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Les effets des conditions de travail sur la santé au travail : quelles actions de prévention ? Le cas des établissements hospitaliers

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Suicides des infirmières, démissions en bloc de médecins urgentistes à bout de nerfs, grèves pour protester contre l’état de leurs conditions de travail ont fait régulièrement la une de l’actualité en 2017. L’hôpital va mal, la santé du personnel semble être oubliée alors même que sa vocation première est de prendre soin. Durant ces dernières années le secteur hospitalier, n’a cessé d’évoluer à travers des réformes successives visant, entre autres, à maîtriser les dépenses (Gheorghiu et Moatty, 2014). Ainsi, un nouveau management public basé sur des outils de gestion issus du secteur privé et portant attention aux résultats ainsi qu’aux moyens engagés pour les atteindre (Burelier, 2011) a pris son essor. Concrètement, à l’hôpital, cela s’est traduit par la transformation des modes d’organisation de l’activité, une nouvelle gouvernance, la réorganisation de la politique de santé sur le territoire ou encore l’introduction d’un nouveau système de financement. Malgré son succès apparent, le NMP est, aujourd’hui, largement interrogé (Pollitt, 2000) notamment parce qu’il impose de nouvelles exigences aux agents publics (Noblet et al., 2006). Le nombre de recherches traitant du malaise des soignants lié au contexte prônant l’efficacité et la performance est d’ailleurs, relativement élevé (Georgescu et Naro, 2012 ; Georgescu et Commeiras, 2011 ; Grévin, 2011). L’objectif de cette communication est de montrer les effets des conditions de travail sur la santé au travail des personnels soignants et d’évaluer l’efficacité des démarches de prévention des RPS mises en place par les établissements hospitaliers, en mobilisant le modèle « Job Demands-Resources » de Demerouti et al. (2001, 2007). Pour répondre à cette problématique, deux études ont été réalisées : une étude qualitative auprès de 63 individus de six établissements hospitaliers et une étude quantitative auprès de 1868 salariés (base de données couplé sur les conditions de travail/DARES). Les résultats de ces études montrent que les établissements hospitaliers mettent en place des actions de prévention des RPS, souvent par mimétisme. Toutefois, ces dernières ont du mal à respecter la complexité de chaque métier, de chaque unité de soins. Elles paraissent donc totalement artificielles pour les acteurs de base et semblent alors « glisser » sur l’organisation sans affecter l’activité quotidienne. Paradoxalement, dans un sursaut de survie, ce sont au sein des services qu’émergent des évolutions qui parviennent à limiter la souffrance des soignants.

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... Alors ces principes d'industrialisation qui constituent le fondement même de ces nouvelles pratiques managériales vont s'installer en EHPAD (Marquier et al, 2016). Les conséquences constatées de ce NMP sont : la pression à la performance financière 52 , les injonctions paradoxales (Marquier et al,52 Marie-Anne Dujarier, sociologue in Boulet, A M. (2017) Les écueils du NMP, santé &travail P a g e 64 | 437 2016), le stress professionnel (Rivière et al, 2019), les risques psychosociaux (Commeiras et al, 2018) et la manipulation des données comme le surcodage (Naro, 2019). ...
... Le constat s'impose de lui-même, la COVID 19 a mis en lumière que le NMP était un modèle en crise inadapté aux situations vécues dans les établissements sanitaires et médico-sociaux. Si le NMP était annoncé comme un modèle capable de mettre fin aux dysfonctionnements des administrations publiques (Lahjouji et al, 2018), il apparaît aujourd'hui qu'il a failli à sa tâche (Marquier et al, 2016 ;Commeiras et al, 2018 ;Rivière et al, 2019 ;Naro et Travaillé, 2019) ! P a g e 80 | 437 ...
