PubMed · 10180271
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1998. What consumer backlash?. https://pubmed.ncbi.nlm.nih.gov/10180271/
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This paper commences by refining the psychometric characteristics of a quantitative instrument, which was developed to examine the caring attributes of an international sample of 1957 nurses working in 11 countries. Using factor analysis to support the construct validity, and removing weak items, the original 60 caring items were reduced to a 31 item global caring scale which revealed the sub-scales: 'caring communication'; 'caring involvement'; 'caring advocacy'; and 'learning to care'. The sub-scales were internally consistent and revealed generally high correlation coefficients. The subjects also responded to a scale, which was designed to measure degree of technological influence and provide a score for each respondent to reflect how highly they were influenced by technology in the work units of their hospital. The sample was then divided into three equal groups to reflect high, medium and low technological influence. The caring attribute scores then became the dependent variable by which the degree of technology was compared. The group with the lowest technological influence recorded the lowest mean score for caring while the group with the highest technological influence recorded the highest mean score for caring. A significant difference between the group with lowest and highest technological influence (F=6.84, p<0.001) was noted. This also applied to the 'caring communication' and 'caring involvement' sub-scales. For 'caring advocacy' the lowest technology group recorded the highest caring mean which was found to be significantly different to both mean scores for medium and highest technology groups (F=7.15, p<0.001). These results are discussed in the light of the international sample and suggestions for future research are raised.
This study focussed on time as a key resource within a hospital setting. The introduction of casemix-based funding, which changed the ways funds were obtained and distributed within the hospital, was accompanied by large cuts in the funds available to the hospital system. From the introduction of casemix-based funding to the conclusion of this study there was an increase of 20% in the number of cases through the operating suite. The increase was achieved, with a reduced budget, by intensifying work and increasing flexibility in the use of time. This approach to changing the use of time imposed considerable real 'costs' on staff, especially nurses, and created concerns about safety.