title: Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France.
abstract: BACKGROUND
  The study analyzes health care workers' (HCWs) occupational risk perception and compares exposure to occupational risk factors in Moroccan and French hospitals.
  
  
  METHODS
  Across nine public hospitals from three Moroccan regions (north, center and south), a 49 item French questionnaire, based on the Job Content Questionnaire, and 4 occupational risks subscales, was distributed to 4746 HCWs. Internal consistency of the study was determined for each subscale. Confirmatory factor analysis was conducted on the Moroccan questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis was used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. A comparative analysis between Moroccan and French (Nantes Hospitals) investigations data was performed.
  
  
  RESULTS
  In Morocco, 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % Moroccan HCWs are at high strain. Casablanca region (1.75 OR; CI: 1.34-2.28), north Morocco (1.66 OR; CI: 1.27-2.17), midwives (2.35 OR; 95 % CI 1.51-3.68), nursing aides (1.80 OR; 95 % CI: 1.09-2.95), full-time employment (1.34 OR; 95 % CI 1.06-1.68); hypnotics, sedatives use (1.48 OR; 95 % CI 1.19-1.83), analgesics use (1.40 OR; 95 % CI 1.18-1.65) were statistically associated to high strain. 44% Moroccan HCWs are at high strain versus 37 % French (Nantes) HCWs (p < 0.001).
  
  
  CONCLUSIONS
  Moroccan HCWs have high strain activity. Moroccan HCWs and more Moroccan physicians are at high strain than Nantes HCWs. Moroccan and French's results showed that full time workers, midwives, workers using hypnotics, and analgesics are at high strain. Our findings underscore out the importance of implementing a risk prevention plan and even a hospital reform. Further research, with an enlarged study pool will provide more information on psychosocial risks (PSR) and HCWs' health.
authors.affiliation: Department of Occupational Medicine and Environment Health, HCWs Research Laboratory, 5 rue du doyen Boquien, Nantes University Hospital, Nantes, 44 093 France ; "Lucian Blaga" University of Sibiu, 10 Victoriei Boulevard, Sibiu, 550024 Romania.
authors.forename: Doina Ileana
authors.initials: DI
authors.lastname: Giurgiu
authors.affiliation: Psychology Laboratory of Pays de la Loire (LPPL - UPRES EA 4638), Department of Psychology, University of Nantes, BP 81 227 44312 Nantes cedex 3, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Jeoffrion
authors.affiliation: Cognition, Health, Socialization, EA6291 University of Reims Champagne-Ardenne, 57, rue Pierre-Taittinger, Reims, 51 096 France.
authors.forename: Christine
authors.initials: C
authors.lastname: Roland-Lévy
authors.affiliation: Department of Occupational Medicine and Environment Health, HCWs Research Laboratory, 5 rue du doyen Boquien, Nantes University Hospital, Nantes, 44 093 France ; Psychology Laboratory of Pays de la Loire (LPPL - UPRES EA 4638), Department of Psychology, University of Nantes, BP 81 227 44312 Nantes cedex 3, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Grasset
authors.affiliation: Department of Public Health, Nantes University Hospital, 35 rue Saint Jacques, Nantes, 44 000 France.
authors.forename: Brigitte Keriven
authors.initials: BK
authors.lastname: Dessomme
authors.affiliation: Department of Public Health, Nantes University Hospital, 35 rue Saint Jacques, Nantes, 44 000 France.
authors.forename: Leila
authors.initials: L
authors.lastname: Moret
authors.affiliation: Laboratory of Ergonomics Epidemiology Health and Work, LEEST-UA InVS - IFR 132- UPRES EA 4336, University of Angers, Faculty of Medicine, University Hospital, 4 rue Larrey, 49933 Angers Cedex, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Roquelaure
authors.affiliation: Occupational Medicine Department, 6 rue Henri Le Guilloux, University Hospital of Rennes, Rennes, 35 000 France.
authors.forename: Alain
authors.initials: A
authors.lastname: Caubet
authors.affiliation: Occupational Medicine Department, 6 rue Henri Le Guilloux, University Hospital of Rennes, Rennes, 35 000 France.
authors.forename: Christian
authors.initials: C
authors.lastname: Verger
authors.affiliation: Graduate School of Health Engineering and Project Management, 24 rue Lafontaine, Quartier Racine, Casablanca, 20 100 Morocco.
authors.forename: Chakib El Houssine
authors.initials: Cel H
authors.lastname: Laraqui
authors.affiliation: Public Health Department, SMBH, Paris 13 University, 74 avenue Marcel Cachin, Bobigny, 93017 France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lombrail
authors.affiliation: Department of Occupational Medicine and Environment Health, HCWs Research Laboratory, 5 rue du doyen Boquien, Nantes University Hospital, Nantes, 44 093 France.
authors.forename: Christian
authors.initials: C
authors.lastname: Geraut
authors.affiliation: Department of Occupational Medicine and Environment Health, HCWs Research Laboratory, 5 rue du doyen Boquien, Nantes University Hospital, Nantes, 44 093 France ; Psychology Laboratory of Pays de la Loire (LPPL - UPRES EA 4638), Department of Psychology, University of Nantes, BP 81 227 44312 Nantes cedex 3, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Tripodi
keywords: High strain; Medication use; Occupational stress; Public hospital; Risk exposure