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Biomedical subjects

S Carmel

Publications and source records attributed to S Carmel.

At least 55 records · Page 3Linked to original sources
PubMed1990

Patient complaint strategies in a general hospital.

This study aimed to understand specific complaint behaviors of inpatients regarding perceived problems in the receipt of hospital services and to study the effect of provider responses to the different complaint strategies on patients' overall satisfaction with hospital services. The analysis was performed on 155 patients who had reported a problem in the receipt of services and had acted to elicit a change. Three complaint strategies were studied--formal, informal, and a combination of both. The use of these strategies was studied in relation to type of hospital service and the type of ward where the problem emerged. Two questions were investigated--what strategy leads to the best outcome for the patients? and how does each outcome affect overall satisfaction with hospital services?

Behavior↗
PubMed1989

Autonomy, job satisfaction and professional self-image among nurses in the context of a physicians' strike.

This paper tests the hypothesis that structural changes in nurses' work settings, which allow nurses to autonomously exercise their knowledge and skills will lead not only to an enhanced feeling of professional autonomy, but also to an improvement in their professional self-image and to an increase in job satisfaction. An opportunity to test this hypothesis arose when physicians in Israel went on a strike which lasted 116 days. Primary care (PC) clinics were completely abandoned by physicians, leaving nurses to operate them on their own, while in hospitals, nurses continued to work as usual under physicians' supervision. The study compares the effect of the strike on head nurses in the two sectors. Data were collected by means of self administered questionnaires. The findings indicate that during the strike, PC head nurses expanded their activities and responsibilities and consequently felt more professional autonomy and job satisfaction, as well as an improvement in professional self-image. Hospital head nurses experienced significantly less changes in their work situation and, as expected, less change in all work related attitudes. It is suggested that, when given the opportunity to define for themselves roles where they can use their experience, knowledge and skills, senior nurses stand up to the challenge and consequently are more satisfied and their professional self-image improves.

Humans↗
PubMed1989

Trait-anxiety and sense of coherence: a longitudinal study.

A study of trait-anxiety and sense of coherence on a group of medical students over 18 mo. shows that, although both characteristics are rather stable over time, the measure of sense of coherence is more sensitive to stressors than A-trait and is better predicted by A-trait than the opposite.

Adolescent↗
PubMed1988

Nurses' autonomy and job satisfaction.

Nurses' autonomy is structurally limited by physicians' close supervision and control. A prolonged physicians' strike in Israel in 1983 created a special situation where for 3 months nurses had to provide primary health care services without physicians. This study, undertaken at the end of the strike, focuses on nurses' comparative perceptions of autonomy and job satisfaction with relation to role performance during the strike and in usual work conditions. Data were collected by means of a self-administered questionnaire. Sixty one percent (n = 1144) of the primary health care nurses in Israel responded. The strike situation increased the normal work load of the nurses, but it also gave many nurses the opportunity to initiate and carry out special programs in their clinics and communities. The majority of nurses report that in general they are satisfied with their work and perceive it as autonomous. The increase in routine as well as self-initiated activities was found to be positively but weakly correlated with an increase in job satisfaction and in the perception of role autonomy during the strike. These findings suggest that even after, or perhaps because of, being exposed to a significant change in contextual autonomy (working without physicians for a prolonged period of time) most Israeli primary care nurses do not appear to desire increased autonomy in the work place.

Adult↗
PubMed1988

Hospital patients' responses to dissatisfaction.

Hospitalized patients' responses to dissatisfaction in the provision of services are analysed as a function of their perceptions of the severity of the service failure and their relative social power. The analysis is based on the responses of 384 patients in a general hospital who reported experiencing at least one disturbing problem in the receipt of hospital services. Three binary dependent variables were constructed based on three dimensions of intensity of complaint behaviours: passive vs. active, non-directed vs. directed, non-formal vs. formal. The four possible response combinations created an ordinal scale of intensity of response. The set of independent variables included: perceived severity of the problem, general measures of satisfaction with services, structural po wer discrepancies, personal and situational resources of social power, and self perception of social power. The results of multivariate analyses indicate that the perceived severity of the problem best explains the intensity of response. Personal and situational social power resources and self perception of power add to the explanation. Structural power discrepancies, however, do not relate to the intensity of patients' responses to dissatisfaction.

