Wellbeing and stress in helping professions

The aim of the survey on nurse-patient relationship is to study the nurse-patient relationship taking into account the nurses’ personal feelings of comfort with touch in their daily activities, their competence and ability to provide caregiving, their well-being at work and their affective commitment to the hospital. It was carried out in 2014, involving 570 nurses working in North East Italy. This study considers the following eight variables: anxious and avoidant attachment style, self-efficacy in emotions regulation, self-efficacy, altruistic and self-serving caregiving, burnout and affective commitment to the hospital. For each scale, a measurement is obtained making use of the Partial Credit Model, which is a model belonging to the family of the Rasch models. The final scale for the anxious attachment style consists of 10 items on a 5-points Likert scale and the aspect that most easily generates anxiety is self-doubt and fear to lose others’ approval. Taking into account the avoidant attachment style, the final scale consists of 7 items on a 5-points Likert scale and its average measure equal to -0.768 suggests that the nurses are not dismissive. Moreover, the aspect that most easily represents an avoidant attachment is others’ intrusiveness and lack of trust. The emotional self-efficacy final scale consists of 6 items on a 6-points Likert scale and its average measure is 0.537, suggesting that the nurses score high in self- efficacy’s perception in emotions regulation. Moreover, the most difficult aspect to overcome is the irritation toward unfairness. The perceived general self-efficacy final scale consists of 5 items on a 6-points Likert scale and its average measure is 0.963, suggesting that the nurses perceive themselves as effective and efficient. Moreover, the most difficult aspect to overcome is the capability to iron out thorny issues among colleagues. The altruistic caregiving behaviour final scale consists of 6 items on a 5-points Likert scale and its average measure is 0.690, indicating that the nurses have a positive altruistic caregiving behaviour. The most difficult aspect is the capability to help a suffering patient. Considering the self-serving caregiving behaviour, the scale consists of 5 items on a 4- points Likert scale and its average measure is -1.116, indicating that the nurses do not have a self-serving caregiving behaviour. Moreover, the easiest negative behavior refers to the incapability to notice a request for help. The burnout scale consists of 5 items on a 5-points Likert scale; the most difficult aspect to agree with is the feeling of depletion felt at work. The commitment final scale consists of 5 items on a 5-points Likert scale and its average measure is 0.855, indicating that the nurses have a high level of commitment. Moreover, the most difficult aspect to agree with is sharing the problems of the hospital. These eight measures have been standardized and used in the second step of the analysis, that is to find causal relationships between these psychological dimensions. In order to do that, a causal model has to be identify. It is specified in two parts: a statistical model and a causal graph, called Directed Acyclic Graph (DAG). DAG can be learned using the constraint-based or a score-based approach. In this study the score-based algorithm GES is used. The resulting DAG highlights a model of adjustment in helping professions: insecure attached subjects easily feel emotional exhausted facing distress at work and exhibiting a form selfish caregiving. Altruistic caregiving sustains general self-efficacy and self-efficacy in emotional regulation.