Social network characteristics and well-being in Italy: insights from the PHRASI Study

Social network characteristics and well-being in Italy: insights from the PHRASI Study

Authors

  • Nausicaa Berselli
  • Marta Caminiti
  • Angela Ancona
  • Lorenzo Stacchini
  • Veronica Gallinoro
  • Alessandro Catalini
  • Claudia Cosma
  • Valentina De Nicolò
  • Clara Mazza
  • Giuseppa Minutolo
  • Fabrizio Cedrone
  • Vincenza Gianfredi

Keywords:

Social networking; cross-sectional study; well-being; mental health; Public Health; healthcare personnel

Abstract

Background. Mental well-being should be prioritized in public health as it represents a valuable resource for individuals and

communities, influencing behavior, social cohesion and social inclusion. The support individuals receive from their social networks

can have a significant impact on mental well-being. This study used data from the Public Health Residents’ Anonymous Survey in

Italy, a nationwide cross-sectional survey. The objective was to assess the level of well-being among the Public Health Residents

and investigate the association between the social network characteristics and the well-being in this population.

Study design. The current cross-sectional study targeted 1,600 public health residents enrolled in various Italian public health

specialization schools between June 14 and July 26, 2022.

Methods. Participants self-reported both functional and structural characteristics of social network. Well-being was assessed

using the WHO-5 well-being index. Linear regression models, adjusted for age and sex, were applied to examine the association

between WHO-5 score and social network characteristics.

Results. Out of 379 participants, 51.5% reported bad well-being. Those with bad well-being are more likely women, experience

lower peer-to-peer and supervisor support, face higher work-to-private life interference, and less frequently have a partner.

Greater peer-to-peer support (β=1.13, 95% CI=0.68; 1.57), and increased supervisor support (β=1.26, 95% CI=0.86; 1.67),

were associated with higher levels of well-being. Conversely, higher work-to-private life interference was associated with lower

perceived well-being. Having a partner resulted in a better perceived well-being (β=1.96, 95% CI=0.94; 2.98). In logistic regression

analysis, higher peer-to-peer support (OR=0.68, 95% CI = 0.55;0.85) greater supervisor support (OR=0.60, 95% CI=0.49;0.74)

and having a partner (OR=0.51, 95% CI = 0.32;0.82) were associated with reduced odds of bad well-being. Conversely, increased

WLI was associated with higher odds of bad well-being (OR=1.47, 95% CI = 1.19;1.82).

Conclusions. The characteristics of an individual’s social network play a crucial role in her/his well-being and should be considered

both in personal and professional contexts when aimed to enhance mental well-being in communities.

References

1. Dodge R, Daly AP, Huyton J, Sanders LD. The challenge

of defining wellbeing. International Journal of Wellbeing.

2012;2(3): 222-235. doi:10.5502/ijw.v2i3.4

2,. World Health Organization (WHO). Health Promotion Glos-

sary of Terms. 2021. Available from: https://www.who.int/

publications-detail-redirect/9789240038349 [Last accessed:

2023 Nov 12].

3. Gianfredi V, Balzarini F, Gola M, Mangano S, Carpagnano

LF, Colucci ME, et al. Leadership in Public Health: Opportu-

nities for Young Generations Within Scientific Associations

and the Experience of the “Academy of Young Leaders”.

Front Public Health. 2019 Dec 17;7:378. doi: 10.3389/

fpubh.2019.00378

4. Kirkwood, T. Foresight Mental Capital and Wellbeing

Project 2008: Final Project Report Executive Summary.

Mental Capital through Life. London: Government Office

for Science. 2008. Available from: http://www.prevencion-

basadaenlaevidencia.net/uploads/PDF/ODI_MentalCapi-

talThroughLife_Kirkwood.pdf [Last accessed: 2023 Nov

12].

5. Chida Y, Steptoe A. Positive psychological well-being and

mortality: a quantitative review of prospective observa-

tional studies. Psychosom Med. 2008 Sep;70(7):741-56.

doi: 10.1097/PSY.0b013e31818105ba

6. Kettlewell N, Lam J. Retirement, social support and mental

well-being: a couple-level analysis. Eur J Health Econ. 2022

Apr;23(3):511-535. doi: 10.1007/s10198-021-01374-1.

