Vol. 30. Num. 3. - 2014. Pages 105-112

Overcoming job demands to deliver high quality care in a hospital setting across Europe: The role of teamwork and positivity

[La superación de las exigencias laborales para ofrecer una elevada calidad asistencial en el ámbito hospitalario en Europa: papel del trabajo en equipo y la positividad]

Patrícia L. Costa1 , Ana M. Passos1 , Sílvia A. Silva1 , Ema Sacadura-Leite2 , Susana M. Tavares1 , Florina Spanu3 , Elitsa Dimitrova4 , Vera Basarovska5 , Milan Milosevic6 , Meral Turk7 , Efharis Panagopoulou8 , Anthony Montgomery9

1Inst. Univ. Lisboa, Portugal ,2Hosp. Santa Maria, Lisboa, Portugal ,3Babes-Bolyai Univ., Dep. Psychology, Cluj-Napoca, Rumanía ,4Bulgarian Academy of Sciences, Inst. Population and Human Studies, Bulgaria ,5Inst. Occupational Health of RM, Neuropsychiatric Dep., Skopje, Macedonia ,6Univ. Zagreb, School of Medicine, Croacia ,7Ege Univ., Dep. Public Health, Turquía ,8Aristotle Univ., Medical School, Thessaloniki, Grecia ,9Univ. Macedonia, Dep. Education and Social Policy, Thessaloniki, Grecia


Health care professionals deal on a daily basis with several job demands – emotional, cognitive, organizational and physical. They must also ensure high quality care to their patients. The aim of this study is to analyse the impact of job demands on quality of care and to investigate team (backup behaviors) and individual (positivity ratio) processes that help to shield that impact. Data was collected from 2,890 doctors and nurses in 9 European countries by means of questionnaires. Job demands have a negative impact on the quality of care delivered by health professionals. Backup behaviors had a mediating effect between job demands and quality of care. Also, the positivity ratio of professionals (ratio of positive and negative emotions experienced) was also found as a significant mediator between most job demands and quality of care dimensions. Finally, we found a double mediation between most job demands and quality of care, where backup behaviors influenced the positivity ratio. Quality of care in hospitals is closely related to job demands. Hospital managers should consider the importance of cooperation within health care professionals’ teams and ought to find ways to develop teamwork in order to promote patients’ safety.


Los profesionales de la salud tratan a diario con múltiples exigencias laborales -emocionales, cognitivas, organizacionales y físicas. También deben garantizar la máxima calidad de atención a sus pacientes. El objetivo de este estudio es analizar el impacto de las demandas laborales en la calidad de los cuidados y de investigar los procesos de equipo (backup behaviors) e individuales (positivity ratio) que ayudan a proteger al trabajador de ese impacto. Se recogieron datos de 2.890 médicos y enfermeros en 9 países europeos a través de cuestionarios. Las demandas laborales tienen un impacto negativo en la calidad de los cuidados proporcionados por profesionales de la salud. Los procesos de equipo (backup behaviors) tuvieron un efecto de mediación entre las demandas del trabajo y la calidad de los cuidados. Además, la ratio de positividad de los profesionales (proporción de emociones positivas y negativas) también se encontró como un mediador importante entre la mayoría de demandas de trabajo y la calidad del cuidado. Por último, se encontró una doble mediación entre la mayoría de las demandas de trabajo y calidad de la atención, donde los procesos de equipo influyeron en la ratio de positividad. La calidad de los cuidados proporcionados en los hospitales está muy relacionada con las exigencias del trabajo. Los directores de hospitales deben considerar la importancia de la cooperación entre equipos de profesionales de salud y encontrar formas de desarrollar el trabajo en equipo con el fin de promover la seguridad de los pacientes. 


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