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1.
Nurse Educ Today ; 110: 105225, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35344840

RESUMEN

BACKGROUND: Training helps maintain high-quality supervision and its associated benefits (e.g. reduced burnout, improved care). While studies have previously evaluated extended-duration supervision training programmes, none have treated these as complex interventions so have not employed realist approaches. OBJECTIVES: Building on a previous realist synthesis, this evaluation tests and develops programme theory for extended-duration supervision training to answer the question: to what extent does the supervision training programme work, for whom, under what circumstances and why? DESIGN: We conducted a realist evaluation of a novel state-wide Victorian 3-month supervision training programme including one or two 3.5-h workshops followed by weekly reflexive longitudinal audio diaries (LADs) for up to 12 weeks. METHODS: Realist evaluation data comprised 25 entrance interviews with nurses and allied health professionals, 176 LADs (and 29 written diaries), and 23 exit interviews. We employed team-based realist analysis to identify context-mechanism-outcome configurations (CMOCs) to test and develop programme theory. RESULTS: We refined four recurring CMOCs from the realist synthesis programme theory, found insufficient evidence for two, and established five new recurring CMOCs. We identified multiple positive outcomes from our extended-duration supervision training programme (e.g. improved supervisor practices) through various mechanisms relating to pedagogy (e.g. weekly reflexivity), supervisors (e.g. engagement), and workplaces (e.g. enabling supervision cultures). Some negative outcomes were reported (e.g. decreased engagement) through various mechanisms (e.g. suboptimal training design). Such mechanisms were thought to come about by diverse contexts including supervisors (e.g. inexperienced/experienced), professions (nursing/allied health), and organisations (supervision-enabled/non-enabled cultures). CONCLUSIONS: Our findings extend the realist synthesis programme theory by highlighting various contexts triggering outcome-generating mechanisms. Programme outcomes are maximised through ongoing supervisor reflexivity paying attention to facilitator-supervisor relationships, as well as protected time for supervisors to translate learning into practice.


Asunto(s)
Técnicos Medios en Salud , Lugar de Trabajo , Humanos , Aprendizaje
2.
MedEdPORTAL ; 18: 11233, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35497676

RESUMEN

Introduction: Racism is a public health threat, and racist behaviors adversely affect clinicians in addition to patients. Medical trainees commonly experience racism and bias. More than half of pediatric residents at a single institution reported experiencing or witnessing discriminatory behavior at work; only 50% reported receiving training on implicit bias, delivering difficult feedback, or peer support. Our multispecialty team created Realizing Inclusion and Systemic Equity in Medicine: Upstanding in the Medical Workplace (RISE UP), an antibias, anti-racism communication curriculum composed of three hybrid (virtual and in-person) workshops. Methods: During the pediatric resident workshops, we introduced tools for addressing bias, presented video simulations, and led small-group debriefings with guided role-play. We also reviewed escalation pathways, reporting methods, and support systems. Residents completed an evaluation before and after each workshop to assess the curriculum's efficacy. Results: Thirty-nine residents participated in RISE UP, with 20 attending all three workshops. Ninety-six percent of participants indicated they would recommend the workshops to colleagues. After the third workshop, 92% reported having tools to respond to bias, and 85% reported knowing how to escalate concerns regarding discriminatory behavior. Chief residents were most frequently identified as sources of resident support when encountering discriminatory behavior. Discussion: This curriculum was successful in developing and strengthening residents' responses to discrimination, including upstander support. The curriculum is adaptable for virtual, in-person, and hybrid settings, allowing for flexibility. Establishing institutional support, promoting faculty development, and creating and disseminating escalation pathways are critical to addressing racism in health care.


Asunto(s)
Medicina , Racismo , Niño , Curriculum , Docentes , Humanos , Racismo/prevención & control , Lugar de Trabajo
3.
Aust J Gen Pract ; 51(5): 304-309, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35491453

RESUMEN

BACKGROUND AND OBJECTIVES: In workplace-based training and assessment of registrars and supervised doctors, the influence of contextual factors such as consultation room layout, including placement of chairs, may be overlooked. The aim was to identify the room's seating arrangements in consultation observation between the assessor, the assessed and the patient. METHOD: Qualitative research was undertaken to explore the perceptions of consultation observation as a tool in workplace-based training and assessment through semi­structured one-on-one interviews. Thematic analysis was employed to analyse the data; secondary data analysis highlighted the use of metaphors to describe seating arrangements. RESULTS: Chair placement tended to be discussed by participants in terms of triangles - equilateral, isosceles and scalene. Other metaphors included curved lines, compasses or clock faces. Notions of agency in seating positions and constraints by room layout were also identified. DISCUSSION: There is a tension between the physical layout and structure of the consultation room, seating preferences of the observer and the agency of registrar as the observed.


