Search PubMed⌕ Search

Biomedical subjects

J Shamian

Publications and source records attributed to J Shamian.

At least 19 recordsLinked to original sources
PubMed2002

A hospital-level analysis of the work environment and workforce health indicators for registered nurses in Ontario's acute-care hospitals.

The purpose of this study was to explore the relationship between hospital-level indicators of the work environment and aggregated indicators of health and well-being amongst registered nurses working in acute-care hospitals in Ontario, Canada. This ecological analysis used data from a self-reported survey instrument randomly allocated to nurses using a stratified sampling approach. Multivariable linear regression models were used to examine hospital-level associations for burnout, musculoskeletal pain, self-rated general health, and absence due to illness. The unit of analysis was the hospital (n = 160), with individual nurse responses (n = 6,609) aggregated within hospitals. After controlling for basic differences in nurse workforces, including mean age and education, higher (better) work-environment scores were found to be generally associated with higher health-indicator scores, while a larger proportion of full-time than part-time nurses was found to be associated with lower (poorer) health scores. This study may provide direction for policy-makers in coping with the recruitment and retention of nursing staff in light of the current nursing shortage.

Health Facility Environment↗
PubMed2001

The impact of workplace empowerment, organizational trust on staff nurses' work satisfaction and organizational commitment.

A predictive, nonexperimental design was used to test Kanter's work empowerment theory in a random sample of 412 staff nurses selected from the professional registry list of a central Canadian province. Kanter argues that work environments that provide access to information, support, resources, and opportunity to learn and develop are empowering and influence employee work attitudes, productivity, and organizational effectiveness. Test results suggest that fostering environments that enhance perceptions of empowerment will have positive effects on organizational members and increase organizational effectiveness.

Adult↗
PubMed2001

Testing Karasek's Demands-Control Model in restructured healthcare settings: effects of job strain on staff nurses' quality of work life.

BACKGROUND: Job strain among staff nurses has become an increasingly important concern in relationship to employee performance and commitment to the organization in current restructured healthcare settings. OBJECTIVES: The purpose of this study was to test Karasek's Demands-Control Model of job strain by examining the extent to which the degree of job strain in nursing work environments affects staff nurses' perceptions of structural and psychological empowerment, work satisfaction, and organizational commitment. METHOD: A predictive, nonexperimental design was used to test these relationships in a random sample of 404 Canadian staff nurses. Karasek's Job Content Questionnaire, the Conditions of Work Effectiveness Questionnaire-II, Spreitzer's Psychological Empowerment Questionnaire, Meyer and Allen's Organizational Commitment Questionnaire, and the Global Satisfaction Scale were used to measure the major study variables. RESULTS: Nurses with higher level of job strain were found to be significantly more empowered, more committed to the organization, and more satisfied with their work. CONCLUSIONS: Support for Karasek's Demands/Control theory was established in this study.

Adult↗
PubMed2001

Impact of structural and psychological empowerment on job strain in nursing work settings: expanding Kanter's model.

OBJECTIVE: In this study, we tested an expanded model of Kanter's structural empowerment, which specified the relationships among structural and psychological empowerment, job strain, and work satisfaction. BACKGROUND: Strategies proposed in Kanter's empowerment theory have the potential to reduce job strain and improve employee work satisfaction and performance in current restructured healthcare settings. The addition to the model of psychological empowerment as an outcome of structural empowerment provides an understanding of the intervening mechanisms between structural work conditions and important organizational outcomes. METHODS: A predictive, nonexperimental design was used to test the model in a random sample of 404 Canadian staff nurses. The Conditions of Work Effectiveness Questionnaire, the Psychological Empowerment Questionnaire, the Job Content Questionnaire, and the Global Satisfaction Scale were used to measure the major study variables. RESULTS: Structural equation modelling analyses revealed a good fit of the hypothesized model to the data based on various fit indices (chi 2 = 1140, df = 545, chi 2/df ratio = 2.09, CFI = 0.986, RMSEA = 0.050). The amount of variance accounted for in the model was 58%. Staff nurses felt that structural empowerment in their workplace resulted in higher levels of psychological empowerment. These heightened feelings of psychological empowerment in turn strongly influenced job strain and work satisfaction. However, job strain did not have a direct effect on work satisfaction. CONCLUSIONS: These results provide initial support for an expanded model of organizational empowerment and offer a broader understanding of the empowerment process.

Adult↗
PubMed2000

Organizational trust and empowerment in restructured healthcare settings. Effects on staff nurse commitment.