7. Evans M, Fisher EB. Social Isolation and Mental Health:

The Role of Nondirective and Directive Social Support.

Community Ment Health J. 2022 Jan;58(1):20-40. doi:

10.1007/s10597-021-00787-9.

8. Gianfredi V, Beran M, Koster A, Eussen SJ, Odone A,

Signorelli C, et al. Association between social network

characteristics and prevalent and incident depression: The

Maastricht Study. J Affect Disord. 2021 Oct 1;293:338-346.

doi: 10.1016/j.jad.2021.06.046.

9. Fuller-Iglesias HR, Webster NJ, Antonucci TC. The com-

plex nature of family support across the life span: Impli-

cations for psychological well-being. Dev Psychol. 2015

Mar;51(3):277-88. doi: 10.1037/a0038665.

10. Daniels K, Watson D, Gedikli C. Well-Being and the Social

Environment of Work: A Systematic Review of Interven-

tion Studies. Int J Environ Res Public Health. 2017 Aug

16;14(8):918. doi: 10.3390/ijerph14080918.

11. Noblet A, Lamontagne AD. The role of workplace health

promotion in addressing job stress. Health Promot Int. 2006

Dec;21(4):346-53. doi: 10.1093/heapro/dal029.

12. Gianfredi V, Blandi L, Cacitti S, Minelli M, Signorelli C,

Amerio A, et al. Depression and Objectively Measured

Physical Activity: A Systematic Review and Meta-Analysis.

Int J Environ Res Public Health. 2020 May 25;17(10):3738.

doi: 10.3390/ijerph17103738.

13. Rautenbach CL. Flourishing of employees in a fast

moving consumable goods environment [Thesis]. 2015

[cited 2023 May 28]. Available from: https://repository.

nwu.ac.za/handle/10394/17030 [Last accessed: 2024 Dec

7].

14. Inoue R, Hikichi H, Inoue A, Kachi Y, Eguchi H, Watanabe

K, et al. Workplace Social Support and Reduced Psycho-

logical Distress: A 1-Year Occupational Cohort Study. J

Occup Environ Med. 2022 Nov 1;64(11):e700-e704. doi:

10.1097/JOM.0000000000002675.

15. Cedrone F, Berselli N, Stacchini L, De Nicolò V, Caminiti

M, Ancona A, et al. Depressive Symptoms of Public Health

Medical Residents during the COVID-19 Pandemic, a

Nation-Wide Survey: The PHRASI Study. Int J Environ

Res Public Health. 2023 Apr 24;20(9):5620. doi: 10.3390/

ijerph20095620.

16. Stacchini L, Catalini A, De Nicolò V, Cosma C, Gallinoro V,

Ancona A, et al. Social Network Characteristics and Depres-

sive Symptoms of Italian Public Health Medical Residents:

The Public Health Residents’ Anonymous Survey in Italy

(PHRASI). Behav Sci (Basel). 2023 Oct 25;13(11):881. doi:

10.3390/bs13110881.

17. Della Monica A, Ferrara P, Dal Mas F, Cobianchi L, Scan-

napieco F, Ruta F. The impact of Covid-19 healthcare

emergency on the psychological well-being of health profes-

sionals: a review of literature. Ann Ig. 2022;34(1):27–44.

doi: 10.7416/ai.2021.2445. Epub 2021 Mar 30.

18. Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh

MW, Grobler C, et al. Prioritizing the Mental Health and

Well-Being of Healthcare Workers: An Urgent Global Public

Health Priority. Front Public Health. 2021;9:679397. doi:

10.3389/fpubh.2021.679397.

19. Amerio A, Odone A, Aguglia A, Gianfredi V, Bellini L,

Bucci D, et al. La casa de papel: A pandemic in a pandemic.

Social network characteristics and well-being

J Affect Disord. 2020 Dec 1;277:53-54. doi: 10.1016/j.

jad.2020.07.134.

