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Motivation and satisfaction among polyclinic volunteers at the 2002 Winter Olympic and Paralympic Games.

BACKGROUND: The Olympic and Paralympic Games rely heavily on volunteers to provide many essential services, including medical care of athletes. OBJECTIVE: This preliminary investigation sought to characterise the motivational influences and factors responsible for the satisfaction of Olympic and Paralympic healthcare volunteers. METHODS: The 2002 Winter Games polyclinic healthcare volunteers were asked to complete a questionnaire designed to elicit information about their motives for volunteering and the factors that contributed to their satisfaction with their volunteer experience. RESULTS: There was no significant difference in the motivation or satisfaction summary scores based on event worked. There was a strong positive correlation between motivation and satisfaction. Physician respondents had a lower mean motivation score than did non-physician volunteers. CONCLUSIONS: There were no significant motivational differences between Olympic and Paralympic volunteers, but there were several differences noted between physician and non-physician volunteers. The 2002 polyclinic volunteers appear to have been motivated by a complex process best described as "enlightened self interest," and all were generally well satisfied with their experience. These results may assist organisers of future Games in selecting appropriately motivated volunteer personnel and creating rewarding work environments for them.

Adult↗

Prescribing authority for pharmacists as viewed by organized pharmacy, organized medicine, and the pharmaceutical industry.

This study identifies attitudes of organized pharmacy, organized medicine, and the pharmaceutical industry about prescribing authority for pharmacists. A questionnaire designed to assess the impact of a legislative bill permitting a pharmacist in an organized health care setting to initiate or modify drug therapy was mailed to state pharmacy associations, state hospital pharmacy associations, state pharmacy boards, state medical associations, Pharmaceutical Manufacturers Association (PMA)-member manufacturers, and non-PMA-member generic manufacturers. Responses from 194 of the 307 invited organizations were used. The six organization types viewed the impact of the legislative bill differently (p less than 0.05). Hospital pharmacy associations and boards of pharmacy, to a lesser extent, supported the legislative bill; non-PMA-member generic manufacturers and state pharmacy associations were relatively neutral. The medical associations and the PMA-member companies opposed the passage of the bill. Furthermore, medical associations believed that the bill would not be passed in the majority of states in the next five years.

Attitude of Health Personnel↗

Correlations with patients' perspectives of the result of lower-extremity amputation.

BACKGROUND: Patients' perceptions of the result of lower-extremity amputation vary widely, yet the factors associated with this variability are not well understood. Our objective was to identify important correlations with the perceived result that may help to indicate the factors that deserve particular emphasis in the management of patients who have had an amputation. METHODS: In this retrospective study, 148 patients who had had a major lower-extremity amputation completed a standardized questionnaire designed to assess the demographic characteristics, comorbidities, amputation characteristics, prosthetic function, and social function at a mean of seven years after surgery. We correlated each of these variables with four result metrics: general satisfaction, quality of life, freedom from frustration, and walking distance. RESULTS: The four result metrics were significantly and strongly correlated with (1) the comfort of the residual limb; (2) the condition of the contralateral limb; (3) the comfort, function, and appearance of the prosthesis; (4) social factors; and (5) the ability to exercise recreationally (p < 0.0001). Interestingly, the level and laterality of the amputation were not significantly correlated with the patients' perceived result. CONCLUSIONS: The perceived result of amputation is not associated with the amount of the limb that was amputated but rather with factors that may be optimized by surgical, prosthetic, and social management.

Amputation, Surgical↗

Inviting teaching behaviors of clinical faculty and nursing students' anxiety.

This study explored baccalaureate nursing students' perceptions of inviting teaching behaviors of clinical nursing faculty and students' state anxiety while interacting with faculty during clinical experiences. A total of 229 junior and senior generic baccalaureate nursing students comprised the sample. Participants completed three questionnaires: a demographic data questionnaire, the Clinical Teaching Survey, and a Self-Evaluation Questionnaire, designed to measure state anxiety. Results indicated there were moderate negative correlations between students' perceptions of the personally and professionally inviting teaching behaviors of clinical faculty and students' self-reports of state anxiety. A stepwise multiple regression analysis revealed that perceptions of personally inviting teaching behaviors explained 41% of the variance in students' state anxiety. Junior students rated faculty higher on personally and professionally inviting teaching behaviors than did senior students. However, both groups of students scored similarly on self-reports of state anxiety while interacting with clinical faculty. Findings indicate that clinical faculty should be intentionally aware of how their teaching behaviors are perceived by students and influence student anxiety during clinical experiences.

Adult↗

[Isolated Burch type indirect colposuspension of the bladder neck in the treatment of stress urinary incontinence in women. Long-term results].

