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Role Stress and Emotional Exhaustion Among Health Care Workers: The Buffering Effect of Supportive Coworker Climate in a Multilevel Perspective

Portoghese, Igor PhD; Galletta, Maura PhD; Burdorf, Alex PhD; Cocco, Pierluigi MD; D’Aloja, Ernesto PhD; Campagna, Marcello MD

Journal of Occupational and Environmental Medicine: October 2017 - Volume 59 - Issue 10 - p e187–e193
doi: 10.1097/JOM.0000000000001122

Objective: The aim of the study was to examine the relationship between role stress, emotional exhaustion, and a supportive coworker climate among health care workers, by adopting a multilevel perspective.

Methods: Aggregated data of 738 health care workers nested within 67 teams of three Italian hospitals were collected. Multilevel regression analysis with a random intercept model was used.

Results: Hierarchical linear modeling showed that a lack of role clarity was significantly linked to emotional exhaustion at the individual level. At the unit level, the cross-level interaction revealed that a supportive coworker climate moderated the relationship between lack of role clarity and emotional exhaustion.

Conclusion: This study supports previous results of single-level burnout studies, extending the existing literature with evidence on the multidimensional and cross-level interaction associations of a supportive coworker climate as a key aspect of job resources on burnout.

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy (Drs Portoghese, Galletta, Cocco, D’Aloja, Campagna), and Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands (Dr Burdorf).

Address correspondence to: Maura Galletta, PhD, Department of Medical Sciences and Public Health, University of Cagliari, ss554 bivio per Sestu, 09042 Monserrato (Ca), Italy (

This research did not receive any source of funding. We certify that all our affiliations with or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in this manuscript (NIH, Wellcome Trust, HHMI, and others).

None of the authors have competing interests to declare.

Copyright © 2017 by the American College of Occupational and Environmental Medicine