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The role of personal and social resources in preventing adverse health outcomes in employees of uniformed professions.

OBJECTIVES: The purpose of the study was to investigate the impact of experienced job stress and personal and social resources (e.g., sense of coherence, self-esteem, self-efficacy, dispositional optimism and social support) on health outcomes in employees of uniformed professions. MATERIALS AND METHODS: A sample of 330 men representing uniformed professions (70 policemen, 70 firefighters, 60 prison officers, 70 security guards and 60 city guards) participated in the study. The mean age was 33.99 (SD = 6.44). The Perceived Job Stress Questionnaire, the Orientation to Life Questionnaire (SOC-29), Rosenberg's Self-Esteem Scale, the Generalized Self-Efficacy Scale, the Life Orientation Test, the Social Support Scale, and the General Health Questionnaire (GHQ-28) were used in the study. RESULTS: The results of the study confirmed a significant role of personal and social resources and perceived social support in particular in reducing job stress and preventing negative health outcomes in the study group of workers of uniformed professions. CONCLUSION: Enhancing personal and social resources should be considered in preventive programs aimed at reducing stress in the workplace and protecting health of workers of uniformed professions.

Adult↗

Breezing up--an interdisciplinary health professions course for high school juniors and seniors and college freshmen.

Recruiting students into the health professions is an ever growing problem as young people are faced with many attractive options for career choices. At the same time, a rapidly growing elderly population will require more health professionals to maintain the health system. To address this recruitment issue an interdisciplinary health professions course delivered to high schools and college campuses in North Dakota via the Internet was developed at the University of North Dakota (UND) School of Medicine and Health Sciences (SMHS). The participating high schools embedded the course in the health professions curriculum and students were given the option of receiving college credit. The course features presentations by professionals representing 16 different health professions and were developed using a new software called Macromedia Breeze that allows for easy recording of PowerPoint audio presentations and imputing video content into the presentation. Blackboard was utilized for course management.

Career Choice↗

[Concurrent development trends in the international nursing profession].

The modern nursing profession, established by Florence Nightingale, is influenced by myriad factors that include politics, legislation, societal priorities, advances in medical and computer technologies, and changes in the economic and the medical environments. Nursing profession development in Taiwan is further influenced by western culture through overseas study by scholars and the frequent holding of academic activities. Nursing education, administration and standards of practice in Taiwan are similar to that in western countries. In fact, we can anticipate that the gap that still remains between Taiwan and international nursing development will close during the course of the 21st century. The purpose of this article is to analyze the vision and development of ICN and ANA, the two nursing organizations responsible for keeping Taiwan in step with international nursing profession trends, to help the readers understand concurrent developments in the international nursing profession.

Education, Nursing↗

Nurses' health, age and the wish to leave the profession--findings from the European NEXT-Study.

BACKGROUND AND OBJECTIVES: In many industrialised countries the number of workers with low health is expected to increase in the nursing profession. This will have implications for occupational health work in health care. The European NEXT-Study (www. next-study. net, funded by EU) investigates working conditions of nurses in ten European countries and provides the opportunity to evaluate the role of health with respect to age and the consideration of leaving nursing. METHODS: 26,263 female registered nurses from Belgium, Germany, Finland, France, England, Italy, Netherlands, Poland and Slovakia were eligible for analysis. RESULTS: In most countries, older nurses considered leaving the profession more frequently than younger nurses. 'Health' was--next to 'professional opportunities' and 'work organisational factors'--strongly associated with the consideration of leaving nursing. However, more than half of all nurses with low health wanted to remain in the profession. This group reported rather positive psychosocial working conditions--but also the highest fear for unemployment. CONCLUSIONS: The findings indicate that 'the nurse with low health' is reality in many health care settings. Both positive supporting working conditions but also lack of occupational alternatives and fear of unemployment may contribute to this. Current economic, political and demographic trends implicate that the number of active nurses with low health will increase. Occupational health surveillance will be challenged by this. But NEXT findings implicate that prevention also will have to regard work organisational factors if the aim is to sustain nurses' health and to enable nurses to remain healthy in their profession until retirement age.

Adolescent↗

Occupational attainment in selected allied health professions.

