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PubMed1992

Two key factors that belong in a macroergonomic analysis of electronic monitoring: Employee perceptions of fairness and the climate of organizational trust or distrust.

Two microergonomic elements not usually discussed in treatments of electronic monitoring of VDT clerical work are employee perceptions of fairness (in work standards and measurement process) and the overall climate of employee trust in management. The author's field studies found these factors serving as major mitigating or intensifying elements in the stress that clerical employees can experience when they perform intensive heavy-duty VDT applications, and as central variables in distinguishing beneficial from harmful monitoring programmes. A case study involving change in supervisory monitoring policies for 200 customer service agents at one of Federal Express Corporation's telecommunication call centres in the USA in 1985-86 demonstrates how a Unit Head at a non-union company long known for its positive employee relations policies installed monitoring practices that the call agents considered unfair and a breach of the company's traditional climate of employee-employer trust. Employee protests, when communicated to top management, led to discarding the unilaterally-instituted and quantity-oriented monitoring policy and replacing it with a consensually-developed supervisory monitoring system balancing quality and quantity elements in a way that satisfied both employees and management. The present system of supervisory monitoring of customer service work at Federal Express (1991) enjoys broad employee support, suggesting that a fair system of monitoring, applied in an environment of earned trust between employees and employer, can meet critical productivity and quality interests of employers in clerical VDT work without creating harmful employee stress and discontent. It also suggests that empirical investigation of the fairness and trust factors represents an important and practical area of research in a macroergonomic analysis of employee monitoring programs and impacts.

Journal Article↗

PubMed1992

Electronic performance monitoring: A review of research issues.

The research literature on electronic performance monitoring (EPM) has attributed different outcomes to monitoring, including improved worker performance, reduced job satisfaction and increased job stress. A variety of research methods (case study, cross-sectional and laboratory designs) has been utilized to study these effects of EPM. In this paper, these methods are reviewed, and the results of several studies are summarized. The existing literature often does not clearly specify what is meant by monitoring. Future research on outcomes associated with monitoring should describe carefully the type of monitoring technology and system used - who does the monitoring, when it is done, and what aspect of performance is monitored. It is further suggested that future EPM research should describe in greater detail the work environment, the job tasks, and the organizational climate of monitored and non-monitored workers to determine whether these groups are comparable with respect to these factors, and that observed outcomes are not misattributed to EPM.

Journal Article↗

PubMed1993

Relationship between self-monitoring of diet and exercise change and subsequent risk factor changes in children and adults.

Self-monitoring is often used in health behaviour change programs; but it is not known to what extent self-monitoring data are valid and useful in predicting changes in cardiovascular disease (CVD) risk. Subjects included 72 Anglo adults, 68 Anglo children, 80 Mexican-American adults and 94 Mexican-American children. Subjects were families with fifth and sixth grade children who participated in an 18-session family-based diet and exercise change program designed to reduce CVD risk. During the intervention, each participant self-monitored diet and aerobic physical activity. Families were measured at baseline, 3, 12, and 24 months. For adults, self-monitored changes in diet correlated with changes in body mass index, systolic blood pressure, total cholesterol and LDL 1 and 2 years later. Correlations between self-monitored diet and diet-related risk factor changes were not observed among children. Correlations between self-monitored exercise and subsequent risk factor changes were not observed among adults. For children, self monitored changes in aerobic physical activity correlated significantly with changes in VO2Max and HDL/LDL ratio 1 and 2 years later. Thus, this study provides some support for the predictive validity of diet self-monitoring in adults and exercise self-monitoring in children.

Adult↗

PubMed2004

An investigation of monitoring for sleep-related threat in primary insomnia.

