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Helgesson M, Marklund S, Gustafsson K, Aronsson G, Leineweber C. Favorable Working Conditions Related to Health Behavior Among Nurses and Care Assistants in Sweden-A Population-Based Cohort Study. Front Public Health 2021; 9:681971. [PMID: 34222181 PMCID: PMC8249917 DOI: 10.3389/fpubh.2021.681971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
Objective: To analyze the associations between favorable physical and psychosocial work factors and health behavior among healthcare employees (nurses and care assistants) with health complaints. Methods: The study was based on seven iterations (2001–2013) of a biennial Swedish work environment survey linked with data from public registers. In all, 7,180 healthcare employees, aged 16–64 years, who had reported health complaints, were included. Health behavior was operationalized through four combinations of sickness absence (SA) and sickness presence (SP): ‘good health behavior' (Low SP/Low SA), ‘recovery behavior' (Low SP/High SA), ‘risk behavior' (High SP/Low SA), and ‘poor health behavior' (High SP/High SA). Odds ratios (OR) were calculated by multinomial logistic regression with 95% confidence intervals (CI). Results: After adjusting for socio-demographic factors, those who rarely worked in strenuous postures had an increased probability of having ‘good health behavior' (OR range: nurses 1.72–2.02; care assistants 1.46–1.75). Those who rarely experienced high job demands had increased odds for having ‘good health behavior' (OR: nurses 1.81; OR range: care assistants 1.67–2.13), while having good job control was found to be related to ‘good health behavior' only among care assistants (OR range 1.30–1.68). In the full model, after also considering differences in health, none of the work environment indicators affected ‘good health behavior' among nursing professionals. Among care assistants, rarely having heavy physical work and having low psychosocial demands remained significantly associated with ‘good health behavior' (OR range: 1.24–1.58) and ‘recovery behavior' (OR range: 1.33–1.70). No associations were found between favorable work environment factors and ‘risk behavior' among the two groups of employees. However, positive assessments of the work situation were associated with ‘good health behavior,' even after controlling for all confounders for both groups (OR range: 1.43–2.69). Conclusions: ‘Good health behavior' and ‘recovery behavior' among care assistants were associated with favorable physical and psychosocial working conditions even when health was considered. This implies that reduced sickness presence and sickness absence among care assistants can be achieved through improved physical and psychosocial working conditions.
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Affiliation(s)
- Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Marklund
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Klas Gustafsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Aronsson
- Department of Psychology, Stockholm University, Stockholm, Sweden
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Alcorn J, Burton R, Topping A. Withdrawing from treatment for Bladder cancer: Patient experiences of
BCG
installations. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2020. [DOI: 10.1111/ijun.12236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jason Alcorn
- Mid Yorkshire Hospitals NHS Trust Pinderfields Hospital Wakefield West Yorkshire UK
| | - Rob Burton
- School of Nursing and Midwifery Griffith University Mount Gravatt Queensland Australia
| | - Annie Topping
- School of Nursing University of Birmingham & University Birmingham Hospitals NHS Foundation Trust Birmingham UK
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Mikkola L, Suutala E, Parviainen H. Social support in the workplace for physicians in specialization training. MEDICAL EDUCATION ONLINE 2018; 23:1435114. [PMID: 29464988 PMCID: PMC5827784 DOI: 10.1080/10872981.2018.1435114] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/22/2018] [Indexed: 05/30/2023]
Abstract
When becoming a specialist, learning-through-service plays a significant role. The workplace affords good opportunities for learning, but the service-learning period may also impose stress on phycisians in specialization training. In medical work, social support has proved to be a very important factor in managing stress. Social support may afford advantages also for learning and professional identity building. However, little was known about how social support is perceived by doctors in specialization training. This study aimed to understand the perceptions of physicians in specialization training regarding social support communication in their workplace during their learning-through-service period. The study was conducted qualitatively by inductively analyzing the physicians' descriptions of workplace communication. The dataset included 120 essays, 60 each from hospitals and primary healthcare centres. Physicians in specialization training explained the need of social support with the responsibilities and demands of their clinical work and the inability to control and manage their workloads. They perceived that social support works well for managing stress, but also for strengthening relational ties and one's professional identity. A leader's support was perceived as being effective, and both senior and junior colleagues were described as an important source of social support. Also co-workers, such as the individual nurse partner with whom one works, was mentioned as an important source of social support. The results of this study indicate that social support works at the relational and identity levels, which is due to the multi-functional nature of workplace communication. For example, consultation functions as situational problem-solving, but also the tone of social interaction is meaningful. Thus, strengthening one's professional identity or collegial relationships requires further attention to workplace communication. Abbreviations PiST: Physician in specialization training.