Asunto(s)
Personal de Salud , Derivación y Consulta , Actitud del Personal de Salud , Humanos , Investigación Cualitativa , Lugar de Trabajo
4.
Front Public Health ; 10: 791902, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35493358

RESUMEN

Research has demonstrated the effects of workplace gossip on employees' work attitudes and behaviors. However, little emphasis has been placed on the psychological influence of workplace gossip on employees. The present study investigated the relationships among workplace gossip, psychological capital, and individual mental health. Data were collected in three waves from 222 full-time employees of a Taiwanese tourism company to explore the effect of workplace gossip on employees' mental health. The results suggested that workplace gossip was associated with employees' mental health through psychological capital. Moreover, developmental job experience plays a moderator role in the relationships among workplace gossip, psychological capital, and mental health. A moderated mediation model was also proposed in this study.


Asunto(s)
Salud Laboral , Lugar de Trabajo , Comunicación , Salud Mental , Encuestas y Cuestionarios
5.
Front Public Health ; 10: 772601, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35493385

RESUMEN

Background: Maintaining the subjective wellbeing of the elderly people is one of the major concerns in promoting health aging. This study concerned the influence of multi-level social capital on subjective welling and explored the affecting path among the elderly. Methods: A total of 1,078 elderly individuals anonymously and effectively surveyed in 2018, data was collected including their family, workplace, community, society social capital and subjective wellbeing, we used the structural equation modeling to test the hypothesis relationships among the variables. Results: We found that the total score of subjective wellbeing among the aging participants was 72.36 ± 10.08 on a range of 0-100. Family (ß = 0.151, P < 0.001), workplace (ß = 0.090, P < 0.001), community (ß = 0.163, P < 0.001) social capital had a direct positive effect on subjective wellbeing. Society social capital had a direct positive effect on family (ß = 0.253, P < 0.001), workplace (ß = 0.585, P < 0.001), community (ß = 0.438, P < 0.001) social capital. And society social capital had an indirect positive effect on subjective wellbeing through the mediating role of family, workplace, and community social capital. Conclusion: The research demonstrated that all the micro, meso and macro levels of social capital have protective effects for subjective wellbeing through direct or indirect way, inspiring to provide continuous improvement measures for multi-level social capital aimed at the elderly people.


Asunto(s)
Capital Social , Anciano , Humanos , Encuestas y Cuestionarios , Lugar de Trabajo
6.
Front Public Health ; 10: 832374, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35493386

RESUMEN

The workplace is a major contributor to excessive sitting in office workers. There are a wide array of adverse effects of high volumes of sitting time, including an increased risk of type 2 diabetes and depression. Active workstations can be used in effective interventions to decrease workplace sitting. However, there are a lack of interventions that have been developed using a systematic process that is informed by participant needs and a framework for identifying the most appropriate content for the intervention. Applying these methods could increase adherence and potential effectiveness of the intervention. Therefore, the purpose of this pilot study is to examine the feasibility, acceptability, and efficacy of a tailored workplace intervention to reduce and break up sitting in office workers that has been developed using the Behavior Change Wheel and the APEASE (Acceptability, Practicability, Effectiveness/cost-effectiveness, Affordability, Safety/side-effects, Equity) criteria. This article reports the protocol for this study that is currently ongoing. Participants will be cluster-randomized (by offices) to control and intervention groups. The evaluation of the intervention includes determining feasibility by assessing participant recruitment, retention and data completion rates. Adherence to the intervention will be assessed based on daily sitting and standing time relative to guidelines provided to participants as part of the intervention. Outcome measures also include productivity measured using Ecological Momentary Assessment, absenteeism, presenteeism, cardiometabolic risk markers, and wellbeing. The findings of this study will inform the effective design and implementation of interventions for reducing and breaking up sitting in office workers.