In Study 1, individuals with primary insomnia (n=32) and good sleepers (n=38), recruited from a university population, completed a semi-structured interview. The interview assessed monitoring for sleep-related threat, negative thoughts and safety behaviours, at night and during the day. Compared to good sleepers, individuals with insomnia reported more frequent monitoring at night and during the day, more negative thoughts associated with monitoring at night and during the day, and the use of more safety behaviours associated with monitoring at night. A path analysis showed that the total monitoring frequency was significantly positively related to the score for total negative thoughts, which in turn, was significantly positively related to the total number of safety behaviours used. Study 2 aimed to test the generalisability of these findings in a clinical sample of individuals with primary insomnia (n=23). The results indicated that the clinical sample also engaged in monitoring for sleep-related threat, experienced negative thoughts and used safety behaviours. Further, more severe insomnia was associated with more negative thoughts and the use of more safety behaviours associated with monitoring at night. Together, these results are consistent with the proposal that monitoring for sleep-related threat functions to maintain insomnia by triggering negative thoughts and the use of safety behaviours. Future research is required to verify the proposed causal status of monitoring, using prospective designs and experimental manipulations.

Adaptation, Psychological↗

PubMed2006

HIS-Monitor: an approach to assess the quality of information processing in hospitals.

OBJECTIVES: Hospital information systems (HIS) are a substantial quality and cost factor for hospitals. Systematic monitoring of HIS quality is an important task; however, this task is often seen to be insufficiently supported. To support systematic HIS monitoring, we developed HIS-Monitor, comprising about 107 questions, focusing on how a hospital information system does efficiently support clinical and administrative tasks. METHODS: The structure of HIS-Monitor consists of a matrix, crossing HIS quality criteria on one axis with a list of process steps within patient care on the other axis. HIS-Monitor was developed based on several pretests and was now tested in a larger feasibility study with 102 participants. RESULTS: HIS-Monitor intends to describe strengths and weaknesses of information processing in a hospital. Results of the feasibility study show that HIS-Monitor was able to highlight certain HIS problems such as insufficiently supported cross-departmental communication, legibility of drug orders and other paper-based documents, and overall time needed for documentation. We discuss feasibility of HIS-Monitor and the reliability and validity of the results. CONCLUSIONS: Further refinement and more formal validation of HIS-Monitor are planned.

Austria↗

PubMed2006

Effects of self-efficacy, social support and knowledge on adherence to PEFR self-monitoring among adults with asthma: a prospective repeated measures study.

BACKGROUND: Long-term adherence to self-monitoring of peak expiratory flow rate (PEFR) is essential for early detection of declining lung function in individuals with asthma. Psychosocial and cognitive factors can influence adherence to PEFR self-monitoring behaviors. OBJECTIVES: The specific aims of this prospective, repeated measures study were to: (1) determine the effects of asthma self-efficacy, perceived satisfaction with social support and asthma knowledge on adherence to PEFR self-monitoring behavior; and (2) examine whether adherence to PEFR self-monitoring mediates the effects of psychosocial/cognitive factors on lung function and asthma symptoms in adults with asthma. DESIGN: Sixty-eight participants completed standardized questionnaires three times at baseline, 1 month, and 3 months and kept the records of PEFR self-monitoring behaviors twice a day. Data were analyzed using multiple linear regressions. Adherence rates to PEFR self-monitoring were 93.5% and 74.9% at 1 and 3 month, representing those who remained in the study (n=39). Other participants withdrew from the study. FINDINGS: Both at 1 and 3 month, psychosocial/cognitive factors as a whole did not account for a significant variance in adherence to PEFR self-monitoring. Univariate analyses, however, indicated that baseline asthma self-efficacy and asthma knowledge at 1 month were significant independent predictors for adherence to PEFR self-monitoring at 3 month. CONCLUSION: Adherence to PEFR self-monitoring did not mediate the effects of asthma self-efficacy, perceived satisfaction with social support, and asthma knowledge on lung function and asthma symptoms. Lung function was low, but participants reported low asthma symptoms, both of which remained stable over time. Because of a small sample size and high attrition, the findings of the study need to be interpreted with caution. Given the importance of long-term adherence to self-management in asthma and other chronic illnesses, factors influencing adherence need to be further investigated to set a basis for future interventions.