OBJECTIVES: Burch indirect colposuspension remains the reference surgical operation in the treatment of female urinary stress incontinence. The stability of the results is highly controversial and the causes of failure remain hypothetical. The objective of this study was to analyse the long-term results of this technique. METHODS: 100 women suffering from pure urinary stress incontinence, in whom a Burch indirect colposuspension was performed, were included in this study. These patients were reviewed with a mean follow-up of 5.2 years and a questionnaire designed to assess the results was sent to their homes. RESULTS: 64% of patients no longer suffered from incontinence. Deterioration of the results was observed up to 5 years after the operation, but subsequently remained stable. The results were operator-independent. Low sphincter pressure (< 30 cm H2O), preoperative detrusor instability, insufficient hormonal impregnation and a history of pelvic surgery were the main factors predictive of failure of this technique. CONCLUSION: This study confirms the benefit provided by this technique in almost two-thirds of patients and indicates the risk factors of failure which must be taken into account before proposing Burch indirect colposuspension to a woman suffering from urinary stress incontinence.

Adult↗

Patient tolerance of colonoscopy without sedation during screening examination for colorectal polyps.

BACKGROUND: The administration of sedative drugs at colonoscopy has its drawbacks such as increases in the rate of complications and cost. Our aim was to study how individuals, drawn from a population registry and invited to undergo screening colonoscopy for colorectal polyps, experienced the procedure without conscious sedation. METHODS: Four hundred fifty-one individuals underwent the screening examination (median age 67 years, range 63 to 72). The cecum was intubated in 369 (82%). Fourteen days after the examination, 429 of the attendees received a questionnaire designed to evaluate their tolerance of the procedure. RESULTS: Four hundred nine participants (95%) replied.Twenty-one (5%) of these individuals found the examination very uncomfortable, 184 (45%) found it moderately uncomfortable, and 204 (50%) did not find it uncomfortable. A larger proportion of women than men, 110 (63%) versus 79 (41%), found the procedure very or moderately uncomfortable (p<0.001). Three hundred sixty-eight (90%) individuals stated that they would undergo repeat colonoscopy in 5 years. CONCLUSION: In this screening setting, routine use of conscious sedation did not seem to be necessary, as most participants found the examination to be only moderately uncomfortable or not at all uncomfortable. Colonoscopy without conscious sedation may, however, reduce the rate of intubation of the cecum and increase the risk of missing adenomas and cancers.

Aged↗

Factors important to students in selecting a residency program.

A 22-item questionnaire, designed to assess the factors students considered important when they ranked residency programs, was distributed to the 1988 senior class of Tulane University School of Medicine just before the submission deadline of the National Residency Matching Program. Completed surveys were obtained from 111 of the 157 graduating students (approximately 71%) and were representative of the entire class in terms of sex, age, race, marital status, and anticipated field of specialization. Results of this investigation suggest that the satisfaction of a program's house officers and the seniors' general impression at the interview were the most important selection factors of the matriculating seniors surveyed. Diversity of the training experience and geographic location were also important selection factors. House officer benefits and salary were low-priority factors in the seniors' program selections.

Career Choice↗

Level of occupational stress in male and female rural general practitioners.

General practitioners (GPs) in five rural divisions in New South Wales completed questionnaires designed to assess the degree to which various stressors were present in their work environment; the degree to which these stressors distressed them; their general stress; and their general health. Results published in a previous paper showed that high occupational stress in doctors was associated with high general stress and poor general health. Results reported in this paper showed that male doctors were more stressed than female doctors, GPs working on a full-time basis were more stressed than those working on a part-time basis, GPs who were also working as visiting medical officers were more stressed than those who did not work in this capacity, and younger GPs were more stressed than older GPs. High workload, governments, interference with their work, and family and leisure concerns were the major stressors for rural GPs.

Adult↗

Study of dog and cat owners' perceptions of medical treatment for cancer.

Between April 10 and June 9, 2000, 91 owners of cats and dogs that were being or had been treated with anticancer chemotherapy were given a questionnaire designed to obtain information about their experiences as a result of the discovery and treatment of the disease, the efficacy and side effects of the treatment and their perceptions of the procedures associated with the administration of the drugs. Nearly all of the owners felt that the treatment was worthwhile. The level of observed side effects was low. Well over half of the owners believed that their animal had lived longer than it would have if it had not been treated and that its general wellbeing had improved. In general, they felt that the treatment had been rewarding and that any adverse side effects had been outweighed by the positive experiences during the treatment; they felt that they had been well informed and that their animals had benefited from the treatment.

Animals↗

Examination of specific nutrition/health behaviors using a social cognitive model.