Asunto(s)
Diabetes Mellitus Tipo 2 , Salud Laboral , Diabetes Mellitus Tipo 2/prevención & control , Promoción de la Salud/métodos , Humanos , Proyectos Piloto , Ensayos Clínicos Controlados Aleatorios como Asunto , Conducta Sedentaria , Factores de Tiempo , Lugar de Trabajo
7.
J Contin Educ Nurs ; 53(5): 198-199, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35510922

RESUMEN

As the world watches war unfolding in Ukraine, leadership under the most extreme pressures is on full display. Health care and practice environments are not being bombed, but similar extreme events from the pandemic to workforce shortages to workplace safety to worsening equity outcomes are converging to challenge leaders in their roles. The daily pressures of solving and responding can drain the reserves of any leader. What can courageous leadership do for teams and those who lead them? [J Contin Educ Nurs. 2022;53(5):198-199.].


Asunto(s)
Liderazgo , Lugar de Trabajo , Humanos , Pandemias , Recursos Humanos
8.
Vet Rec ; 190(9): 381, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35521878

RESUMEN

Mental Health Awareness Week 2022 will focus on loneliness. Here, Rosie Allister, Vetlife Helpline manager, suggests how workplaces and individuals can help tackle loneliness among vet professionals.


Asunto(s)
Soledad , Veterinarios , Animales , Humanos , Soledad/psicología , Salud Mental , Veterinarios/psicología , Lugar de Trabajo
10.
BMC Emerg Med ; 22(1): 78, 2022 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-35524175

RESUMEN

BACKGROUND: Workplace violence by patients and bystanders against health care workers, is a major problem, for workers, organizations, patients, and society. It is estimated to affect up to 95% of health care workers. Emergency health care workers experience very high levels of workplace violence, with one study finding that paramedics had nearly triple the odds of experiencing physical and verbal violence. Many interventions have been developed, ranging from zero-tolerance approaches to engaging with the violent perpetrator. Unfortunately, as a recent Cochrane review showed, there is no evidence that any of these interventions work in reducing or minimizing violence. To design better interventions to prevent and minimize workplace violence, more information is needed on those strategies emergency health care workers currently use to prevent or minimize violence. The objective of the study was to identify and discuss strategies used by prehospital emergency health care workers, in response to violence and aggression from patients and bystanders. Mapping the strategies used and their perceived usefulness will inform the development of tailored interventions to reduce the risk of serious harm to health care workers. In this study the following research questions were addressed: (1) What strategies do prehospital emergency health care workers utilize against workplace violence from patients or bystanders? (2) What is their experience with these strategies? METHODS: Five focus groups with paramedics and dispatchers were held at different urban and rural locations in Canada. The focus group responses were transcribed verbatim and analyzed using thematic analysis. RESULTS: It became apparent that emergency healthcare workers use a variety of strategies when dealing with violent patients or bystanders. Most strategies, other than generic de-escalation techniques, reflect a reliance on the systems the workers work with and within. CONCLUSION: The study results support the move away from focusing on the individual worker, who is the victim, to a systems-based approach to help reduce and minimize violence against health care workers. For this to be effective, system-based strategies need to be implemented and supported in healthcare organizations and legitimized through professional bodies, unions, public policies, and regulations.


Asunto(s)
Violencia Laboral , Agresión , Técnicos Medios en Salud , Personal de Salud , Humanos , Lugar de Trabajo , Violencia Laboral/prevención & control
11.
BMC Med Educ ; 22(1): 351, 2022 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534819

RESUMEN

BACKGROUND: In order to curb healthcare workplace violence (WPV) and better allocate healthcare resources, China launched the descending resources reform in 2013 and tightened the anti-violence legal environment simultaneously. Medical students are expected to reconsider their working intentions of entering the medical market (inter-market effect) and choosing high- or low-level hospitals (intra-market effect) in response to the evolving WPV. The goal of this study was to explore the link between the perceived WPV incidence and medical students' willingness to practice medicine in the context of China's descending resources reform. METHOD: Medical students were selected with cluster sampling from 8 medical colleges in Zhejiang Province, China, and 1497 valid questionnaires were collected by using a five-point unbalanced scale, to perform cross-sectional empirical research using the ordered logit model (OLM). RESULTS: The perceived WPV incidence negatively correlate with the willingness of medical students to practice medicine but positively correlate with their willingness to practice in low-level hospitals, indicating the existence of inter- and intra-market effects. The anti-violence legal environment has no direct link with working intention but contributes to the perceived decline in the incidence of violence. Descending resources reform has simultaneous opposite effects on medical students, with the coexistence of prudent motives driven by reform costs and optimistic expectations of sharing external benefits. CONCLUSIONS: Safety needs and risk aversion motive play an important role in medical students' career choice when facing severe WPV. Tightening of the anti-violence legal environment and the descending resources reform could drive medical students to low-level hospitals.


