Domestic workers are a fast-growing segment of the labor force in China,but their work remains invisible.Using a respondent-driven sampling survey data collected in Beijing,Jinan,and Changsha during 2019 and 2020(N=2,...Domestic workers are a fast-growing segment of the labor force in China,but their work remains invisible.Using a respondent-driven sampling survey data collected in Beijing,Jinan,and Changsha during 2019 and 2020(N=2,20),this study pro-vides socio-demographic and work profiles of domestic workers in these cities.Most domestic workers are rural women with junior-high-school or lower education.They are predominantly informal workers with no labor contract and have no access to labor rights protections and social security.A majority of domestic workers have done overtime work that is often underpaid or unpaid.Live-in domestic workers work excessive hours and earn significantly less per hour than their live-out coun-terparts.While the hourly wages of child and elder care workers are significantly lower than those of other domestic workers,the hourly pay of elder care workers is the lowest.Despite the working conditions,domestic workers have high levels of job satisfaction probably partly due to their low perceived value of paid domestic work.Policy implications of this study include the formulation of specialized laws to protect domestic workers’labor rights and regulate family employers’behaviors,improving informal domestic workers’access to social security,change the social norms that devalue care work mainly performed by women,and collecting system-atic statistics of paid domestic work.展开更多
In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-base...In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-based care, 8 core categories (19 categories) were extracted and as actual situations of interprofessional work for dementia care, 8 core categories (13 categories) were obtained. The authors examined a function of interprofessional work model and practice contents using these categories. The results revealed that better interprofessional work can be expected by six specialists of nurses rehabilitation specialists, MSW, pharmacists, dietitians and care workers developing dementia care based on “Family handling function” “ADL maintenance and improved function” “Staff member education and empowerment function”.展开更多
Research studies conducted in the healthcare sector usually examine patients’ and workers’ wellbeing as separate entities;however, recent studies have revealed significant correlations between, for example, patient ...Research studies conducted in the healthcare sector usually examine patients’ and workers’ wellbeing as separate entities;however, recent studies have revealed significant correlations between, for example, patient satisfaction, workers stress and burnout. The present study examines the relationships between patient perceived quality of care (in terms of satisfaction with regard to accessibility, organizational efficiency and humaneness of care), and workers’ perceived quality of organizational life (in term of organizational support and availability of resource and reward), quality of relationship in the work-unit (superior and coworkers), quality of relationship with patients (disproportionate client expectations and customer verbal aggression) and individual health (emotional exhaustion and depersonalization, job satisfaction). 147 workers and 132 patients from seven hospital wards in northern Italy constitute the data base for the study. Analyses showed that accessibility and humaneness of care were negatively associated with disproportionate patient expectations, patient verbal aggression, emotional exhaustion and positively associated with availability of material recourses. Moreover, accessibility was also positively associated with the organizational support while organizational efficiency with support from colleagues. Globally, the results of the present study confirm that staff wellbeing is an essential aspect in relation to the patient perception of the quality of care and supporting the assumption that healthy organizations improve the wellbeing of their workers, their organizational performance and the quality of their service at the same time.展开更多
Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread...Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.展开更多
AIM To determine the prevalence of work disability in inflammatory bowel disease(IBD), and to assess risk factors associated with work disability.METHODS For this retrospective cohort study, we retrieved clinical data...AIM To determine the prevalence of work disability in inflammatory bowel disease(IBD), and to assess risk factors associated with work disability.METHODS For this retrospective cohort study, we retrieved clinical data from the Dutch IBD Biobank on July 2014, containing electronic patient records of 3388 IBD patients treated in the eight University Medical Centers in the Netherlands. Prevalence of work disability was assessed in 2794 IBD patients and compared with the general Dutch population. Multivariate analyses were performed for work disability(sick leave, partial and full disability) and long-term full work disability(> 80% work disability for > 2 years).RESULTS Prevalence of work disability was higher in Crohn's disease(CD)(29%) and ulcerative colitis(UC)(19%) patients compared to the general Dutch population(7%). In all IBD patients, female sex, a lower education level, and extra-intestinal manifestations, were associated with work disability. In CD patients, an age > 40 years at diagnosis, disease duration > 15 years,smoking, surgical interventions, and anti-TNFα use were associated with work disability. In UC patients, an age > 55 years, and immunomodulator use were associated with work disability. In CD patients, a lower education level(OR = 1.62, 95%CI: 1.02-2.58), and in UC patients, disease complications(OR = 3.39, 95%CI: 1.09-10.58) were associated with long-term full work disability.CONCLUSION The prevalence of work disability in IBD patients is higher than in the general Dutch population. Early assessment of risk factors for work disability is necessary, as work disability is substantial among IBD patients.展开更多
