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PubMed2003

The importance of social and cultural factors to nursing status.

The objective of the authors was to examine nursing staff workload. The examination is based on the workload model of Robert Karasek and on the status integration theory of P. Gibbs and Walter T. Martin. As a means of examination, an open questionnaire consisting of 55 items and 76 variables was given to nurses working in different fields of health care, studying in higher education instead, or to persons with a degree in nursing (n = 465). The main concern of the authors was to attempt to identify the inconsistencies in nursing status which might come from limited decision-making freedom and high workplace requirements. In the process of statistical analysis of the data, considerable deviation was observed regarding some scales of the questionnaire. The authors emphasize that the reasons for the inconsistencies in nursing status might originate either from traditional cultural elements or from increased workload based on unclear competencies which are forced on the nurses.

Adult↗
PubMed2001

Emotional labor and nursing: an under-appreciated aspect of caring work.

This paper describes one component of the findings of a larger research study entitled 'Nurses' social construction of self: Implications for work with abused women'. One of the most consistent themes arising from that study involved nurses' views regarding the relevance of emotional engagement/detachment in pursuit of excellence in their practice. In this article this theme is examined in the light of work on emotional labor and the emotional work of nursing. Nurses' high degree of satisfaction in the emotional rewards of their work with clients is described and contrasted with their dissatisfaction in relation to nursing education and their views of the lack of valuing of nurses' work by others within the healthcare system. The importance of supporting them in relation to the emotional aspects of their work is explored.

Attitude of Health Personnel↗
PubMed2003

Hassles and uplifts associated with caring for people with cognitive impairment in community settings.

In this study we explored the hassles and uplifts (i.e. negative and positive emotional events) experienced by registered nurses, nursing assistants and personal carers working with people with cognitive impairment in community and residential healthcare settings in Brisbane, Queensland, Australia. The primary aim of the research was to explore what aspects of caring for cognitively impaired clients hassles nurses, what helps to relieve these hassles, what aspects of this work nurses find rewarding and what detracts from those rewards, as well as the intensity with which each of these aspects were felt. A questionnaire developed to explore hassles and uplifts at work was administered and 57 responses obtained. Results indicated that caring for the cognitively impaired client provides many uplifts for nurses and few hassles. However, the hassles that occurred were of high importance. This paper will be of interest to managers, nurses and carers in settings where there are people with cognitive impairment as well as scholars, who may find that assessing emotional hassles and uplifts provides additional insights into other areas of nursing.

Adaptation, Psychological↗
PubMed1999

Changes in the work and motivation of staff delivering home care services in Finland.

This article describes how the policy to emphasize noninstitutional care is reflected in home care service strategies and work characteristics as well as the work motivation of home care staff in Finland. The data were gathered through a questionnaire answered by 312 employees in home care services and 22 social welfare and primary health care administrators. The methods of analysis used were cross-tabulations, one-way analysis of variance, and regression analysis. According to the results, institutional care had been reduced too fast and home care services had not been developed sufficiently. Most of the staff reported that their work had changed considerably. Although their work had become more interesting and more independent, over one third of the employees felt that the pressure of work had become unbearable and their responsibility was too heavy. The views of the home care staff differed from those of the administrators regarding the change strategies that had been carried out. The majority of the staff were moderately or highly motivated. Thirty-four percent of the variance of work motivation was explained mainly by work characteristics. More attention should be paid to the development of home care services before institutional care is reduced. Training the staff and informing them about the planned reform should not be neglected.

Analysis of Variance↗
PubMed1999

Community health workers: examining the Helper Therapy principle.

A community approach to the integration of health and social services for low-income pregnant women is being addressed through Community Integrated Service System (CISS) initiatives of the Maternal Child Health Bureau. This particular CISS program model was designed to enable low-income mothers to function in a Community Health Worker (CHW) role providing social support for at-risk pregnant women. Using Riessman's notion of "helper therapy," the model was also developed to enhance the potential for CHWs to gain helper benefits. The purpose of this exploratory study was to describe perceived helper benefits and stressors associated with the CHW role and to examine the usefulness of an instrument developed to assess benefits and stressors. The study findings revealed that the majority of CHWs perceived helper benefits that included positive feelings about self, a sense of belonging, valuable work experience, and access to health information and skills through training or contact with program staff. Stressors such as feeling inadequate to help, however, were associated with the helper role for some CHWs. Preliminary analysis of the Helper's Perception Measure indicated that it may be an effective measure and should be tested with a larger sample of CHWs.

Adult↗
PubMed1998

Work activities of clinician-educators.