In today's dramatically restructured healthcare work environments, organizational trust is an increasingly important element in determining employee performance and commitment to the organization. The authors used Kanter's model of workplace empowerment to examine the effects of organizational trust and empowerment on two types of organizational commitment. A predictive, nonexperimental design was used to test Kanter's theory in a random sample of 412 Canadian staff nurses. Empowered nurses reported higher levels of organizational trust, which in turn resulted in higher levels of affective commitment. However, empowerment did not predict continuance commitment--that is, commitment to stay in the organization based on perceived lack of other job opportunities. Because past research has linked affective commitment to employee productivity, these results suggest that fostering environments that enhance perceptions of empowerment and organizational trust will have positive effects on organizational members and increase organizational effectiveness.

Adult↗
PubMed1999

An evaluation of WHA resolution 45.5: health human resource implications.

The World Health Assembly approved resolution WHA45.5 in 1992. This paper reports the findings of an evaluation of the implementation of this resolution using a survey technique. A total of 150 WHO Member States responded, for a 79% response rate. Findings suggest that the greatest strides worldwide have been made in education. While the data show that progress has been made at the country level, far more action is needed to strengthen nursing and midwifery if these cost-effective resources are to play a decisive role in improving the extent and quality of services, especially as delivered to people in the greatest need.

Cross-Sectional Studies↗
PubMed1998

Quality management: the role of hospital boards.

The changing social, political and economic environment has, for the first time, forced hospitals to account for their financial performance. Hospitals have responded to this demand by restructuring, downsizing and implementing efficiencies. At the same time, professionals and consumers are becoming increasingly concerned about the impact of rapid change on the quality of hospital care. In this context, the challenge for all stakeholders is to explicitly outline who is responsible and accountable for assuring high quality hospital care. The purpose of this paper is to discuss the role of hospital boards in relation to quality improvement. A framework currently used by a metropolitan Canadian teaching hospital, to assure continuous quality improvement despite significant budget cuts, is outlined.

Canada↗
PubMed1997

Hospital restructuring initiatives in Canada.

OBJECTIVES: Recent changes in the organization, staffing, and utilization of acute hospitals in Canada are reviewed with regard to the potential implications for quality of care, national nurse workforce requirements, and research. METHODS: Available national and selected provincial data and trends in hospital utilization, capacity, and staffing are synthesized. RESULTS: Health system reform in Canada has resulted in lower utilization of acute inpatient resources, excess hospital capacity, and increased budgetary constraints in the hospital sector. In response, there is widespread hospital restructuring, which includes modifications in nurse staffing ratios and skill mix. Little is known about the potential impact of these changes on patient outcomes. From a workforce perspective, changes in the hospital sector have reduced demand for registered nurses but nursing schools have not modified enrollments. As a result, new graduates are experiencing difficulty obtaining registered nurse positions. CONCLUSIONS: Research should be undertaken to evaluate the impact of changes in the organization and staffing of hospitals on patient outcomes, and on the future requirements for nurses.

Canada↗
PubMed1996

Work empowerment and organizational commitment.

As organizations struggle to deliver the same level and quality of services with fewer resources, administrators are challenged with redesigning workplaces to maximize nurses' commitment. This study used Kanter's Structural Theory of Organizational Behavior to examine the relationship between job-related empowerment perceptions of staff nurses and their commitment to the organization. Strategies for creating more empowered work environments are discussed.

Adult↗
PubMed1994

Staff nurses' and nurse managers' perceptions of job-related empowerment and managerial self-efficacy.

Although much has been written about the importance of empowerment in nursing, few theoretical frameworks provide guidance for nurse administrators in their attempts to create empowered nursing work environments. The authors describe a study testing Kanter's Theory of Structural Power in Organizations in a nursing setting. They argue that the findings provide evidence of the usefulness of this model for increasing perceptions of job-related empowerment of both staff nurses and managers. Specific empowerment strategies derived from Kanter's theory are described.

Adult↗
PubMed1992

Integrating a nursing professional practice model and nursing informatics in a collective bargaining environment.

The integration of a professional practice model of nursing and nursing informatics support for that model is congruent with the goals of a professional nursing union. Thus, the collective-bargaining unit can be a powerful ally to nursing management in achieving the integration of a professional practice model of nursing and nursing informatics. This alliance is based on a shared vision of the nature of professional nursing practice and a common concern for the quality of working life and working environment of the professional nurse. This alliance can provide the basis for decision making about the type of nursing information system to be selected or developed for installation in a particular organization. Use of a participatory decision-making process will ensure that all nursing stakeholders are committed to the decision made and prepared to assist with the resolution of implementation issues as they arise. A harmonious alliance of nursing management and the nursing union ensures a partnership that will protect the clinical nursing caregiver and provide a unified voice for nursing within the organization to resist any attempt by other stakeholders to implement an information system that will not meet the needs of nursing. If nursing management and the collective bargaining unit share the concept of a professional model of nursing practice and view nursing informatics as a tool to assist the nursing staff to operationalize the professional model of nursing, then collaboration in resolving issues related to the implementation of nursing information systems will facilitate the process of achieving the integration of a professional practice model of nursing and nursing informatics support for that model.

Collective Bargaining↗