Nurses' and Physicians' Responses to a New Active Antimicrobial Stewardship Program: A Two-Phase Study of Responses and Their Underlying Perceptions and Values.

BACKGROUND: Successful implementation of an antimicrobial stewardship program (ASP) depends on staff members' response to it. We introduced at the Hadassah Medical Center in Israel a significant change to our long-standing handshake ASP. As before, the new ASP involved a dialogue between the treating physician and the infectious disease physician over the appropriate antibiotic therapy. The main change was that the infectious disease physician's decision was now integrated into the patient's electronic medical record (EMR). Our purpose in this study was to uncover the concerns and expectations of physicians and nurses towards the new ASP, before and after its implementation, and link these with their basic perceptions of the ASP and their personal values. METHODS: We used open-ended questions and Likert-type scales to study staff members' personal values, basic perceptions of the new system, and attitudes towards it, both before (N = 143), and one year after (N = 103) the system's implementation. Relationships of the system's perceptions and personal values with attitudes toward the system were tested using correlations and multiple regression analyses. RESULTS: Prior to its implementation, physicians and nurses had multiple concerns about the new ASP's demandingness and inefficiency and its threat to physicians' autonomy and expertise. They also had positive expectations for benefits to the hospital, the patients and society. A year later, following the system's implementation, concerns dissipated, whereas the perceived benefits remained. Moreover, staff members' attitudes tended to be more positive among those who value conformity. CONCLUSION: Introducing new ASPs is a challenging process. Our findings suggest that hospital staff's initial concerns about the new ASP were primarily about its ease of use and demandingness. These concerns, which diminished over time, were linked with perceived satisfaction with the system. Conformity values had an indirect effect in predicting satisfaction with the system, mediated by perceptions of the system as straightforward.

Personal Values Across Cultures.

Values play an outsized role in the visions, critiques, and discussions of politics, religion, education, and family life. Despite all the attention values receive in everyday discourse, their systematic study took hold in mainstream psychology only in the 1990s. This review discusses the nature of values and presents the main contemporary value theories, focusing on the theory of basic personal values. We review evidence for the content and the structure of conflict and compatibility among values found across cultures. We discuss the assumptions underlying the many instruments developed to measure values. We then consider the origins of value priorities and their stability or change over time. The remainder of the review presents the evidence for the ways personal values relate to personality traits and subjective well-being and the implications of value differences for religiosity, prejudice, pro- and antisocial behavior, political and environmental behavior, and creativity, concluding with a discussion of mechanisms that link values to behavior.

How Do Values Affect Behavior? Let Me Count the Ways.

The impact of personal values on preferences, choices, and behaviors has evoked much interest. Relatively little is known, however, about the processes through which values impact behavior. In this conceptual article, we consider both the content and the structural aspects of the relationships between values and behavior. We point to unique features of values that have implications to their relationships with behavior and build on these features to review past research. We then propose a conceptual model that presents three organizing principles: accessibility, interpretation, and control. For each principle, we identify mechanisms through which values and behavior are connected. Some of these mechanisms have been exemplified in past research and are reviewed; others call for future research. Integrating the knowledge on the multiple ways in which values impact behavior deepens our understanding of the complex ways through which cognition is translated into action.

Roles affect individuals' preferences for organizations: A values perspective.

People are guided by the roles they assume in their everyday lives. Roles are cognitive schemas that are associated with specific goals and expectations that organize and guide individuals' perception and preferences. The social roles individuals assume affect their goals, which in turn affect their point of view and preferences. We propose and show that role schemas are malleable, allowing individuals to shift from one schema to another depending on the role they assume at the moment of judgment. Drawing on role theory and theories of espoused organizational values, we show that matching between the goals derived from a specific role and espoused organizational values influence the preferences of individuals toward an organization. An experiment with 476 working adults and students in three countries, found that individual assumed role (as a potential employee or an investor) and espoused organizational values (embeddedness-autonomy, egalitarianism-hierarchy, and mastery-harmony) affected individuals' preferences to invest or work in organizations. Our findings suggest that role-specific goals are important drivers of how individuals perceive organizations, and that individuals seek "fit" between organizational values and their role-specific goals. Finally, we discuss supplementary analyses testing the classical notion of value-based person-organization fit. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Culture and problem-solving: Congruency between the cultural mindset of individualism versus collectivism and problem type.

