PERSONALITY TRAITS AS RISK FACTORS FOR OCCUPATIONAL INJURY IN HEALTH CARE WORKERS By HILARY STEVENS MORGAN A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2007 1 © 2007 Hilary Stevens Morgan 2 To my parents who always stressed the value of education and instilled in their children a belief that anything was possible 3 ACKNOWLEDGMENTS I would like to thank my committee chair, Dr. Nancy Nivison Menzel, for her guidance, encouragement, and patience throughout this research study. I appreciate her knowledge of occupational health nursing and her commitment to provide leadership for this study despite moving over 2,000 miles westward. I gratefully acknowledge and extend my appreciation to the members of my committee, Jo Snider, PhD, Jiunn-Jye Sheu, PhD, and James V. Jessup, PhD. Each of them provided unique talents, time, and moral support during this study. I would like to thank Dr. Snider for her support during my struggles understanding psychology, Dr. Sheu for his patience in dealing with my epidemiology and study design questions and Dr. Jessup for his calm and encouragement in my moments of doubt. I also want to thank Seaborn Hunt, MD for his support of my returning to school. I know my absences in the office for school activities presented an additional burden on him, but he never wavered in his encouragement of my endeavors. The same appreciation is extended to Paula Murphy, Kathy Sandor, Ronnie Maxim, Vickie Hall, Milly Wilkinson and Renee' Brown who tolerated, with good graces, my vacillating moods throughout this long process. I also want to extend thanks to “my friend” Alice Carlisle. We began this journey as PhD students together and it would not have been as successful or as enjoyable without her companionship, friendship and advice over these last four years. Lastly, a special thanks to my sister, Lesley Morgan, PhD, RN, who paved the road before me and provide much insight, guidance and encouragement to get me to the end of the journey successfully. 4 TABLE OF CONTENTS page ACKNOWLEDGMENTS ...............................................................................................................4 LIST OF TABLES ...........................................................................................................................8 LIST OF FIGURES .........................................................................................................................9 List of Key Terms ..........................................................................................................................10 ABSTRACT ...................................................................................................................................13 CHAPTER 1 INTRODUCTION ..................................................................................................................14 Background of the Problem ....................................................................................................14 Costs of Safety/Injury ......................................................................................................15 Health Care Workers .......................................................................................................15 History of Occupational Health and Safety .....................................................................15 The Role of NIOSH and OSHA ......................................................................................17 Epidemiology ..................................................................................................................17 Theories on Accidents and Safety ...................................................................................19 The Safe Environment .....................................................................................................22 Personality Theories ........................................................................................................22 Biological and genetic theories on personality development ...................................23 Environmental theories on personality .....................................................................25 Situation vs. person ..................................................................................................26 Development of traits ...............................................................................................26 Industrial/Organizational Psychology .............................................................................27 Ethical Considerations in Personality Testing .................................................................31 Purpose of the Study ...............................................................................................................33 Significance of the Study ........................................................................................................33 Theoretical Framework ...........................................................................................................34 Social Ecology Theory ....................................................................................................34 The PRECEDE-PROCEED Model .................................................................................35 Epidemiological Triad .....................................................................................................36 Hypotheses ..............................................................................................................................37 Variables .................................................................................................................................37 2 REVIEW OF LITERATURE .................................................................................................39 Agent Factors ..........................................................................................................................39 Environmental Factors ............................................................................................................41 Host Factors ............................................................................................................................44 Personality, Accidents and Injuries ........................................................................................46 5 The Five Factor Model in the Workplace ...............................................................................54 Summary of Literature Review ..............................................................................................56 3 METHODS .............................................................................................................................58 Research Design .....................................................................................................................58 Research Setting .....................................................................................................................59 Sample ....................................................................................................................................59 Sample Criteria .......................................................................................................................59 Measures .................................................................................................................................60 Personality Inventory .......................................................................................................60 Job Relative Risk .............................................................................................................62 Demographic Information ...............................................................................................62 Procedures ...............................................................................................................................63 Data Collection Procedures ....................................................................................................64 Procedures for the Protection of Human Subjects ..................................................................65 Data Analysis ..........................................................................................................................68 Power Analysis ................................................................................................................69 4 ANALYSIS AND RESULTS.................................................................................................70 Demographic Statistics ...........................................................................................................70 Personality Statistics ...............................................................................................................71 Research Question ..................................................................................................................72 5 CONCLUSIONS AND RECOMMENDATIONS .................................................................77 Discussion of Findings ...........................................................................................................77 Hypotheses ..............................................................................................................................79 Limitations of Study ...............................................................................................................80