Thesis
Depuis plus de trente ans, les normes de management public ont amené peu à peu les établissements d’hébergement pour personnes âgées dépendantes (EHPAD) à appliquer la même logique gestionnaire qui conduit à exclure tout ce qui fait sens dans le soin. Ce mode de fonctionnement confronte les salariés à des aberrations. Comment ne pas se questionner sur la finalité de sa tâche de professionnel du soin quand les autorités de tarification fixent à la minute près le temps que doit passer chaque soignant auprès des patients selon les niveaux de GIR104 ? De ce fait, les personnels souffrent de l’incapacité de pouvoir traiter dignement les usagers par manque de temps et d’être paradoxalement soumis à l’évaluation permanente de la qualité. Cette gouvernance montre aujourd’hui ses limites en EHPAD et la récente crise de la COVID 19 n’a fait que révéler ces dysfonctionnements. C’est pourquoi nous proposons dans cette recherche-action d’étudier des voies d’amélioration avec la mise en place d’un management du prendre soin. Ces nouvelles pistes de travail prennent appui sur les principes de l’éthique du care appliqués au management d’un EHPAD dans un cadre méthodologique de recherche action en sciences de gestion. Ainsi la réciprocité du prendre soin qui caractérise l’application des principes du care sera modélisée grâce à l’approche inter-liée du changement de Kurt Lewin. Cette approche lewinienne du changement va d’ailleurs démontrer son étonnante modernité et son adaptation aux problématiques spécifiques des EHPAD. Grâce à ce management innovant, il va être possible de rendre visible ce travail de care caractéristique du travail en gériatrie afin de le rendre appréciable et reconnu dans les indicateurs de type gestionnaire.
... Dans un environnement où les employés se désintéressent de leurs activités quotidiennes, l'activité physique peut devenir un moyen pour eux de reprendre contact avec les aspects les plus concrets de leur travail. Même si cette association a également été constatée en milieu hospitalier (Commeiras et al., 2018), ce résultat doit être explorée plus avant. Une approche emploi par emploi contribuerait certainement à affiner ce résultat. ...
Thesis
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À l’heure où les entreprises, confrontées à de nombreux bouleversements, sont plus que jamais en recherche de performance, et à l’heure où les salariés, dénonçant les conditions de travail et les pratiques managériales, n’ont jamais été aussi demandeurs de bien-être au travail, réconcilier le bien-être des salariés et la performance de l’entreprise est un sujet d’actualité et un enjeu stratégique pour les entreprises.La revue de la littérature et les résultats d’une analyse qualitative exploratoire menée à l’aide d’entretiens semi-directifs auprès de 55 salariés du groupe RESSIF (Réseau des Services Sociaux Interentreprises de France) nous amènent à envisager le « bien-être au travail » et la « performance de l’entreprise » en termes de méta-perspective paradoxale et à proposer des voies de résolution de ce paradoxe organisationnel.Pour ce faire, nous avons mené deux études quantitatives. La première étude est basée sur 5300 observations issues de l’enquête « conditions de travail » du Ministère français du travail. La deuxième est basée sur les réponses de 270 entreprises à un questionnaire en ligne portant sur les pratiques de gestion des ressources humaines.Finalement, nos résultats empiriques concluent que les facteurs permettant de concilier le bien-être au travail et la performance de l’entreprise sont, parmi les conditions de travail, la lutte contre l’intensité et l’insoutenabilité du travail et, parmi les pratiques de ressources humaines, le développement de la participation des salariés aux décisions de l’entreprise, la formation, les promotions et perspectives de carrière et, dans une moindre mesure, l’évaluation de la performance.Pour conclure ce travail, sont présentées les contributions théoriques, méthodologiques et managériales, ainsi que les voies futures de recherche.
... Les logiques professionnelles ont été présentées comme laissant place à une logique administrative et managériale, mais les professionnels résistent aux réformes en essayant de protéger leurs activités de base et leurs valeurs clés (Broadbent et Laughlin, 1998 ;Robbins, 2007). Les professionnels ayant un engagement élevé envers les valeurs professionnelles et un faible engagement envers les valeurs managériales (Comerford et Abernethy, 1999 ;Exworthy et Halford, 1999), ont tendance à résister. Broadbent et al. (2001) montrent l'existence de résistances de médecins face au risque d'évolution de leur relation avec les patients lors de la mise en oeuvre de l'accountability (p.566). ...