This research investigates how the cultural mindset influences problem-solving. Drawing on the notion that cultural mindset influences the cognitive process individuals bring to bear at the moment of judgment, we propose that the congruency between the cultural mindset (individualistic vs. collectivistic) and problem type (rule-based vs. context-based) affects success in problem-solving. In 7 studies we incorporated the traditional approach to studying the impact of culture (i.e., comparing cultural groups) with contemporary approaches viewing cultural differences in a more dynamic and malleable manner. We first show that members of an individualistic group (Jewish Americans) perform better on rule-based problems, whereas members of collectivistic groups (ultra-Orthodox Jews and Arabs from Israel) perform better on context-based problems (Study 1). We then study Arabs in Israel using language (Arabic vs. Hebrew) to prime their collectivistic versus individualistic mindsets (Study 2). As hypothesized, among biculturals (those who internalize both cultures) Arabic facilitated solving context-based problems, whereas Hebrew facilitated solving rule-based problems. We follow up with 5 experiments priming the cultural mindset of individualism versus collectivism, employing various manifestations of the cultural dimension: focusing on the individual versus the collective (Studies 3, 6, and 7); experiencing independence versus interdependence (Study 4); and directing attention to objects versus the context (Studies 5a-b). Finally, we took a meta-analytic approach, showing that the effects found in Studies 3-6 are robust across priming tasks, problems, and samples. Taken together, the differences between cultural groups (Studies 1-2) were recreated when the individualistic/collectivistic cultural mindset was primed. (PsycINFO Database Record

Personal values in human life.

The construct of values is central to many fields in the social sciences and humanities. The last two decades have seen a growing body of psychological research that investigates the content, structure and consequences of personal values in many cultures. Taking a cross-cultural perspective we review, organize and integrate research on personal values, and point to some of the main findings that this research has yielded. Personal values are subjective in nature, and reflect what people think and state about themselves. Consequently, both researchers and laymen sometimes question the usefulness of personal values in influencing action. Yet, self-reported values predict a large variety of attitudes, preferences and overt behaviours. Individuals act in ways that allow them to express their important values and attain the goals underlying them. Thus, understanding personal values means understanding human behaviour.

Overriding "doing wrong" and "not doing right": validation of the Dispositional Self-Control Scale (DSC).

We present the Dispositional Self-Control (DSC) Scale, which reflects individuals' tendency to override 2 types of temptations, termed doing wrong and not doing right. We report a series of 5 studies designed to test the reliability and validity of the scale. As hypothesized, high DSC predicts distant future orientation and low DSC predicts deviant behaviors such as aggression, alcohol misuse, and aberrant driving. DSC also predicts task performance among resource-depleted participants. Taken together, these findings suggest that the DSC Scale could be a useful tool toward further understanding the role of personality in overcoming self-control challenges.

Not all great minds think alike: systematic and intuitive cognitive styles.

Individuals process information and make decisions in different ways. Some plan carefully and analyze information systematically, whereas others follow their instincts and do what "feels right." We aimed to deepen our understanding of the meaning of the intuitive versus systematic cognitive styles. Study 1 (N = 130, 39% female, M(age) = 24) compared cognitive styles of arts, accounting, and mathematics students. Cognitive styles were associated with values (Study 2: N = 154, 123, 78; female = 59%, 49%, 85.9%; M(age) = 22, 23, 27) and traits (Study 3: N = 77, 140, 151; female = 59%, 66%, 46%; M(age) = 22, 25, 23), and they interacted with experience in predicting performance (Study 4: N = 63, 48% female, M(age) = 23; Study 5: N = 44, 39% female, M(age) = 23). All participants were Caucasian Israeli students. The systematic style was most frequent among accountants, and the intuitive style was most frequent among artists, validating the meaning of the styles. Systematic style was positively correlated with Conscientiousness and with security values and negatively correlated with stimulation values. The intuitive style had the opposite pattern and was also positively correlated with Extraversion. Experience improved rule-based performance among systematic individuals but had no effect on intuitive ones. Cognitive style is consistent with other personal attributes (traits and values), with implications for decision making and task performance.