Asunto(s)
Estudiantes de Medicina , Violencia Laboral , China/epidemiología , Estudios Transversales , Atención a la Salud , Humanos , Intención , Encuestas y Cuestionarios , Lugar de Trabajo
12.
BMC Public Health ; 22(1): 868, 2022 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-35501746

RESUMEN

BACKGROUND: Increasing the availability of healthier or plant-based foods increases their selection. The current studies aimed to examine the extent to which relative preferences account for food selections following availability interventions. In particular, (a) whether increasing the availability of lower-energy options increases the likelihood that individuals' highest-ranked option is lower-energy, and (b) the extent to which selections reflect individuals' highest-ranked option from the available range. METHODS: UK adults (Study 1: n = 1976; Study 2: n = 1078) took part in within-subjects online studies. In both studies, the order of preference between food options was established by participants choosing the option that they would prefer "to eat right now" from every possible pairing within a pool of eight options. Then, participants were shown either predominantly higher-energy options (three higher- and one lower-energy) or predominantly lower-energy options (vice versa), presented in a random order. RESULTS: When predominantly lower-energy options were presented, the odds of the highest-ranked option being a lower-energy option increased ten-fold (Study 1: odds ratio: 10.1; 95%CI: 8.9,11.4; Study 2: odds ratio: 10.4; 95%CI: 7.4,14.7), compared to when predominantly higher-energy options were available. In both studies, around 90% of selections reflected the highest-ranked option in the range offered in the studied availability conditions (range 88-92%). CONCLUSIONS: These studies suggest that increased availability of lower-energy options increases the likelihood of an individual's highest-ranked option being lower-energy, and that the highest-ranked option has the greatest likelihood of selection. As such, preferences may be a key contributor to the effects of altering availability on food selections. TRIAL REGISTRATION: ISRCTN ( http://www.isrctn.com/ISRCTN27598623 ; 3/12/19 [Study 1]; http://www.isrctn.com/ISRCTN61010183 ; 20/4/20 [Study 2]).


Asunto(s)
Preferencias Alimentarias , Lugar de Trabajo , Adulto , Humanos
13.
BMC Psychol ; 10(1): 114, 2022 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-35501849

RESUMEN

BACKGROUND: Being a victim support worker (VSW) involves exposure to victims' suffering, pain, and traumatic events, which may trigger the risk of VSWs developing mental health problems. Psychosocial risks (PSR) and work-related stress are considered the most challenging issues in occupational safety and health, considering they impact individuals, organizations, and economies. METHODS: The purpose of the present study was to identify the PSR in a sample of 196 Portuguese victim support workers (VSW) (Mean age = 36.49; SD = 10.52). A questionnaire with socio-demographic characteristics, variables related to VSW's job, and the Portuguese medium version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) were used to assess these professionals' perception of PSR factors. RESULTS: The results reveal that although VSW recognizes some psychosocial factors favourable to their health and well-being, they also identify some PSR that place them at intermediate and severe risk, i.e., emotional and cognitive demands, which are the main areas of risk to the VSW. VSW over 38 years old scored higher in job insecurity, burnout, and offensive behaviours. CONCLUSIONS: These findings give important insights into the areas that must be enhanced in this context involving VSW. Additionally, the results highlight the relevance of encouraging a healthy and supportive work environment, preventing and promoting the health and well-being of VSW, particularly when considering the coronavirus disease (COVID-19) pandemic.


Asunto(s)
COVID-19 , Salud Laboral , Adulto , COVID-19/epidemiología , Humanos , Pandemias , Encuestas y Cuestionarios , Lugar de Trabajo/psicología
14.
Elife ; 112022 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-35503004

RESUMEN

Having a formal onboarding procedure for new lab members can lead to a happier and more productive working environment.