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Affiliation(s)
- Leena Mikkola
- Department of Language and Communication Studies, University of Jyvaskyla, Jyvaskyla, Finland
| | - Elina Suutala
- Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
| | - Heli Parviainen
- Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
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Wranik WD, Haydt SM, Katz A, Levy AR, Korchagina M, Edwards JM, Bower I. Funding and remuneration of interdisciplinary primary care teams in Canada: a conceptual framework and application. BMC Health Serv Res 2017; 17:351. [PMID: 28506224 PMCID: PMC5433058 DOI: 10.1186/s12913-017-2290-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 05/04/2017] [Indexed: 12/03/2022] Open
Abstract
Background Reliance on interdisciplinary teams in the delivery of primary care is on the rise. Funding bodies strive to design financial environments that support collaboration between providers. At present, the design of financial arrangements has been fragmented and not based on evidence. The root of the problem is a lack of systematic evidence demonstrating the superiority of any particular financial arrangement, or a solid understanding of options. In this study we develop a framework for the conceptualization and analysis of financial arrangements in interdisciplinary primary care teams. Methods We use qualitative data from three sources: (i) interviews with 19 primary care decision makers representing 215 clinics in three Canadian provinces, (ii) a research roundtable with 14 primary care decision makers and/or researchers, and (iii) policy documents. Transcripts from interviews and the roundtable were coded thematically and a framework synthesis approach was applied. Results Our conceptual framework differentiates between team level funding and provider level remuneration, and characterizes the interplay and consonance between them. Particularly the notions of hierarchy, segregation, and dependence of provider incomes, and the link between funding and team activities are introduced as new clarifying concepts, and their implications explored. The framework is applied to the analysis of collaboration incentives, which appear strongest when provider incomes are interdependent, funding is linked to the team as a whole, and accountability does not have multiple lines. Emergent implementation issues discussed by respondents include: (i) centrality of budget negotiations; (ii) approaches to patient rostering; (iii) unclear funding sources for space and equipment; and (iv) challenges with community engagement. The creation of patient rosters is perceived as a surprisingly contentious issue, and the challenges of funding for space and equipment remain unresolved. Conclusions The development and application of a conceptual framework is an important step to the systematic study of the best performing financial models in the context of interdisciplinary primary care. The identification of optimal financial arrangements must be contextualized in terms of feasibility and the implementation environment. In general, financial hierarchy, both overt and covert, is considered a barrier to collaboration. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2290-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- W Dominika Wranik
- School of Public Administration, Dalhousie University, Halifax, Canada.