This study examined the factors in the process of occupational attainment for a single group, the allied health professions. A 14-variable causal model was developed to explain postcollege attainment of a job in one of five allied health professions: medical dietetics, medical social work, occupational therapy, physical therapy, or speech therapy. The sample was composed of 272 college students who responded to the Cooperative Institutional Research Program surveys of 1971 and 1980. Analysis indicated that several variables, including academic integration, having a science major, and being oriented to service, had significant direct effects on attainment in the allied health professions. Knowledge of the personal characteristics and achievements of those who successfully enter jobs in the allied health professions may allow informed student and faculty choices and reduce recruitment and retention problems in schools of allied health.

Allied Health Occupations↗

Accreditation in the allied health professions.

Specialized accreditation in the allied health professions can and will fulfill its basic purpose if its efforts are guided by the principle that evaluation must place its emphasis on the outcome of the educational process, no matter how difficult it may be to assess. This requires the commitment and cooperation of both the accrediting body and the institution and program under review. Accreditation is a vitally important and valuable system in higher education in general, and the allied health professions are no exception. If the system is to be effective, however, every temptation must be resisted by all involved parties to debase it by using it for self-serving purposes. A recognized accrediting agency not only has the right, but indeed the responsibility, to ensure that the graduates of a program under review possess the prerequisite knowledge and skills essential for entrance into a given allied health profession. In cases where that minimal standard is not attained, the program should be required to remove those deficiencies in a timely manner or, if sufficiently serious, have its accreditation withheld or withdrawn. There should be no exceptions to this course of action. Every standard or essential adopted should be defensible on sound educational grounds, and every program should be evaluated according to whether it is in compliance. Accrediting bodies must direct their efforts toward evaluating educational quality. They must respect institutional rights and responsibilities and not even attempt to prescribe what will be taught or by whom, or who will administer a given program. The entire accreditation process must account for institutional diversity and should not discourage experimentation, innovation, or modernization. However, the standards and essentials that are ultimately adopted must be applied uniformly and fairly and not in an arbitrary or capricious manner. Hence, it is imperative that the standards and essentials be stated in such a way that they are clear and understandable. For those programs in which an enhancement or upgrading is deemed necessary for one or more aspects of the educational experience, it would be a genuine service to the institution and its consistuency if the accrediting agency could offer sound advice and suggestions for remedying those factors that may be causing or contributing to the observed deficiencies in the educational outcome. Any responsible institution would welcome such an approach, and the outcome should be an upgrading of the program under review with a concomitant enhancement of the profession involved.(ABSTRACT TRUNCATED AT 400 WORDS)

Accreditation↗

The social position and internal organization of the medical profession in the Third World: the case of Singapore.

This paper probes two aspects of the medical profession in Singapore: its structure and its social position. The first section reviews the relevant concepts concerning the structure and the social position of the professions that may be applied to medicine in Singapore. The second section looks into the structure of the medical profession in Singapore from an historical perspective. The third section deals with the internal organization of the medical profession. The fourth section focuses on its social position. The paper concludes with a summary of the main points and a brief comparison of the situation in Singapore with that in other countries.

Clinical Medicine↗

The changing character of the medical profession: a theoretical overview.

Technological advances in medicine have greatly enhanced the ability of physicians to treat disease and disability, but, at the same time, changes in the organization and management of health care services in the United States have imposed constraints on their autonomy. How have these changes--medical advancement and professional decline--affected the theoretical concept of the medical profession? Challenging the prevailing model of professional dominance, the concepts of deprofessionalization, corporatization, and proletarianization emphasize the effects of recent social and economic developments on the changing status of the medical profession. There is evidence, however, that what the proponents of these concepts perceive as the profession's response to external forces are, in fact, the unanticipated consequences of the profession's campaign for autonomy.

Europe↗

Leadership in a clinical profession.