Asunto(s)
Lugar de Trabajo
15.
Cien Saude Colet ; 27(5): 1803-1812, 2022 May.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-35544810

RESUMEN

Patient safety in health care is the cornerstone of quality in nursing care. It is a duty of nurses and an objective of the health organizations. This article aims to analyze the scientific evidence on the nurses' perception and opinion on patient safety in the emergency department. Systematic literature review with 3 steps. 1) Primary search at CINHAL and MEDLINE. 2) A broader search, using the same keywords and search terms in the remaining database of the EBSCOHost platform. 3) Search the bibliographic references of the selected articles. The selected studies were published between 2014 and 2019. Five articles were selected. The nurses' perception reveal that the work environment, teamwork and matters related to the leadership of hierarchical superiors are fundamental factors to improve the quality of care provided and patient safety. Promoting teamwork improves patient care, reduces adverse events and improves quality. Recognizing the nurses' perception on patient safety culture in emergency services, contributes to improving the quality of care provided.


A segurança do paciente é uma dimensão essencial da qualidade dos cuidados de enfermagem. É um dever dos enfermeiros e um objetivo das organizações de saúde. O objetivo deste artigo é analisar a evidência científica acerca da segurança do paciente em hospital - serviço de urgência, na opinião dos enfermeiros. Trata-se de uma revisão sistemática da literatura com três etapas. 1) Pesquisa inicial nas bases CINAHL e MEDLINE. 2) Pesquisa mais alargada, nas restantes bases de dados da plataforma EBSCOHost. 3) Pesquisa nas referências bibliográficas dos artigos selecionados. Os estudos selecionados compreendem o período entre 2014 e 2019, resultando em cinco artigos. Os enfermeiros consideram que o ambiente de prática de enfermagem, o trabalho em equipa e as questões relacionadas com a liderança dos enfermeiros gerentes são fatores fundamentais para se melhorar a qualidade dos cuidados prestados e a segurança do paciente. Incentivar o trabalho em equipa melhora a assistência ao paciente, reduz os eventos adversos e incrementa a qualidade. Conhecer a opinião dos enfermeiros sobre a segurança do paciente nos serviços de urgência contribui para melhorar a qualidade dos cuidados de enfermagem.


Asunto(s)
Hospitales , Seguridad del Paciente , Servicio de Urgencia en Hospital , Humanos , Pacientes Internos , Lugar de Trabajo
16.
Cien Saude Colet ; 27(5): 1951-1963, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35544822

RESUMEN

Occupational stress has been the object of research in different populations. The aim of this study is to analyze the association between psychosocial job stress and quality of life of nutritionists working in public hospitals in Rio de Janeiro, Brazil. Cross-sectional study in public hospitals with nutritionists working as civil servants and CLT. Psychosocial job stress was assessed through the Demand-Control-Support Questionnaire. Quality of life was assessed through the WHOQOL-Bref. The outcome was modeled by means of multiple linear regression and adjusted by covariates. Job demands were inversely associated with quality of life in the physical and environment domains. Job control was directly associated with quality of life in the psychological domain. High strain, in comparison to low strain, was inversely associated with quality of life in the physical and psychological domains. Social support was directly associated with all fields of quality of life domains. Psychosocial job stress, as expressed by psychological job demands and job control, affects self-assessed quality of life, especially in the physical domain.


Asunto(s)
Nutricionistas , Estrés Laboral , Brasil , Estudios Transversales , Hospitales Públicos , Humanos , Estrés Laboral/epidemiología , Calidad de Vida/psicología , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Lugar de Trabajo/psicología
17.
Cochrane Database Syst Rev ; 5: CD015112, 2022 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-35514111