Thesis
Comment les dispositifs de l’accountability sont-ils utilisés par les acteurs de la sphère administrative ? Quels sont les effets qui en découlent pour les professionnels de santé ?La recherche en contrôle a montré que le champ hospitalier français a subi de profonds changements, notamment à travers l’introduction de l’accountability. La conformité aux pressions institutionnelles pousse les organisations à s’orienter vers de nouveaux outils et principes pour renfoncer leur légitimité externe (Power, 2003).Cette même littérature a montré que l’accountability s’infiltre dans la sphère médicale et démontre des phénomènes d’hybridation de rôle chez les médecins hospitaliers, qui sont ainsi sensibilisés aux contraintes financières (Kurunmäki, 1999). La sphère administrative ne fait pas exception et subit également des pressions coercitives.L’objectif de notre thèse est de contribuer à cette littérature en analysant les effets et les rôles de l’accountability dans le secteur hospitalier public français sur la sphère médicale. Pour analyser ces effets, nous nous ciblons sur les dispositifs d’accountability tels que le reporting d’informations (audit financier, pratique budgétaire). Pour répondre à cette problématique, notre terrain s’est focalisé sur des entretiens semi-directifs et une approche ethnographique dans un CHU de grande taille.Premièrement, à travers une étude exploratoire qualitative menée auprès de 19 directeurs administratifs financiers (représentant 19 CHU/CH), nous montrons que l’accountability au travers de l’exemple de l’audit financier amène à des changements organisationnels et sert également à « rendre des comptes » aux parties prenantes externes (Agence Régionale de Santé, banques) mais aussi internes des organisations hospitalières. Nos résultats soulignent notamment que l’audit financier renforce la légitimité de la sphère administrative vis-à-vis de la sphère médicale.Deuxièmement, nous identifions à partir d’une approche ethnographique (observation non-participante et entretiens) menée dans un CHU des acteurs administratifs spécifiques, servant de vecteurs pour l’infiltration de l’accountability dans la sphère médicale : les Techniciens d’Information Médicale. Ces acteurs administratifs ont un rôle essentiel dans l’hybridation des médecins aux compétences gestionnaires, et les sensibilisent aux logiques financières. A travers le reporting de leur activité médicale, nos résultats mettent en lumière une atténuation du clivage traditionnel observé dans la littérature entre acteurs administratifs et corps médical.Nous montrons également que l’infiltration de l’accountability par d’autres agents administratifs spécialisés, tend à sensibiliser les médecins à la réduction de surplus, de slack présent dans la prise en charge des patients. Il s’avère que cette organisation hospitalière privilégie des dispositifs d’accompagnements afin de solliciter les médecins à intégrer de nouvelles responsabilités dans l’efficience de leur rôle. Notre étude montre que les médecins tentent désormais de trouver un équilibre afin d’articuler « logique patient » et logique gestionnaire. Pour cela, nos résultats soulignent une modification des protocoles de soins ainsi que le raisonnement et les valeurs des professionnels de santé qui concilient et promeuvent le médico-économique.Cette thèse fait émerger que l’introduction de l’accountability au sein du secteur hospitalier public français a des effets intra-organisationnels tant sur la sphère administrative que médicale et met en lumière que sur la base du slack organisationnel, les conflits entre logique médicale et gestionnaire s’atténuent.