Background: In Congo-Brazzaville, there is a lake of mental healthcare provider and facilities specialized on psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciati...Background: In Congo-Brazzaville, there is a lake of mental healthcare provider and facilities specialized on psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients. Aims: The study aimed to assess the perception of the staff of the only psychiatric service in Congo. Material and methods: We conducted a cross-sectional descriptive, prospective survey;conducted among the psychiatric staff of the Brazzaville University Hospital in September 2019. An anonymous individual questionnaire was administered to collect: 1) socio-professional data, 2) perceptions (assignment, role, workload and working conditions), and 3) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.2.2.6. Results: Thirty out of 42 staff had responded (71.4%);16 were male and at their first psychiatric assignment (28/30), with an average age of 44.7 ± 7 and seniority of 8.4 ± 8.3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving. Conclusion: Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care.展开更多
Purpose: Cooperation between organizations is an often-suggested remedy for handling unsolved borderland problems. However, actual projects aiming at cooperation are seldom very successful. The purpose here is to high...Purpose: Cooperation between organizations is an often-suggested remedy for handling unsolved borderland problems. However, actual projects aiming at cooperation are seldom very successful. The purpose here is to highlight obstacles related to cooperation between different organizations based on a case study of a rehabilitation project where health care and several social service organizations (social insurance, social welfare, and the local employment agency) were involved. Data were gathered through participation and interviews. Findings: It seems that efficient cooperation requires an understanding of the participating organizations’ differences in work logic as well as work practices. Furthermore, only certain fairly standardized “normal” problems may be handled through organized cooperation while non-routine exceptional problem requires a more fully integrated work organization. Implications: Obstacles to cooperation are highlighted and ways to improve the possibilities of cooperation between organizations are suggested although such possibilities are generally hampered by differences in work logic.展开更多
Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthc...Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.展开更多
文摘Domestic workers are a fast-growing segment of the labor force in China,but their work remains invisible.Using a respondent-driven sampling survey data collected in Beijing,Jinan,and Changsha during 2019 and 2020(N=2,20),this study pro-vides socio-demographic and work profiles of domestic workers in these cities.Most domestic workers are rural women with junior-high-school or lower education.They are predominantly informal workers with no labor contract and have no access to labor rights protections and social security.A majority of domestic workers have done overtime work that is often underpaid or unpaid.Live-in domestic workers work excessive hours and earn significantly less per hour than their live-out coun-terparts.While the hourly wages of child and elder care workers are significantly lower than those of other domestic workers,the hourly pay of elder care workers is the lowest.Despite the working conditions,domestic workers have high levels of job satisfaction probably partly due to their low perceived value of paid domestic work.Policy implications of this study include the formulation of specialized laws to protect domestic workers’labor rights and regulate family employers’behaviors,improving informal domestic workers’access to social security,change the social norms that devalue care work mainly performed by women,and collecting system-atic statistics of paid domestic work.
文摘In this manuscript the authors have studied interprofessional work model for dementia care in hospitals for community-based care. As present situations and problems of dementia patients in hospitals for community-based care, 8 core categories (19 categories) were extracted and as actual situations of interprofessional work for dementia care, 8 core categories (13 categories) were obtained. The authors examined a function of interprofessional work model and practice contents using these categories. The results revealed that better interprofessional work can be expected by six specialists of nurses rehabilitation specialists, MSW, pharmacists, dietitians and care workers developing dementia care based on “Family handling function” “ADL maintenance and improved function” “Staff member education and empowerment function”.
文摘Research studies conducted in the healthcare sector usually examine patients’ and workers’ wellbeing as separate entities;however, recent studies have revealed significant correlations between, for example, patient satisfaction, workers stress and burnout. The present study examines the relationships between patient perceived quality of care (in terms of satisfaction with regard to accessibility, organizational efficiency and humaneness of care), and workers’ perceived quality of organizational life (in term of organizational support and availability of resource and reward), quality of relationship in the work-unit (superior and coworkers), quality of relationship with patients (disproportionate client expectations and customer verbal aggression) and individual health (emotional exhaustion and depersonalization, job satisfaction). 147 workers and 132 patients from seven hospital wards in northern Italy constitute the data base for the study. Analyses showed that accessibility and humaneness of care were negatively associated with disproportionate patient expectations, patient verbal aggression, emotional exhaustion and positively associated with availability of material recourses. Moreover, accessibility was also positively associated with the organizational support while organizational efficiency with support from colleagues. Globally, the results of the present study confirm that staff wellbeing is an essential aspect in relation to the patient perception of the quality of care and supporting the assumption that healthy organizations improve the wellbeing of their workers, their organizational performance and the quality of their service at the same time.