RESUMEN

BACKGROUND: Although many people infected with SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) experience no or mild symptoms, some individuals can develop severe illness and may die, particularly older people and those with underlying medical problems. Providing evidence-based interventions to prevent SARS-CoV-2 infection has become more urgent with the spread of more infectious SARS-CoV-2 variants of concern (VoC), and the potential psychological toll imposed by the coronavirus disease 2019 (COVID-19) pandemic.   Controlling exposures to occupational hazards is the fundamental method of protecting workers. When it comes to the transmission of viruses, such as SARS-CoV-2, workplaces should first consider control measures that can potentially have the most significant impact. According to the hierarchy of controls, one should first consider elimination (and substitution), then engineering controls, administrative controls, and lastly, personal protective equipment (PPE). OBJECTIVES: To assess the benefits and harms of interventions in non-healthcare-related workplaces to reduce the risk of SARS-CoV-2 infection relative to other interventions, or no intervention. SEARCH METHODS: We searched MEDLINE, Embase, Web of Science, Cochrane COVID-19 Study Register, the Canadian Centre for Occupational Health and Safety (CCOHS), Clinicaltrials.gov, and the International Clinical Trials Registry Platform to 14 September 2021. We will conduct an update of this review in six months. SELECTION CRITERIA: We included randomised control trials (RCT) and planned to include non-randomised studies of interventions. We included adult workers, both those who come into close contact with clients or customers (e.g. public-facing employees, such as cashiers or taxi drivers), and those who do not, but who could be infected by co-workers. We excluded studies involving healthcare workers. We included any intervention to prevent or reduce workers' exposure to SARS-CoV-2 in the workplace, defining categories of intervention according to the hierarchy of hazard controls, i.e. elimination; engineering controls; administrative controls; personal protective equipment. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were incidence rate of SARS-CoV-2 infection (or other respiratory viruses), SARS-CoV-2-related mortality, adverse events, and absenteeism from work. Our secondary outcomes were all-cause mortality, quality of life, hospitalisation, and uptake, acceptability, or adherence to strategies. We used the Cochrane RoB 2 tool to assess the risk of bias, and GRADE methods to assess the certainty of evidence for each outcome. MAIN RESULTS: Elimination of exposure interventions We included one study examining an intervention that focused on elimination of hazards. This study is an open-label, cluster-randomised, non-inferiority trial, conducted in England in 2021. The study compared standard 10-day self-isolation after contact with an infected person to a new strategy of daily rapid antigen testing and staying at work if the test is negative (test-based attendance). The trialists hypothesised that this would lead to a similar rate of infections, but lower COVID-related absence. Staff (N = 11,798) working at 76 schools were assigned to standard isolation, and staff (N = 12,229) at 86 schools to the test-based attendance strategy.  The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of symptomatic PCR-positive SARS-COV-2 infection rate ratio ((RR) 1.28, 95% confidence interval (CI) 0.74 to 2.21; 1 study, very low-certainty evidence)). The results between test-based attendance and standard 10-day self-isolation were inconclusive for the rate of any PCR-positive SARS-COV-2 infection (RR 1.35, 95% CI 0.82 to 2.21; 1 study, very low-certainty evidence). COVID-related absenteeism rates were 3704 absence days in 566,502 days-at-risk (6.5 per 1000 days at risk) in the control group and 2932 per 539,805 days-at-risk (5.4 per 1000 days at risk) in the intervention group (RR 0.83; 95% CI 0.55 to 1.25). The certainty of the evidence was downgraded to low, due to imprecision. Uptake of the intervention was 71 % in the intervention group, but not reported for the control intervention.  The trial did not measure other outcomes, SARS-CoV-2-related mortality, adverse events, all-cause mortality, quality of life, and hospitalisation. We found one ongoing RCT about screening in schools, using elimination of hazard strategies. Personal protective equipment We found one ongoing non-randomised study on the effects of closed face shields to prevent COVID-19 transmission. Other intervention categories We did not find studies in the other intervention categories. AUTHORS' CONCLUSIONS: We are uncertain whether a test-based attendance policy affects rates of PCR-postive SARS-CoV-2 infection (any infection; symptomatic infection) compared to standard 10-day self-isolation amongst school and college staff. Test-based attendance policy may result in little to no difference in absence rates compared to standard 10-day self-isolation. As a large part of the population is exposed in the case of a pandemic, an apparently small relative effect that would not be worthwhile from the individual perspective may still affect many people, and thus, become an important absolute effect from the enterprise or societal perspective.  The included study did not report on any other primary outcomes of our review, i.e. SARS-CoV-2-related mortality and adverse events. No completed studies were identified on any other interventions specified in this review, but two eligible studies are ongoing. More controlled studies are needed on testing and isolation strategies, and working from home, as these have important implications for work organisations.