Behavior↗
PubMed1988

Self-rated health among the elderly. A comparative analysis of health status measures, leisure activities and social contacts in age/sex groups.

A comparative analysis of self-rated health (SRH) by demographic characteristics, health status measures, leisure activities and social contacts was performed in four age/sex groups of elderly. The relative contribution of each group of variables to the explained variation in SRH was assessed using multiple regression analyses. A stratified sample drawn in an Israeli city led to 606 structured home interviews. The results show that: 1) for all groups the strongest correlates with SRH are health status measures, 2) for all groups the weakest correlates with SRH are demographic variables, 3) a significant relationship is found between SRH and age at immigration only for younger males, and 4) the explanatory power of social contacts and leisure activity variables varies significantly among the different groups. These factors explain relatively more of SRH in the younger age groups, and especially among younger males. Such findings suggest careful analyses of concepts in different socio-demographic groups for theoretical reasons and for purposes of planning health promotion community programs.

Aged↗
PubMed1987

Perceptions of medical school stressors: their relationship to age, year of study and trait anxiety.

It has been noted that medical school is a stressful social environment. This study proposes to determine domains of medical school stressors and to investigate to what extent the perceived stressfulness of these domains is explained by age, year of study, marital status, sex, and trait anxiety. Data were obtained by self-administered questionnaires filled out by 131 students in four classes of a six-year medical school. Four clusters of stressors were revealed by factor analysis: "off-time death," "incurable condition," "patient contact," and "medical practice demands." Marital status, sex, and year of study did not correlate with any of these stressor domains. Age was positively correlated with the perception of off-time death as stressful and negatively correlated with patient contact. Trait anxiety was directly correlated with the perceived stressfulness of patient contact and medical practice demands. No independent variable explained differences in perception of all four domains. It is suggested that there are some experiences, such as facing off-time death, that are so painful that repeated exposure to them augments, rather than decreases, the perception of their stressfulness.

Adult↗
PubMed1987

Perceived health damages during a physicians' strike in Israel.

This study analyzed the relationship between perceived need for health services and perceived damages to the health of the public due to curtailment of medical services during a physicians' strike. A model describing this relationship was hypothesized and tested in one city in Israel during the course of the strike. Results indicated that significant damage was perceived by the public as a result of the strike, a perception that persisted despite utilization of alternative care centers set up by the strikers. Furthermore, it was shown that financially weaker segments of the population were more likely to perceive damages to their health during a strike than were the more affluent segments of society.

Adolescent↗
PubMed1986

Identifying with the patient: an intensive programme for medical students.

An intensive programme called 'Hospitalization Week' was developed at the medical school of the Ben-Gurion University of the Negev in Israel. The main goal of the programme is to give first-year medical students an opportunity to understand the complexity of the needs and problems of hospitalized patients. To achieve this goal each student accompanies two patients from their arrival at the emergency room throughout their stay in the hospital. The goals and methods of the programme are described and evaluated.

Consumer Behavior↗
PubMed1985

Satisfaction with hospitalization: a comparative analysis of three types of services.

A study of patient's satisfaction with hospital services was undertaken. The purpose of the study was to explore whether and to what extent patients' satisfaction with three types of hospital services (medical, nursing and supportive) is differentially explained by patient's sociodemographic, psychosocial, situational and attitudinal characteristics. To achieve this, 476 patients were interviewed. The results of the analysis of their general satisfaction with hospitalization and a comparative analysis of satisfaction with the three types of services are presented. The best predictors of satisfaction with all three types of services (in order of their importance) are found to be: perceived improvement in health, size of social networks, satisfaction with organizations in the past, and age. The type of ward (medical vs surgical) is found to be a powerful predictor of satisfaction with physicians and nurses only. Ward effect is also interactive--improvement in one's health predicts significantly more satisfaction with medical services in medical wards than in surgical wards. The findings of this study suggest that when clients perceive that their main goal has been achieved (i.e. improvement in health), they tend to attach little importance to deficiencies in the process of achieving it (i.e. the provision of services).

Adolescent↗
PubMed1975

Antibacterial activity of human cervical mucus.