The contributions of residency training programs to pharmacy's development into a clinical profession are described. Residency programs supply institutional pharmacy with mature, highly skilled clinical and managerial practitioners, and ASHP's accreditation process ensures the programs' quality. Residents develop values, philosophy, and vision that breed innovation and advancement of the profession. As pharmacy departments strive to meet the standards set by the accreditation program, the level of services rises; subsequently, higher standards are established and practice advances accordingly. Future residency training for community practice and the movement toward the Pharm.D. as the sole entry-level degree for practitioners must be evaluated in terms of effect on patient care and on pharmacy school and hospital resources. Planning for future pharmacy education and manpower needs should involve the whole profession, but the needs of community and hospital pharmacy may differ. A goal for the future is entry-level residency training for all hospital pharmacists, with the Pharm.D. degree as a prerequisite. Such a residency program would focus on clinical practice and provide experience in all pharmaceutical services and the overall management of a pharmacy department; it would be a prerequisite for advanced specialized residency programs. Managers of departments providing clinical services will need an entry-level clinical residency followed by a specialized residency in administration. In their 25-year history, residency programs have contributed greatly to the profession. Efforts to develop quality residency training sites and promote them to pharmacy graduates should continue.

Accreditation↗

The future of the health education profession: implications for preparation and practice.

The health education profession has come to a critical point in its development. If health education is to fulfill its promise as a worthwhile strategy to improve health, the specific competencies of health education specialists and, concomitantly, the educational preparation that they need must be clearly defined. In the past, no clear definition was possible because of the diversity of preparatory programs, the absence of commonly accepted accreditation standards, educators, inconsistent employment requirements, inadequate manpower data, and poor mechanisms for quality assurance. Health educators are examining the various forms of credentialing--accreditation, licensure, and certification--with a view to their use as a means of strengthening the profession's preparation and practice standards. A Role Delineation Project undertaken by the National Center for Health Education, San Francisco, under a contract with the Bureau of Health Professions of the Health Resources Administration, has been completed. Activities that will be carried out subsequent to role delineation are expected to enable the health profession to resolve systematically fundamental issues in respect to manpower standards.

Credentialing↗

[Spinal diseases in the nursing profession--a cross-sectional study].

A cross-sectional study on the profession-specific prevalence rates of back pain symptoms was conducted including N = 3332 nurses as the exposed group and N = 1720 office clerks as a control group. Only participants who had never changed from an exposed to an unexposed profession or vice versa, were included for the results presented here. Severity of symptoms was assessed, dividing into low back pain on the one hand, and lumbago-sciatica/sciatica on the other; frequency of pain episodes was measured using lifetime- and point-prevalence, in all these four combinations of severity and frequency the prevalence rates among nurses were clearly and significantly higher. Multivariate analyses revealed that profession is the most important risk factor among many others that were tested. Estimation of the prevalence rate for the heaviest symptom, the point-prevalence of lumbago-sciatica/sciatica, showed that about 4 out of 5 cases among nursing staff can be attributed to their profession. On the background of this high attributable risk the acceptance rate for LBP diseases of suspected occupational origin among nursing staff by statutory occupational health insurance bodies appears much too low.

Adult↗

Professional behavior and the optometric profession.

BACKGROUND: Optometry has been recognized as a profession within the United States, both legally and socially, for the better part of the past century. Historically, there have been expectations placed on the behavior of individuals within the professions that would not generally be placed on the general business person. These expectations have existed to protect the clients or patients of professionals from incompetence, uncaring, or selfish excesses. Behavior of an exceptional nature is expected of professionals because of the unusual vulnerability of clients and patients to unprofessional conduct. Doctors of Optometry, as members of the optometric profession, have professional standards placed on their behavior. METHODS: A search of the literature was conducted to discover the historical and current bases for setting standards for professional behavior. RESULTS: The literature search reinforces the rationale for the optometric professions long-standing practice of setting standards for professional conduct. CONCLUSIONS: Individual Doctors of Optometry will find that the trust resulting from high standards of professional conduct bring many positive benefits to the doctor-patient relationship. The rewards that come to both the doctor and patient from these trusting relationships make the practice of optometry truly an exceptional experience.

Behavior↗

A longitudinal study of the attitudes of the medical profession towards competition and advertising.