Asunto(s)
COVID-19 , SARS-CoV-2 , Adulto , Anciano , COVID-19/prevención & control , Canadá , Causas de Muerte , Atención a la Salud , Humanos , Lugar de Trabajo
18.
JAMA Netw Open ; 5(5): e2210768, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35522279

RESUMEN

Importance: Reducing physician occupational distress requires understanding workplace mistreatment, its relationship to occupational well-being, and how mistreatment differentially impacts physicians of diverse identities. Objectives: To assess the prevalence and sources of mistreatment among physicians and associations between mistreatment, occupational well-being, and physicians' perceptions of protective workplace systems. Design, Setting, and Participants: This survey study was administered in September and October 2020 to physicians at a large academic medical center. Statistical analysis was performed from May 2021 to February 2022. Main Outcomes and Measures: Primary measures were the Professional Fulfillment Index, a measure of intent to leave, and the Mistreatment, Protection, and Respect Measure (MPR). Main outcomes were the prevalence and sources of mistreatment. Secondary outcomes were the associations of mistreatment and perceptions of protective workplace systems with occupational well-being. Results: Of 1909 medical staff invited, 1505 (78.8%) completed the survey. Among respondents, 735 (48.8%) were women, 627 (47.1%) were men, and 143 (9.5%) did not share gender identity or chose "other"; 12 (0.8%) identified as African American or Black, 392 (26%) as Asian, 10 (0.7%) as multiracial, 736 (48.9%) as White, 63 (4.2%) as other, and 292 (19.4%) did not share race or ethnicity. Of the 1397 respondents who answered mistreatment questions, 327 (23.4%) reported experiencing mistreatment in the last 12 months. Patients and visitors were the most common source of mistreatment, reported by 232 physicians (16.6%). Women were more than twice as likely as men to experience mistreatment (31% [224 women] vs 15% [92 men]). On a scale of 0 to 10, mistreatment was associated with a 1.13 point increase in burnout (95% CI, 0.89 to 1.36), a 0.99-point decrease in professional fulfillment (95% CI, -1.24 to -0.73), and 129% higher odds of moderate or greater intent to leave (odds ratio, 2.29; 95% CI, 1.75 to 2.99). When compared with a perception that protective workplace systems are in place "to a very great extent," a perception that there are no protective workplace systems was associated with a 2.41-point increase in burnout (95% CI, 1.80 to 3.02), a 2.81-point lower professional fulfillment score (95% CI, -3.44 to -2.18), and 711% higher odds of intending to leave (odds ratio, 8.11; 95% CI, 3.67 to 18.35). Conclusions and Relevance: This survey study found that mistreatment was common among physicians, varied by gender, and was associated with occupational distress. Patients and visitors were the most frequent source, and perceptions of protective workplace systems were associated with better occupational well-being. These findings suggest that health care organizations should prioritize reducing workplace mistreatment.


Asunto(s)
Agotamiento Profesional , Médicos , Agotamiento Profesional/epidemiología , Femenino , Identidad de Género , Humanos , Masculino , Encuestas y Cuestionarios , Lugar de Trabajo
19.
JAMA Netw Open ; 5(5): e2210559, 2022 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-35522284