文摘Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.
基金Supported by the Netherlands Organisation for Scientific Research,VIDI grant No.016.136.308 to Weersma RKCareer Development grant of the Dutch Digestive Foundation,No.CDG 14-04 to Festen EAM
文摘AIM To determine the prevalence of work disability in inflammatory bowel disease(IBD), and to assess risk factors associated with work disability.METHODS For this retrospective cohort study, we retrieved clinical data from the Dutch IBD Biobank on July 2014, containing electronic patient records of 3388 IBD patients treated in the eight University Medical Centers in the Netherlands. Prevalence of work disability was assessed in 2794 IBD patients and compared with the general Dutch population. Multivariate analyses were performed for work disability(sick leave, partial and full disability) and long-term full work disability(> 80% work disability for > 2 years).RESULTS Prevalence of work disability was higher in Crohn's disease(CD)(29%) and ulcerative colitis(UC)(19%) patients compared to the general Dutch population(7%). In all IBD patients, female sex, a lower education level, and extra-intestinal manifestations, were associated with work disability. In CD patients, an age > 40 years at diagnosis, disease duration > 15 years,smoking, surgical interventions, and anti-TNFα use were associated with work disability. In UC patients, an age > 55 years, and immunomodulator use were associated with work disability. In CD patients, a lower education level(OR = 1.62, 95%CI: 1.02-2.58), and in UC patients, disease complications(OR = 3.39, 95%CI: 1.09-10.58) were associated with long-term full work disability.CONCLUSION The prevalence of work disability in IBD patients is higher than in the general Dutch population. Early assessment of risk factors for work disability is necessary, as work disability is substantial among IBD patients.
文摘Background: In Congo-Brazzaville, there is a lake of mental healthcare provider and facilities specialized on psychiatric care: only two psychiatrists and one psychiatric department around the country. Poor appreciation of their role and work environment can negatively impact the esteem of psychiatric staff and lead to stigma and discrimination towards patients. Aims: The study aimed to assess the perception of the staff of the only psychiatric service in Congo. Material and methods: We conducted a cross-sectional descriptive, prospective survey;conducted among the psychiatric staff of the Brazzaville University Hospital in September 2019. An anonymous individual questionnaire was administered to collect: 1) socio-professional data, 2) perceptions (assignment, role, workload and working conditions), and 3) identify the main problems of the service. Averages and frequencies were calculated on Epi info 7.2.2.6. Results: Thirty out of 42 staff had responded (71.4%);16 were male and at their first psychiatric assignment (28/30), with an average age of 44.7 ± 7 and seniority of 8.4 ± 8.3 years. Among them: one psychiatrist, two psychologists, and 19 nurses. Their assignment in psychiatry was well perceived in 93.3% (27/30), as well as their role (the importance of psychiatric care and psychiatry). Working conditions were perceived as poor: precarious hygiene (93.3%), cohabitation with dangerous patients (82.1%), heavy workload due to lack of staff (100%). Of their professional future, 23.3% (7/30) were considering leaving. Conclusion: Almost all psychiatric staff had a good perception of their role and psychiatry, but not of the working conditions. Local measures to improve working conditions must be carried out to improve the attractiveness of psychiatry and the quality of care.
文摘Purpose: Cooperation between organizations is an often-suggested remedy for handling unsolved borderland problems. However, actual projects aiming at cooperation are seldom very successful. The purpose here is to highlight obstacles related to cooperation between different organizations based on a case study of a rehabilitation project where health care and several social service organizations (social insurance, social welfare, and the local employment agency) were involved. Data were gathered through participation and interviews. Findings: It seems that efficient cooperation requires an understanding of the participating organizations’ differences in work logic as well as work practices. Furthermore, only certain fairly standardized “normal” problems may be handled through organized cooperation while non-routine exceptional problem requires a more fully integrated work organization. Implications: Obstacles to cooperation are highlighted and ways to improve the possibilities of cooperation between organizations are suggested although such possibilities are generally hampered by differences in work logic.
文摘Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.
