The aim of this study should be modified to assess the relations between occupational safety, working conditions and social performance of health professionals working in a private hospital located in Gaziantep province. Furthermore, it was aimed to minimize the influence levels of risks and give advices to increase the personal and social performances. The universe of the cross sectional and descriptive study was composed of health professionals working in Gaziantep in January 2016. All of these health professionals were included in the study. The data of the study related to socio-demographic characteristics, perception of work environment related risks and hazards were collected by using Occupational Health Safety (OHS) application and Health Professionals Safety Scale (HPSS). The scale was composed of questions related to the personal and social performance. The scale was applied by using direct observation method. The data of the study were analyzed by using frequency, t-test, one-way variance analysis and correlation analysis. Among all health professionals, 78.7% of the health professionals were female, 21.3% of them were male and the mean age of them was 25.00±7.44. 1.3% of them had a graduate degree, 28% of them had an undergraduate degree, 14.7% of them had an associate degree, and 56% of them graduated from health occupational high school. It was found that health professionals who had 0-4 years of occupational experience felt themselves more secure compared to others. Besides, health professionals who were working in the hospital between 0-4 years felt more secure compared to the ones who were working 5-9 years. Health professionals who were felt more secure compared to the ones who did not and health professionals who perceived their health status as good felt more secure compared to others who felt themselves bad. It was detected that the occupational health was moderately provided to health professionals. The controls and inspections related to the occupational health and safety applications for health professionals should be increased.
Keywords: Occupational health; Occupational risks; Safety, Personal and social performance; Health
There is a direct relationship between work life and health. Working environments have various health and safety hazards. These hazards include occupational diseases and occupational accidents that can directly affect an individual's health. All health professionals are exposed to biological, chemical, physical, environmental, psycho-social and biomechanical risks in the hospital environment. Therefore, the main objective should be to make the working environment suitable for health conditions, to remove certain hazard possibilities, to arrange the working hours, to set the working method according to the physiological characteristics and to ensure that the tools and equipment adapt to the work and the user . The concept of "Occupational Health and Safety (OHS)", which expresses the work carried out in a multidisciplinary way to protect employees from the risk factors in the working environment that can negatively affect their health, to ensure production continuity and to increase productivity is becoming increasingly important in parallel with the development of the industry and technology . Mobbing is performed generally by management team, but it can be directed also by colleagues, subordinates or a group of employees. It has been specified that health professionals particularly nurses are seriously a risk group exposed to mobbing in workplace [3,4]. Mobbing leads to excessive stress, exclusion, anxiety, digestive system problems, sleep disorders, depression, anxiety, job dissatisfaction and burnout [3-7].
The Central Council of the Turkish Medical Association initiated first studies about the health status of health professionals in Turkey in 1989 with the slogan entitled ‘This is our health’. Then, a database on the subject was aimed to be established . The requirement of a committee, which should carry out the studies regarding the health and safety of employees working in the hospital, was discussed in 1999-2000, the pilot studies were initiated but these studies were not completed. The precautions were compiled intended for the safety of the health professionals in the 15th item of the “Notification on Principles and Procedures related to Ensuring the Patient and Staff Safety and Protection in Health Institutions" which was approved in 29th of April 2009. In a sense, this document created a basis for the establishment of the related OHS unit [9,10].
Hospitals are organizations that include many business lines. In no work place except hospitals is there coexistence of continuous use of electrical and electronic equipment, transport of heavy materials, processing with chemical substances, use of radioactive materials, biological material bearing infectious risk, cutting-drilling tools. In the hospital there is also the crowd of a large shopping mall that can be seen on weekends, as well as a kitchen that prepares meals for thousands of people three times a day, a laundry room which provides clean clothes continuously, a sterilization, unit various bureaus and warehouses. With all of these factors, intensive work pace, long and continuous work, non-ergonomic work environments and work stress lead health sector professionals to face a greater variety of occupational risks than their counterparts in other business lines and adversely affect their health [11,12].
It is possible to keep the performances of the employees at the desired level by performance evaluation. Performance appraisal is not intended to rank the organization's employees from good to bad but to ensure that the organizational goals are understood by the employees, ensuring that the objectives are fulfilled by everyone at the minimum level, and that the dynamic working environment, where everyone is happy, is maintained. The coordination of organizational activities on a regular basis, the sharing of information and the resolving of problems are realized through effective communication and affect the performance of employees . In today's world, where the borders have been lifted, information and technology are easily accessible; the way to make a difference in the healthcare sector, like in all other areas, goes through the strategic management of human resources. That is why there has been an effort to improve the performance of health systems all around the world in recent years. These initiatives are usually about the financing, leadership, funding and procurement of services, which are the main functions of health systems. The power at the center of the system is human resources in health, and studies show that efforts to improve human resources have a good effect on the performance of the main functions of health systems .