RESUMEN

Importance: Longitudinal mass testing using rapid antigen detection tests (RADT) for serial screening of asymptomatic persons has been proposed for preventing SARS-CoV-2 community transmission. The feasibility of this strategy relies on accurate self-testing. Objective: To quantify the adequacy of serial self-performed SARS-CoV-2 RADT testing in the workplace, in terms of the frequency of correct execution of procedural steps and accurate interpretation of the range of possible RADT results. Design, Setting, and Participants: This prospective repeated cross-sectional study was performed from July to October 2021 at businesses with at least 2 active cases of SARS-CoV-2 infection in Montreal, Canada. Participants included untrained persons in their workplace, not meeting Public Health quarantine criteria (ie, required quarantine for 10 days after a moderate-risk contact with someone infected with SARS-CoV-2). Interpretation and performance were compared between participants who received instructions provided by the manufacturer vs those who received modified instructions that were informed by the most frequent or most critical errors we observed. Data were analyzed from October to November 2021. Exposures: RADT testing using a modified quick reference guide compared with the original manufacturer's instructions. Main Outcomes and Measures: The main outcome was the difference in correctly interpreted RADT results. Secondary outcomes included difference in proportions of correctly performed procedural steps. Additional analyses, assessed among participants with 2 self-testing visits, compared the second self-test visit with the first self-test visit using the same measures. Results: Overall, 1892 tests were performed among 647 participants, of whom 278 participants (median [IQR] age, 43 [31-55] years; 156 [56.1%] men) had at least 1 self-testing visit. For self-test visit 1, significantly better accuracy in test interpretation was observed among participants using the modified quick reference guide than those using the manufacturer's instructions for reading results that were weak positive (64 of 115 participants [55.6%] vs 20 of 163 participants [12.3%]; difference, 43.3 [95% CI, 33.0-53.8] percentage points), positive (103 of 115 participants [89.6%] vs 84 of 163 participants [51.5%]; difference, 38.1 [95% CI, 28.5-47.5] percentage points), strong positive (219 of 229 participants [95.6%] vs 274 of 326 participants [84.0%]; difference, 11.6 [95% CI, 6.8-16.3] percentage points), and invalid (200 of 229 participants [87.3%] vs 252 of 326 participants [77.3%]; difference, 10.0 [95% CI, 3.8-16.3] percentage points). Use of the modified guide was associated with improvements on self-test visit 2 for results that were weak positive (difference, 15.4 [95% CI, 0.7-30.1] percentage points), positive (difference, 19.0 [95% CI, 7.2-30.9] percentage points), and invalid (difference, 8.0 [95% CI, 0.8-15.4] percentage points). For procedural steps identified as critical for test validity, adherence to procedural testing steps did not differ meaningfully according to instructions provided or reader experience. Conclusions and Relevance: In this cross-sectional study of self-performed SARS-CoV-2 RADT in an intended-use setting, a modified quick reference guide was associated with significantly improved accuracy in RADT interpretations.


Asunto(s)
COVID-19 , SARS-CoV-2 , Adulto , COVID-19/diagnóstico , COVID-19/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Tamizaje Masivo , Estudios Prospectivos , Lugar de Trabajo
20.
Artículo en Chino | MEDLINE | ID: mdl-35545592

RESUMEN

Objective: To explore the influential factors of job stress suffered by workers in railway stations, the level of job stress of were measured and subjective comfort of employees targeting to working environment were reported. Methods: In March 2019, a cluster sampling study was designed to collect the personal characteristics, job characteristics and subjective comfort degree of working environment of 432 employees in Chongqing railway stations. Meanwhile, job stress was assessed using the effort-reward imbalance scale. Chi-square test was used to compare the difference of occupational stress detection rate among different stratified factors such as occupational characteristics. Logistic regression was applied to analyze the influential factors of occupational stress. Results: The detection rate of job stress of workers in the railway stations was 31.02% (134/432) . The detection rate of job stress was higher among the divorced workers in railway stations, those earning less than 5, 000 yuan per month, those with 10-20 years' length of service, those who worked as a conductor and other workers including baggageman, station master on duty and assistant engineer (χ(2)=9.61, 14.76, 23.28, 11.06, P=0.008, 0.002, 0.000, 0.011) . The detection rate of job stress was higher among those whose working environment subjective feelings were uncomfortable, the differences were statistically significant (P<0.001) . The results showed that the occupational stress of the staff in the railway stations was influenced by their subjective feeling of air quality, noise and Space Layout (P<0.05) . The risk factors of occupational stress were air quality, noise and uncomfortable space layout (OR=0.571, 0.068, 0.441, P=0.051, 0.054, 0.007) . Conductor, other (Bellboy, Duty Station Master, assistant engineer) were the risk factors of occupational stress (OR=1.884, 2.703, P=0.065, 0.019) . The employees of station A and station B were the risk factors of occupational stress (OR=4.681, 1.811, P=0.002, 0.067) . Conclusion: The higher detection rate of job stress of workers in the railway stations is correlated with the subjective comfort degree of the working environment of the workers.


Asunto(s)
Estrés Laboral , Estrés Psicológico , Estudios Transversales , Humanos , Satisfacción en el Trabajo , Estrés Laboral/epidemiología , Encuestas y Cuestionarios , Lugar de Trabajo
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