Nutrition intervention programs are not always successful. In some cases, an insufficient understanding of the interrelationships among factors influencing health behaviors may be responsible for the failures. This study used social cognitive theory, a framework for studying behaviors, to structure the relationships between measurable factors important to the frequency of health-oriented food consumption. We developed a model that incorporated factors for social environment, reinforcement, commitment, behavior modeling, knowledge, and attitude relative to the frequency of consumption of four beverages (whole milk, low-fat/skin milk, regular soda, and diet soda). Four-hundred fifty-seven middle-aged adults (mean age, 47 years; 58% female) and 709 college students (mean age, 21 years; 50% female) responded to a written questionnaire designed as a self-report on frequency of consumption and measures for 10 social cognitive variables. For all four beverages, the model explained 35% or more of the variance in frequency of consumption, thus confirming its predictive power. We used the statistical approach known as path analysis to examine the relationships within the model. The analysis demonstrated that factors influencing the consumption varied between the two age groups (e.g., nutrition knowledge was related to attitude in adult soda-drinking models but not in student soda-drinking models) and between forms of the beverages (e.g., for student models, nutrition knowledge was related to taste enjoyment for low-fat/skim milk but not for whole milk).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Job satisfaction of psychiatric hospital employees: a new measure of an old concern.

The authors report on the factor structure of an employee satisfaction questionnaire designed for use with psychiatric hospital employees. The actions and attitudes of management were, by far, the single most prominent factor. This factor captures the extent to which management respects workers, operates with honesty and integrity, promotes efficiency, and has open lines of communication with employees. By surveying employees about the 15 items of this factor, psychiatric hospital managers can obtain a sense of their employees' overall satisfaction. Hospitals must hire and train managers who can convey the qualities represented in this satisfaction factor. It is also important for hospital managers to recognize that employee satisfaction is strongly related to how employee complaints are handled, how employees perceive the quality of patient care, and the extent to which employees believe the hospital serves the greater community.

Attitude of Health Personnel↗

A survey of directors of Canadian academic acute pain management services: the nursing team members role--a brief report.

PURPOSE: The purpose of this study was to identify Canadian academic centres with Acute Pain Management Service (APMS), and to describe the nature of nursing involvement on the APMS. METHODS: Departments of Anesthesiology in the 16 Canadian medical schools were contacted to obtain a list of affiliated hospitals and the person most responsible for acute pain. A questionnaire designed to gain insight into nursing involvement on APMS was sent out to the 62 hospitals between June 2000 and January 2001. RESULTS: Seventy-six percent of centres responded and of these 89% (n = 42) had an APMS. In 76% of APMS nursing was involved on the service. Sixty-two percent (n = 26) had a designated nursing team member on the APMS who contributed in the realms of patient care, staff and patient education, and administrative development. The APMS nurse performed patient rounds independently (62%) and with a physician (64%). Decision-making was primarily the responsibility of anesthesiology, however, the APMS nurse (38%) and the bedside nurse (23%) were involved in some centres. The highest educational attainment in the 26 hospitals with an APMS nurse was, diploma RN (27%), BScN (31%) and MSc (12%). The distribution of advance practice nursing was nurse practitioner (12%), clinical nurse specialist (27%), or both (8%). CONCLUSION: Nursing played an important role on the APMS, however, quality acute pain management can only be achieved with continuing efforts by anesthesiology, nursing and hospital administration to support the role of nurses as essential members of the acute pain team.

Academic Medical Centers↗

Sexual behavior and sexual problems among patients with severe chronic psychoses.

The aim of the present study was to investigate sexual behavior in population of psychiatric patients affected by schizophrenia, schizoaffective disorder or bipolar disorder by means of an ad hoc questionnaire designed to explore the three phases of the sexual response: desire (or interest), arousal, and performance. The study assessed patients' attitude toward sexuality, several aspects of their sexual behavior, including patients' awareness of the risk of sexually transmitted diseases (STD), contraceptive strategy preferred by patients, and sexual effects of psychotropic medication. Patients reported a high frequency of sexual dysfunction, in particular, hyposexuality. Schizophrenia diagnosis and female gender were associated with lower levels of sexual performance. The impact of psychotropic drugs on patients' sexuality was significant, with both positive and negative effects. Although 65.8% of patients reported to be concerned about the risk of contracting infections during sexual intercourse, most of them engaged in sexual behavior at high risk for acquisition and transmission of STD. Patients' compliance with contraceptive measures was poor.

Adult↗

A review of emergency equipment carried and procedures performed by UK front line paramedics on paediatric patients.