Adult↗

PubMed2006

A randomised-controlled trial evaluating a fetal monitoring education programme.

OBJECTIVE: to evaluate the effectiveness of a fetal monitoring education programme on midwives' fetal monitoring knowledge and intrapartum cardiotocograph interpretation skills. DESIGN: two group, before-after, randomised-controlled trial. SETTING: two maternity hospitals in the Republic of Ireland. PARTICIPANTS: 55 midwives were randomly assigned to either the experimental group (n=27) or the control group (n=28). INTERVENTIONS: the experimental group participated in a 1.5 hr fetal monitoring education programme, whereas the control group attended an alternative education programme consisting of a non-fetal-monitoring-related video presentation. MEASUREMENTS: the primary outcomes of interest were fetal monitoring knowledge and intrapartum cardiotocograph interpretation skills test. FINDINGS: in the fetal monitoring knowledge post-test, the median percentage correct responses for the control and experimental groups were 56% (IQR 18.75) and 88% (IQR 12.5), respectively. This difference, 31.2%, was statistically significant (U=78.5, 95.1% CI -31.25 to -18.75, p<0.001). In the intrapartum cardiotocograph interpretation skills post-test, the median percentage correct responses for the control and experimental groups were 55.6% (IQR 16.7) and 66.7% (IQR 22.2), respectively. This difference, of 11.1%, was statistically significant (U=186, 95.2% CI -16.67 to -5.56, p<0.001). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: attendance at a short (1.5 hr), in-service fetal monitoring education programme can increase midwives' fetal monitoring knowledge and cardiotocograph interpretation skills. The availability of in-service fetal monitoring education programmes is sporadic, often less than recommended, and is a cause for concern.

Adult↗

PubMed1998

Use of bedside activated partial thromboplastin time monitor to adjust heparin dosing after thrombolysis for acute myocardial infarction: results of GUSTO-I. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.

BACKGROUND: The safety and efficacy of bedside monitors of activated partial thromboplastin time (aPTT) have not been examined in a large population receiving intravenous heparin after thrombolytic treatment for acute myocardial infarction. We compared outcomes among patients monitored with these devices versus standard monitoring methods. METHODS AND RESULTS: Investigators chose the bedside device (n = 1713 patients) or their standard method (n = 26,162) for all aPTT measurements at their sites. Clinical outcomes at 30 days, 1-year mortality rate, and aPTT levels at 6, 12, and 24 hours were compared. Bedside-monitored patients had significantly less moderate/severe bleeding (10% vs 12%, P < .01), fewer transfusions (7% vs 11%, P < .001), and a smaller decrease in hematocrit (5.5% vs 6.7%, P < .001) but significantly more recurrent ischemia (22% vs 20%, P = .01). Fewer bedside-monitored patients had subtherapeutic aPTT levels at 12 and 24 hours. Among patients with subtherapeutic levels at 6 and 12 hours, more bedside-monitored patients had therapeutic levels when next monitored. After adjustment for baseline differences, no significant difference in mortality rate was observed in bedside-monitored patients at 30 days (4.3% vs 4.8%, P = .27) and at 1 year (7.1% vs 7.7%, P = .38). The groups had similar rates of reinfarction, shock, heart failure, and stroke. CONCLUSIONS: This prospective substudy supports the use of bedside monitoring of heparin anticoagulation after thrombolysis.

Aged↗

PubMed1997

A randomized comparison of fixed power and temperature monitoring during slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia.