20. Cuda A, Gentile L, Voglino G, Gianfredi V; Gruppo di lavoro

Vaccini e Vaccine Hesitancy Consulta degli Specializzandi

S.It.I.. Costruzione e validazione di un questionario rivolto

a Medici in formazione specialistica in Igiene e Medicina

Preventiva, riguardante opinioni e conoscenze relative al

DL 73/2017 [Design and validation of a questionnaire for

assessing Public Health residents’ opinions and knowledge

regarding the new mandatory vaccination law in Italy (DL

73/2017)]. Ig Sanita Pubbl. 2018 Mar-Apr;74(2):137-152.

21. 21. Wasfie T, Kirkpatrick H, Barber K, Hella J, Lange M,

Vogel M. Burnout and well-being of medical and surgical

residents in relation to emotional intelligence: A 3-year

study. Surgery. 2023 Oct 18;S0039-6060(23)00602-5.

22. Al-Kofahi M, Mohyuddin GR, Taylor ME, Eck LM.

Reducing Resident Physician Workload to Improve Well

Being. Cureus. 2019 Jun 29;11(6):e5039. doi: 10.7759/

cureus.5039.

23. Alraeesi FH, Alblooshi RM, Al Zuraiqi EA, Al Busu-

mait RS, Aman RA, Al Fahim MM, et al. The Impact of

COVID-19 Pandemic on Medical Residents’ Well-Being

in the Emirate of Abu Dhabi. J Fam Med Prim Care. 2022

Nov;11(11):6896–901. doi: 10.4103/jfmpc.jfmpc_932_22.

Epub 2022 Dec 16.

24. Ayed M, Yazdani A, Esmaelili H, Alsaleh A, Sultan A, Ala-

mad E, et al. COVID-19 Pandemic and Its Effect on Resident

Physicians’ Mental Well-Being: A Cross-Sectional Study

in Kuwait. Cureus. 2023 Jan;15(1):e33606. doi: 10.7759/

cureus.33606.

25. Steil A, Pereira Tokeshi AB, Bernardo LS, da Silva Neto

GP, Davi RF, Bárbara AFS, et al. Medical residents’ mental

distress in the COVID-19 pandemic: An urgent need for

mental health care. PloS One. 2022;17(3):e0266228. doi:

10.1371/journal.pone.0266228.

26. Djundeva M, Dykstra PA, Fokkema T. Is Living Alone

‘Aging Alone’? Solitary Living, Network Types, and

Well-Being. J Gerontol B Psychol Sci Soc Sci. 2019 Oct

4;74(8):1406–15. doi: 10.1093/geronb/gby119.

27. Henry JD, Coundouris SP, Mead J, Thompson B, Hubbard

RE, Grainger SA. Social Frailty in Late Adulthood: Social

Cognitive and Psychological Well-Being Correlates. J

Gerontol B Psychol Sci Soc Sci. 2023 Jan 28;78(1):87–96.

doi: 10.1093/geronb/gbac157.

28. Qi X, Zhang W, Wang K, Pei Y, Wu B. Social isolation and

psychological well-being among older Chinese Americans:

Does resilience mediate the association? Int J Geriatr Psy-

chiatry. 2022 Aug;37(8). doi: 10.1002/gps.5791.

29. Wang H, Zhang J, Yu Z, Hu N, Du Y, He X, et al. Association

between changes in social capital and mental well-being

among older people in China. PeerJ. 2022;10:e13938. doi:

10.7717/peerj.13938.

30. Chou KL, Ho AHY, Chi I. Living alone and depres-

sion in Chinese older adults. Aging Ment Health. 2006

Nov;10(6):583–91. doi: 10.1080/13607860600641150.

31. Catalini A, Mazza C, Cosma C, Minutolo G, De Nicolò V,

Gallinoro V, et al. Public Health Residents’ Anonymous Sur-

32. 33. 34. 35. 36. 37. 38. 39. 179

vey in Italy (PHRASI): Study Protocol for a Cross-Sectional

Study for a Multidimensional Assessment of Mental Health

and Its Determinants. Int J Environ Res Public Health. 2023

Jan 21;20(3):2003. doi: 10.3390/ijerph20032003.

de Girolamo G, Ferrari C, Candini V, Buizza C, Calaman-

drei G, Caserotti M, et al. Psychological well-being during

the COVID-19 pandemic in Italy assessed in a four-waves

survey. Sci Rep. 2022 Oct 26;12(1):17945. doi: 10.1038/

s41598-022-22994-4.