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The purpose of this article is to analyze the impact of working conditions defined in terms of demand and resources on job stress through the work-family conflict, retaining as theoretical foundation the theory of conservation of resources (Hobfoll, 1989) but also incorporating the individual characteristics and the type of hotel as moderator variables. A study was conducted among 648 customer contact employees in the hospitality industry in France. The main results show that the work-family conflict has a partial mediatory effect on the relationship between job demands (and more particularly mental and physical workload and verbal abuse from clients) and professional stress. These results also identify the mediatory effect of the work-family conflict on the relationship between the social support provided by the immediate superior and colleagues and stress. Besides the results of the moderated mediation test show that individual characteristics and the type of hotel are moderating variables. Keywords: working conditions, job stress, work-family conflict, hospitality, customer-contact employees.
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Recent theoretical developments suggest that management actions have different impacts on outcomes in public and private organizations. This proposition is important to public organizations' widespread import of private sector management tools, such as performance management. This article examines how performance management influences performance outcomes in otherwise similar public and private organizations. Showing that the factors expected to diminish the impact of performance management parallel the organizational characteristics of public organizations, we hypothesize that this type of management is less effective in public organizations. A difference-in-differences model based on survey data on management in Danish public and private schools, combined with administrative data of students' test scores, confirms the hypothesis. The results have important implications for the transfer of management actions across sectors. © 2013 © The Author 2013. Published by Oxford University Press on behalf of the Journal of Public Administration Research and Theory, Inc. All rights reserved.
Article
This study empirically tests the role of sector in accounting for differences among individuals on various work-related values and reward preferences. Results indicate that there are sector differences for the relative importance of items such as pay, serving others, community service, status, and job security. Findings also reveal that subjects give high importance to co-worker and peer respect across sectors.
Article
Among the many assumptions about public management widely embraced but rarely tested is the notion that public sector managers are more averse to risk than managers in the private sector. Taking a multivariate measure of "risk culture," this study seeks to identify and to explain differences between public and private organizations. The concept of risk culture pertains to managers perceptions that their co-workers and superiors take risks and promote risk-taking. Some of the factors examined as possible determinants of risk culture include political control nature of reward systems, levels of formalization and red tape, bureaucratic structures, and goal ambiguity. Using questionnaire data from a variety of public and private organizations we find that there is considerable variance in organizations' risk culture but the sector of an organization tells us little about its risk culture. Risk culture is, however wall accounted for by the various explanatory factors employed here. Particularly, a riskier culture is positively related to the willingness of top managers to trust employees and to the clarity of organizations' missions. Organizations with more red tape, weak links between promotion and performance, and high involvement with elected officials tend to have a less risky culture.
Article
Despite numerous studies, the relationship between employment sector and public service motivation remains unclear. When studies focus on differences in overall levels of public service motivation and fail to control for the work task and occupational affiliation of the investi-gated employees, the commonly presented sector difference in public service motivation may simply be due to differences in educational background and job content. Based on 32 semi-structured interviews with nurses and nursing assistants performing similar tasks in Danish public and private hospital care and home care, I take this concern into consideration and show that occupation and employment sector have very different, complex relationships with the separate dimensions of public service motivation, when the work task is held constant. This suggests that future studies of differences in employee public service motivation should be very aware of: 1) The multi-dimensional structure of the concept and the occupational affiliation of the investi-gated employees, and 2) The benefits of using a qualitative methodological approach.
Article
Increasing employees’ innovative work behaviour is a complex process of developing an internal climate supportive of idea generation and realization through use of financial, participative, and decentralization mechanisms. This article investigates the effectiveness of these managerial mechanisms in a public versus private context. In a survey in Scandinavia, 8,310 full-time employees were split into public and private employees and analysed with regression models for differences in effectiveness. From the results, two distinct perceptions emerged. Public employees perceive innovative work behaviour as extra-role behaviour to be compensated for. Private employees recognize innovative work behaviour as necessary behaviour for career advancement.
