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Lack of application of the European Work Time Directive: effects on workload, work satisfaction and burnout among Italian physicians

Paola Gnerre, Domenico Montemurro, Andrea P. Rossi, Costantino Troise, Carlo Palermo, Dario Amati, Chiara Rivetti, Matteo D’Arienzo, Gabriele Romani, Fabio Ragazzo
  • Paola Gnerre
    Department of Internal Medicine, San Paolo Hospital, Savona, Italy | pgnerre@yahoo.it
  • Domenico Montemurro
    Department of Internal Medicine, Sant’Antonio Hospital, Padova, Italy
  • Andrea P. Rossi
    Department of Medicine, Division of Geriatrics, University of Verona, Italy
  • Costantino Troise
    Department of Allergology, IRCSS San Martino, Genova, Italy
  • Carlo Palermo
    Department of Internal Medicine, Valdelsa Hospital, Poggibonsi (SI), Italy
  • Dario Amati
    Department of Medicine, Division of Geriatrics, Nuovo Ospedale degli Infermi, Biella, Italy
  • Chiara Rivetti
    Department of Internal Medicine, Maggiore Hospital, Chieri (TO), Italy
  • Matteo D’Arienzo
    Department of Emergency, Magati Hospital, Scandiano (RE), Italy
  • Gabriele Romani
    Department of Medicine, Division of Medicine, San Bortolo Hospital, Vicenza, Italy
  • Fabio Ragazzo
    Department of Medicine, Division of Medicine, San Bortolo Hospital, Vicenza, Italy

Abstract

The Italian Parliament has excluded hospital physicians from the application of the European Work Time Directive (EWTD), which imposes a maximum workweek of 48 h and compulsory resting periods. This resulted in extended and excessive work time for the category. This paper is aimed at evaluating the impact of this legislation gap, by assessing the presence of excessive work-related stress and risk for burnout syndrome among Italian physicians working in public hospitals. This observational study is based on an on-line survey conducted on a sample of 1925 Italian doctors (covering a wide range of age, work experience and contractual positions) from October 2014 to February 2015. The questionnaire included 30 questions concerning their personal and professional life (e.g., assessment of workloads, number of uncomfortable or extra shifts, unused days-off, etc.). On the basis of the results, it can be inferred that the average Italian doctor working in public hospitals is under considerable stress at work with negative consequences on his health. He is exposed to high risk of suffering from sleep disorders and cardiovascular diseases (due to the lack of time for private practice and eating regular meals). Overall, his perception is that his job worsens his quality of life. This study shows the relevance of the risk of burnout among Italian physicians employed in public hospitals due to severe workload and work conditions. The resulting impact on the quality of care and the significant cost involved - both in human and economic terms - calls for significant emergency measures by the Italian health work organization. An important increase and prolonged working time is associated with a worsening of the objective cognitive performance and an increase of clinical risk, but also to an increased risk of diseases for operators and of the burnout syndrome. Our survey shows that lack of application of the EWTD has adverse effects on the quality of life and performance of Italian doctors. Failure to respond by all Italian doctors is the greatest limitation of our survey.

Keywords

Burnout; European Work Time Directive; workload.

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Submitted: 2016-03-12 10:00:40
Published: 2017-06-14 12:04:05
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Copyright (c) 2017 Paola Gnerre, Domenico Montemurro, Andrea P. Rossi, Costantino Troise, Carlo Palermo, Dario Amati, Chiara Rivetti, Matteo D’Arienzo, Gabriele Romani, Fabio Ragazzo

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