The antimicrobial property of human uterine cervical mucus was tested in three groups of women. Healthy women, using no contraception, women using an intrauterine device and women receiving hormonal treatment for contraception. Cervical mucus was taken on the 10th, 14th, 18th and 22nd day of the menstrual cycle. Cervical mucus had a strong inhibitory effect on the growth of Micrococcus lysodeicticus in all three groups. The strength of the inhibitory effect on the other microorganisms were in the following order: Staphylococcus albus, Staphylococcus aureus, Proteus mirabilis, Escherichia coli, Candida albicans, Streptococcus haemolyticus, Streptococcus faecalis. Use of an intrauterine device did not affect the antimicrobial effect of cervical mucus. The use of hormonal contraceptive canceled the antimicrobial effect on the series of microorganisms, with the exception of M. lysodeicticus. The maximum inhibitory effect occurred on the 14th day and declined toward the end of the menstrual cycle.

Adult↗
PubMedDate not supplied

Medical students' attitudes regarding the use of life-sustaining treatments for themselves and for elderly persons.

This study investigated students' wishes regarding the use of life-sustaining treatments (LST) in different health conditions compared with their evaluations of the wishes of elderly people, and with reports of a group of elderly people about themselves. Data were collected from two consecutive classes of first year medical students (n = 101), and a random sample of Israeli elderly aged 70+ (n = 987) who responded to fixed-choice questions regarding their will to live and wishes for three kinds of LST in a number of hypothetical illness conditions. The students were also asked to assess elderly's wishes. Students ranked the will to live of elderly persons significantly lower than their own. The elderly ranked their will to live significantly lower than did the students, but higher than the students assumed about them, indicating that although the will to live is weaker among older people, it is stronger than young persons believe. With regard to the use of LST, students believe that old people want less LST than themselves, but the elderly want even less LST than assumed by the students. The best predictors of students' wishes for themselves were fear of dying and religiosity. Fear of dying, the students' self-esteem and religiosity were the best predictors of their evaluations of the elderly's wishes. The results indicate that both the elderly and the students have a relatively strong will to live, but this desire is dependent on quality of life. The implications of this study for medical education are discussed.

Adolescent↗
PubMedDate not supplied

Health and well-being among elderly persons in Israel: the role of social class and immigration status.

OBJECTIVES: The purpose of the study was to compare three groups of Israeli elderly that differ in social class and immigration status on measures of health and psycho-social well-being, and assess the factors which explain their self-rated health (SRH). DESIGN: Based on a random sample of Israeli Jewish elderly (70 +), data were collected from 1138 persons during 1994 by structured home interviews. RESULTS: Social class differences among Israeli veterans were mainly found with regard to psycho-social characteristics. They were less conspicuous in health measures. New immigrants, who had a higher level of education than the veterans, but ranked lower on economic status, reported lower levels of health and psycho-social well-being than the veterans. Self-rated health among the immigrants was mainly explained by objective measures of health, and economic status, while in the higher social class of veterans it was also explained by education and psycho-social variables such as self-esteem and social support. CONCLUSIONS: These findings indicate that in contradiction to the convergence hypothesis, social class and immigration status affect health and well-being also in old age. It is suggested that the immigration crisis and factors related to the standard of living and health services in the countries of origin, as well as the lower social and economic status of the immigrants in Israel, outweigh their relative advantage in age and education in influencing their health and well-being. The differences found among the three groups in the factors that explain self-rated health have implications for the use of economic status as a relevant indicator of social class when considering health status among the elderly, and for the interpretation of SRH, as a global measure of health, in different socio-cultural groups.

Aged↗
PubMedDate not supplied

The Health Belief Model in the research of AIDS-related preventive behavior.

Studies of AIDS-related behavior change which used a systematic psychosocial conceptual model--The Health Belief Model (HBM)--are reviewed. Based on this, it is suggested for further studies: (1) to differentiate among different patterns of potential behavioral change--acceptance of new behaviors, change of existing behaviors, and maintenance of current behaviors; (2) to widen the conceptual model, (3) to use a similar model systematically in studies of different populations. A proposed application of an extended version of the HBM for the study of condom use among adolescents is presented.

Acquired Immunodeficiency Syndrome↗