The aim of this study should be modified to assess the relations between occupational safety, working conditions and social performance of health professionals working in a private hospital located in Gaziantep province. Furthermore, it was aimed to minimize the influence levels of risks and give advices to increase the personal and social performances.
The results can contribute to the provision of work safety in hospitals and to the adoption of measures to improve personal and social performance.
The cross-sectional and descriptive type study's universe consists of health professionals (n=75) working in a private hospital in Gaziantep in January 2016. The entire universe was included in the study and the response rate was 100%. Participants working such health services departments; obstetrics and gynecology, internal medicine, surgery, operating room, urgent, intensive care service, pediatric diseases and health, orthopedics and traumatology, radiology, laboratory. Permission and the ethical approvals were obtained from the institution. Besides, the informed consent form was also given to health professionals to read and understand the aim and content of the study. Each participant signed the form which declares that they voluntarily participate in the study.
It started to serve in Gaziantep city Sahinbey district as of 2011 date. The hospital has a bed capacity of 72. The hospital provides health services in such branches; nurse, nutrition and diet, and clinical psychologist in general, including obstetrics and gynecology, internal medicine, urology, neurology, pediatric diseases and health, general surgery-endoscopy, ear, nose throat, infectious diseases, orthopedics and traumatology, radiology, laboratory anesthesia and renal as well as health services. The Infection Control Committee at the hospital is staffed by 7 personnel (obstetrics and gynecology, surgery branch, internal branch, pediatrics and infectious diseases one of the physicians, infection necrosis, health care services manager). The hospital also has one Occupational Safety Expert in the OSH unit and seven personnel in total.
The data of the study were obtained by performing the questionnaire as well as questions the Health Professionals’ Safety Scale (HPSS) survey under direct observation. The questions (80 questions in total) were related to the sociodemographic characteristics (age, gender, marital status, economic status, educational status), risk and danger perception from the hospital working environment (infected sharp and penetrating object injuries, hand washing, glove use, injector use, violence, etc.), health conditions (nutrition, exercise, rest, chronic illness, sleep, smoking, alcohol, health check etc.), working conditions (duration of service, working hours, work efficiency etc.) and their personal and social performance.
Health Professionals Safety Scale (HPSS): Cronbach Alpha: 0.96 (0.95 for Cronbach Alpha for nurses, 0.97 for physicians, 0.96 for other health staff) was found for all health personnel, which were developed by Ozturk and Babacan . In this study, the Cronbach Alpha reliability coefficient was found as 0.96. The purpose of this Scale is to determine if the occupational safety provided for health staffs in (private) hospitals and to evaluate activities for work safety. This is a Likert-type scale consisting 45 items, which is evaluated between “6” positive statements completely agree and “1” strongly disagree regarding to evaluate occupational safety, occupational accidents and occupational diseases in hospitals. The total score interval of scale is between 45-270 points. Scores close to 270 indicate that work security is provided in hospitals, and scores close to 45 indicate that work security is not provided. When these scores are divided by the number of items in order to make a comparison, they take values between 1 and 6 points in the scale sum and sub-factor level, and thus the scale scores are evaluated in this manner .
By assessing the data; categorical measurements are summarized as number or percentage and also numerical measurements are expressed with mean deviation and Standard deviation. From the parametric tests in normal distributing data’s; one-way analysis of variance has been used for the average of more than two groups and for comparing avarage of two groups, the importance test of difference between two averages, Kruskal-Wallis, Mann-Whitney U and correlation has been used.
The entire universe (75 people) was included in the study and the response rate was 100%. 78.7% (59 people) of the health professionals included in the scope of the study were female and 21.3% (16 persons) were male. The mean age was 25.00±7.44 (Min:20, Max:55). The distribution of health professionals according to their socio-demographic characteristics is given in Table 1.
|Over 31 ages||29||38.7|
|Health Vocational College||42||56.0|
|Vocational High School||11||14.7|
While 26.7% (20 people) of married health professionals have children, 73.3% (55 people) have no children. 10.7% of the health professionals who have children have single children, 16.0% have two or more. The distributions of the health professionals according to their working characteristics are given in Table 2.
