been shown to operate as a protective factor for suicide-related behaviors. However, empirical studies that considered social capital at the individual and household levels and investigated their longitudinal association with suicide-related behaviors using a multilevel framework have received little attention to date. To fill this gap, the objectives of the current study were to examine: how much of the variance in suicidal ideation could be attributed to the household level and to examine the longitudinal association between social capital at the individual and household levels and suicidal ideation using a nationally representative sample of South Korea.
Methods: This study was a secondary analysis of data from the Korean Welfare Panel Study (KOWEPS). Data for wave 13 (2018) and wave 14 (2019) of the KOWEPS were combined to generate a longitudinal dataset. The final sample for this study includes 10,490 respondents within 6,135 households. A series of multilevel logistic regression analyses were conducted.
Results: The results showed that 30.49% of respondents’ variance in suicidal ideation was attributed to the household level. At the individual level, trust (OR=0.70, 95% CI=0.56, 0.86) and reciprocity (OR=0.63, 95% CI=0.50, 0.79) were inversely associated with suicidal ideation. At the household level, trust (OR=0.92, 95% CI=0.85, 0.98) and reciprocity (OR= 0.90, 95% CI=0.84, 0.96) were negatively associated with suicidal ideation, while volunteering did not show a clear relationship with suicidal ideation both at the individual and household levels.
Discussion: In conclusion, this study provides evidence that a relatively large proportion of the variance in ideation could be attributed to the household level, indicating the importance of considering the household context to better understand an individual’s suicidal ideation. It further provides evidence that some components of social capital could reduce suicide risks.
Keywords: Suicidal ideation; suicide; social capital; household context; South Korea.
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JHSS 2024;9(3):432-456
ORIGINAL ARTICLE IN PUBLIC HEALTH
Military medicine and morale: Perceptions of inequities in triage impact national security
Authors: Tanisha M. FAZAL1, Jane L. SUMNER2, Jessica KORONA-BAILEY3*, Tracey Pérez KOEHLMOOS4
1 University of Minnesota, Minneapolis Minnesota, United States. E-mail: fazal007@umn.edu ORCID: https://orcid.org/0000-0003-3314-5815
2 University of Minnesota, Minneapolis Minnesota, United States. E-mail: jlsumner@umn.edu ORCID: https://orcid.org/0000-0001-6616-2238
3 Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States. The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, United States. E-mail: jessica.korona.ctr@usuhs.edu ORCID: https://orcid.org/0000-0002-0314-5171
4 Center for Health Services Research, Uniformed Services University of the Health Sciences, Bethesda, Maryland, United States. E-mail: tracey.koehlmoos@usuhs.edu ORCID: https://orcid.org/0000-0003-1377-8615
*Corresponding Author: Jessica Korona-Bailey, Center for Health Services Research, Uniformed Services University of the Health Sciences, The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, Maryland, United States. Email: jessica.korona.ctr@usuhs.edu
Abstract
Introduction: There is an established relationship between military morale and battlefield effectiveness. Theoretically, better military medicine should increase morale leading to increased effectiveness as such we sought to investigate the relationship between military medicine and military morale.
Methods: We conducted a survey experiment of active-duty service members aged 18-62 years. The virtual survey was advertised in a social media campaign using Meta from July 23, 2022, through July 20, 2023. Service members were randomly assigned scenarios regarding a theoretical conflict. One set of scenarios included a triage protocol where mission-essential personnel would be prioritized for medical care even if not the most severely injured. The other set of scenarios did not mention triage. A Total Morale Index score was developed. Linear regression was used to test the relationship between military medicine and morale adjusting for treatment conditions and covariates of age, rank, and service years.
Results: The final sample was comprised of 1808 active-duty service members mean age of 25.28 years ± 7.7 standard deviation and 87.5% male. Respondents who received the triage treatment consistently reported lower morale compared to respondents who did not receive the triage treatment controlling for demographic and military-specific factors; this difference was statistically significant at the p=.05 level. Women, married respondents, and those with a longer time in their unit had lower morale scores.
Discussion: Respondents who received a randomly assigned prompt indicating that they would be less likely to receive medical care if injured on the battlefield report significantly lower levels of morale compared to respondents who did not receive this prompt. Given that prior research has demonstrated a relationship between military morale and military effectiveness, investments in military medicine can contribute to effectiveness by improving morale.
Keywords: Military effectiveness; military morale; military medicine.
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