AIMS: To measure changes in the attitudes of medical practitioners toward the move from a collegial to a more competitive orientation of the medical profession and, in particular, toward the role of advertising. METHOD: In the years 1985, 1988 and 1994, self-completion questionnaires were mailed to samples of medical practitioners. The questionnaires for each year were identical, containing forty Likert scales with questions relating to advertising, competition and commercial behaviour. Similar data were also gathered from members of the dental, veterinary, legal and accounting professions. RESULTS: Over the three studies there has been an undramatic but steady movement towards acceptance of a competitive orientation in general and towards acceptance of informative advertising in particular. There remains substantial reservation towards the use of persuasive advertising. Although patients are viewed as being more demanding than in past times, practitioners still expect their relationships with patients to be long lasting. CONCLUSION: The results suggest that acceptance of the move towards a more competitively oriented profession will continue. The results also suggest that in view of the kinds of advertising that are now used by medical practices, and of the change in attitudes that has occurred, control of advertising might cease to be a concern to the profession.

Advertising↗

Professional identity: key to the future of the osteopathic medical profession in the United States.

The authors have been professionally and personally associated with osteopathic medicine since 1972. During this period, they have observed, from several perspectives, the processes by which trainees and osteopathic physicians inculcate their unique professional identity. Yet, increasingly, the philosophic and practical components that have historically defined osteopathic medicine as a distinctive approach to medical practice are rapidly eroding. Powerful forces associated with such things as professional prestige, public acceptance, professional collaboration with allopathic physicians, as well as changing trainee expectations, are rapidly reshaping the osteopathic medical profession. The degree to which osteopathic medical practitioners embrace the philosophic and clinical components unique to their profession will determine whether the profession retains its identity as a separate medical entity. If the current de-emphasis of these identifying characteristics continues, little more than a name will distinguish osteopathic medicine from the allopathic medical profession.

Attitude of Health Personnel↗

Politicization of health professions regulation.

Professions evolve through five stages of development--ideology, implementation, evaluation, incorporation, and maturation. Further, the development and implementation of health professions regulation is fraught with political overtones. This article provides an analysis of regulation in advanced practice nursing as it relates to the other health professions and presents efforts to reform health professions regulation using strategies offered by major philanthropic foundations.

Credentialing↗

Professing ethically. On the place of ethics in defining medicine.

Medicine, despite technological advances and societal changes, remains essentially what it has always been, a profession rather than a trade, with its own ends, means, and intrinsic norms of conduct. Being a professional is an ethical matter, entailing devotion to a way of life, in the service of others and of some higher good. The medical profession is devoted to the naturally given end of health and assists the immanent powers of self-healing. It serves the needs as it treats the infirmities of the sick, sensitive to their vulnerability, shame, and exposure and mindful of the meaning of the delicate tension between bodily wholeness and necessary decay. These special characteristics imply specific and inherently medical obligations, both of omission and commission, as well as an appropriately reverential stance of the physician before his chosen profession.

Ethics, Medical↗

Informatics education and the professions.

This Perspectives is the outgrowth of work begun at Maryland under the Informatics Task Force and its national and international advisory groups. In a theoretical discussion of what information science can contribute to the health professions, the authors address questions of definition and describe application and knowledge models for the emerging profession of informatics. A review of existing programs includes curriculum models and provides details on informatics programs emphasizing information and computer science; programs emphasizing the health sciences; and specialized informatics programs (undergraduate, master, and doctoral level). Focus is placed on models for informatics program development. The authors hope to build upon the database reported on in this article, and thereby foster the informatics education for the professions.

Canada↗

Assessing continuing education needs of five allied health professions in rural California.

Meeting the needs of rural health care professionals for continuing education remains a challenge for health planners. An assessment of these needs is the focus of this survey of rural practitioners. A continuing education needs survey of five allied health professions in an agricultural region of California was conducted. Variables selected related to professional education and retention and included paramedics, physical therapists, pharmacists, clinical psychologists, and medical technologists. Results indicated a strong need for high quality, moderate cost, locally offered continuing education seminars. Access to professional literature searches was also regarded as important. Several of the selected health profession groups were concerned about maintaining licensure; most intended to remain in their professions for at least six to ten years. These survey findings clearly suggest a need for centrally coordinated continuing education opportunities for allied health personnel in rural service delivery areas.

Allied Health Personnel↗