|Period of Service at the Institution|
|Less than 4 years||61||81.3|
|Work on Duty|
|Once a month||1||1.7|
|Once a week||59||98.3|
|Number of Patients Treated|
|51 and over patient||21||28.0|
80% (60 people) of the health professionals stated that they served on duty and more than 98.3% (59 people) served on duty once a week. The distribution of health professionals’ mean score of the HPSS given in Table 3.
|Health Professionals Safety Scale-HPSS||75||45||270||158.29||49.99|
It was determined that the occupational safety is ensured in the hospital included in the scope of the research (HPSS score mean=158.29±49.99). The distribution of personal and social performance of health professionals given in Table 4.
|Personal and Social Performance||Number||%|
|Do you think you make enough effort for your personal development?|
|Do you find your social relationships satisfactory?|
|Do you have enough time for your individual needs?|
|Do you display behaviors that are disturbing to your environment?|
Of the health personnel, 66.7% stated that they did not make enough efforts in their personal development, 65.3% did not find their social relations satisfactory, 38.7% did not have enough time for their personal needs and 73.3% said they did not display disturbing behavior. Table 5 shows the distribution of the mean scores of HPSS according to the working status of the health personnel in the institution.
|Satisfaction on Working in the Inst.||N||Mean
|Professional exp. years||N||Mean||SD||KW||P|
|10 years and over||10||126.90||58.72|
|45 Hours and over||69||162.55||47.66|
|Serve on Duty||N||Mean||SD||U||P|
Occupational safety of newly-recruited health professionals is higher than that of experienced ones (KW=2.866, p=0.05). The distribution of the frequency of personal and social performance of health professionals according to some variables is given in Table 6.
|Do you think you make enough effort for your personal development?
|Do you find your social relationships satisfactory?
|Do you have enough time for your individual needs?
|Do you display behaviors that are disturbing to your environment?
|36 and over||4||3||2||5||4||3||2||5|
|Health Vocational College||12||30||12||30||26||16||15||27|
|Vocational High School||3||8||3||8||6||5||1||10|
|8 and over||7||20||9||18||19||8||8||19|
It has been determined that non-exercising health professionals cannot devote enough time to their personal development and cannot spare enough time for their individual needs. Distribution of the mean scores of personal and social performance and HPSS scores are given in Table 7.
|Do you think you make enough effort for your personal development?||N||Mean||SD||t
|Do you find your social relationships satisfactory?||N||Mean||SD||t||p|
|Do you have enough time for your individual needs?||N||Mean||SD||t||p|
|Do you display behaviors that are disturbing to your environment?||N||Mean||SD||t||p|
There was no significance between of personal and social performance and HPSS (p>0.05). The relationship between the age and experience period of the health professionals in the institution and the HPSS mean scores given in Table 8.
There is an insignificant negative correlation between the age of the health personnel (r=-0.176, p=0.13) and the working hours (r=-0.010, p=0.93) and their mean HPSS score.
It is important to identify the variables that are related to occupational safety and performance in health professional with respect to the resolution of the problems and the quality of patient care. This study evaluates the relations between occupational safety, working conditions and social performance of health professionals. There are no studies in the literature evaluating social performance and HPSS in the comparison between a hospital and another hospital. It can be said that this constitutes the strong side of our research. It can be seen as a weakness of our research to conduct our work with health professionals working only in a private hospital. It is planned to make a comparison with other hospitals in order to make reference to the next studies.
78.7% of the health personnel included in the study are female and 21.3% are male (Table 1). Similar to our findings, the study of Sahin (2013) included 74.0% female and 26.0% male . In the study of Y?ld?r?m et al. "Assessing the job satisfaction levels of the health professionals in Public Hospitals in Tekirda? Province", included 65.1% female and 31.8% male participants . This may be due to the high number of female health professionals in the society. In the survey, 61.3% of the health professionals are in the age group 20-30. Matching with the findings our research, the percentage of this age group were as follows in the studies conducted with the nurses on the same subjects; Mollaoglu and his colleagues found 47.3% in the study "Evaluating perceptions of nurses working at the hospital on their working environment"  and it was found 31.7% in the study of Aldem et al. "Occupational safety of health professionals" . This is consistent with the demographic structure of our country and active working age categories of health professionals. 56.0% of health professionals stated that they graduated from health vocational college. In a study by Ulutasdemir et al., 41.9% of them were found to have graduated from health vocational college , and this rate was 48.7% in a study by Erguney et al. . These findings are close to each other and they match up with the profile of the healthcare professionals in our country. In the survey, 81.3% of health professionals have been working for 0-4 years. This ratio is 41.8%  in the study on "the effects of risks and hazards encountered by nurses in the context of occupational health and safety on their occupational stress levels" and 38.3% in the study conducted by Mollaoglu et al. . These findings show that the health professionals who have worked in the professional life for 3-5 years constitute the majority. This situation may caused by the disorders in the appointment of health professionals in Turkey.
