Clinical Practice & Epidemiology in Mental Health

ISSN: ― Volume ,

Staff Perception of Respect for Human Rights of Users and Organizational Well-being: A Study in Four Different Countries of the Mediterranean Area

Yosra Zgueb1, 2, *, Antonio Preti3, Alessandra Perra3, Sofian El-Astal4, Cesar Ivan Aviles Gonzalez3, Martina Piras5, 6, Giorgia Testa5, 6, Iskren Kirolov7, Giorgio Tamburini3, Uta Ouali1, 2, Goce Kalcev8, Ferdinando Romano9, Viviane Kovess10, Mauro Giovanni Carta3
1 Department of Psychiatry A, Razi Hospital, La Manouba, Tunisia
2 Faculty of Medicine of Tunis, University of Tunis El Manar, Manouba, Tunisia
3 Center for Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
4 Department of Psychology, Al Azhar University-Gaza, Gaza, Palestine
5 Department of innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy
6 Department of Medical Sciences and Public Health, University of Cagliari,Cagliari, Italy
7 Department of Higher Education,European Association of Institutions in Higher Education, Brussels, Belgium
8 University Goce Delcev, Stip, North Macedonia
9 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
10 Laboratoire de Psychopathologie et Processus de Santé, Université Paris-Descartes, Paris, France



The perception by mental health service staff of respect for users' rights is a fundamental component of organizational well-being. The objective of this work is to examine how cultural differences and the working context can influence the perception of respect for users' rights in mental health professionals in the Mediterranean area.


An observational survey carried out in four different mental health networks in four countries of the Mediterranean area (Tunisia, North-Macedonia, Italy, Palestine). Each invited participant fulfilled a format on socio-demographic information and coded the Well-Being at Work and Respect Right Questionnaire (WWRR). All data were encrypted and analysed using the Statistical Package for Social Sciences (SPSS) version 20. The Games-Howell post-hoc test was used to assess differences between countries. The Games-Howell test does not assume equal variances and sample sizes. Eta-squared (η2) was used as a measure of effect size in the ANOVA (η2 around 0.01, 0.06, and 0.14 are considered small, medium, and large, respectively).


The sample included 590 professionals working in the mental health field. The four countries showed statistically significant differences with regards to the quality rights assessment tool. Participants from Italy reported, on average, the highest scores across the questions. There were also differences across the countries about the perception of the impact of available resources on the effectiveness of care (η2 = 0.106).


Our findings offer a useful insight into the perception of the quality of mental health services, especially from a users’ rights point of view.

Keywords: Human rights, Job satisfaction, Wellbeing, Mental health, Psychiatry, Mediterranean area, Multicenter study.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 16
Issue: Suppl-1, M6
First Page: 109
Last Page: 114
Publisher Id: CPEMH-16-109
DOI: 10.2174/1745017902016010109

Article History:

Received Date: 26/12/2019
Revision Received Date: 21/02/2020
Acceptance Date: 23/02/2020
Electronic publication date: 30/07/2020
Collection year: 2020

© 2020 Zgueb et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Psychiatry A, Razi Hospital La Manouba, Cité des Orangers, 2010 La Manouba, Tunisia; Tel: +216 22810685; E-mail:

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