When resources spirals and psycho-social distress meet in hospital

Abstract

Public hospitals undergo pressure of work intensification coupled with increasingly heavy management constraints that have consequences for the occupational health of public officials. For a long time occupational health was approach from a pathogenic perspective. Attention was focused on suffering or ill-being. A new approach tends to develop: salutogenic perspective. The major interest is to place individuals in a positive and proactive dynamic. The aim is to place the individual in a positive and proactive dynamic, thus offering him the possibility of envisaging a favorable outcome to sometimes unsustainable situations, and also to make the organizations potentially capable of nurturing more favorable environments to this development.
In order to explore this subject, we chose to use Hobfoll’s Conservation of Resources (COR) theory as work stress is understood as the expression of a dynamic relationship between an individual and his environment. In this perspective, the individual will act and react proactively to establish or restore a situation that suits him best. Resources are the central element. This article aims to examine how current developments and situations in the hospital sometimes lead to resource degradation by illustrating concrete examples of the spiral process of loss and gain of resources. The challenge would be, as Hobfoll (1989) suggests, to focus on the process, not just the outcome.
To do this, we conducted a qualitative study that is part of an interpretative perspective. The aim is not to draw generalities from these analyzes but to place this research work in a comprehensive understanding of a phenomenon and make a process visible through the analysis of speeches. The challenge is thus to be closer to what the actors live and their perception. It is important to understand the process, depending on the context in which it occurs. 17 interviews were conducted in three public hospitals with nurses, health managers, occupational physicians and psychologists, analyzed using textual data analysis software (Nvivo 11).
By identifying resources associated with work situations and characterizing the spiral process, we highlight the dynamic and processual nature of occupational health. The resource approach also allows us to show that the process of deteriorating health does not seem irreversible or inescapable. Supporting actions by the organization by providing resources that accompany individuals in the preservation of their health are then possible at different times of the different «episodes» experienced.