Article
Ergonomics action on psychosocial risks in firms: theoretic and methodologic opportunities To be efficient, an action on psychosocial risks requires a questioning of the organization, the distribution of power and decision processes. The aim of this paper is to discuss theoretical and methodological stakes of an ergonomic intervention on psychosocial risks. First, a theoretical frame is proposed, to support the legitimacy of an ergonomic intervention on psychosocial risks. Suffering expressed by the operators is linked to production difficulties stemming from organizational malfunctioning, notably difficulties faced by the workers when trying to « work well ». An example of an intervention in a service company is presented. The concept of subsidiarity is proposed as a guide for the ergonomists’ thinking on organizational design.
Article
This study compares the job satisfaction and turnover intentions of private- and public-sector employees in Taiwan. Questionnaires were used to collect data from employees of various private enterprises and public organizations. The results show that the job satisfaction and turnover intentions of public employees are different from those of private employees'. First, public employees in Taiwan have lower extrinsic job satisfaction and lower turnover intentions compared to their counterparts in the private sector. Second, the negative relationship between extrinsic job satisfaction and turnover intention is weaker in public than in private employees. To enhance employee motivation, public-sector managers in Taiwan should improve their employees' extrinsic job satisfaction and help unsatisfied employees transfer to jobs they find more satisfying. In addition, they may wish to examine if turnover rate at their organizations is too low to support healthy workforce mobility.
Article
Over the past several years, a growing body of research has compared public and private organizations, using a variety of approaches to examine which organizational attributes are shared across sectors and which are primarily sector specific. Although the evidence has yet to resolve the debate over differences between public and private organizations, three underlying conceptual frame works have emerged: the generic approach, the core approach, and more recently, the dimensional approach. This study compares the relative utility of each framework, using a national sample of public, private, and hybrid research and development laboratories. The findings provide support primarily for the core and dimensional framework, with personnel functions and external outputs better explained by the core approach, and internal resource acquisition functions better explained by the dimensional approach. This article discusses these findings and their implications for future comparative research.
Article
Advancements in our knowledge of red tape have been handicapped by a serious neglect in the development of red tape as an organizational concept. Progress has also been hindered by the rather haphazard application of this concept in much of the empirical research. In this paper we examine some of the principal factors that have impeded conceptual development, paying particular attention to the relationship between red tape and bureaucratic formalization. We argue that progress in red-tape research and knowledge requires attention to several issues, including the measurement of red tape, origins and sources of red tape, and the need to consider red tape from the perspective of multiple stakeholders.
Article
Public management has been rapidly developing as a subfield. Since other recent reviews have discussed many disciplinary and paradigmatic issues, this one concentrates on developments in research on the distinctive characteristics of public managers and the organizations in which they work. It takes aframework developed over a decade ago to describe propositions about public managers and organizations prevalent at that time, and describes how those observations have fared in conceptual and empirical work since then.
Article
To date, few studies have focused on employee reactions to the quality-related aspects of the introduction of New Public Management (NPM). The aim of this study was to investigate the effects on employee strain and satisfaction of the implementation NPM in a public service organization. The study was designed as an empirical examination of the 'context-dependent approach' ( Edwards, Collinson, & Rees, 1998 ). This approach suggests that effects of an organizational change depend on the context of the implementation, i.e. organizational aspects (implementation strategies), job content and job context dimensions. They employed a single-case longitudinal design. The case was a large municipal service unit responsible for the public housing system of a city in Austria. The sample consisted of 217 employees. Measurements were taken before the organizational change, and at two different times during the change process. While the implementation of NPM can be considered to have been an organizational success (increase in customer satisfaction), it was accompanied by increases in job strain, and, at the same time, mixed results in job satisfaction. Less qualified employees mainly responsible for the customer interface experienced the organizational change most negatively. Using structural equation modelling, the context-dependent approach was empirically confirmed. Job control, role clarity and information were found to be the most important job and organizational resources.