OBJECTIVES: In 1997 a review of paramedic practice upon adult patients in the UK found many inconsistencies and deficiencies in basic care. A follow up review in 2002 identified widespread improvement in provision of equipment and skills to provide basic and advanced life support.Paediatric care was not assessed in either review. The authors conducted this study to identify current standards of care in paediatric paramedic practice and areas of potential improvement. METHOD: A questionnaire designed to determine what equipment and skills were available to paramedics for the management of common or serious paediatric emergencies was sent to chief executives of the 32 NHS Ambulance Trusts in England and Wales. RESULTS: The trend of expanding and standardising practice among adult patients has not extended to paediatric practice despite national guidelines from the Joint Royal Colleges Ambulance Liaison Committee (JRCALC). Furthermore there are some serious failings in the provision of care and skills. Many Trusts have not adopted JRCALC guidelines for the management of life threatening paediatric emergencies such as asthma, meningitis, and fluid replacement in hypovolaemia. CONCLUSIONS: Ambulance Trusts not meeting standards set out in the JRCALC guidelines must address their areas of deficiency. Failure to do so endangers children's lives and leaves Trusts open to criticism.

Child↗

Attributions and personality as predictors of the road rage response.

This study examined the ability of attributions and personality traits to predict the emotional and behavioural components of the road rage response. Participants recalled a recent time when they experienced three different anger-provoking events when driving. They then rated their behaviours and emotions during the event, and their attributions for why the event occurred. Participants also completed a battery of personality questionnaires designed to predict their responses to the situations. Attributing causality for the anger-arousing event to a stable factor in the offending driver was uniquely related to aggressive behaviour and anger in all three situations. Hostile and blame attributions predicted aggressive behaviour and anger in different situations. In addition to dispositional measures of aggressiveness and anger predicting aggressive behaviour and anger in each of the anger-provoking situations, other personality variables were also related to aspects of the road rage response (e.g. conscientiousness, agreeableness, narcissism, and extraversion). Attributions and personality traits accounted for unique variance in the outcomes, and there were only sporadic effects of attributions partially mediating the relationships between personality variables and responses to the anger-provoking situations. Therefore, it is unlikely that the relationships between personality traits and responses to anger-provoking situations are completely mediated by attributional processing.

Adolescent↗

The relationship of dieting to weight in adolescents.

Using a sample of 1,269 high school students, black and white, male and female, this study compared the actual and preferred weights of dieters and nondieters and examined the relationship of increasing weight to preferred weight and the decision to diet. Seventy-two percent of the enrolled students in ten schools of a large metropolitan area participated in the study by completing a self-administered questionnaire designed for the research. The mean age was 17.5 + or - 0.6 years. To be identified as a dieter a student had to report having lost five or more pounds through dieting. Nearly half of the black and white males, two thirds of the black females, and three quarters of the white females met this criterion. Although mean heights of dieters and nondieters did not differ significantly in each race-sex group, dieters weighed at least 14 pounds more than nondieters. While dieters set higher preferred weights for themselves as their own weight increased, white male and female dieters preferred to weigh about 11 pounds less than black male and female dieters, respectively. The majority of dieters were not overweight; some were even underweight. This study documents the need for effective nutrition and exercise programs in the schools to help students accept and achieve reasonable weights.

Adolescent↗

An in-depth study of long-term users of transcutaneous electrical nerve stimulation (TENS). Implications for clinical use of TENS.

This in-depth study examines the relationships between patient, stimulator and outcome variables in a large number of chronic pain patients utilising TENS on a long-term basis. 179 patients completed a TENS questionnaire designed to record age, sex, cause and site of pain and TENS treatment regime. Of these 179 patients, 107 attended our research unit for assessment of the electrical characteristics of TENS during self-administered treatment. Although a remarkable lack of correlation between patient, stimulator and outcome variables was found to exist, the analysis revealed much information of importance: 47% of patients found TENS reduced their pain by more than half; TENS analgesia was rapid both in onset (less than 0.5 h in 75% patients) and in offset (less than 0.5 h in 51% patients); one-third of patients utilised TENS for over 61 h/week; pulse frequencies between 1 and 70 Hz were utilised by 75% of patients; 44% of patients benefitted from burst mode stimulation. The clinical implications of these findings are discussed.

Adult↗

Factor structure and interpretation of the K10.

The Kessler 10 Psychological Distress Scale (K10) is a brief 10-item questionnaire designed to measure the level of distress and severity associated with psychological symptoms in population surveys. It is being used widely, including in the World Health Organization World Mental Health Survey, and as a clinical outcome measure, although little information is available about the structure of the measure. The factorial composition of the K10 was examined in a prospective community survey and cross-validated in a separate large community survey. The K10 was found to consist of 4 factors and a 2-factor second-order factor structure. This was stable across the 2 waves of the prospective study and the Australian National Survey of Mental Health and Well-Being. The 4 factors, labeled Nervous, Negative Affect, Fatigue, and Agitation, were consistent with the original scales from which the items were taken. The 2 second-order factors represent Depression and Anxiety.

Data Interpretation, Statistical↗