| | - Susan M Haydt
- Faculty of Management, Dalhousie University, Halifax, Canada
| | - Alan Katz
- Department of Community Health Sciences, Department of Family Medicine, University of Manitoba, Winnipeg, Canada
| | - Adrian R Levy
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Maryna Korchagina
- Provider Compensation and Strategic Partnership Branch, Alberta Health, Edmonton, Canada
| | - Jeanette M Edwards
- Primary Health Care and Chronic Disease, Winnipeg Regional Health Authority, Winnipeg, Canada
| | - Ian Bower
- Primary Care, Nova Scotia Department of Health and Wellness, Halifax, Canada
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Wranik WD, Hayden JA, Price S, Parker RM, Haydt SM, Edwards JM, Suter E, Katz A, Gambold LL, Levy AR. How best to structure interdisciplinary primary care teams: the study protocol for a systematic review with narrative framework synthesis. Syst Rev 2016; 5:170. [PMID: 27716357 PMCID: PMC5050675 DOI: 10.1186/s13643-016-0339-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/13/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Western publicly funded health care systems increasingly rely on interdisciplinary teams to support primary care delivery and management of chronic conditions. This knowledge synthesis focuses on what is known in the academic and grey literature about optimal structural characteristics of teams. Its goal is to assess which factors contribute to the effective functioning of interdisciplinary primary care teams and improved health system outcomes, with specific focus on (i) team structure contribution to team process, (ii) team process contribution to primary care goals, and (iii) team structure contribution to primary care goals. METHODS AND DESIGN The systematic search of academic literature focuses on four chronic conditions and co-morbidities. Within this scope, qualitative and quantitative studies that assess the effects of team characteristics (funding, governance, organization) on care process and patient outcomes will be searched. Electronic databases (Ovid MEDLINE, Embase, CINAHL, PAIS, Web of Science) will be searched systematically. Online web-based searches will be supported by the Grey Matters Tool. Studies will be included, if they report on interdisciplinary primary care in publicly funded Western health systems, and address the relationships between team structure, process, and/or patient outcomes. Studies will be selected in a three-stage screening process (title/abstract/full text) by two independent reviewers in each stage. Study quality will be assessed using the Mixed Methods Assessment Tool. An a priori framework will be applied to data extraction, and a narrative framework approach is used for the synthesis. DISCUSSION Using an integrated knowledge translation approach, an electronic decision support tool will be developed for decision makers. It will be searchable along two axes of inquiry: (i) what primary care goals are supported by specific team characteristics and (ii) how should teams be structured to support specific primary care goals? The results of this evidence review will contribute directly to the design of interdisciplinary primary care teams. The optimized design will support the goals of primary care, contributing to the improved health of populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016041884.
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Affiliation(s)
- W. Dominika Wranik
- School of Public Administration, Faculty of Management, Dalhousie University, Halifax, Canada
| | - Jill A. Hayden
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
| | - Sheri Price
- Faculty of Nursing, Dalhousie University, Halifax, Canada
| | | | - Susan M. Haydt
- Faculty of Management, Dalhousie University, Halifax, Canada
| | - Jeanette M. Edwards
- Primary Health Care and Chronic Disease, Winnipeg Regional Health Authority, Winnipeg, Canada
| | - Esther Suter
- Workforce Research and Evaluation, Alberta Health Services, Calgary, Canada
| | - Alan Katz
- Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Liesl L. Gambold
- Department of Sociology and Social Anthropology, Faculty of Arts and Social Sciences, Dalhousie University, Halifax, Canada
| | - Adrian R. Levy
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada
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Wilkinson A, Whitehead L, Ritchie L. Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes. Int J Nurs Stud 2014; 51:111-22. [DOI: 10.1016/j.ijnurstu.2013.01.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 01/18/2013] [Accepted: 01/26/2013] [Indexed: 10/27/2022]
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García-Juárez MDR, López-Alonso SR, Moreno-Verdugo A, Guerra-González S, Fernández-Corchero J, Márquez-Borrego MJ, Orozco-Cózar MJ, Ramos-Bosquet G. Personalización de cuidados hospitalarios y su efecto sobre la relación de confianza enfermera-paciente. ENFERMERIA CLINICA 2013; 23:243-51. [DOI: 10.1016/j.enfcli.2013.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 08/12/2013] [Accepted: 09/08/2013] [Indexed: 11/25/2022]