Temperature monitoring may be helpful for ablation of accessory pathways, however its role in ablation of atrioventricular nodal reentrant tachycardia (AVNRT) using the slow pathway approach is unclear. Therefore, the purpose of this study was to prospectively compare slow pathway ablation for AVNRT using fixed power or temperature monitoring. The study included 120 patients undergoing ablation for AVNRT. Patients were randomly assigned to receive either fixed power at 32 watts, or to temperature monitoring with a target temperature of 60 degrees C. The primary success rate was 72% in the fixed power group and 95% in the temperature monitoring group (p = 0.001). The ablation procedure duration (35 +/- 29 min vs 35 +/- 30 min; p = 0.9), fluoroscopic time (32 +/- 17 vs 35 +/- 19 min; p = 0.4), mean number of applications (10.2 +/- 8.1 vs 8.4 +/- 7.9; p = 0.2), and coagulum formation per application (0.2% vs 0.5%; p = 0.6) were statistically similar in the fixed power and temperature monitoring groups, respectively. The mean temperature (47.3 +/- 4.8 degrees C vs 48.6 +/- 3.8 degrees C; p < 0.01), and the temperature associated with junctional ectopy (48.2 +/- 3.8 degrees C vs 49.3 +/- 3.6 degrees C, p < 0.01) were less for the fixed power than the temperature monitoring group. In the temperature monitoring group, only 31% of applications achieved an electrode temperature of 60 degrees C. During follow up of 6.6 +/- 3.6 months there were two recurrences in the fixed power group and one in the temperature monitoring group (p = 1.0). In summary, power titration directed by temperature monitoring was associated with an improved primary procedural success rate. Applications of energy were associated with a temperature of approximately 50 degrees C with both techniques, suggesting that there is a low efficiency of heating in the posterior septum.

Adult↗

PubMed2003

In-situ near-infrared spectroscopy monitoring of the lyophilization process.

PURPOSE: The purpose of this work was to demonstrate the feasibility of using near-infrared spectroscopy (NIRS) to monitor the freeze-drying process in-situ. METHODS: The experiment was performed in a pilot-scale freeze-dryer, in which the NIRS probe was interfaced using a lead-through to the lyophilizer. Special equipment for the sample presentation was developed. NIRS measurements were made using a FT (Fourier transform)-NIR spectrometer fitted with a single fiber reflectance probe. RESULTS: The physical changes, that is, freezing, sublimation, and desorption, generated significant spectral changes. There was good agreement between NIRS monitoring and product temperature monitoring about the freezing process and the transition from frozen solution to ice-free material. The NIRS monitoring also provided new information about the process that was not possible to detect with product temperature monitoring, such as the rate of the desorption process and the steady-state where the drying was complete. The NIRS monitoring yields significantly more information about the actual process and essentially explains the observed changes of the product temperature during the lyophilization process. CONCLUSIONS: NIRS monitoring is a viable tool for in-situ monitoring, both qualitatively and quantitatively. It can facilitate investigations of the drying process within a sample. The small volume monitored makes sample presentation very important.

Chemical Phenomena↗

PubMed1987

Monitoring and blunting: validation of a questionnaire to assess styles of information seeking under threat.

Subjects were divided into information seekers (high monitors)/information avoiders (low monitors) and distractors (high blunters)/nondistractors (low blunters) on the basis of their scores on a self-report scale to measure coping styles, the Miller Behavioral Style Scale (MBSS). In Experiment 1, subjects were faced with a physically aversive event (the prospect of electric shock). High monitors and low blunters chose to seek out information about its nature and onset whereas low monitors and high blunters chose to distract themselves. This effect was strongest with the blunting dimension. High monitoring and low blunting were also accompanied by sustained high anxiety and arousal. In contrast, low monitors and high blunters were able to relax themselves over time. In Experiment 2, subjects worked on a series of tests that presumably predicted success in college. They could attend as often as they wished to a light that signaled how well they were performing. Results showed that coping-style scores accurately predicted informational strategy, particularly with the monitoring dimension: High monitors tended to look at the light whereas low monitors tended to ignore it. Thus the MBSS measure of coping styles appears to be a valid instrument for predicting behavioral strategies in response to both physical and psychological stressors. The theoretical and practical implications of these findings are discussed.

