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Biomedical subjects

J Diederiks

Publications and source records attributed to J Diederiks.

4 recordsLinked to original sources

Physician satisfaction, professional characteristics and behavior formalization in hospitals.

In this paper, an analysis is presented of professional and bureaucratic predictors of physician satisfaction. Results from 210 physicians in 17 medical departments of university hospitals support the hypotheses that both professional attitudes and formal structuring of work activities have a positive effect on physician satisfaction. It is shown that behavior formalization, preference for professional autonomy and the time spent on patient care activities within medical departments are positive predictors of satisfaction with work environment, while 'traditional' professional attitudes like craftsmanship and client service have more impact on satisfaction with patient demand. Certification is a strong positive predictor of work load satisfaction. Satisfaction with work environment was the most important factor in explaining other satisfaction dimensions. This finding supports the hypothesized 'buffering' effect of the affective climate or 'feel' of the professional work environment in hospitals. The implication of the findings is, that in the process of bureaucratization of medical practice in hospitals, specific attention should be paid to the maintenance of professional values as guidelines for professional work and to the maintenance of a good affective work environment for professionals in order to prevent dissatisfaction with patient demand and work load.

Attitude of Health Personnel↗

Do personal computers make doctors less personal?

Ten months after the installation of a computer in a general practice surgery a postal survey (piloted questionnaire) was sent to 390 patients. The patients' views of their relationship with their doctor after the computer was introduced were compared with their view of their relationship before the installation of the computer. More than 96% of the patients (n = 263) stated that contact with their doctor was as easy and as personal as before. Most stated that the computer did not influence the duration of the consultation. Eighty one patients (30%) stated, however, that they thought that their privacy was reduced. Unlike studies of patients' attitudes performed before any actual experience of use of a computer in general practice, this study found that patients have little difficulty in accepting the presence of a computer in the consultation room. Nevertheless, doctors should inform their patients about any connections between their computer and other, external computers to allay fears about a decrease in privacy.

Attitude to Computers↗

Subjective complaints and blood pressure.

The relationship between blood pressure and subjective complaints concerning physical well-being has been investigated. The complaints have been measured by means of the Inventory of Subjective Health. The total number of complaints are the summation of 39 items. Hypertension is assumed to have no clear-cut symptoms. This statement gives rise to the hypothesis that there is no relationship between blood pressure and subjective complaints. The hypothesis was refuted after several tests. We found a curvilinear relationship between diastolic blood pressure and subjective complaints in representative groups of men of 21-65 and 31-50 years old, valid for the total number of complaints and dizziness. This curvilinear relationship is found again after a matching procedure in order to exclude possible confounding effects of age, cigarette smoking and knowledge about elevated blood pressure status. The total number of complaints of males with a diastolic pressure higher than 95 mmHg are not significantly higher than the total number of complaints of males with a lower diastolic pressure, but the difference is significant for dizziness.

Adult↗

Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention.

OBJECTIVE: The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure. DESIGN: The study design was an experimental, random assignment. SETTING: The study was located at the University Hospital in Maastricht, The Netherlands. PATIENTS: The study included 179 patients (mean age 73 years, 58% men, New York Heart Association classification III and IV) admitted to a university hospital with symptoms of heart failure. OUTCOME MEASURES: Outcome measures included self-care abilities (Appraisal of Self-care Agency Scale), self-care behavior (Heart Failure Self-care Behavior Scale), 3 dimensions of quality of life (functional capabilities, symptoms, and psychosocial adjustment to illness), and overall well-being (Cantril's ladder of life). INTERVENTION: The intervention patients received systematic education and support by a nurse in the hospital and at home. Control patients received routine care. RESULTS: Self-care abilities did not change as a result of the intervention, but the self-care behavior in the intervention group was higher than the self-care behavior in the control group during follow-up. The effect of the supportive educational intervention on quality of life was limited. The 3 dimensions of quality of life improved after hospitalization in both groups, with no differences between intervention and control group as measured at each follow-up measurement. However, there was a trend indicating differences between the 2 groups in decrease in symptom frequency and symptom distress during the 9 months of follow-up. CONCLUSION: A supportive educational nursing intervention is effective in improving self-care behavior in patients with advanced (New York Heart Association class III-IV) heart failure; however, a more intensive intervention is needed to show effectiveness in improving quality of life.

Adaptation, Psychological↗