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Kilpatrick K. Understanding acute care nurse practitioner communication and decision-making in healthcare teams. J Clin Nurs 2012; 22:168-79. [DOI: 10.1111/j.1365-2702.2012.04119.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Del Barrio Linares M, Reverte Sanchez M. Evaluación del trabajo en equipo en seis unidades de cuidados intensivos de dos hospitales universitarios. ENFERMERIA INTENSIVA 2010; 21:150-60. [DOI: 10.1016/j.enfi.2010.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 03/29/2010] [Indexed: 10/19/2022]
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Mukamel DB, Cai S, Temkin-Greener H. Cost implications of organizing nursing home workforce in teams. Health Serv Res 2009; 44:1309-25. [PMID: 19486181 DOI: 10.1111/j.1475-6773.2009.00980.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To estimate the costs associated with formal and self-managed daily practice teams in nursing homes. DATA SOURCES/STUDY SETTING Medicaid cost reports for 135 nursing homes in New York State in 2006 and survey data for 6,137 direct care workers. STUDY DESIGN A retrospective statistical analysis: We estimated hybrid cost functions that include team penetration variables. Inference was based on robust standard errors. DATA COLLECTION Formal and self-managed team penetration (i.e., percent of staff working in a team) were calculated from survey responses. Annual variable costs, beds, case mix-adjusted days, admissions, home care visits, outpatient clinic visits, day care days, wages, and ownership were calculated from the cost reports. PRINCIPAL FINDINGS Formal team penetration was significantly associated with costs, while self-managed teams penetration was not. Costs declined with increasing penetration up to 13 percent of formal teams, and increased above this level. Formal teams in nursing homes in the upward sloping range of the curve were more diverse, with a larger number of participating disciplines and more likely to include physicians. CONCLUSIONS Organization of workforce in formal teams may offer nursing homes a cost-saving strategy. More research is required to understand the relationship between team composition and costs.
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Affiliation(s)
- Dana B Mukamel
- University of California, Irvine, Center for Health Policy Research, Irvine, CA, USA.
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Reineck CA. Best practice models for acute and critical care: today and into the future. Crit Care Nurs Clin North Am 2009; 20:375-81. [PMID: 19007703 DOI: 10.1016/j.ccell.2008.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this article is to describe selected best practices in acute and critical care. The evidence base for these models is steadily building. Attributes of past, present, and emerging models are discussed in the context of important considerations such as stress, capacity, and infection. The author offers suggestions for using what we know to advance models of care in the information age that has only just begun.
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Affiliation(s)
- Carol A Reineck
- Department of Acute Nursing Care, The University of Texas Health Science Center at San Antonio School of Nursing, 7703 Floyd Curl Drive, Mail Code 7975, San Antonio, TX 78229, USA.
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Temkin-Greener H, Cai S, Katz P, Zhao H, Mukamel DB. Daily practice teams in nursing homes: evidence from New York state. THE GERONTOLOGIST 2009; 49:68-80. [PMID: 19363005 DOI: 10.1093/geront/gnp011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Most health care organizations, including nursing homes, report having teams. However, little is known about everyday practice teams among staff providing direct resident care. We assess the prevalence of such teams in nursing homes as reported by direct care staff and administrators, and examine characteristics of facilities that foster these teams. DESIGN AND METHODS The analytical model is based on 149 nursing homes. Data sources include surveys of administrators (n = 292) and direct care staff (n = 6,867), and Online Survey Certification and Reporting System. Linear regression with robust standard errors and sampling probability weights is used to examine the relationship between daily practice teams and facility characteristics. RESULTS On average, 16% of workers per facility report practicing in formal multidisciplinary teams providing daily resident care. Team prevalence is 3.3% higher when managers view teams as very important for clinical care quality, 2.6% higher when the directors of nursing report formally organized teams, 2.5% higher for each 10% increase in workers' involvement in teams other than the daily practice teams, and 1.95% higher for each 1-hr increase in nursing hours. IMPLICATIONS Our study shows that multidisciplinary daily practice teams can be found in most facilities in our large sample, but their penetration within nursing homes is far from pervasive; in 72% of facilities, staff report team prevalence of less than 25%. Given that the majority of managers report teamwork as very important to their facilities' operations, we discuss why only a relatively small proportion of daily care is provided in this fashion.
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Affiliation(s)
- Helena Temkin-Greener
- Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA.
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