Adaptation, Psychological↗

PubMed2001

The role of participation and control in the effects of computer monitoring on fairness perceptions, task satisfaction, and performance.

Procedural justice and social facilitation theories were used to investigate effects of 2 kinds of process control on fairness perceptions, task satisfaction and performance of complex, computer-monitored tasks. A laboratory study manipulated participation (high or low voice) and monitoring approach (monitoring, control over monitoring, or no monitoring). High-voice participants perceived higher justice. Monitored participants reported higher satisfaction with high voice and lower satisfaction with low voice. Task performance was poorer for monitored participants unless they had control over monitoring. Among those with control, performance was not impaired for higher baseline performers. The 2 kinds of process control had different effects on the outcome variables. Results suggest the value of considering variations in the kinds of control provided and the justice principles that may apply in predicting effects of monitoring procedures.

Adult↗

PubMed2006

What's good for the goose may not be as good for the gander: the benefits of self-monitoring for men and women in task groups and dyadic conflicts.

The authors posit that women can rely on self-monitoring to overcome negative gender stereotypes in certain performance contexts. In a study of mixed-sex task groups, the authors found that female group members who were high self-monitors were considered more influential and more valuable contributors than women who were low self-monitors. Men benefited relatively less from self-monitoring behavior. In an experimental study of dyadic negotiations, the authors found that women who were high self-monitors performed better than women who were low self-monitors, particularly when they were negotiating over a fixed pool of resources, whereas men did not benefit as much from self-monitoring. Further analyses suggest that high self-monitoring women altered their behavior in these negotiations--when their partner behaved assertively, they increased their level of assertiveness, whereas men and low self-monitoring women did not alter their behavior.

Attitude↗

PubMed1986

On the nature of self-monitoring: matters of assessment, matters of validity.

An extensive network of empirical relations has been identified in research on the psychological construct of self-monitoring. Nevertheless, in recent years some concerns have been expressed about the instrument used for the assessment of self-monitoring propensities, the Self-Monitoring Scale. Both the extent to which the measure taps an interpretable and meaningful causal variable and the extent to which the self-monitoring construct provides an appropriate theoretical understanding of this causal variable have been questioned. An examination of reanalyses of studies of self-monitoring, analyses of the internal structure of the Self-Monitoring Scale, and further relevant data suggest that the measure does tap a meaningful and interpretable causal variable with pervasive influences on social behavior, a variable reflected as a general self-monitoring factor. We discuss the evaluation and furthering of the interpretation of this latent causal variable, offer criteria for evaluating alternative measures of self-monitoring, and present a new, 18-item Self-Monitoring Scale.

Factor Analysis, Statistical↗

PubMed2001

Home apnea monitor use in preterm infants discharged from newborn intensive care units.

PURPOSE: To identify current factors associated with home apnea monitor use in preterm infants and to determine whether home monitor use was associated with a shorter length of hospital stay. SETTING: We evaluated neonates who were < or =34 weeks' estimated gestational age and admitted for neonatal intensive care. We excluded neonates with congenital anomalies, neonates transferred out before discharge, and neonates who died. METHODS: Using a database created with a computer-assisted tool that generates hospital notes, we reviewed the epidemiology of monitor use. Differences between neonates sent home with an apnea monitor and those who were not were evaluated by using stepwise logistic regression analysis to identify which factors were independently associated with a neonate being discharged with a monitor. RESULTS: We studied 14,532 neonates; 1588 (11%) were sent home with monitors and 12,944 (89%) were not. The most important variables associated with being discharged with a monitor were site of care and a diagnosis of apnea. Site variation remained significant when adjusted for gestational age, diagnosis of apnea, and a history of use of methylxanthines. When corrected for gestational age, monitor use was not associated with shorter hospital stays. CONCLUSION: The data suggest that monitor use is more dependent on physician preference than medical indication and is not associated with earlier hospital discharge.

Apgar Score↗

PubMed1994

The National Nutrition Monitoring and Related Research Program: progress and activities.

