[Shift work and its effects. Mother, homemaker and caregiver--a problem?].
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Home health care has undergone startling changes in the past decade and, in the process, become a strategically important ingredient of health care delivery. However, the question remains whether home health care organizations can deliver the benefits anticipated for integrated care delivery systems. The answer to this question depends to a great extent on whether home health care organizations build vibrant, visionary leadership capable of transforming organizations and motivating staff to deliver high quality and low cost services. This paper examines a case study of transformational leadership as it relates to the quality of working life for nurses, homemakers, and staff. The findings indicate that leader behaviour is strongly associated with homemakers', and to a lesser extent staff members', job satisfaction, job involvement, and propensity to remain with the organization. These job attitudes have been shown to be related to higher job performance. The implications for leadership in home health agencies are discussed.
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This paper reviewed the outcome for people with severe multiple sclerosis admitted to an inpatient rehabilitation center. Data was gathered on admission, at discharge, and at three months postdischarge. Over a four-year period 28 patients received care comprising a total of 33 patient admissions. Seventy-three percent of the cases were women, ages 23 to 69. Sixty-one percent were admitted from acute care medical services. On admission, 18% ambulated independently, by discharge 76% could do so. Fifteen cases changed from dependent to independent status in stair climbing by discharge. Less dramatic improvements were noted for activities of daily living categories. In general, individuals who stayed at the center longer were initially more dependent and made greater relative gains. More patients with multiple admissions were married, and they tended either to be employed or to have at least partial homemaking responsibilities.
The Americans with Disabilities Act will change the employment practices of all home care agencies by prohibiting employers from discriminating against individuals on the basis of a disability. While the act requires an employer to reasonably accommodate all applicants and employees must be reasonably accommodated, home care agencies face a particular challenge in employing and accommodating individuals with a disability who are homemaker-home health aides, nurses, or therapists.
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We evaluated the role of occupational factors on the prevalence of self-reported asthma, chronic bronchitis, and asthma-like respiratory symptoms among women >= 55 yr. Occupational history, smoking, and respiratory conditions were collected through an interviewer-administered questionnaire from 1,226 women. Lung function data from 820 subjects were used for group "validation" of the outcome variables. Significant associations were observed between the respiratory conditions and occupational groupings based on the longest occupation held. Artists, writers, decorators, and photographers (odds ratio [OR] = 3.1), and women in service occupations (OR = 2.4) had a significantly increased risk of asthma. The odds of asthma-like symptoms was significantly elevated among nurses and other nonphysician health workers (OR = 2.9), social workers (OR = 2.9), and homemakers (OR = 2.4). Exposure to dusts, gas, vapors, fumes, or sensitizers was associated with a significantly increased odds of asthma (OR = 1.8) and with a marginally significant increased odds of asthma-like symptoms (OR = 1.4). Smoking accounted for a large proportion of asthma and asthma-like conditions in this population (population attributable risk [PAR] = 40.5% and 35.0%, respectively); employment in occupations with a high probability of exposures to dusts, gas, vapors, fumes, or sensitizers also contributed significantly to the burden of asthma (PAR = 15.1 to 20.0%) and asthma-like symptoms (PAR = 7.5 to 10.2%).
Competitive bidding is a relatively new strategy for setting rates and choosing providers for public medical care programs. In this article, the experience in competitive bidding by home health care providers and homemaker agencies in the National Long-Term Care Channeling Demonstration is described. Particular attention is paid to contrasting approaches that select a single winning bidder with those that select multiple winning bidders for the same service. Results are discussed with respect to bid prices, characteristics of winning bidders, administrative demands, and service delivery.
The factors affecting choice of destination of U.K. internal migrants are analyzed using Labour Force Survey data. "A logit analysis of destination choice indicates that job movers are attracted to areas with high wages but are not affected by high house prices in such areas. In contrast, active non-job movers are deterred from areas of high house prices. Regional house price differences do not influence the destination choice of homemakers or the terminally sick but they do influence the destination choice of retirees. All groups prefer to travel the least distance when moving."
Early childhood programs are usually viewed as a service that promotes children's development. In addition, these programs often serve a broader purpose of enabling mothers with young children to join the paid labor force. Therefore, government policies relating to the provision and use of child care programs reflect such economic and social factors as the demand for women workers in the labor market; expectations of the relationship among government, family, and the private market; and the value placed on maintaining traditional family structures with a breadwinner, a homemaker, and children. This article examines the evolution of policies toward maternal employment and child care provision in the United States, Sweden, and the Netherlands--three countries that differ sharply in the extent of government involvement in child and family policy, and in the emphasis government leaders place on promoting or discouraging maternal employment. This analysis shows that child care policy is best viewed as but one element among many that make it more or less likely that mothers of young children will be employed and will need to rely on early childhood programs to care for their youngsters. The design of tax codes, labor laws, parental leave policies, and cash assistance programs combines with child care policies to shape women's choices about employment.
OBJECTIVE: Purposes of this study are: (1) to evaluate attitudes, beliefs and experiences towards dementia among relatives of Italian familial cases; (2) to perform a cross-cultural comparison between Italian and American samples; (3) to identify predictors of intentions to undergo hypothetical genetic testing. METHODS: Participants were 134 relatives of patients affected by familial forms of dementia. We administered tests measuring health psychological styles, social variables, illness perceptions, intentions regarding genetic testing, and perceptions of the pros and cons of genetic testing. RESULTS: Respondents had a poor Alzheimer's disease knowledge and a low perceived dementia threat. When compared to Americans, Italians reported greater willingness to undergo genetic testing and perceived a different subset of benefits and risks. The strongest predictors of test intention were decisional balance, homemaker status and two beliefs concerning dementia causes. CONCLUSIONS: Italians had a poor knowledge of the disease and a low awareness of personal risk of developing dementia. As compared to Americans, they expressed higher intentions to undergo genetic testing and they have a different perception of benefits and risks. PRACTICE IMPLICATIONS: Understanding of cultural differences in knowledge, attitudes and perception of the disease is important to design optimal health services and education programs for dementia.
This research combined social psychological theory testing with the practical concern of gathering information useful for the social marketing of active living. The study examined variables related to the intentions and behaviour of rural homemakers with respect to moderate physical activity, using the theory of planned behaviour as a framework. Rural homemakers (n = 630) in four Alberta communities were surveyed by telephone concerning their attitudes, self-efficacy, perceived social support, intentions, and present activity behaviour. Intentions, self-efficacy, and various beliefs related to barriers and social support discriminated active from inactive homemakers. For active homemakers (n = 473), attitude, perceived social support, and self-efficacy predicted future intentions. For inactive homemakers (n = 157), only attitude and self-efficacy predicted intentions. The practical implications of the findings are discussed, in terms of fostering enjoyable experiences, reducing barriers, and providing supportive environments.
This study queried 508 persons diagnosed with multiple sclerosis (MS) regarding what conditions made performing their work or tasks 'difficult' and 'easier'. The subjects represented four groups: employed outside the home, homemakers, unemployed, and retired. Their written responses were content analysed. Conditions reported to impede the performance of work and tasks were related to three categories: physical restrictions, person-environment interaction, and MS-related symptoms. Conditions reported to enhance the performance of work and tasks were related to five categories: assistive devices, human support, personal attributes, health promotion behaviors, and person-environment adjustment. Study findings provide useful information for families, health service providers and employers of persons with MS in assisting them enhance their ability to perform work or tasks.