Charan J, Biswas T. How to calculate sample size for differ-

ent study designs in medical research? Indian J Psychol Med.

2013 Apr;35(2):121–6. doi: 10.4103/0253-7176.116232.

Italia. Decreto Legislativo 30 Giugno 2003, n. 196. Codice

in Materia Di Protezione Dei Dati Personali. In: Ministero

Della Giustizia - Ufficio Pubblicazioni Leggi e Decreti, Edi-

tor. Supplemento Ordinario Alla “Gazzetta Ufficiale Della

Repubblica Italiana” [Internet]. Roma: Istituto Poligrafico

e Zecca Dello Stato; 2003 [Cited 2019 Dec 31]. p. 11–207.

(Serie Generale; Vol. 123/L). Available from: Https://Www.

Gazzettaufficiale.It/Eli/Gu/2003/07/29/174/so/123/Sg/Pdf.

[Last accessed: 2023 Nov 30].

Italia. Decreto Legislativo 10 Agosto 2018 , n. 101 . Di-

sposizioni per l’adeguamento Della Normativa Nazionale

Alle Disposizioni Del Regolamento (UE) 2016/679 Del

Parlamento Europeo e Del Consiglio, Del 27 Aprile 2016,

Relativo Alla Protezione Delle Persone Fisiche Con Riguar-

do al Trattamento Dei Dati Personali, Nonché Alla Libera

Circolazione Di Tali Dati e Che Abroga La Direttiva 95/46/

CE (Regolamento Generale Sulla Protezione Dei Dati). [In-

ternet]. Gazzetta Ufficiale Della Repubblica Italiana Serie

Generale n. 159 Del 04-09-2018; Available from: Https://

Www.Gazzettaufficiale.It/Eli/Gu/2018/09/04/205/Sg/Pdf.

[Last accessed: 2023 Nov 21].

European Union. Regulation (EU) 2016/679 of the Euro-

pean Parliament and of the Council of 27 April 2016 on the

protection of natural persons with regard to the processing

of personal data and on the free movement of such data,

and repealing Directive 95/46/EC (General Data Protection

Regulation) [Internet]. Eur-lex. Access to European Unione

law. 2016 [cited 2021 Nov 21]. Available from: https://eur-

lex.europa.eu/eli/reg/2016/679/oj. Available from: https://

eur-lex.europa.eu/eli/reg/2016/679/oj [Last accessed: 2023

Nov 16].

Vincenty T. Direct and inverse solutions of geodesics on

the ellipsoid with application of nested equations: Survey

Review 1975; 23(176) [Internet]. Available from: doi:

10.21236/AD0657591.

Nicolucci A, Giorgino R, Cucinotta D, Zoppini G, Muggeo

M, Squatrito S, et al. Validation of the Italian version of

the WHO-Well-Being Questionnaire (WHO-WBQ) and

the WHO-Diabetes Treatment Satisfaction Questionnaire

(WHO-DTSQ). Diabetes Nutr Metab. 2004 Aug;17(4):235–

43.

World Health Organization. Regional Office for Europe.

(1998). Wellbeing measures in primary health care/the

DEPCARE project. Stockholm, Sweden: WHO Regional

Office for Europe; 1998 13/02 p. 45. Available from: https://

180 N. Berselli et al.

iris.who.int/handle/10665/349766 [Last accessed: 2023 Nov

30].

40. Mazzotti E, Fassone G, Picardi A, Sagoni E, Ramieri L,

Lega I, et al. II Patient Health Questionnaire (PHQ) per

lo screening dei disturbi psichiatrici. Giornale Italiano di

Psicopatologia. 2003 Sep;9(3):235–42.

41. Galletta M, Portoghese I, Penna MP, Battistelli A, Saiani

L. Turnover intention among Italian nurses: the moderating

roles of supervisor support and organizational support. Nurs

Health Sci. 2011 Jun;13(2):184–91. doi: 10.1111/j.1442-

2018.2011.00596.x.Epub 2011 May 19.