When the distribution of the health professionals according to their working characteristics are examined; 66.7% of the health professionals are nurses, 9.3% are midwives, 9.3% are health operators, 8.0% are health technicians and 6.7% are health officers (Table 2). Ozturk et al. (2012) worked with 522 nurses, 232 physicians and 271 other health professionals in the state hospital . It is similar to the distribution of categories of health professionals in our country. 81.3% of the health professionals stated that they worked less than four years in the institution. This rate was 41.8%  in the study by Sar?cam and 38.3% in the study by Mollaoglu et al. . These findings show that the health professionals who have worked in the professional life for 4 years constitute the majority. This situation may be due to problems in the health professionals’ appointments in Turkey and may be considered as a problem. In the study, 80% of the health professionals stated that they served on duty. This rate was 81.9%  in the study of Sar?cam and 41.7% in the study of Ulutasdemir et al. . It can be said that health professionals who serve too much on duty experience a decrease their personal and social performance while their work performances increase as they serve greater number of patients and are exposed to intensive and complicated processes and procedures.
In the private hospital included in the scope of the research, it was determined that medium level occupational safety was ensured (HPSS=158.29±49.99) (Table 3). Similar to our findings, Ozturk and Babacan (2012) conducted “A scale development study: Professional Safety Scale for Healthcare professionals Working at the Hospital” with 522 nurses, 232 physicians and 271 other health professionals working in 5 public hospitals in province center and 11 public hospitals in districts of Trabzon. It was determined that HPSS is a valid and reliable tool that could be used in assessing occupational safety and that occupational safety was ensured at the hospital where the survey was conducted" . In the study of Atasalan (2015), "The effects of risks and hazards encountered by health professionals working in Family Health Centers within the scope of occupational health and safety on the level of their work stress", the mean score of HPSS was 95.21±37.37 . It can be said that the research hospital ensures the occupational safety of health professionals in the working environment.
It was found that, as expressed by them, 66.7% of the health professionals do not spend enough effort to their personal development, 65.3% do not find their social relations satisfactory, 38.7% cannot spare time for their individual needs and 73.3% do not display disturbing behaviors (Table 4). There have been no studies in the literature evaluating personal and social performance. Health professionals working for 4 years in the profession provide higher occupational safety (Table 5). Unlike research findings, Özmusul (2015) found that health professionals working for 5-9 years provided higher occupational safety . The perfectionist attitude in the first years of the profession can increase occupational safety. It has been shown that, for personal and social performance, it is important to spare time to personal development and social relations as well as professional knowledge and skills. It has been determined that non-exercising health personnel cannot spend enough time on personal development and not enough time for their individual needs (Table 6). There have been no studies in the literature evaluating personal and social performance. Exercising was thought to have a direct impact on the health professionals’ efforts towards personal development and needs.
There was no statistically significant between of personal and social performance and HPSS score (p>0.05) (Table 7). There was an insignificant negative correlation between the healthcare professionals’ age (r=-0.176, p=0.13) and working hours (r=-0.010, p=0.93) and their mean HPSS scores (Table 8). In the literature, shift work is found to have negative effects on employees [19,21,24]. It can be explained by the fact that busy healthcare professionals feel themselves in an unsafe environment and take more precautions. Age and working hours may have direct or indirect impact on occupational safety.
In this study, it was determined that health professionals working in a private hospital are provided with occupational safety but most of the health professionals are not able to make sufficient efforts to personal development and find their social relations insufficient. It was concluded that were found to feel more confident in the hospital environment those with less than 4 years of professional than those who are more experienced, those who did not exercise than those who exercise, those who expressed their health conditions good than those who expressed bad; and those who did not have a hobby than those who have.
The social and sports activities should be organized aiming to increase the motivation and performance of the health professionals with more years of professional experience. Due to the workload caused by the intensive work in private hospitals, it is necessary to ensure that the staff can rest adequately and devote as much time as possible to personal development and social relations. It is planned to make a comparison with other hospitals in order to make reference to the next studies.
We thank the health professionals and managers working in private hospital in Turkey for their participation in our study.
No outside funding was received for this study.
The authors declare that they have no conflict of interest.
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