Convincing Yourself to Care About Others: An Intervention for Enhancing Benevolence Values.

To study value change, this research presents an intervention with multiple exercises designed to instigate change through both effortful and automatic routes. Aiming to increase the importance attributed to benevolence values, which reflect the motivation to help and care for others, the intervention combines three mechanisms for value change (self-persuasion, consistency-maintenance, and priming). In three experiments, 142 undergraduates (67% male, ages 19-26) participated in an intervention emphasizing the importance of either helping others (benevolence condition) or recognizing flexibility in personality (control condition). We measured the importance of benevolence values before and after the task. In Experiment 1, the intervention increased U.S. participants' benevolence values. In Experiment 2, we replicated these effects in a different culture (Israel) and also showed that by enhancing benevolence values, the intervention increased participants' willingness to volunteer to help others. Experiment 3 showed that the increases in the importance of benevolence values lasted at least 4 weeks. Our results provide evidence that value change does not require fictitious feedback or information about social norms, but can occur through a 30-min intervention that evokes both effortful and automatic processes.

Integrating content and structure aspects of the self: traits, values, and self-improvement.

Research on the structure of the self has mostly developed separately from research on its content. Taking an integrative approach, we studied two structural aspects of the self associated with self-improvement--self-discrepancies and perceived mutability--by focusing on two content areas, traits and values. In Studies 1A-C, 337 students (61% female) reported self-discrepancies in values and traits, with the finding that self-discrepancies in values are smaller than in traits. In Study 2 (80 students, 41% female), we experimentally induced either high or low mutability and measured perceived mutability of traits and values. We found that values are perceived as less mutable than traits. In Study 3, 99 high school students (60% female) reported their values, traits, and the extent to which they wish to change them. We found that values predict the wish to change traits, whereas traits do not predict the wish to change values. In Study 4, 172 students (47.7% female) were assigned to one of four experimental conditions in which they received feedback denoting either uniqueness or similarity to others, on either their values or their traits. The results indicated that feedback that one's values (but not traits) are unique affected self-esteem. Integrating between theories of content and structure of the self can contribute to the development of both.

Don't judge a book by its cover, revisited: perceived and reported traits and values of attractive women.

Research has documented a robust stereotype regarding personality attributes related to physical attractiveness (the "what is beautiful is good" stereotype). But do physically attractive women indeed possess particularly attractive inner attributes? Studying traits and values, we investigated two complementary questions: how perceived attractiveness relates to perceived personality, and how it relates to actual personality. First, 118 women reported their traits and values and were videotaped reading the weather forecast. Then, 118 judges rated the traits, values, and attractiveness of the women. As hypothesized, attractiveness correlated with attribution of desirable traits, but not with attribution of values. By contrast, attractiveness correlated with actual values, but not actual traits: Attractiveness correlated with tradition and conformity values (which were contrasted with self-direction values) and with self-enhancement values (which were contrasted with universalism values). Thus, despite the widely accepted "what is beautiful is good" stereotype, our findings suggest that the beautiful strive for conformity rather than independence and for self-promotion rather than tolerance.

Identification with groups: the role of personality and context.