Article
Proportionately higher rates of work stress compensation claims in the public sector, and the media's portrayal of stress in the public sector as an epidemic has fuelled the commonly held notion that stress levels are higher in the public sector. However, reports from the research literature are somewhat contradictory. Using a heterogeneous community sample of public (NÂ=Â84) and private (NÂ=Â143) sector employees, we found no difference between sectors on levels of stress (psychological distress, job satisfaction). Using the Demand-Control-Support (DCS) model to operationalise psychosocial risk and the work stress process we found no difference on levels of risk by sector, however public sector workers reported higher levels of control. For psychological distress we found clear support for a DC interaction effect. Further support for an interactive DCS by sector (4 way) effect was found, with social support operating differently between the sectors. For job satisfaction a DCS main effects model was found in both sectors. The results also showed important differences in stress levels between gender and job categories. The study challenges the commonly held notion that work stress is only a public sector phenomenon.
Article
Purpose – The purpose of this paper is to give a state‐of‐the art overview of the Job Demands‐Resources (JD‐R) model Design/methodology/approach – The strengths and weaknesses of the demand‐control model and the effort‐reward imbalance model regarding their predictive value for employee well being are discussed. The paper then introduces the more flexible JD‐R model and discusses its basic premises. Findings – The paper provides an overview of the studies that have been conducted with the JD‐R model. It discusses evidence for each of the model's main propositions. The JD‐R model can be used as a tool for human resource management. A two‐stage approach can highlight the strengths and weaknesses of individuals, work groups, departments, and organizations at large. Originality/value – This paper challenges existing stress models, and focuses on both negative and positive indicators of employee well being. In addition, it outlines how the JD‐R model can be applied to a wide range of occupations, and be used to improve employee well being and performance.
Article
In this article the concept of mobbing is introduced. Mobbing means harassing, ganging up on someone, or psychologically terrorizing others at work. Although mobbing is a very old phenomenon, it was not described and systematically researched until the early 1980s. The article begins with a case example, some historical notes, and a definition of mobbing, and then regards mobbing in the context of medical and psychological stress research. Several stages in the development of mobbing are described, based on about 800 case studies. Some epidemiological findings from a representative sample of the Swedish work population are reported. Causes and consequences of mobbing are discussed, and conclusions for prevention and intervention are drawn.
Article
This paper assesses our state of knowledge concerning the ‘New Public Management’ (NPM) reforms which seem to have been launched in so many countries. In the first section it appraises the types of materials available as a basis for such an assessment. It then considers, and rejects, the thesis that, because of the improved performance they bring, these reforms are global in reach and inevitable in nature. Subsequently, the main part of the paper assesses the available evidence with respect to a number of key dimensions of reform impacts. It concludes that, while there is evidence of specific improvements in particular instances, the general case for NPM as a solution to diverse problems of governance in many different countries is far less firmly established than is commonly supposed.
Article
Comparing public and private managers is a major subject in the public management literature, but there have been only a few empirical studies of the differences in their respective leadership styles. Traditionally, leadership style is explained by the characteristics of the manager, the employees, and their job. This study explains leadership by the manager's job context: the degree of job complexity, role clarity, and job autonomy. We argue that differences in job context explain the use of different leadership styles in the public and private sector. To clearly specify the importance of sector, the study investigates direct, mediating, and moderating effects. Based on a survey of Danish public and private managers with 949 respondents, this article shows that job context variables vary significantly between public and private sector managers. The article provides some explanations for why public managers use more participative leadership, while private ones use more directive leadership.
Article
Discusses a salutogenic model (SM) of health and illness, which focuses on why people remain healthy despite stress. It is proposed that what is common to all resistance resources is that they help make sense out of the stressors with which individuals are constantly bombarded. The concept sense of coherence is described, which expresses the extent to which an individual has a pervasive, enduring though dynamic, feeling of confidence that life is comprehensible, manageable, and meaningful. The SM is compared to the traditional pathogenic approach to health. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This article aims to find out whether there are behavioral differences between public and private sector managers. Two groups of public managers (managers of social insurance agencies and public school principals) and a group of private managers (two samples) are investigated. Behavioral dimensions are investigated including leadership style (task, relationship, and change orientation), decision-making style (the functions of sensing, intuition, thinking, and feeling), and motivation profile (achievement, affiliation, and power motivation). An analysis of data from 459 managers in four organizations in Sweden reveal significant differences in behavior between public and private managers. However, no significant differences in leadership behavior are discovered among public managers. Possible explanations for such differences and similarities are explored.