42. Gibson JA, Grey IM, Hastings RP. Supervisor support as a

predictor of burnout and therapeutic self-efficacy in thera-

pists working in ABA schools. J Autism Dev Disord. 2009

Jul;39(7):1024–30. doi: 10.1007/s10803-009-0709-4.Epub

2009 Mar 17.

43. Beehr TA, Farmer SJ, Glazer S, Gudanowski DM, Nair VN.

The enigma of social support and occupational stress: source

congruence and gender role effects. J Occup Health Psychol.

2003 Jul;8(3):220–31. doi: 10.1037/1076-8998.8.3.220.

44. Willemse BM, de Jonge J, Smit D, Depla MFIA, Pot AM.

The moderating role of decision authority and coworker- and

supervisor support on the impact of job demands in nurs-

ing homes: a cross-sectional study. Int J Nurs Stud. 2012

Jul;49(7):822–33. doi: 10.1016/j.ijnurstu.2012.02.003. Epub

2012 Mar 11.

45. Selvarajan TT, Cloninger PA, Singh B. Social support and

work–family conflict: A test of an indirect effects model.

J Vocat Behav. 2013 Dec 1;83(3):486–99. doi: 10.1016/j.

jvb.2013.07.004.

46. Nakata A, Haratani T, Takahashi M, Kawakami N, Arito H,

Kobayashi F, et al. Job stress, social support, and prevalence

of insomnia in a population of Japanese daytime workers.

Soc Sci Med. 2004 Oct 1;59(8):1719–30. doi: 10.1016/j.

socscimed.2004.02.002.

47. Nagami M, Tsutsumi A, Tsuchiya M, Morimoto K. Job

Control and Coworker Support Improve Employee Job

Performance. Ind Health. 2010;48(6):845–51. doi: 10.2486/

indhealth.ms1162. Epub 2010 Jul 1.

48. Kossek E, Pichler S, Bodner T, Hammer L. Workplace

social support and work-family conflict: a meta-analysis

clarifying the influence of general and work-family spe-

cific supervisor and organizational support. Pers Psychol.

2011 Summer;64(2):289–313. doi: 10.1111/j.1744-6570

.2011.01211.x.

49. Jenkins R, Elliott P. Stressors, burnout and social sup-

port: nurses in acute mental health settings. J Adv

Nurs. 2004;48(6):622–31. doi: 10.1111/j.1365-2648

.2004.03240.x.

50. Babiker A, El Husseini M, Al Nemri A, Al Frayh A, Al

Juryyan N, Faki MO, et al. Health care professional devel-

opment: Working as a team to improve patient care. Sudan

J Paediatr. 2014;14(2):9–16.

51. Amerio A, Aguglia A, Odone A, Gianfredi V, Serafini G,

Signorelli C, et al. Covid-19 pandemic impact on mental

health of vulnerable populations. Acta Biomed. 2020 Jul

20;91(9-S):95–6. doi: 10.23750/abm.v91i9-S.10112.

52. Bolliger L, Debra G, Lukan J, Peeters R, Colman E, Baele

E, et al. The association between day-to-day stress experi-

ences and work–life interference among office workers in

academia: an ecological momentary assessment study. Int

Arch Occup Environ Health. 2023 Mar 1;96(2):201–12. doi:

10.1007/s00420-022-01915-y.Epub 2022 Sep 15.

53. Robles TF, Slatcher RB, Trombello JM, McGinn MM.

Marital quality and health: a meta-analytic review. Psychol

Bull. 2014 Jan;140(1):140–87. doi: 10.1037/a0031859.

Epub 2013 Mar 25.

54. Gianfredi V, Koster A, Eussen SJPM, Odone A, Amerio A,

Signorelli C, et al. The association between cardio-respira-

tory fitness and incident depression: The Maastricht Study.

J Affect Disord. 2021 Jan 15;279:484–90. doi: 10.1016/j.

jad.2020.09.090. Epub 2020 Sep 29.

55. Musick K, Bumpass L. Reexamining the case for marriage:

Union formation and changes in well‐being. J Marriage Fam.

2012;74:1–18. doi: 10.1111/j.1741-3737.2011.00873.x.

Epub 2012 Jan 11.

56. Ostberg M, Hagekull B. A structural modeling ap-

proach to the understanding of parenting stress. J Clin

Child Psychol. 2000 Dec;29(4):615–25. doi: 10.1207/

S15374424JCCP2904_13.