In order to make meaningful scholarly contributions, clinician-educators need protected time. Forty-one clinician-educators at the University of Washington recorded their work activities in 30-minute intervals for 2 weeks. The average work week was 58.7 hours (SD = 13.8). The time devoted to scholarship, 7.6 hours (13%), was significantly less than the 20% designated for scholarship in the clinician-educator job description (p < .001); 42% of scholarly work occurred outside the regular work week. At a time when many schools rely on clinician-educators to sustain their clinical and teaching missions, schools should ensure that faculty have adequate time and resources to meet scholarly expectations for promotion.

Adult↗
PubMedDate not supplied

Two models of restorative nursing care in the nursing home: designated versus integrated restorative nursing assistants.

A 6-month clinical trial was conducted to evaluate two models of restorative nursing care designed to improve mobility in nursing home residents. The models were compared on number of residents enrolled, documentation of nursing assistant (NA) compliance, and nursing staff satisfaction. The designated model, which relied on one specially trained NA to perform restorative activities on the unit, resulted in higher rates of enrollment, compliance, and staff satisfaction compared with the integrated model, which relied on regular staff NAs who were trained to incorporate restorative activities into their daily routines.

Activities of Daily Living↗
PubMedDate not supplied

Professionalism in nursing behaviors of nurse practitioners.

Little research on the level of professionalism of nurse practitioners has been published to date. These nurses are expected to practice relatively autonomously in delivering client care and therefore must monitor their own levels of professionalism. At a national conference, 502 nurse practitioners completed the Professionalism in Nursing Behaviors Inventory. Participants represented all of the states and the most common specialties of nurse practitioners. Nearly 68 per cent had been practitioners less than 5 years and were primarily employed in physicians' offices. The majority had received their master's degrees from schools with nurse practitioner curricula, and 8 per cent held doctorates. More than one half of the practitioners had written a research proposal or participated in a project within the past 2 years. In terms of autonomy, nearly 50 per cent of the nurses had written their own job descriptions. Maintaining certification motivated them to engage in some professionalism behaviors. Results indicated these nurse practitioners had high levels of professionalism. J Prof Nurs 17:203-210, 2001.

Adult↗
PubMedDate not supplied

The relationships among turnover intentions, professional commitment, and job satisfaction of hospital nurses.

This study investigated the relationships among turnover intentions, professional commitment, and job satisfaction of registered nurses. A structured, self-administered questionnaire, including the Professional Commitment Scale, job satisfaction, turnover intentions, and demographic data, was distributed to 2,550 registered nurses. A total of 2,197 subjects completed the questionnaires with an 86.2 per cent response rate. All of the subjects were women. The mean age was 28.56 years. Seventy-two per cent of respondents had graduated with an associate's degree and 59 per cent were unmarried. There was a positive correlation between job satisfaction and professional commitment, intention to leave the organization, and between intention to leave the profession. The negative correlation was significant between professional commitment and turnover intentions, and between job satisfaction and turnover intentions. The discriminant analysis showed that 38.4 per cent of job satisfaction was correctly classified in predicting intention to leave the organization, and 30.5 per cent in predicting the intention to leave the profession. Thirty per cent of professional commitment was correctly classified in predicting intention to leave the organization, and 39.7 per cent in predicting the intention to leave the profession. The study suggests that there were different moderators that affect different turnover intentions of staff nurses.

Adolescent↗
PubMed2006

[How do community-based mental health staff in Austria perceive their job? -- a qualitative study].

OBJECTIVE: The aim of this study was to explore, using a simple qualitative design, how community mental health staff in Austria perceive their job. METHOD: 195 community-based mental health professionals answered seven open questions on how they perceive their job. The main areas covered were the most important tasks of the job, skills necessary to perform these tasks, as well as positive and negative aspects of the job. Answers were subjected to thematic content analysis. RESULTS: For most professionals, contact with clients and team colleagues were the major rewards of the job. Aspects experienced as stressful were the clients' illness, role ambiguity, team conflicts and lack of time. Necessary skills many respondents did not feel competent in were specialised knowledge and psychosocial skills. CONCLUSIONS: It might be useful to revise existing forms of collaboration within multiprofessional teams. The responsibility for difficult patients may be shared by several members of the team, who should contribute their specific knowledge. Training should be tailored towards the needs of the different professional groups and focus on those skills that are required in community mental health care.