Article
This study investigated differences in general values, work values and organizational commitment among 549 private sector, public sector, and parapublic sector knowledge workers. No differences in general values were observed across sectors, although five significant work value differences were revealed: parapublic employees value work that contributes to society more than public servants, who value it more than private sector employees; parapublic employees value opportunities for advancement less than both public and private sector employees; public servants value intellectually stimulating and challenging work more than parapublic employees; and private sector employees value prestigious work more than public servants. Private sector employees displayed greater organizational commitment than the employees in the other two sectors. Overall, the findings suggest only limited value differences among employees of the various sectors. The finding of some work value differences between employees in the public and parapublic sectors suggests that these two groups merit separate consideration in comparative studies such as this one.
Article
Position du problèmeLa violence psychologique au travail est considérée comme un facteur majeur de stress au travail ayant des effets délétères sur la santé mentale. À ce jour, il n’existait pas de version française validée du questionnaire élaboré par Leymann intitulé « Leymann Inventory of Psychological Terror » (LIPT), considéré comme l’instrument de référence. La présente étude vise à présenter le développement de cette version française et des éléments de sa validité factorielle, convergente et prédictive.MéthodesL’étude s’appuie sur un large échantillon d’hommes et de femmes de la population salariée sollicités pour participer à une enquête transversale par l’intermédiaire d’un réseau de 143 médecins du travail de la région PACA. L’étude porte sur 7 694 salariés, dont 3 132 hommes et 4 562 femmes, ayant répondu à l’auto-questionnaire anonyme contenant la version française du LIPT. Cette version a été obtenue par une procédure classique de traduction/contre-traduction.RésultatsLe LIPT permet d’évaluer la prévalence d’exposition à 45 situations de violence au cours des 12 derniers mois. L’étude d’une question ouverte invitant les salariés à citer toute autre situation, potentiellement manquante, souligne la bonne couverture du LIPT. L’étude de la validité factorielle montre une cohérence satisfaisante dans l’interprétation des facteurs. La définition de la violence psychologique au travail de Leymann définit les salariés exposés par ceux ayant été confrontés à au moins une situation, au moins une fois par semaine, pendant six mois ou plus. L’ajout de se déclarer être exposé par le salarié permet d’accroître la validité convergente et la validité prédictive.ConclusionCette étude est la première à développer et à valider la version française du LIPT élaboré par Leymann. Ce travail de développement et de validation semble une étape importante tant pour mener des études de qualité utilisant des instruments validés que pour permettre des comparaisons futures au niveau international. La violence psychologique au travail semble être par sa prévalence (environ 10 % ici) un problème sérieux en milieu de travail. Les études futures devront privilégier un tel instrument validé pour mieux comprendre et prévenir ce facteur de risque professionnel.Background Workplace bullying is considered as a major job stress factor and is associated with mental disorders. To date, there was no validated French version of the « Leymann Inventory of Psychological Terror » (LIPT), considered to be the instrument of reference. The objective of this study was to elaborate this French version and to explore its factorial, convergent and predictive validity.Methods The present study was based on a large sample of men and women of the working population asked to participate to a cross-sectional survey by a network of 143 occupational physicians in the South-East of France. This study included 7 694 subjects, 3 132 men and 4 562 women, who responded to the anonymous self-questionnaire including the French version of the LIPT. This version was obtained by a standard forward/backward translation procedure.ResultsThe LIPT allows to evaluate the 12-month prevalence of exposure to 45 forms of bullying. The analysis of an open question asking for other potentially missing forms of bullying underlined the satisfactory coverage of the LIPT. The study of the factorial validity showed a satisfactory coherence in the interpretation of the factors obtained. Leymann defined workplace bullying by the exposure to at least one form of bullying, weekly or more, and for at least six months. The convergent and predictive validity were increased when this definition was combined with the self-report of being exposed to bullying.Conclusion This study is the first one elaborating and validating the French version of the LIPT by Leymann. This step of development and validation of the French version of questionnaires seems crucial to set up future high-quality studies, and to allow comparisons at the international level. Workplace bullying seems to be a serious problem in the French working life given the prevalence observed here (around 10%). Forthcoming studies should prefer using such validated questionnaire to better understand and prevent this occupational risk factor.
