| Abstract | Ova doktorska disertacija prikazuje radnu sposobnost, kvalitetu života i salutogenu produktivnost zdravstvenih djelatnika u sedam hrvatskih bolnica. U presječnom je istraživanju sudjelovalo 1633 ispitanika (267 muškaraca, 1363 žena i 3 bez podatka o spolu), u dobi od 19 do 64 godine, zaposlenih u bolnicama različitih županija u Hrvatskoj. Bile su obuhvaćene 2 kliničke, 4 opće i 1 specijalna bolnica. Istraživanje je bilo provedeno krajem 2007. i početkom 2008. godine. Istraživanje je bilo anonimno i dragovoljno, te je uključilo cijeli spektar zdravstvenih djelatnika: liječnike, medicinske sestre i tehničare, fizioterapeute, farmaceute i ostale zdravstvene djelatnike. Stopa odgovora iznosila je 57,08%. Istraživanje se provelo primjenom triju upitnika: Upitnik za određivanje indeksa radne sposobnosti (engl. Work Ability Index, WAI), Upitnik o kvaliteti života World Health Organization Quality of Life-Brief Version questionnaire (WHOQOL-BREF) kojim se određuje kvaliteta života u 4 domene (fizičko zdravlje, psihičko zdravlje, društvena interakcija i okoliš), te Upitnik za određivanje indeksa ljudskog rada (Human Work Index, HWI). Od statističkih testova korišteni su Mann-Whitney U-test, Kruskal-Wallisova analiza varijance rangova, te χ2-test u svrhu deskriptivne analize, dok se u svrhu analize povezanosti domena kvalitete života i radne sposobnosti bila korištena binarna logistička regresija s indeksom radne sposobnosti kao zavisnom varijablom. Kvaliteta života u svim mjerenim domenama pokazala je zadovoljavajuće vrijednosti, uz izuzetak domene okoliša, čije su vrijednosti bile granične, što je bio konzistentan nalaz u svim bolnicama. Vrijednosti pojedinih domena kvalitete života značajno su se razlikovale s obzirom na bolnicu, uz iznimku psihičkog zdravlja gdje značajnost nije nađena. Indeks radne sposobnosti zdravstvenih djelatnika imao je zadovoljavajuće vrijednosti u svim bolnicama, uz izuzetak Specijalne bolnice gdje je vrijednost istog bila granično zadovoljavajuća. Razlika u radnoj sposobnosti prema bolnicama bila je statistički značajna. Na ukupnom uzorku, samo 32% ispitanika je imalo održivu radnu sposobnost. Vrijednost ukupnog indeksa ljudskog rada (HWI), izražena kao postotak skalnog maksimuma, na uzorku svih ispitanika bila je osrednja (68% SM), kao i vrijednost dimenzije interesa za rad (65% SM) i suradnje (57% SM), dok je vrijednost dimenzije radne sposobnosti bila dobra (81% SM). Analiza povezanosti domena kvalitete života i radne sposobnosti je pokazala da su fizičko zdravlje i psihičko zdravlje značajni prediktori dobre radne sposobnosti. Pri tome, zdravstveni djelatnici boljeg fizičkog zdravlja imaju 6,8 puta veće šanse za dobru radnu sposobnost nego oni lošeg fizičkog zdravlja. Također, zdravstveni djelatnici s boljim psihičkim zdravljem imaju 1,8 puta značajno veću šansu za dobru radnu sposobnost nego oni lošeg psihičkog zdravlja. Od ostalih prediktora dobre radne sposobnosti u multivartijatnoj analizi, statistički značajni su bili dob (inverzna povezanost), te edukacijski stupanj (pozitivna povezanost). Unatoč metodološkim nedostacima provedene studije, ovi rezultati daju uvid u stanje radne sposobnosti i kvalitete života bolničkih zdravstvenih djelatnika, te upućuju na potrebu provedbe programa održanja radne sposobnosti i promocije zdravlja na radnom mjestu. |
| Abstract (english) | This dissertation analyzes work ability, quality of life and salutogenic productivity of hospital health care workers employed in seven hospitals in Croatia. A cross-sectional study was conducted. The study population consisted of 1633 participants (267 men, 1363 women and 3 with no information on sex), aged 19-64 years. Different types of hospitals were included: 2 clinical, 4 general and 1 specialized hospital. The study was carried out in 2007 and 2008. The study was anonymous and voluntary with a response rate of 57,08%. The study included a wide range of health care workers: physicians, nurses/medical technicians, physiotherapists, pharmacists and other health care professionals. Three questionnaires were used: Work Ability Index Questionnaire, World Health Organization Quality of Life-Brief Version questionnaire, which measures quality of life in 4 domains (physical health, psychological health, social interaction and environment), and Human Work Index Questionnaire (HWI). Mann-Whitney U-test, Kruskal-Wallis analysis of variance by ranks and χ2-test were used for descriptive analyses. Binary logistic regression models were used to assess the association between the domains of quality of life and work ability, with work ability index being the dependent variable. The participants had satisfactory values of quality of life (QoL) in all its domains, with exception of environment which consistently showed borderline values in all hospitals. The values of all QoL-domains significantly differed according to hospital, with exception of psychological domain. Furthermore, Work Ability Index (WAI) was satisfactory in all hospitals, with exception of a specialized hospital, where its values were borderline. There was a substantial difference in WAI with respect to hospital. Only 32% of all participants had sustainable work ability. Analysis of HWI among all participants revealed that the value of the total HWI was moderate (68% of scale maximum, SM). The values of the components of HWI were as follows: work interest and cooperation showed moderate values, with 65% SM and 57% SM, respectively, while work ability component was good (81% SM). Analysis of the association between QoL-domains and work ability showed that good physical and psychological health were significant predictors of good work ability, whereby health care workers with good physical health had 6,8 greater likelihood of having good work ability compared with those without good physical health. Also, participants with good psychological health were 1,8 times more likely to have good work ability than their counterparts without good psychological health. Other factors that were considerably associated with good work ability were age (inverse association) and education level (positive association). Despite the methodological limitations, this study clearly shows the descriptive details of work ability, QoL and salutogenic productivity of hospital health care workers and points to the need to formulate and implement a workplace health promotion program that aims at maintaining work ability. |