Attitude of Health Personnel↗
PubMed1991

Cancer mortality in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

BACKGROUND: In both animal and epidemiologic studies, exposure to dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin, or TCDD) has been associated with an increased risk of cancer. METHODS: We conducted a retrospective cohort study of mortality among the 5172 workers at 12 plants in the United States that produced chemicals contaminated with TCDD. Occupational exposure was documented by reviewing job descriptions and by measuring TCDD in serum from a sample of 253 workers. Causes of death were taken from death certificates. RESULTS: Mortality from several cancers previously associated with TCDD (stomach, liver, and nasal cancers, Hodgkin's disease, and non-Hodgkin's lymphoma) was not significantly elevated in this cohort. Mortality from soft-tissue sarcoma was increased, but not significantly (4 deaths; standardized mortality ratio [SMR], 338; 95 percent confidence interval, 92 to 865). In the subcohort of 1520 workers with greater than or equal to 1 year of exposure and greater than or equal to 20 years of latency, however, mortality was significantly increased for soft-tissue sarcoma (3 deaths; SMR, 922; 95 percent confidence interval, 190 to 2695) and for cancers of the respiratory system (SMR, 142; 95 percent confidence interval, 103 to 192). Mortality from all cancers combined was slightly but significantly elevated in the overall cohort (SMR, 115; 95 percent confidence interval, 102 to 130) and was higher in the subcohort with greater than or equal to 1 year of exposure and greater than or equal to 20 years of latency (SMR, 146; 95 percent confidence interval, 121 to 176). CONCLUSIONS: This study of mortality among workers with occupational exposure to TCDD does not confirm the high relative risks reported for many cancers in previous studies. Conclusions about an increase in the risk of soft-tissue sarcoma are limited by small numbers and misclassification on death certificates. Excess mortality from all cancers combined, cancers of the respiratory tract, and soft-tissue sarcoma may result from exposure to TCDD, although we cannot exclude the possible contribution of factors such as smoking and occupational exposure to other chemicals.

Bronchial Neoplasms↗
PubMed2000

Community and consumer participation in Australian health services--an overview of organisational commitment and participation processes.

This article briefly describes recent initiatives to improve consumer participation in health services that have led to the establishment of the National Resource Centre for Consumer Participation in Health. The results of a component of the needs assessment undertaken by the newly established Centre are presented. They provide a 'snapshot' of the types of feedback and participation processes mainly being utilised by Australian health services at the different levels of seeking information, information sharing and consultation, partnership, delegated power and consumer control. They also allow identification of the organisational commitment made by Australian health services to support a more coordinated approach to community and consumer feedback and participation at different levels of health services such as particular emphasis on determining the presence of community and consumer participation in key organisational statements, specific consumer policies and plans, identifiable leadership, inclusion into job descriptions, allocation of resources, and staff development and consumer training. Discussion centres around four key observations and some of the key perceived external barriers.

Australia↗
PubMed2001

Queensland public sector nurse executives: job satisfaction and career opportunities.

During the past decade, economic and political forces have caused radical transformations in health care systems resulting in changed circumstances within which nursing executives must function. This paper provides an understanding of nursing executives' roles and responsibilities and the impact changes in the health industry have had on their careers. One hundred and forty-seven (52%) of the 281 nursing executives employed in the Queensland Public Health Sector completed a postal self-administered survey. The findings of this study demonstrate their role has expanded to include not only nursing administration, but also responsibility for financial, human resources, strategic and resource management, staff development and quality improvement. The impact of these role changes has affected the health and well-being of nursing executives, with nearly half reporting increased stress, frustration and irritation. Their workload has increased and some reported deterioration in their health, specifically, exhaustion, fatigue and insomnia. Respondents reported they now have less time to spend with families and friends, which has had a negative impact on family relationships. Overall, nursing executives were satisfied with their current position, the work itself and their relationships with their co-workers, but dissatisfied with organisational aspects, especially the quality of mentorship and opportunities for promotion.

Adult↗
PubMedDate not supplied

Symptoms and pulmonary function in western red cedar workers related to duration of employment and dust exposure.

Measurements of total dust concentration were made in a western red cedar sawmill that employed 701 workers. Both area sampling and personal sampling of total dust were done over an 8-hr shift corresponding to job descriptions and locations to assign each worker an exposure level. A total of 652 (93%) of the workers completed a respiratory-occupational questionnaire and performed spirometry, of whom 334 were assigned an exposure level. Dust exposure ranged from undetectable to 6.0 mg/m3 with a median exposure level of 0.2 mg/m3. Only 10% of the workers with an assigned exposure level were exposed to more than 1.0 mg/m3. Work-related asthma, defined as symptoms of asthma which improved on days off work, was reported by 52 workers (8.0%) and was more prevalent after 10 or more yr of employment. Chronic cough, dyspnea, persistent wheeze, and physician-diagnosed asthma were unrelated to either work duration or exposure. Levels of forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1.0) were lower with dust concentrations greater than 2.0 mg/m3, controlling for age and smoking; maximum mid-expiratory flow rate (FEF25-75%) and FEV1.0/FVC were unrelated to dust exposure concentration. Work-related symptoms of eye irritation were seen more commonly with exposure to dust concentrations of 3.0 mg/m3 or more. It is concluded that symptoms of work-related asthma in red cedar workers are more common after 10 yr of exposure, and that levels of pulmonary function are lower with higher wood dust exposures.

Adult↗