57. Spinelli M, Lionetti F, Pastore M, Fasolo M. Parents’

Stress and Children’s Psychological Problems in Families

Facing the COVID-19 Outbreak in Italy. Front Psychol.

2020;11:1713. doi: 10.3389/fpsyg.2020.01713.

58. Signorelli C, Odone A, Gianfredi V, Balzarini F, Bucci

D, Croci R, et al. Epidemiological assessment of the first

COVID-19 epidemic wave in Lombardy. A systematic

review. Acta Biomed. 2021 Oct 7;92(S6):e2021462. doi:

10.23750/abm.v92iS6.12340.

59. Nelson SK, Kushlev K, Lyubomirsky S. The pains and

pleasures of parenting: when, why, and how is parenthood

associated with more or less well-being? Psychol Bull. 2014

May;140(3):846–95. doi: 10.1037/a0035444. Epub 2014

Feb 3.

60. Sinokki M, Hinkka K, Ahola K, Koskinen S, Kivimäki M,

Honkonen T, et al. The association of social support at work

and in private life with mental health and antidepressant use:

The Health 2000 Study. J Affect Disord. 2009;115:36–45.

61. Sinokki M, Ahola K, Hinkka K, Sallinen M, Härmä M,

Puukka P, et al. The association of social support at work

and in private life with sleeping problems in the Finnish

health 2000 study. J Occup Environ Med. 2010;52:54–61.

doi: 10.1016/j.jad.2008.07.009. Epub 2008 Aug 21.

62. Boruch RF. Assuring Confidentiality of Responses in Social

Research: A Note on Strategies. Am Sociol. 1971;6(4):308–

11.

63. Paulhus DL. Measurement and Control of Response Bias. In:

Robinson JP, Shaver PR, Wrightsman LS, editors. Measures

of personality and social psychological attitudes [Internet].

San Diego, CA: Academic Press; 1991. p. 17–59. Avail-

able from: https://www.researchgate.net/profile/Delroy-

Paulhus/publication/246790479_Measurement_and_Con-

trol_of_Response_Bias/links/59ddd2a5458515f6ef0670bb/

Measurement-and-Control-of-Response-Bias.pdf

Social network characteristics and well-being

181

64. Tourangeau R, Yan T. Sensitive questions in surveys.

Psychol Bull. 2007;133:859–83. doi: 10.1037/0033-2909

.133.5.859.

65. Ramsey CA, Hewitt AD. A Methodology for Assessing

Sample Representativeness. Environ Forensics. 2005 Mar

16;6(1):71–5. doi: 10.1080/15275920590913877.

66. Li Y, Scherer N, Felix L, Kuper H. Prevalence of depres-

sion, anxiety and post-traumatic stress disorder in health

care workers during the COVID-19 pandemic: A systematic

review and meta-analysis. PloS One. 2021;16(3):e0246454.

doi: 10.1371/journal.pone.0246454.

67. Hassan TM, Ahmed SO, White AC, Galbraith N. A postal

survey of doctors’ attitudes to becoming mentally ill.

68. 69. Clin Med (Lond). 2009 Aug;9(4):327–32. doi: 10.7861/

clinmedicine.9-4-327.

Regan M, Elliott I, Goldie I. Better Mental Health for

All: A Public Health Approach to Mental Health Im-

provement. Mental Health Foundation. London, 2016.

Available from: https://www.fph.org.uk/media/1644/

better-mental-health-for-all-final-low-res.pdf [Last ac-

cessed: 2023 Nov 30].

Royal College of Physicians. Improving teams in healthcare:

Resource 1 - Building effective teams. London, 2017. Avail-

able from: http://www.rcplondon.ac.uk/projects/outputs/

improving-teams-healthcare-resource-1-building-effective-

teams [Last accessed: 2023 Nov 30].

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1.
Berselli N, Caminiti M, Ancona A, Stacchini L, Gallinoro V, Catalini A, et al. Social network characteristics and well-being in Italy: insights from the PHRASI Study. Ann Ig [Internet]. 2024 Mar. 30 [cited 2025 Oct. 8];36(2):169-81. Available from: https://mail.mattioli1885journals.com/index.php/annali-igiene/article/view/17492