Article
Public and private sector decision making is studied with an experiment. The study compares decision making in a tax-supported general purpose governmental agency with that done by a business firm selling to a market, using a simulation to capture differences in the preferences and practices of mid-level managers working in the two sectors. The simulation calls for participating managers to assess the risk and prospect of adopting budgets tailored to match each sector. A cognitive culture that stresses analysis, speculation, bargaining, or networking is employed to fashion a budget appropriate for a public and a private sector organization, each with a controversial and a noncontroversial budget amount. The literature on public/private differences was consulted to make predictions, suggesting that public sector managers would favor bargaining and networking and private sector managers would favor analysis and speculation. The cognitive style literature suggests that managers favor budgets constructed with an approach that is consistent with their preferred cognitive style and see less risk in the choice, except in a public setting where risk would be unaffected. The study finds that private sector managers are more apt to support budget decisions made with analysis and less likely to support them when bargaining is applied. Public sector managers are less likely to support budget decisions backed by analysis and more likely to support those that are derived from bargaining with agency people.
Article
This study contributes to our understanding of the differences in work motivation between the public and private sectors. Data from a survey of 3,314 private sector and 409 public sector employees in Belgium strongly confirm previous research showing that public sector employees are less extrinsically motivated. Differences in hierarchical level are more important determinants of work motivation than sectoral differences. In addition, most observed differences can be wholly or partially explained by differences in job content, not by the sector itself. Evidence is presented to show that motivational differences can be explained by a positive choice of work–life balance.
Article
This paper sets out to test the ‘convergence thesis’ in respect of managers in the public and private sectors in Britain. New Public Management (NPM) initiatives have had the objective of making managerial behaviour in public sector organizations more similar to that in the private sector. Based on unique national surveys undertaken in 1980, 1990 and 2000, using quite large random samples of fellows and members of the Chartered Management Institute (CMI), comparisons are made to investigate whether ‘convergence’ between public and private sector managers has actually occurred. The patterns are found to be complex and, although there are some signs of convergence, the two sectors continue to exhibit similarities, persistent differences and parallel movements evident in managerial attitudes, behaviour and experiences.
Book
Since its publication in 2000, Public Management Reform has established itself as the standard text in the field, presenting a comparative analysis of recent changes in Public Management and Public Administration in a range of countries in Europe, North America, and Australasia. This completely rewritten second edition radically expands, develops, and updates the original. Two countries have been added to the comparison (making twelve countries in all) and a much fuller treatment has been provided of the European Commission (including a commentary on the recent reforms led by Vice-President Kinnock). Empirical data has been brought up to date, so as to cover many key developments of the last few years. The theoretical framework of the book has been further developed, including a challenging new interpretation of the trends in continental Europe, which are seen here as markedly different from the Anglo-American style 'New Public Management'. This second edition provides an unparalleled synthesis of developments in Australia, Belgium, Canada, Finland, France, Germany, Italy, the Netherlands, New Zealand, Sweden, the UK, the USA, and the European Commission. It is organized in an integrated format, within an overall theoretical framework that identifies the main pressures for, and trajectories of, change. It includes a multi-dimensional analysis of the results of reform, and a chapter reflecting on the dynamic relationship between management reform and politics. Extensive appendices provide an invaluable information resource for students.
Article
In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.
Article
A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.