Is identification a product of personality or of the context? We examine this question by adopting a multidimensional conceptualization of identification (the CIDS model) that integrates research perspectives on personality and contextual effects. We investigate (Study 1) the relationships of traits to identification with the nation (students, N = 77), the army (soldiers, N = 220), and a business school (students, N = 123). Then we show that the modes of identification vary in their stability across social contexts and in their susceptibility to contextual change. Idealizing groups' symbols ("deference" identification) is especially stable across different foci of identification (Study 2): the military and former high school (soldiers, N = 188), the business school and the nation (students, = 62), and the military and one's ethnic group (soldiers, N = 95). Perceiving the group as a central part of the self ("importance" identification) is the most susceptible to contextual effects of priming values (Study 3; students, N = 80, 60) and the group's status (Study 4; students, N = 68).

Toward a unifying model of identification with groups: integrating theoretical perspectives.

Building on the contributions of diverse theoretical approaches, the authors present a multidimensional model of group identification. Integrating conceptions from the social identity perspective with those from research on individualism-collectivism, nationalism- patriotism, and identification with organizations, we propose four conceptually distinct modes of identification: importance (how much I view the group as part of who I am), commitment (how much I want to benefit the group), superiority (how much I view my group as superior to other groups), and deference (how much I honor, revere, and submit to the group's norms, symbols, and leaders). We present an instrument for assessing the four modes of identification and review initial empirical findings that validate the proposed model and show its utility in understanding antecedents and consequences of identification.

"In-group love" and "out-group hate" as motives for individual participation in intergroup conflict: a new game paradigm.

What motivates individual self-sacrificial behavior in intergroup conflicts? Is it the altruistic desire to help the in-group or the aggressive drive to hurt the out-group? This article introduces a new game paradigm, the intergroup prisoner's dilemma-maximizing difference (IPD-MD) game, designed specifically to distinguish between these two motives. The game involves two groups. Each group member is given a monetary endowment and can decide how much of it to contribute. Contribution can be made to either of two pools, one that benefits the in-group at a personal cost and another that, in addition, harms the out-group. An experiment demonstrated that contributions in the IPD-MD game are made almost exclusively to the cooperative, within-group pool. Moreover, preplay intragroup communication increases intragroup cooperation, but not intergroup competition. These results are compared with those observed in the intergroup prisoner's dilemma game, in which group members' contributions are restricted to the competitive, between-group pool.

Perceiving intergroup conflict: from game models to mental templates.

This article puts forward a parsimonious framework for studying subjective perceptions of real-life intergroup conflicts. Four studies were conducted to explore how individuals perceive the strategic properties of the Israeli-Palestinian conflict. Studies 1 and 2 found theory-driven associations between people's subjective perception of the conflict's structure as a Chicken, Assurance, or Prisoner's Dilemma game and their ingroup/outgroup perceptions, national identification, religiosity, political partisanship, voting behavior, and right-wing authoritarianism. Studies 3 and 4 manipulated the saliency of the needs for cognitive closure and security, respectively, demonstrating that these needs affect people's endorsement of the game models as descriptions of the conflict.

Theory-based study of the basic values of 565 physical therapists.

BACKGROUND AND PURPOSE: There is a prevailing belief expressed in the physical therapy literature that values influence behavioral choices. There is, however, meager research on physical therapists' values. A values theory was used to study the organization of physical therapists' basic values and to generate hypotheses about age-related value priority differences. SUBJECTS: Participants were volunteers from the Wisconsin Physical Therapy Association (N=565). METHODS: Values importance ratings were gathered using a modified Schwartz Values Survey. Demographic data were obtained with an investigator-developed questionnaire. Analyses included descriptive and nonparametric statistics and nonmetric multidimensional scaling. RESULTS: The organizational structure of therapists' values was similar to the theoretical model. Physical therapists rated values associated with benevolence as most important and values associated with power as least important. Three of 7 age-related hypotheses were supported. DISCUSSION AND CONCLUSION: The theory adequately explained the organization of physical therapists' values and provided rational explanations for age-based value priority differences. Compared with occupationally heterogeneous samples, the results suggest that physical therapists highly prize values that benefit others and give remarkably little importance to values associated with power.