The National Nutrition Monitoring and Related Research Act of 1990 outlined a number of requirements for nutrition monitoring and research relevant to nutrition monitoring needs of today and tomorrow. The Department of Agriculture (USDA) along with the Department of Health and Human Services (HHS) are charged with carrying out the requirements. The Act legally established the National Nutrition Monitoring and Related Research Program and numerous activities including development and implementation of a Ten-Year Comprehensive Plan and formation of the Interagency Board for Nutrition Monitoring and Related Research. Both requirements serve as the basis for planning and coordinating the activities of 22 Federal agencies that either conduct nutrition monitoring surveys and surveillance activities or are major users of nutrition monitoring data. As an advisory mechanism to both USDA and HHS, the law required establishment of a 9-member National Nutrition Monitoring Advisory Council. Progress and future activity plans for the Nutrition Monitoring Program are discussed.

Humans↗

PubMed2004

Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit.

OBJECTIVE: To determine whether electronic monitoring of hand hygiene and voice prompts can improve hand hygiene and decrease nosocomial infection rates in a surgical intermediate care unit. DESIGN: Three-phase quasi-experimental design. Phase I was electronic monitoring and direct observation; phase II was electronic monitoring and computerized voice prompts for failure to perform hand hygiene on room exit; and phase III was electronic monitoring only. SETTING: Nine-room, 14-bed intermediate care unit in a university, tertiary-care institution. All patient rooms, utility room, and staff lavatory were monitored electronically. PARTICIPANTS: All healthcare personnel including physicians, nurses, nursing support personnel, ancillary staff, all visitors and family members, and any other personnel interacting with patients on the intermediate care unit. All patients with an intermediate care unit length of stay >48 hrs were followed for nosocomial infection. INTERVENTIONS: Electronic monitoring during all phases, computerized voice prompts during phase II only. MEASUREMENTS AND MAIN RESULTS: We evaluated a total of 283,488 electronically monitored entries into a patient room with 251,526 exits for 420 days (10,080 hrs and 3,549 patient days). Compared with phase I, hand hygiene compliance in patient rooms improved 37% during phase II (odds ratio, 1.38; 95% confidence interval, 1.04-1.83) and 41% in phase III (odds ratio, 1.41; 95% confidence interval, 1.07-1.84). When adjusting for patient admissions during each phase, point estimates of nosocomial infections decreased by 22% during phase II and 48% during phase III; when adjusting for patient days, the number of infections decreased by 10% during phase II and 40% during phase III. Although the overall rate of nosocomial infections significantly decreased when combining phases II and III, the association between nosocomial infection and individual phase was not significant. CONCLUSIONS: Electronic monitoring provided effective ongoing feedback about hand hygiene compliance. During both the voice prompt phase and post-intervention phase, hand hygiene compliance and nosocomial infection rates improved suggesting that ongoing monitoring and feedback had both a short-term and, perhaps, a longer-term effect.

Adolescent↗

PubMed2006

Self-monitoring and consumer psychology.

Research on the relations between self-monitoring differences and two important areas of consumer behavior, reactions to specific advertising approaches and product evaluation strategies, is reviewed and evaluated. First, research on the responsiveness of high and low self-monitors to image-oriented and product-quality-based advertising attempts is addressed. Although findings generally indicate that high self-monitors are more responsive to image-oriented ads and that low self-monitors are more responsive to quality-based appeals, these results have not been robust. Possible reasons for this inconsistency are explored. Second, research on the means by which high and low self-monitors evaluate consumer products is examined. Findings suggest that when judging product quality, low self-monitors tend to rely on product performance and high self-monitors more likely use the product's image-enhancing capabilities. Additionally, research indicates that self-image/product-image congruency is generally a more important concern for low self-monitors, but high and low self-monitors' differential reliance on this congruency might be moderated by the situations in which the product is typically used. Additional possible delimiting conditions of these general findings are discussed.

Behavior Control↗