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OBJECTIVES: To develop a more specific understanding of psychological mechanisms in the development of burnout in long-term care as a basis for potential new intervention strategies aiming at improving nurses' mental health. METHODS: Two qualitative studies with thematic analysis were conducted. In Study 1, we conducted eight group interviews with 110 nurses from May-July 2019 in the context of workshops at eight nursing homes in Germany. In Study 2, we supplemented these with semi-structured interviews with 14 executives at German nursing homes in December 2019. RESULTS: The thematic analysis in Study 1 identified three main themes: causes of challenges, employees' opportunities for change, and organisational opportunities for change. Thematic analysis in Study 2 identified three main themes: job motives, reasons for filling in for others, and employee self-care. Further, our results show that the need to stand in for colleagues, in particular, is one of the greatest challenges for geriatric caregivers. In dealing with these challenges we found that self-endangering behaviour-a diminished ability to say no when asked to fill in or to do work overtime-was an important antecedent of nurses' burnout. Further, high levels of altruistic motivation and identification with the team or organisation were associated with self-endangering behaviour in the presence of adverse working conditions. Low levels of self-worth are a further risk factor for self-endangering. CONCLUSIONS: Our findings are at odds with some core tenets of classic models of job demands and burnout that construe motivation and identification as resources. Our results show the need of a holistic intervention program in nursing including individual coaching, team-based interventions and organisational development processes. Employees themselves should be sensitized to this issue and supported in the long term, and politicians should create structures that do not encourage this behaviour any further.
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BACKGROUND: The characteristics of COVID-19, such as the long incubation period, the fast transmission speed, the high demand for treatment, and the lack of prior treatment experience, have brought tremendous psychological stress to the medical staff involved in the epidemic prevention and control, seriously affecting the mental health of medical staff. Therefore, this paper conducts a discussion on the psychological stress and mental health of medical staff. METHODS: (1)Interview 28 medical staff fighting against COVID-19 from Wuhan Central Hospital and Hubei Provincial Hospital of Traditional Chinese medicine. They have worked as doctors in mental health departments, surgery departments and emergency departments, nurses and management staffs; (2)Based on interviews and literature, the questionnaire survey is conducted among 528 medical personnel from all over the country who have participated in the fight against COVID-19 in Wuhan; (3)Use the structural equation modeling to explore the influence mechanism of medical staff's psychological stress and mental health in the prevention and control of COVID-19. Results: The epidemic severity in hospital and the work intensity are the important psychological stressors for the front-line medical staff. Self-risk perception has a mediating effect on the severity of epidemic in hospitals and mental health of medical staff. Social identification has no moderating effect between the self-risk perception and the mental health.
ABSTRACT
The characterization of non-professional healers as "quacks" or "impostors" has influenced much of how such actors have been perceived by public opinion and in academic research. As a result of this, a divide has emerged between professional physicians, on the one hand, and those who acquired their knowledge in a traditional and non-academic way, on the other. This work questions the alleged divide between these two groups in the health field in order to offer a more complex and richer picture of local practices in Peru. Based mainly on correspondence from the Faculty of Medicine in Lima and newspaper ads, we reconstructed the attempts made by medical authorities to contain and exclude healers of Asian, European, or local backgrounds, many of which failed. For this reason, we studied two specific devices designed to legitimate and monitor physicians trained professionally: degrees or diplomas and lists of graduates, both of which are predecessors to our current identification cards and databases.
La caracterización de sanadores no-titulados como "charlatanes" o "impostores" ha influido notablemente en cómo han sido percibidos por la opinión pública y en las investigaciones académicas. Se creó, entonces, una división entre los médicos profesionales y aquellos que adquirieron su conocimiento de modo tradicional y no-académico. Este artículo cuestiona la supuesta división entre dichos especialistas en el campo de la salud para ofrecer un cuadro más complejo y rico de prácticas locales a partir del caso peruano. A partir, sobre todo, de correspondencia de la Facultad de Medicina de Lima y de avisos en periódicos, reconstruimos la dinámica de las autoridades médicas en sus intentos, muchas veces infructuosos, de contener y excluir a sanadores de origen asiático, europeo o local. Para ello, estudiamos dos artefactos diseñados para legitimar y monitorear a los médicos formados profesionalmente: los títulos o diplomas y las listas de graduados, predecesores de nuestros modernos documentos de identidad y bases de datos.
Subject(s)
Certification/history , Fraud/history , Medicine, Traditional , Physicians , Advertising/history , History, 19th Century , History, 20th Century , Humans , Peru , Physician's Role/history , Professionalism/history , Schools, Medical/historyABSTRACT
RESUMEN La caracterización de sanadores no-titulados como "charlatanes" o "impostores" ha influido notablemente en cómo han sido percibidos por la opinión pública y en las investigaciones académicas. Se creó, entonces, una división entre los médicos profesionales y aquellos que adquirieron su conocimiento de modo tradicional y no-académico. Este artículo cuestiona la supuesta división entre dichos especialistas en el campo de la salud para ofrecer un cuadro más complejo y rico de prácticas locales a partir del caso peruano. A partir, sobre todo, de correspondencia de la Facultad de Medicina de Lima y de avisos en periódicos, reconstruimos la dinámica de las autoridades médicas en sus intentos, muchas veces infructuosos, de contener y excluir a sanadores de origen asiático, europeo o local. Para ello, estudiamos dos artefactos diseñados para legitimar y monitorear a los médicos formados profesionalmente: los títulos o diplomas y las listas de graduados, predecesores de nuestros modernos documentos de identidad y bases de datos.
ABSTRACT The characterization of non-professional healers as "quacks" or "impostors" has influenced much of how such actors have been perceived by public opinion and in academic research. As a result of this, a divide has emerged between professional physicians, on the one hand, and those who acquired their knowledge in a traditional and non-academic way, on the other. This work questions the alleged divide between these two groups in the health field in order to offer a more complex and richer picture of local practices in Peru. Based mainly on correspondence from the Faculty of Medicine in Lima and newspaper ads, we reconstructed the attempts made by medical authorities to contain and exclude healers of Asian, European, or local backgrounds, many of which failed. For this reason, we studied two specific devices designed to legitimate and monitor physicians trained professionally: degrees or diplomas and lists of graduates, both of which are predecessors to our current identification cards and databases.
Subject(s)
Humans , History, 19th Century , History, 20th Century , Physicians , Certification/history , Fraud/history , Medicine, Traditional , Peru , Physician's Role/history , Schools, Medical/history , Advertising/history , Professionalism/historyABSTRACT
OBJECTIVE: The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action. DISCUSSION: This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors' cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care. CONCLUSION: The practice workplace is an effective lever for altering barriers to the use of services. Clarifying rhetoric through conceptualization of core and complementary practices simplifies the socialization dynamic. Further, it takes advantage of accepted cultural semantics in meaningful analogy while continuing to empower practical diversity in care delivery in response to evolving scientific evidence.